|
VAERS ID: |
94045 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Male |
Location: |
Oregon |
Vaccinated: | 1988-10-12 |
Onset: | 1988-11-17 |
Days after vaccination: | 36 |
Submitted: |
1996-12-20 |
Days after onset: | 2955 |
Entered: |
1997-01-27 |
Days after submission: | 38 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH |
- / UNK |
- / - |
Administered by: Other Purchased by: Other Symptoms: Back pain,
Dysuria,
Myasthenic syndrome,
Myelitis,
Nausea,
Pain,
Paraplegia,
Pyrexia SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient Other Medications: UNK Current Illness: UNK Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: 897009014L
Write-up: pt recv vax & w/in 35 days of vax pt devel nausea, elevated body temp, backache, weakness in the lower extremities, & diff urinating;dx of transverse myelitis was allegedly made on 13DEC88;pt exp pain & permanent paraplegia; |
|
VAERS ID: |
94613 (history) |
Form: |
Version 1.0 |
Age: |
72.0 |
Sex: |
Female |
Location: |
Virginia |
Vaccinated: | 1996-11-25 |
Onset: | 1997-01-06 |
Days after vaccination: | 42 |
Submitted: |
1997-01-22 |
Days after onset: | 16 |
Entered: |
1997-02-03 |
Days after submission: | 12 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH |
4968170 / 7+ |
RA / IM |
Administered by: Public Purchased by: Public Symptoms: CSF test abnormal,
Myelitis,
Paraesthesia,
Paraplegia SMQs:, Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient Other Medications: Cordizen, Insulin, Trental Current Illness: diabetes, HTN, periph vasc disease Preexisting Conditions: diabetes, HTN, peripheral vascular disease Allergies: Diagnostic Lab Data: CSF w/elevated protein otherwise negative x/for few WACS;MRI w/ inc signal for T5-T10; CDC Split Type: VA97036
Write-up: dx w/acute transverse myelitis-hosp from 9JAN97-17JAN97 then transported to a rehab facility w/lower extremities paraplegic & numbness up to T4/t% level; |
|
VAERS ID: |
94664 (history) |
Form: |
Version 1.0 |
Age: |
40.0 |
Sex: |
Unknown |
Location: |
New Jersey |
Vaccinated: | 1996-11-18 |
Onset: | 1996-11-20 |
Days after vaccination: | 2 |
Submitted: |
0000-00-00 |
Entered: |
1997-02-06 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Hypersensitivity,
Lymphangitis,
Rash SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: NONE Current Illness: Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: CBC, SMAC, LFT''s all nl; CDC Split Type:
Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant; |
|
VAERS ID: |
95597 (history) |
Form: |
Version 1.0 |
Age: |
78.0 |
Sex: |
Female |
Location: |
Michigan |
Vaccinated: | 1996-10-08 |
Onset: | 1996-10-09 |
Days after vaccination: | 1 |
Submitted: |
1997-01-15 |
Days after onset: | 98 |
Entered: |
1997-03-10 |
Days after submission: | 54 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH |
4968172 / UNK |
RA / IM |
Administered by: Public Purchased by: Public Symptoms: Asthenia,
Back pain,
Hypokinesia,
Infection,
Injection site pain,
Neuralgia,
Pain,
Rhinitis SMQs:, Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt son devel eczema as teenger p/flu vax;~ ()~~~In patient Other Medications: NONE weekly allergy inj Current Illness: NONE Preexisting Conditions: allergies to tree, grass & molds;no food allergies; Allergies: Diagnostic Lab Data: CDC Split Type: MI97009
Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p |
|
VAERS ID: |
95639 (history) |
Form: |
Version 1.0 |
Age: |
72.0 |
Sex: |
Female |
Location: |
Georgia |
Vaccinated: | 1996-09-01 |
Onset: | 1996-12-01 |
Days after vaccination: | 91 |
Submitted: |
1997-03-06 |
Days after onset: | 95 |
Entered: |
1997-03-13 |
Days after submission: | 7 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS |
- / 1 |
- / IM A |
Administered by: Private Purchased by: Private Symptoms: Ageusia,
Infection,
Influenza,
Parosmia,
Rhinitis,
Sinusitis SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: unk Current Illness: NONE Preexisting Conditions: pt medical history is remarkable for phlebitis, hysterectomy & back trouble; Allergies: Diagnostic Lab Data: CDC Split Type: 0010150970090
Write-up: pt recv vax SEP96 & devel flu sx, loss of taste x/events to the present, loss of smell & sinus drainage in DEC96 & cont w/these events to present;pt states these events have affected daily living;pt to MD & given ATB; |
