|
VAERS ID: |
26146 (history) |
Form: |
Version 1.0 |
Age: |
1.8 |
Sex: |
Male |
Location: |
Florida |
Vaccinated: | 1977-10-07 |
Onset: | 1978-04-28 |
Days after vaccination: | 203 |
Submitted: |
1990-09-26 |
Days after onset: | 4533 |
Entered: |
1990-10-01 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
Administered by: Private Purchased by: Private Symptoms: Convulsion,
Mental retardation severity unspecified,
Nervousness SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (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: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt vaccinated with DTP/OPV developed initability, language delay, still has developmental delay; seizures resolved. |
|
VAERS ID: |
26176 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Male |
Location: |
Illinois |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-03 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Depressed level of consciousness,
Mental retardation severity unspecified,
Paralysis,
Speech disorder SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (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: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: ABR0200
Write-up: Pt vaccinated with DTP sustained severe & permanent injury to his entire body, including all extremities, he has lost use of his limbs, the ability to communicate and is severely retarded. Pt has been living in an institutional setting. |
|
VAERS ID: |
26222 (history) |
Form: |
Version 1.0 |
Age: |
39.0 |
Sex: |
Female |
Location: |
Florida |
Vaccinated: | 1990-09-10 |
Onset: | 1990-09-10 |
Days after vaccination: | 0 |
Submitted: |
1990-10-01 |
Days after onset: | 21 |
Entered: |
1990-10-12 |
Days after submission: | 11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES |
0A21041 / UNK |
- / - |
Administered by: Private Purchased by: Other Symptoms: Asthenia,
Chest pain,
Hypertonia,
Pain,
Tremor SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Hypokalaemia (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: Local redness & swelling, fever in pt Tetanus 1972 & 80.~ ()~~~In patient Other Medications: Tetracyclinee 250mg for acne 4xday Current Illness: Preexisting Conditions: Allergies to Iodine & Sulfur Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt vaccinated with TD began with burning in legs, the overall intense shaking, tremors - lasted approx 1 hr next day total soreness/weakness w/2wk of strong muscle contractions spasms & pain. Chest pains during this time. |
|
VAERS ID: |
26464 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Male |
Location: |
Florida |
Vaccinated: | 1989-08-12 |
Onset: | 1989-08-12 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-31 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES |
8F01010 / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Cerebrovascular accident,
Convulsion,
Cough,
Hemiplegia,
Pyrexia,
Somnolence,
Stupor SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: MRI done /p big seizure 22Nov89 CDC Split Type:
Write-up: Pt vaccinated /w DTP 1st & ONLY 12AUG89, slept for 19 hrs & began deteriorating (quit rolling over & was non-responsive) & suffered seizures & storkes, finally having a big storke 22NOV89 leaving him hemiplegic. |
|
VAERS ID: |
26471 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Male |
Location: |
Pennsylvania |
Vaccinated: | 1989-09-27 |
Onset: | 1989-10-26 |
Days after vaccination: | 29 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-31 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES |
8F01010 / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Cough,
Infection,
Pharyngitis,
Pyrexia SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (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? Yes, 10 days
Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt vaccinated with DTP developed low grade fever, chest cold, cough. Admitted to Hosp on 26OCT89 for 10 days dx pertussis. (whooping cough) |
|
VAERS ID: |
26498 (history) |
Form: |
Version 1.0 |
Age: |
1.5 |
Sex: |
Male |
Location: |
Connecticut |
Vaccinated: | 1988-03-28 |
Onset: | 1988-03-28 |
Days after vaccination: | 0 |
Submitted: |
1990-10-30 |
Days after onset: | 946 |
Entered: |
1990-11-05 |
Days after submission: | 6 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
- / 4 |
- / L |
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES |
- / UNK |
- / L |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
- / 4 |
MO / PO |
Administered by: Private Purchased by: Other Symptoms: Anorexia,
Dehydration,
Diabetes mellitus,
Dyspnoea,
Hypotonia,
Influenza,
Insomnia,
Pyrexia,
Screaming,
Somnolence SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Septra Current Illness: Otitis media - resolving Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt vaccinated with DTP/OPV/HIB 8 hrs following injections pt crying steadily & limp unable to stand or sit even propped up. Mentally quite "spacey" temp 101F on acetaminophen all night & sleep was disturbed. see WORM for more details. |
|
VAERS ID: |
26621 (history) |
Form: |
Version 1.0 |
Age: |
1.3 |
Sex: |
Female |
Location: |
North Dakota |
Vaccinated: | 1990-10-30 |
Onset: | 1990-10-30 |
Days after vaccination: | 0 |
Submitted: |
1990-11-08 |
Days after onset: | 9 |
Entered: |
1990-11-13 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES |
OF11073 / 4 |
RL / SC |
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES |
8L01022 / 1 |
LL / SC |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
281933 / 4 |
MO / PO |
Administered by: Military Purchased by: Unknown Symptoms: Convulsion,
Pyrexia,
Somnolence SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient Other Medications: Tylenol Current Illness: Cold symptoms without fever Preexisting Conditions: Allergies: Diagnostic Lab Data: EEG Relatively normal 8 days after 1st seizure. CDC Split Type:
Write-up: Pt vax /w DTP/OPV/HIB/TB TINE TEST /w in 4 hrs pt had grand mal seizure, T was 100.6. Became very lethargic brought to ER then again seizure; admit to Hosp. Seizured again 5 days later 3 times w/no Increase temp. |
|
VAERS ID: |
26695 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Female |
Location: |
Oregon |
Vaccinated: | 1990-07-09 |
Onset: | 1990-08-17 |
Days after vaccination: | 39 |
Submitted: |
1990-10-26 |
Days after onset: | 70 |
Entered: |
1990-11-21 |
Days after submission: | 26 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
271914 / 1 |
- / IM |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
0612H / 1 |
MO / PO |
Administered by: Private Purchased by: Unknown Symptoms: Agitation,
Mental retardation severity unspecified,
Muscle spasms,
Pyrexia SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? Yes, 4 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Tylenol given at time of vaccination by the office nurse. Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: EEG showed frequent seizure activity. All other workup Normal (CT scan, MRI, bloodwork, lumbar puncture). CDC Split Type:
Write-up: Pt vaccinated with DTP/OPV immediately after vaccine administration, pt had a fever of 100 & was fussy. 17AUG90 pt started having seizures, dx as idiopahtic complex focal seizures. Seizures evolved & dx as having infantile spasms. |
|
VAERS ID: |
26735 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Male |
Location: |
Texas |
Vaccinated: | 1986-01-29 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-11-26 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Unevaluable event SMQs:
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: Diagnostic Lab Data: CDC Split Type: 900067901
Write-up: Pt vaccinated with DTP Child seriously and adversely affected by DTP. no details provided. |
|
VAERS ID: |
26798 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Male |
Location: |
Wisconsin |
Vaccinated: | 1984-05-15 |
Onset: | 1984-05-15 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-11-26 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
- / UNK |
- / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
- / UNK |
MO / PO |
Administered by: Unknown Purchased by: Unknown Symptoms: Convulsion,
Dementia SMQs:, Systemic lupus erythematosus (broad), Dementia (narrow), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (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: Current Illness: Preexisting Conditions: Normal pregnancy & birth Allergies: Diagnostic Lab Data: Abnormal EEG & MRI. CDC Split Type: 900143001
Write-up: Pt vac.W/DTP/OPV plaintiff alleged that as a result of immunization on 14MAY84, 29JAN86 & 28APR87 child experienced a grand mal seizure within hrs of first vaccination, & permanent brain damage. |
|