|
VAERS ID: |
25564 (history) |
Form: |
Version 1.0 |
Age: |
36.0 |
Sex: |
Female |
Location: |
Delaware |
Vaccinated: | 1990-06-28 |
Onset: | 1990-06-29 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
- / UNK |
- / IM |
Administered by: Private Purchased by: Private Symptoms: Arthralgia,
Headache,
Hyperhidrosis,
Malaise,
Nausea,
Pyrexia,
Red blood cell sedimentation rate increased,
Vomiting SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: NONE Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: SED RATE 25 CDC Split Type:
Write-up: ACHES, PAIN (JOINT), SWEATS, LOW GRADE TEMP, MALAISE, N & V, AND SEVERE HEADACHE |
|
VAERS ID: |
25570 (history) |
Form: |
Version 1.0 |
Age: |
52.0 |
Sex: |
Male |
Location: |
Pennsylvania |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (FOREIGN) / MERCK & CO. INC. |
- / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Pancreatitis SMQs:, Acute pancreatitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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? Yes
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: no relevant history Allergies: Diagnostic Lab Data: CDC Split Type: WAES90061089
Write-up: Pt (surgeon) was vacc. /w Heptavax-B & was subsequently hospitalized /w pancreatitis. There was no concomitant medication. Additonal detail are beig requested |
|
VAERS ID: |
25581 (history) |
Form: |
Version 1.0 |
Age: |
70.0 |
Sex: |
Male |
Location: |
Oregon |
Vaccinated: | 1990-01-25 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
585A4 / 2 |
- / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Drug ineffective,
Encephalitis,
Infection SMQs:, Lack of efficacy/effect (narrow), Noninfectious encephalitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-05-19
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: no known allergies, non responder to previous 3 dose /w MSD vaccine Allergies: Diagnostic Lab Data: 10Jan90 titer test = non responsive, Herpes varicella recovered from brain CDC Split Type: EBU900170
Write-up: Pt given a series of 3 MSD Hep-B vaccines, & 2 Engerix-B vaccines due to being non responder. Pt developed encephalitis & died. Herpes varicella recovered form brain |
|
VAERS ID: |
25593 (history) |
Form: |
Version 1.0 |
Age: |
37.0 |
Sex: |
Female |
Location: |
Washington |
Vaccinated: | 1990-02-05 |
Onset: | 1990-02-05 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-25 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
586A4 / UNK |
RA / IM |
Administered by: Private Purchased by: Unknown Symptoms: Injection site reaction,
Pruritus SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), 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: Other Medications: Current Illness: Preexisting Conditions: allergies; Neosporin, Sulfa, Neomycin Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Itching, Worst the 1st wk, Taporing off to the end of 3 wks /p shot. Itching in area of shot, upper rt arm. |
|
VAERS ID: |
25442 (history) |
Form: |
Version 1.0 |
Age: |
31.0 |
Sex: |
Female |
Location: |
New Mexico |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-26 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
587A4 / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Injection site pain SMQs:, Extravasation events (injections, infusions and implants) (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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBU900045
Write-up: pain at the injection site event occurred "on all dosing of Engerix B." |
|
VAERS ID: |
25601 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Ohio |
Vaccinated: | 1990-03-22 |
Onset: | 1990-03-22 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-26 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
587A4 / UNK |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Asthenia,
Chills,
Influenza,
Injection site reaction,
Nuchal rigidity,
Pruritus,
Pyrexia,
Vasodilatation SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (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? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Flu-like symptoms, 101 F fever, fatigue, weakness, chills & flushing neck pain, pruritus, erythema & eccymosis at injection site (large surface area). Progress report on WORM |
|
VAERS ID: |
25613 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Male |
Location: |
Missouri |
Vaccinated: | 1990-06-05 |
Onset: | 1990-06-14 |
Days after vaccination: | 9 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-26 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Anorexia,
Chills,
Cholelithiasis,
Hepatic function abnormal,
Nausea,
Pyrexia SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gallbladder related disorders (narrow), Gallstone related disorders (narrow), 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? No 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: Allergies: Diagnostic Lab Data: Jun90-ultasound of gallbladder showed "one stone". Jun90- liver function tests "elevated" CDC Split Type: EBU900263
Write-up: Pt developed chills, nausea, anorexia & elevated liver function tests. Pt hospitalized & is being treated /w antipyretics for fever which recurs in the evenings. |
|
VAERS ID: |
25616 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Unknown |
Location: |
Maryland |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-30 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
597A4 / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Abdominal pain,
Dizziness SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt received a series of vaccine. /P the 2nd dose, pt c/o of abdominal pain. /P 3rd dose, pt c/o dizziness. No treatment was administered. Pt seems all right. Pt is a physician |
|
VAERS ID: |
25621 (history) |
Form: |
Version 1.0 |
Age: |
58.0 |
Sex: |
Female |
Location: |
Florida |
Vaccinated: | 1989-10-17 |
Onset: | 1990-01-03 |
Days after vaccination: | 78 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-31 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
587A4 / UNK |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Arthritis,
Facial palsy SMQs:, Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Arthritis (narrow), Immune-mediated/autoimmune disorders (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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Capozide, Calan, Capozide, Synthroid Current Illness: Preexisting Conditions: medical history of HTN, thyroid, cholecystitis Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt DX with Bell''s Palsy possibly rxn to vaccine ? Out of work X 3 months. 2 wks /p 2nd dose fo Hep B developed generalized arthritis for 6 wks. |
|
VAERS ID: |
25628 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Male |
Location: |
Unknown |
Vaccinated: | 1990-06-20 |
Onset: | 1990-06-20 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-08-06 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / 2 |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Agitation,
Alcohol intolerance,
Asthenia,
Confusional state,
Convulsion,
Dyspnoea SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), 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), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (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: FIRST VAX GIVEN 4 WKS PRIOR WAS UNEVENTFUL Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: ALCOHOL CONC = 1.2 MG/ML; EEG-NORMAL CDC Split Type: EBWWMA011032
Write-up: PT REC''D ENGERIX-B SHOWED SLIGHT SIGNS OF A FIT; GOT HEAVILY DRUNK; FELT TIRED; DAY AFTER RECEIVED A SECOND DOSE WENT ON EXCURSION AND GOT HEAVILY DRUNK. HOSPITALIZED FOR OBSERVATION. REC DIAZEPAM. f/u 03mar91: hosp X 3 days, outcome unk |
|