|
VAERS ID: |
25478 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Male |
Location: |
New York |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-10 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / UNK |
- / NA |
Administered by: Private Purchased by: Private Symptoms: Urticaria SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: N/A~ ()~~~In patient Other Medications: NONE Current Illness: N/A Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: N/A CDC Split Type: EBU900084
Write-up: 15 MIN AFTER VAX, HUGE WELT OCCURRED BEHIND LEFT EAR TO MIDNECK. SEEN IN ER. NO TREATMENT NECESSARY. EVENT RESOLEVED 45 MIN LATER. |
|
VAERS ID: |
25479 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Virginia |
Vaccinated: | 1990-01-11 |
Onset: | 1990-01-18 |
Days after vaccination: | 7 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-10 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
586A4 / UNK |
- / NA |
Administered by: Private Purchased by: Private Symptoms: Malaise,
Pain SMQs:
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: N/A~ ()~~~In patient Other Medications: CAPOTEN, MODURETIC Current Illness: N/A Preexisting Conditions: HAD HEPATITIS A AS A TEENAGER FROM INFECTED SEAFOOD. Allergies: Diagnostic Lab Data: N/A CDC Split Type: EBU900086
Write-up: PT FELT SLUGGISH /w BODY ACHES. EVENTS LASTED 5 TO 7 DAYS. 2ND VACCINATION 21Feb90 NO PROBLEMS FOLLOWING VACCINATION. |
|
VAERS ID: |
25480 (history) |
Form: |
Version 1.0 |
Age: |
23.0 |
Sex: |
Female |
Location: |
Wisconsin |
Vaccinated: | 1990-02-13 |
Onset: | 1990-02-14 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-10 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
587A4 / UNK |
- / NA |
Administered by: Private Purchased by: Private Symptoms: Diarrhoea,
Drug ineffective,
Nausea,
Pyrexia SMQs:, Acute pancreatitis (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: N/A~ ()~~~In patient Other Medications: TRIPHASIL-21 (ONE/DAY) Current Illness: PRE EXPOSURE HEP B PROPHYLAXIS Preexisting Conditions: HISTORY OF PITUITARY MICROADENOMA. ALLERGIC TO POLLENS, DOGS, CATS; THRODUR (NAUSEA) Allergies: Diagnostic Lab Data: 14Feb90 TESTED POS FOR HBSAG; 24Feb90 TESTED NEG FOR HBSAG; ??Feb90 HEPATITIS PANEL = NEG AND FEVER 102 F CDC Split Type: EBU900087
Write-up: 1 DAY /p 1ST VAX, EXP DIARRHEA, FEVER, NAUSEA, & POSS. POTENTIAL CLINICAL HEPATITIS. Unclear if actually had acute Hept B or false positive, off work until retesting done, symptoms resolved /wout Heptatitis 27Feb90. |
|
VAERS ID: |
25481 (history) |
Form: |
Version 1.0 |
Age: |
41.0 |
Sex: |
Female |
Location: |
Virginia |
Vaccinated: | 1990-02-16 |
Onset: | 1990-02-19 |
Days after vaccination: | 3 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-10 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / 2 |
LA / IM |
Administered by: Private Purchased by: Private Symptoms: Arthralgia,
Myalgia,
Pain SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: N/A~ ()~~~In patient Other Medications: NONE Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: N/A CDC Split Type: EBU900090
Write-up: 3 DAYS AFTER 2ND DOSE OF ENGERIX-B, PT EXPERIENCED PAIN IN SHOULDER. EVENTS RESOLVED WITHOUT FURTHER TREATMENT. |
|
VAERS ID: |
25531 (history) |
Form: |
Version 1.0 |
Age: |
28.0 |
Sex: |
Female |
Location: |
New York |
Vaccinated: | 1990-01-17 |
Onset: | 1990-01-18 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-10 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / UNK |
- / IM |
Administered by: Private Purchased by: Private Symptoms: Nausea,
Paraesthesia,
Pyrexia SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes 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: NONE Allergies: Diagnostic Lab Data: BODY TEMP 101 DEGREES F CDC Split Type: EBU900127
Write-up: 1 DAY AFTER VAX EXPER FEVER,NAUSEA,TINGLING. TINGLING LASTED 1 DAY. NAUSEA LASTED 2 WEEKS. "TYLENOL DID HELP WITH SYMPTOMS". TO DATE ALL SYMPS HAVE RESOLVED COMPLETELY |
|
VAERS ID: |
25488 (history) |
Form: |
Version 1.0 |
Age: |
26.0 |
Sex: |
Male |
Location: |
Texas |
Vaccinated: | 1990-05-10 |
Onset: | 1990-05-10 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
48049/1884R / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Amblyopia,
Confusional state,
Dizziness,
Extrasystoles,
Eye pain,
Hyperhidrosis,
Myalgia,
Nausea,
Nervousness,
Vertigo,
