|
VAERS ID: |
37787 (history) |
Form: |
Version 1.0 |
Age: |
34.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 1991-10-03 |
Onset: | 1991-10-25 |
Days after vaccination: | 22 |
Submitted: |
1991-12-02 |
Days after onset: | 38 |
Entered: |
1991-12-05 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
658A4 / 2 |
- / - |
Administered by: Other Purchased by: Other Symptoms: Angioneurotic oedema,
Arthralgia,
Condition aggravated,
Urticaria SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Arthritis (broad), 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: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBW918078
Write-up: Pt recvd 2nd dose of Engerix-B on 3OCT91; 22 days later pt devel urticaria, polyarthralgia & hypothyroidism; pt was hositalized; MD stated that relationship to vax was "doubtful"; |
|
VAERS ID: |
38009 (history) |
Form: |
Version 1.0 |
Age: |
40.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 1991-11-18 |
Onset: | 1991-11-18 |
Days after vaccination: | 0 |
Submitted: |
1991-12-16 |
Days after onset: | 28 |
Entered: |
1991-12-18 |
Days after submission: | 2 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
832A4 / UNK |
- / IM |
Administered by: Other Purchased by: Other Symptoms: Dyspnoea,
Nausea,
Rhinitis,
Thinking abnormal,
Yawning SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Life Threatening? Yes
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: Donnatal, Inderal, Micronase; Pt recvd flu vax; Current Illness: Preexisting Conditions: Diabetic; pt indicated numerous allergies (unspecified); pt has had strange reactions to meds in past; 30 days previously recvd flu vax w/o difficulty Allergies: Diagnostic Lab Data: CDC Split Type: EBU911330
Write-up: Pt recvd vax 18NOV91 @ approx 230-3PM & 530PM devel runny nose, SOB, incoherence & queasiness; 19NOV91 was sl SOB on exertion, yawning & sighing; |
|
VAERS ID: |
38010 (history) |
Form: |
Version 1.0 |
Age: |
68.0 |
Sex: |
Male |
Location: |
New York |
Vaccinated: | 1991-11-08 |
Onset: | 1991-11-08 |
Days after vaccination: | 0 |
Submitted: |
1991-12-16 |
Days after onset: | 38 |
Entered: |
1991-12-18 |
Days after submission: | 2 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / 3 |
- / - |
Administered by: Other Purchased by: Other Symptoms: Cerebrovascular accident,
Drug ineffective,
Haemorrhage intracranial,
Hemiplegia,
Leukocytosis,
Leukopenia,
Myasthenic syndrome,
Vascular anomaly SMQs:, Haematopoietic leukopenia (narrow), Lack of efficacy/effect (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Congenital, familial and genetic disorders (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related conditions (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes 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: Current Illness: Preexisting Conditions: Pt describes self as healthy; no hx high BP, heart problems, diabetes, etc; Allergies: Diagnostic Lab Data: CAT Scan taken revealed a small hemorraghic area in rt thalamus; All the tests & monitoring performed, including MRI & Magnetic resonance angiogram, revealed no poss cause for incident; CDC Split Type: EBU911337
Write-up: Pt recvd 3rd dose of Engerix-B & approx 90 min later suffered a stroke; pt taken to hosp by ambulance; admitted x 4 days; recovered w/o meds; |
|
VAERS ID: |
38090 (history) |
Form: |
Version 1.0 |
Age: |
57.0 |
Sex: |
Male |
Location: |
New Jersey |
Vaccinated: | 1991-11-06 |
Onset: | 1991-11-20 |
Days after vaccination: | 14 |
Submitted: |
1991-12-18 |
Days after onset: | 28 |
Entered: |
1991-12-23 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
826A4 / 2 |
- / IM A |
Administered by: Private Purchased by: Private Symptoms: Hepatic function abnormal,
Hepatitis,
Hyperbilirubinaemia,
Infection,
Jaundice,
Neck pain,
Syncope,
Urine analysis abnormal SMQs:, Torsade de pointes/QT prolongation (broad), Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (narrow), Arrhythmia related investigations, signs and symptoms (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: NONE Current Illness: Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: Hepatitis B Surface Antigen-pos; Hepatitis B core antigen-pos CDC Split Type: EBU911372
Write-up: Pt recvd 2 doses of Engerix-B 2OCT91, 6NOV91, & 20NOV91 reporting MD indicated that pt was admitted to hosp due to acute Hep-B; HBSAG positive; |
|
VAERS ID: |
38119 (history) |
Form: |
Version 1.0 |
Age: |
42.0 |
Sex: |
Female |
Location: |
Rhode Island |
Vaccinated: | 1991-04-21 |
Onset: | 1991-05-01 |
Days after vaccination: | 10 |
Submitted: |
1991-12-12 |
Days after onset: | 225 |
Entered: |
1991-12-23 |
Days after submission: | 11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (FOREIGN) / MERCK & CO. INC. |
0784T / 3 |
- / IM |
Administered by: Private Purchased by: Public Symptoms: Deafness,
Influenza,
Tinnitus SMQs:, Hearing impairment (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: none Current Illness: cold Preexisting Conditions: hypertension Allergies: Diagnostic Lab Data: MRI-neg for acoustic neuroma CDC Split Type:
