|
VAERS ID: |
27153 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Unknown |
Location: |
Ohio |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
1990-12-05 |
Entered: |
1990-12-21 |
Days after submission: | 16 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES |
0B21173 / UNK |
- / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
- / UNK |
MO / PO |
Administered by: Unknown Purchased by: Unknown Symptoms: Sudden infant death syndrome SMQs:, Neonatal disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 0000-00-00
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: CO3729
Write-up: Pt vaccinated with DTP/OPV/HIB; SIDS death 1 day post injection. |
|
VAERS ID: |
27160 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Male |
Location: |
California |
Vaccinated: | 1990-12-18 |
Onset: | 1990-12-18 |
Days after vaccination: | 0 |
Submitted: |
1990-12-19 |
Days after onset: | 1 |
Entered: |
1990-12-26 |
Days after submission: | 7 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES |
0B21173 / 2 |
RL / IM |
HIBV: HIB (HIBTITER) / PFIZER/WYETH |
M730FE / 2 |
LL / IM |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
0615A / 2 |
MO / PO |
Administered by: Private Purchased by: Private Symptoms: Sudden infant death syndrome SMQs:, Neonatal disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-12-18
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Caldesene cream Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt vaccinated with DTP/OPV/HIB expired 7 hrs later. Dx SIDS. |
|
VAERS ID: |
27161 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Male |
Location: |
Massachusetts |
Vaccinated: | 1990-12-11 |
Onset: | 1990-12-12 |
Days after vaccination: | 1 |
Submitted: |
1990-12-17 |
Days after onset: | 5 |
Entered: |
1990-12-26 |
Days after submission: | 9 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / MASS. PUB HLTH BIOL LAB |
DTP272 / UNK |
LL / - |
HIBV: HIB (HIBTITER) / PFIZER/WYETH |
M190FD / UNK |
RL / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
287952 / UNK |
MO / PO |
Administered by: Private Purchased by: Public Symptoms: Sudden infant death syndrome SMQs:, Neonatal disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-12-12
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt vaccinated with DTP/OPV/HIB died approx 24 hrs later. preliminary dx SIDS. |
|
VAERS ID: |
27341 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Male |
Location: |
California |
Vaccinated: | 1990-12-27 |
Onset: | 1990-12-29 |
Days after vaccination: | 2 |
Submitted: |
1991-01-03 |
Days after onset: | 5 |
Entered: |
1991-01-08 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
283910 / UNK |
- / - |
HIBV: HIB (HIBTITER) / PFIZER/WYETH |
M6507B / UNK |
- / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
06137 / UNK |
MO / PO |
Administered by: Private Purchased by: Private Symptoms: Cyanosis SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypotonic-hyporesponsive episode (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-12-29
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt vaccinated with DTP/OPV/HIB Titer found blue in crib. |
|
VAERS ID: |
27451 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Male |
Location: |
Oregon |
Vaccinated: | 1990-11-20 |
Onset: | 1990-11-29 |
Days after vaccination: | 9 |
Submitted: |
1991-01-08 |
Days after onset: | 40 |
Entered: |
1991-01-17 |
Days after submission: | 9 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES |
0L11101 / 2 |
LL / - |
HIBV: HIB (HIBTITER) / PFIZER/WYETH |
M030FC / 1 |
RL / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
0619L / 2 |
MO / PO |
Administered by: Private Purchased by: Private Symptoms: Sudden infant death syndrome SMQs:, Neonatal disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-11-29
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: None Current Illness: None Preexisting Conditions: Allergies: Diagnostic Lab Data: SIDS investigation & autopsy done CDC Split Type:
Write-up: Dx sudden infant death syndrome died 29Nov90 |
|
VAERS ID: |
27506 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Male |
Location: |
Virginia |
Vaccinated: | 1991-01-08 |
Onset: | 1991-01-09 |
Days after vaccination: | 1 |
Submitted: |
1991-01-10 |
Days after onset: | 1 |
Entered: |
1991-01-22 |
Days after submission: | 12 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
293947 / 2 |
LL / IM |
HIBV: HIB (HIBTITER) / PFIZER/WYETH |
M705FE / 1 |
RL / IM |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
291964 / 2 |
MO / PO |
Administered by: Public Purchased by: Public Symptoms: Sudden infant death syndrome SMQs:, Neonatal disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1991-01-09
