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This is VAERS ID 50757

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 50757
VAERS Form:
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 332986 / 0 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M660HH / 0 RL / IM
OPV: ORIMUNE / LEDERLE 0658B / 0 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, INFECT, EDEMA LUNG, BRONCHITIS, HEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': NKA

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;


Changed on 12/8/2009

VAERS ID: 50757 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-18 1993-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 332986 / 0 LL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M660HH / 0 RL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0658B / 0 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Bronchitis, Infection, Lung disorder, Petechiae, Pulmonary oedema, Pyrexia, Sudden infant death syndrome, Haemorrhage, FEVER, INFECT, EDEMA LUNG, BRONCHITIS, HEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': NKA FL93011

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;


Changed on 5/14/2017

VAERS ID: 50757 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 332986 / 0 LL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M660HH / 0 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0658B / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Bronchitis, Infection, Lung disorder, Petechiae, Pulmonary oedema, Pyrexia, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': FL93011

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;


Changed on 9/14/2017

VAERS ID: 50757 Before After
VAERS Form:(blank) 1
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 332986 / 0 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660HH / 0 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0658B / 0 1 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Bronchitis, Infection, Lung disorder, Petechiae, Pulmonary oedema, Pyrexia, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': FL93011

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;


Changed on 2/14/2018

VAERS ID: 50757 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 332986 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660HH / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0658B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Bronchitis, Infection, Lung disorder, Petechiae, Pulmonary oedema, Pyrexia, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': FL93011

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;


Changed on 6/14/2018

VAERS ID: 50757 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 332986 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660HH / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0658B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Bronchitis, Infection, Lung disorder, Petechiae, Pulmonary oedema, Pyrexia, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': FL93011

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;


Changed on 8/14/2018

VAERS ID: 50757 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 332986 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660HH / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0658B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Bronchitis, Infection, Lung disorder, Petechiae, Pulmonary oedema, Pyrexia, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': FL93011

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;


Changed on 9/14/2018

VAERS ID: 50757 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 332986 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660HH / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0658B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Bronchitis, Infection, Lung disorder, Petechiae, Pulmonary oedema, Pyrexia, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': FL93011

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;


Changed on 10/14/2018

VAERS ID: 50757 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 332986 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660HH / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0658B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Bronchitis, Infection, Lung disorder, Petechiae, Pulmonary oedema, Pyrexia, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': FL93011

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;


Changed on 12/24/2020

VAERS ID: 50757 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 332986 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660HH / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0658B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Bronchitis, Infection, Lung disorder, Petechiae, Pulmonary oedema, Pyrexia, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': FL93011

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;


Changed on 12/30/2020

VAERS ID: 50757 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 332986 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660HH / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0658B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Bronchitis, Infection, Lung disorder, Petechiae, Pulmonary oedema, Pyrexia, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': FL93011

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;


Changed on 5/7/2021

VAERS ID: 50757 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 332986 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660HH / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0658B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Bronchitis, Infection, Lung disorder, Petechiae, Pulmonary oedema, Pyrexia, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': FL93011

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;


Changed on 5/21/2021

VAERS ID: 50757 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Florida
Vaccinated:1992-12-16
Onset:1992-12-24
Submitted:1993-03-04
Entered:1993-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 332986 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660HH / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0658B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Bronchitis, Infection, Lung disorder, Petechiae, Pulmonary oedema, Pyrexia, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-12-24
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: HCT 35%;
CDC 'Split Type': FL93011

Write-up: unable to document an adverse effects pt died of SIDS 24DEC92 vaxed 16DEC92;

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