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This is VAERS ID 49953

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 49953
VAERS Form:
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 314957 / 1 RL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M18HH / 1 LL / IM
OPV: ORIMUNE / LEDERLE 0653F / 1 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: SIDS, STUPOR, LYMPHADENO, HEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;


Changed on 12/8/2009

VAERS ID: 49953 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-18 1993-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 314957 / 1 RL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M18HH / 1 LL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0653F / 1 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Lymphadenopathy, SIDS, Stupor, Sudden infant death syndrome, Haemorrhage, STUPOR, LYMPHADENO, HEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) NC93006

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;


Changed on 5/14/2017

VAERS ID: 49953 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314957 / 1 RL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M18HH / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0653F / 1 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Lymphadenopathy, Stupor, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC93006

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;


Changed on 9/14/2017

VAERS ID: 49953 Before After
VAERS Form:(blank) 1
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314957 / 1 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M18HH / 1 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0653F / 1 2 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lymphadenopathy, Stupor, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC93006

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;


Changed on 2/14/2018

VAERS ID: 49953 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314957 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M18HH / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0653F / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lymphadenopathy, Stupor, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC93006

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;


Changed on 6/14/2018

VAERS ID: 49953 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314957 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M18HH / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0653F / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lymphadenopathy, Stupor, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC93006

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;


Changed on 8/14/2018

VAERS ID: 49953 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314957 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M18HH / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0653F / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lymphadenopathy, Stupor, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC93006

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;


Changed on 9/14/2018

VAERS ID: 49953 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314957 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M18HH / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0653F / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lymphadenopathy, Stupor, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC93006

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;


Changed on 10/14/2018

VAERS ID: 49953 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314957 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M18HH / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0653F / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lymphadenopathy, Stupor, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC93006

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;


Changed on 12/24/2020

VAERS ID: 49953 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314957 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M18HH / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0653F / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lymphadenopathy, Stupor, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC93006

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;


Changed on 12/30/2020

VAERS ID: 49953 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314957 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M18HH / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0653F / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lymphadenopathy, Stupor, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC93006

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;


Changed on 5/7/2021

VAERS ID: 49953 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314957 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M18HH / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0653F / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lymphadenopathy, Stupor, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC93006

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;


Changed on 5/21/2021

VAERS ID: 49953 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:North Carolina
Vaccinated:1992-06-05
Onset:1992-06-15
Submitted:1993-01-05
Entered:1993-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314957 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M18HH / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0653F / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lymphadenopathy, Stupor, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC93006

Write-up: pt expired (SIDS) on 15JUN92; pt did not awaken from afternoon nap; pt was not ill;

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