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This is VAERS ID 50878

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 50878
VAERS Form:
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 2C41012 / 1 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M490JK / 1 RL / IM
OPV: ORIMUNE / LEDERLE 0670D / 1 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: SIDS, HEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;


Changed on 12/8/2009

VAERS ID: 50878 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-19 1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 2C41012 / 1 LL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M490JK / 1 RL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0670D / 1 - / PO

Administered by: Private      Purchased by: Unknown Private
Symptoms: SIDS, Sudden infant death syndrome, Haemorrhage, HEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;


Changed on 5/14/2017

VAERS ID: 50878 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2C41012 / 1 LL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M490JK / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0670D / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;


Changed on 9/14/2017

VAERS ID: 50878 Before After
VAERS Form:(blank) 1
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2C41012 / 1 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M490JK / 1 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670D / 1 2 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;


Changed on 2/14/2018

VAERS ID: 50878 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2C41012 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M490JK / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670D / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;


Changed on 6/14/2018

VAERS ID: 50878 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2C41012 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M490JK / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670D / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;


Changed on 8/14/2018

VAERS ID: 50878 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2C41012 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M490JK / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670D / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;


Changed on 9/14/2018

VAERS ID: 50878 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2C41012 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M490JK / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670D / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;


Changed on 10/14/2018

VAERS ID: 50878 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2C41012 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M490JK / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670D / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;


Changed on 12/24/2020

VAERS ID: 50878 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2C41012 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M490JK / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670D / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;


Changed on 12/30/2020

VAERS ID: 50878 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2C41012 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M490JK / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670D / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;


Changed on 5/7/2021

VAERS ID: 50878 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2C41012 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M490JK / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670D / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;


Changed on 5/21/2021

VAERS ID: 50878 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:California
Vaccinated:1993-03-03
Onset:1993-03-04
Submitted:1993-03-10
Entered:1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2C41012 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M490JK / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670D / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-03-04
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: Luride
Current Illness: acute gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: preliminary cause of death-SIDS;
CDC 'Split Type':

Write-up: pt found dead approx 28 hrs p/vax;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=50878&WAYBACKHISTORY=ON


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