|
VAERS ID: |
38317 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
West Virginia |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
1992-01-03 |
Entered: |
1992-01-06 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (FOREIGN) / MERCK & CO. INC. |
- / 1 |
- / - |
Administered by: Other Purchased by: Other Symptoms: Asthenia,
Deafness,
Headache,
Myalgia,
Photophobia,
Tinnitus SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hearing impairment (narrow), Tendinopathies and ligament 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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Flexeril Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: No relevant data; CDC Split Type: WAES91101033
Write-up: Pt recvd Hep B vax & following vax exp partial hearing loss, h/a, photophobia, myalgia & constant tinnitus; Pt recvd 2nd dose of Hep B in approx 1989 & exp total loss of hearing, tinnitus & asthenia; dx fibromyalgia; |
|
VAERS ID: |
38824 (history) |
Form: |
Version 1.0 |
Age: |
43.0 |
Sex: |
Male |
Location: |
Unknown |
Vaccinated: | 1991-11-14 |
Onset: | 1991-11-29 |
Days after vaccination: | 15 |
Submitted: |
1992-01-13 |
Days after onset: | 45 |
Entered: |
1992-01-16 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / 2 |
- / IM A |
Administered by: Other Purchased by: Other Symptoms: Cerebral haemorrhage,
Convulsion,
Gingival bleeding,
Haematuria,
Myocardial infarction,
Petechiae,
Thrombocytopenia,
Ventricular fibrillation SMQs:, Torsade de pointes/QT prolongation (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Ventricular tachyarrhythmias (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Convulsions (narrow), Embolic and thrombotic events, arterial (narrow), Gingival disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 0000-00-00
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: Pt exp generalized weakness, thrombocytopenic purpura, thrombocytopenia @ 43yo~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: pt was exp to many petro chemicals, paint & glue; suffered from diabetes mellitus type II which was dx last yr & treated w/diet only; Allergies: Diagnostic Lab Data: 21NOV91 platelets were 5,000; bleeding time $g10 mins; prothrombin time of 15 vs 12; quick 65%; p/the hosp admission (? 7th day of admission platelet count was 24,000); CDC Split Type: EBW918091
Write-up: 21NOV91 8(?) days p/2nd dose pt exp thrombocytopenia w/petechiae, bleeding gums & hematuria; Pt hospitalized & anti-platelet antibodies detected; 7th day of admission pt suddenly collapsed w/a fit; cerebral bleeding suspected; mass MI & VF; |
|
VAERS ID: |
38838 (history) |
Form: |
Version 1.0 |
Age: |
61.0 |
Sex: |
Male |
Location: |
Wisconsin |
Vaccinated: | 1991-11-21 |
Onset: | 1991-11-23 |
Days after vaccination: | 2 |
Submitted: |
1992-01-09 |
Days after onset: | 47 |
Entered: |
1992-01-16 |
Days after submission: | 7 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
821A4 / 3 |
RA / IM |
Administered by: Private Purchased by: Private Symptoms: Hypokinesia,
Neuropathy peripheral,
Pain,
Paraesthesia SMQs:, Peripheral neuropathy (narrow), 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? Yes
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient Other Medications: NA Current Illness: NONE Preexisting Conditions: To inhalants only Allergies: Diagnostic Lab Data: Lymes-neg; serum protein-WNL, chem-15-WNL, FBS-normal; NCV-EMG-peripheral sensory motor neuropathy; CDC Split Type:
Write-up: Pain & tingling in all extremities; difficulty walking sx aggravated by exercise; areas involved were both feet along sides & soles as well as both hands which inc w/extension of arms; |
|
VAERS ID: |
39029 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Unknown |
Location: |
Texas |
Vaccinated: | 1991-09-19 |
Onset: | 1991-09-20 |
Days after vaccination: | 1 |
Submitted: |
1991-10-28 |
Days after onset: | 38 |
Entered: |
1992-01-24 |
Days after submission: | 88 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (FOREIGN) / MERCK & CO. INC. |
0680T / 1 |
- / IM |
Administered by: Private Purchased by: Public Symptoms: Apnoea,
Cardiac arrest,
Cyanosis,
Hypokinesia SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Parkinson-like events (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1991-09-20
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient Other Medications: Pt recvd Hepatitis B Immune Globulin; Phytonadione, Erythromycin, Ophthalmic Current Illness: Mom Hep B positive Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: Blood C&S neg, good apgars post partum-9 & 9 @ 1 & 5 minutes; no other significant labs; CDC Split Type:
Write-up: Immediately post partum, neonate was administered Hep B vax & Hep Immune globulin & 24 hrs later the neonate was found in crib postioned on abdomen w/head turned to lt side, color was cyanotic; no resp, pulse, or spontaneous movements; |
|
VAERS ID: |
39040 (history) |
Form: |
Version 1.0 |
Age: |
60.0 |
Sex: |
Female |
Location: |
Iowa |
Vaccinated: | 1992-01-06 |
Onset: | 1992-01-10 |
Days after vaccination: | 4 |
Submitted: |