Vomiting SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Eosinophilic pneumonia (broad), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Hypokalaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: allergy to penicillin, hx of PVC''s Allergies: Diagnostic Lab Data: Holter moniter- pretreatment, no adv. Dysrhythmias CDC Split Type: WAES90050424
Write-up: Pt vaccinated /w 1st dose of Recombivax, developed dizziness, blurred vision, jitteriness, sweating, myalia, vomiting, nause, vertigo, disorientation & pain in eye. Exam revealed Pt''s fundi & intraocular pressure WNL. Pt hospitalized. |
|
VAERS ID: |
25521 (history) |
Form: |
Version 1.0 |
Age: |
47.0 |
Sex: |
Female |
Location: |
Kentucky |
Vaccinated: | 1990-04-05 |
Onset: | 1990-04-09 |
Days after vaccination: | 4 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
591A4 / 4 |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Back pain,
Dizziness,
Drug ineffective,
Dyspnoea,
Hepatic function abnormal,
Hypokalaemia,
Nausea,
Pallor,
Vomiting SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Lack of efficacy/effect (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Ogen, Prinzide, Synthroid, Vivactil Current Illness: Gallbladder removed 30 yrs ago; Preexisting Conditions: Hypothyroid, Hypertension; Allergic to Codeine, sulfa; Allergies: Diagnostic Lab Data: LDH inc, GGTP inc, SGOT inc, Liver func Abnorm, CAT SCAN of ADBOMEN was negative CDC Split Type: EBU900128
Write-up: Pt given Engerix-B experienced dizziness, non responder, feeling of faintness, flank pain rt side, nausea became very pale, decreased potassium, and back pain rt side. Was admitted to hospital given Phenergan 25 mg & Demerol to relieve pain |
|
VAERS ID: |
25522 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Iowa |
Vaccinated: | 1990-06-08 |
Onset: | 1990-06-11 |
Days after vaccination: | 3 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
587A4 / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Oedema peripheral,
Pruritus,
Rash SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Hormones Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBU900241
Write-up: Pt received lst does of Engerix-B on 8-JUN-90 & was hospitalized on 11-JUN-90 w/significant swelling of both hands also experienced itching of hands, rash on arms & hands club like fingers |
|
VAERS ID: |
25523 (history) |
Form: |
Version 1.0 |
Age: |
21.0 |
Sex: |
Female |
Location: |
Pennsylvania |
Vaccinated: | 1990-03-09 |
Onset: | 1990-03-11 |
Days after vaccination: | 2 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
533A4 / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Headache,
Vertigo,
Vestibular disorder SMQs:, Vestibular disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes 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: Anti-HBS dosage was performed on17-Feb-990, prior to vaccination, the results were negative. Results to test to detect anti-influenza virus antibodies was negative. Audiometric test were normal. CT scan was negative. CDC Split Type: EBWWMA010775
Write-up: Headache. Labyrinthitis. Developed headache & vertigo 48 hrs after vaccination. Hospitalized. Acute labyrinthitis diagnosed. |
|
VAERS ID: |
25536 (history) |
Form: |
Version 1.0 |
Age: |
92.0 |
Sex: |
Male |
Location: |
Pennsylvania |
Vaccinated: | 1990-02-09 |
Onset: | 1990-03-22 |
Days after vaccination: | 41 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-16 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
1647R / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Anorexia,
Arthritis,
Blood creatine phosphokinase increased,
Chills,
Confusional state,
Dehydration,
Haematuria,
Hepatic function abnormal,
Myasthenic syndrome,
Oedema,
Pain,
Purpura,
Pyrexia,
Synovitis,
Tremor,
Urinary incontinence,
Urine analysis abnormal SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dementia (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (narrow), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes 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: Diabetes mellitus, allergies to codeine, sulfa drugs Allergies: Diagnostic Lab Data: BUN- 30, WBC- 12600, platelet- 695000, ESR- 110, Hct-29, Hgl-10.3 EXTENSIVE SEE WORM CDC Split Type: WAES90040623
Write-up: Pt dev pain in arms & legs which inc til unable to walk. T to 105, shaking, chills, arthritis, incontinent, poor oral intake. Rt wrist edematous /w pain on mvmt, erythema & effusion. Extensive pt hx & hospital course |
|