|
VAERS ID: |
97013 (history) |
Form: |
Version 1.0 |
Age: |
38.0 |
Sex: |
Male |
Location: |
New York |
Vaccinated: | 1996-10-23 |
Onset: | 1996-10-23 |
Days after vaccination: | 0 |
Submitted: |
1997-02-14 |
Days after onset: | 114 |
Entered: |
1997-04-21 |
Days after submission: | 65 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH |
- / 1 |
LA / - |
Administered by: Private Purchased by: Other Symptoms: Back pain,
CSF test abnormal,
Encephalitis,
Infection,
Muscle atrophy,
Myositis,
Neuropathy,
Paraesthesia SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: NONE Current Illness: NONE Preexisting Conditions: Allergies: Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein; CDC Split Type: 897072001L
Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd; |
|
VAERS ID: |
97986 (history) |
Form: |
Version 1.0 |
Age: |
78.0 |
Sex: |
Male |
Location: |
Pennsylvania |
Vaccinated: | 0000-00-00 |
Onset: | 1996-06-18 |
Submitted: |
0000-00-00 |
Entered: |
1997-05-14 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Paraesthesia SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Inderal, Trutal, Muro, prednic, Betagan, APAP Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: tingling of legs; |
|
VAERS ID: |
98352 (history) |
Form: |
Version 1.0 |
Age: |
58.0 |
Sex: |
Male |
Location: |
Minnesota |
Vaccinated: | 1996-11-12 |
Onset: | 1996-11-19 |
Days after vaccination: | 7 |
Submitted: |
1997-05-15 |
Days after onset: | 176 |
Entered: |
1997-05-28 |
Days after submission: | 13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH |
- / UNK |
- / - |
Administered by: Private Purchased by: Other Symptoms: Asthenia,
Facial palsy,
Guillain-Barre syndrome,
Influenza,
Myasthenic syndrome,
Ophthalmoplegia,
Paraesthesia SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Demyelination (narrow), Hearing impairment (broad), Ocular motility disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 24 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: NONE Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: spinal tap & EMG; CDC Split Type:
Write-up: Got Guillain-Barre synd; 5-7 days pvax stomach flu; numb in boxer short area, then wst to toes, then upper body. Intens care 14d, on respirator; still problems-- eyes yes don''t close, tape eyes to sleep, mouth tired when eating; tiredness |
|
VAERS ID: |
98454 (history) |
Form: |
Version 1.0 |
Age: |
62.0 |
Sex: |
Female |
Location: |
Iowa |
Vaccinated: | 1997-02-26 |
Onset: | 1997-02-26 |
Days after vaccination: | 0 |
Submitted: |
1997-05-09 |
Days after onset: | 71 |
Entered: |
1997-06-02 |
Days after submission: | 24 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Asthenia,
Guillain-Barre syndrome,
Myasthenic syndrome,
Myopathy,
Pain SMQs:, Rhabdomyolysis/myopathy (narrow), Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient Other Medications: clinoril;Zocor Current Illness: Preexisting Conditions: allergies Demerol; Allergies: Diagnostic Lab Data: EMG + deneration; CDC Split Type:
Write-up: weakness, pain lower extremities, GBS vs myopathy secondary to Zocor;thought to be GBS more than Zocor myopathy;? r/t vax; |
|
VAERS ID: |
98497 (history) |
Form: |
Version 1.0 |
Age: |
39.0 |
Sex: |
Female |
Location: |
Iowa |
Vaccinated: | 1996-11-03 |
Onset: | 1996-11-03 |
Days after vaccination: | 0 |
Submitted: |
1996-11-03 |
Days after onset: | 0 |
Entered: |
1997-06-04 |
Days after submission: | 212 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH |
4968169 / 1 |
LA / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Arthralgia,
Hypokinesia,
Injection site pain,
Laryngospasm,
Pain,
Tendon disorder SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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 to mold, pollens, sulfa, PCN;alcohol 1-2mo;I do have alot of low back pain, heel pain, bursitis hip, arthritis, psoriasis, asthma; Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: pt recv vax & felt tightness in throat;severe pain in arm & couldn''t lift arm;JAN97 call MD still couldn''t move arm;MD felt probable rotary cuff tendinitis;pt to physical therapy;arm & shoulder getting worse;still painful; |
|