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Tylenol drops PRN Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: other pending autopsy at hospital. No lab work done 8JAN91 CDC Split Type: VA91001
Write-up: Pt vaccinated with DTP/OPV/HIB phone call from ER 9JAN91 at 1210PM requesting info re: child''s status on visit 8JAN91. Informed ER child well-given 2nd DTP, OPV & 1st HBCV - ER stated child "SIDS" found by mother - brought to ER via rescue. |
|
VAERS ID: |
27509 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Male |
Location: |
Alaska |
Vaccinated: | 1991-01-14 |
Onset: | 1991-01-15 |
Days after vaccination: | 1 |
Submitted: |
1991-01-17 |
Days after onset: | 2 |
Entered: |
1991-01-22 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. |
1726S / 1 |
LL / IM |
Administered by: Public Purchased by: Public Symptoms: Apnoea SMQs:, Acute central respiratory depression (narrow), Respiratory failure (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1991-01-15
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Received BPIG (IND drug) by Mass Biologic Labs, Lot #8, IM, RL, 1 prev dose at same time as HIB. Current Illness: none Preexisting Conditions: none Allergies: Diagnostic Lab Data: autopsy pending CDC Split Type:
Write-up: Received PRP-OMP & BPIG (IND drug) after being evaluated & found afeb. & in good health. Infant was found apneic in his bed the next AM. |
|
VAERS ID: |
27510 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Female |
Location: |
California |
Vaccinated: | 1990-12-21 |
Onset: | 1990-12-22 |
Days after vaccination: | 1 |
Submitted: |
1991-01-16 |
Days after onset: | 25 |
Entered: |
1991-01-22 |
Days after submission: | 6 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HIBV: HIB (HIBTITER) / PFIZER/WYETH |
M730FF / 1 |
RL / - |
Administered by: Private Purchased by: Unknown Symptoms: Abdominal distension,
Apnoea,
Brain oedema,
Haemorrhage,
Haemothorax,
Lung disorder,
Pulmonary oedema,
Sudden infant death syndrome SMQs:, Cardiac failure (narrow), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Acute central respiratory depression (narrow), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Neonatal disorders (narrow), Respiratory failure (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-12-22
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Pedi-Care Decongestant Drops Current Illness: Decongested Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt given HIB titer 21DEC90 aprox 1230PM pt died 22DEC90 738 HRS.F/U 19Apr91 Autopsy rept-Acute respiratory failure,SIDS.Petechial hemorrhages of pleurae,epicardium & thymus.Pulmonary/cerebral edema &congestion.Congestion of abdo viscera. |
|
VAERS ID: |
28073 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Female |
Location: |
Arizona |
Vaccinated: | 1990-12-19 |
Onset: | 1990-12-22 |
Days after vaccination: | 3 |
Submitted: |
1990-12-26 |
Days after onset: | 4 |
Entered: |
1991-02-12 |
Days after submission: | 48 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES |
0F11081 / 1 |
LL / IM |
HIBV: HIB (HIBTITER) / PFIZER/WYETH |
M190FO / 1 |
RL / IM |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
291938 / 1 |
MO / PO |
Administered by: Private Purchased by: Private Symptoms: Sudden infant death syndrome SMQs:, Neonatal disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-12-22
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: In sister; high fever; DTP/OPV; 1 dose.~ ()~~~In Sibling Other Medications: None Current Illness: None Preexisting Conditions: Resolved otitis media Allergies: Diagnostic Lab Data: Autopsy consistent with SIDS. CDC Split Type:
Write-up: Baby found dead in crib early in tha AM on 22DEC90; Sudden Infant Death Syndrome. |
|
VAERS ID: |
28321 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Male |
Location: |
Oregon |
Vaccinated: | 1991-02-05 |
Onset: | 1991-02-06 |
Days after vaccination: | 1 |
Submitted: |
1991-02-07 |
Days after onset: | 1 |
Entered: |
1991-02-15 |
Days after submission: | 8 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
285918 / 1 |
LL / - |
HIBV: HIB (HIBTITER) / PFIZER/WYETH |
M200FE / 1 |
LL / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
291938 / 1 |
MO / PO |
Administered by: Private Purchased by: Private Symptoms: Sudden infant death syndrome SMQs:, Neonatal disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1991-02-06
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Tylenol poss. Current Illness: None Preexisting Conditions: None Allergies: Diagnostic Lab Data: Autopsy-$g no cause found CDC Split Type:
Write-up: sids death 16-24 hrs /p administration of imm. |
|
Link To This Search Result:
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