Write-up: Deafness-lt ear 50% loss of hearing, tinnitus, 12Apr91 poss cold prior to vaccince, put on cough syrup. Sxs much worse p/vax. Probably viral synd but pt insists much worse p/vax. |
|
VAERS ID: |
38469 (history) |
Form: |
Version 1.0 |
Age: |
26.0 |
Sex: |
Female |
Location: |
Illinois |
Vaccinated: | 1991-09-03 |
Onset: | 1991-09-16 |
Days after vaccination: | 13 |
Submitted: |
1991-12-09 |
Days after onset: | 84 |
Entered: |
1991-12-23 |
Days after submission: | 14 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / 3 |
- / IM |
Administered by: Other Purchased by: Other Symptoms: Asthenia,
Hypokinesia,
Myelitis,
Paraesthesia,
Urinary retention SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (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, 6 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Cytotec, Pred, PCN & Floxacillin; Current Illness: Pharyngitis; Preexisting Conditions: Allergies: Diagnostic Lab Data: MRI & Sp tap; CDC Split Type: EBU911092
Write-up: Pt recvd 3 doses of Engerix-B vax 1MAR91, 4APR91 & 3SEP91; On 6 or 7SEP91 p/3rd dose of vax pt exp urinary retention, numbess, dec sensation in lower extremity & weakness; also needed assistance to walk; dx transverse myelitis; |
|
VAERS ID: |
38470 (history) |
Form: |
Version 1.0 |
Age: |
31.0 |
Sex: |
Female |
Location: |
Florida |
Vaccinated: | 1991-03-05 |
Onset: | 1991-07-11 |
Days after vaccination: | 128 |
Submitted: |
1991-12-10 |
Days after onset: | 152 |
Entered: |
1991-12-23 |
Days after submission: | 13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / 2 |
RA / IM |
Administered by: Other Purchased by: Other Symptoms: Anaemia,
Arthralgia,
Bone pain,
Hypokinesia,
Immune system disorder,
Jaundice,
Neuropathy,
Paraesthesia SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (narrow), Parkinson-like events (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (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: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: MD indicated that a full vasculitis workup has been completely neg; normal nerve conduction, EMG study, lab serology titers including VDRL; Lyme dis & serum portein electrophoresis; CDC Split Type: EBU911093
Write-up: Pt recvd 2 doses of Engerix-B FEB & 5MAR91; 11JUL91 pt exp rt arm & leg neuropathy & long bone & joint pain, jaundiced x 2 wks; dysesthesia; |
|
VAERS ID: |
38653 (history) |
Form: |
Version 1.0 |
Age: |
39.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 1991-11-05 |
Onset: | 1991-11-05 |
Days after vaccination: | 0 |
Submitted: |
1991-12-04 |
Days after onset: | 29 |
Entered: |
1991-12-23 |
Days after submission: | 19 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
813A4 / 2 |
- / - |
Administered by: Other Purchased by: Other Symptoms: Asthenia,
Dizziness,
Infection,
Nervousness,
Nuchal rigidity,
Palpitations,
Syncope,
Urticaria SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt became flushed @39 y/o w/Engerix-B #1 dose;~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: hx of drug allergies; Allergies: Diagnostic Lab Data: 5NOV91 pulse=88; BP 120/80; CDC Split Type: EBU911213
Write-up: Pt recvd 2 doses Engerix-B 2nd dose 5NOV91 & 3 min later felt hot, nauseous, dizzy, did not feel well & heart started to pound; @ 5min pt started to vomit, hives, felt nervous from vax, exhausted; 7NOV91 seen by MD felt virus or drug rxn; |
|
VAERS ID: |
38194 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 1991-02-01 |
Onset: | 0000-00-00 |
Submitted: |
1991-12-27 |
Entered: |
1992-01-02 |
Days after submission: | 6 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / UNK |
- / - |
Administered by: Other Purchased by: Other Symptoms: Multiple sclerosis,
Pain,
Paraesthesia SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)
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: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBW918086
Write-up: Pt recvd 1st dose of Engerix-B FEB91 & some day later felt paresthesias in one foot & "bad pain to walk" 3 wks p/vax pt hospitalized; dx multiple sclerosis was made; MD stated that this event is unlikely related to the vax; |
|
VAERS ID: |
38316 (history) |
Form: |
Version 1.0 |
Age: |
11.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 1991-12-11 |
Onset: | 1991-12-11 |
Days after vaccination: | 0 |
Submitted: |
1992-01-02 |
Days after onset: | 22 |
Entered: |
1992-01-06 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / UNK |
- / - |
Administered by: Other Purchased by: Other Symptoms: Blood creatine phosphokinase increased,
Confusional state,
Hypertonia,
Myopathy,
Neuropathy,
Pyrexia,
Urine analysis abnormal SMQs:, Rhabdomyolysis/myopathy (narrow), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (narrow), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Hypokalaemia (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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: Blood Analysis-inc of CPK; Hemoculture-results awaited; LP-nl; Scanner-nl; Urine analysis-myoglobinuria; CDC Split Type: EBW918090
Write-up: Pt recvd 1st dose of Engerix-B & 6 hrs later exp fever, hypermyotonia, & confusion; Hospitalization was necessary; Pt, @ time of report, still had a fever; No meds taken; |
|