1992-01-22 |
Days after onset: | 12 |
Entered: |
1992-01-28 |
Days after submission: | 6 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
821A4 / UNK |
- / IM A |
Administered by: Private Purchased by: Private Symptoms: Back pain,
Guillain-Barre syndrome,
Hyperreflexia,
Hypertonia,
Hypokinesia,
Neuritis SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (narrow)
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, 6 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: NONE Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBU920122
Write-up: 6JAN92 pt recvd dose of Engerix-B & 10JAN92 devel neuritis & s&s consistent w/GBS; pt hospitalized for 8 days; MD performed CT Scan & Lumbar spine both neg; orthopedic consult proved neg; 17JAN92 pt ambulatory & recovering from events; |
|
VAERS ID: |
39353 (history) |
Form: |
Version 1.0 |
Age: |
24.0 |
Sex: |
Female |
Location: |
Louisiana |
Vaccinated: | 1991-10-29 |
Onset: | 1991-12-10 |
Days after vaccination: | 42 |
Submitted: |
1992-01-09 |
Days after onset: | 30 |
Entered: |
1992-02-05 |
Days after submission: | 27 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
0503T / 2 |
LA / - |
Administered by: Other Purchased by: Public Symptoms: Drug ineffective,
Hepatitis,
Hepatitis B surface antigen,
Infection SMQs:, Hepatitis, non-infectious (narrow), Lack of efficacy/effect (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? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient Other Medications: UNK Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: HBSAG-pos CDC Split Type: LA920104
Write-up: Hospitalized w/Hepatitis B illness; 30JAN92 test nl; |
|
VAERS ID: |
39361 (history) |
Form: |
Version 1.0 |
Age: |
36.0 |
Sex: |
Female |
Location: |
Virginia |
Vaccinated: | 1992-01-22 |
Onset: | 1992-01-22 |
Days after vaccination: | 0 |
Submitted: |
1992-02-03 |
Days after onset: | 12 |
Entered: |
1992-02-07 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
638A4 / 1 |
- / A |
Administered by: Private Purchased by: Private Symptoms: Asthenia,
CSF test abnormal,
Injection site hypersensitivity,
Meningitis,
Nuchal rigidity,
Post vaccination syndrome,
Rash maculo-papular,
Sinusitis SMQs:, Guillain-Barre syndrome (broad), Noninfectious meningitis (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? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: LP; CDC Split Type: EBU920209
Write-up: Pt recvd 1st dose of Engerix-B 22JAN92 & same day exp swelling @ inject site, fever, h/a; Also LP was done & viral meningitis is suspected; Reporter indicated info regarding tx is not available; 27JAN92 events still present; |
|
VAERS ID: |
39629 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
1992-02-21 |
Entered: |
1992-02-24 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / UNK |
- / - |
Administered by: Other Purchased by: Other Symptoms: Angioneurotic oedema,
Hypersensitivity SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (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? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Genhevac B by Merieux Current Illness: Preexisting Conditions: Pt recvd Genhevax B previously w/o adverse event; Allergies: Diagnostic Lab Data: CDC Split Type: EBW928005
Write-up: Shortly p/pt recvd 1st dose of engerix-B, pt exp severe quincke''s edema; Pt was hospitalized & recovered; MD indicated that this allergic rxn could be related to HG in the thiomersal preservative; |
|
VAERS ID: |
39710 (history) |
Form: |
Version 1.0 |
Age: |
51.0 |
Sex: |
Male |
Location: |
Unknown |
Vaccinated: | 1992-01-13 |
Onset: | 1992-01-14 |
Days after vaccination: | 1 |
Submitted: |
1992-02-21 |
Days after onset: | 38 |
Entered: |
1992-02-27 |
Days after submission: | 6 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
765A6 / 4 |
- / IM |
Administered by: Other Purchased by: Other Symptoms: Dehydration,
Diarrhoea,
Nausea SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Dehydration (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, 2 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Bacteriological & virological screening was neg; CDC Split Type: EBW928009
Write-up: In 1989, pt recvd 3 injects of Engerix-B uneventfully; On 13JAN92, pt recvd booster dose of vax on 14JAN92, the following evening pt exp nausea & devel diarrhea; 16JAN92 hospitalized x 2 days due to dehydration; tx meds; |
|
VAERS ID: |
39718 (history) |
Form: |
Version 1.0 |
Age: |
19.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 1991-09-02 |
Onset: | 0000-00-00 |
Submitted: |
1992-02-24 |
Entered: |
1992-02-28 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / 2 |
- / - |
Administered by: Other Purchased by: Other Symptoms: Blindness,
CSF test abnormal,
Dysphagia,
Encephalitis,
Multiple sclerosis,
Neuropathy,
Paraesthesia,
Paraplegia SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Retinal disorders (broad), 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? 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: Neuro exam: nl discs, rt homonymous hemianopia, dense rt upper motor neuron facial weakness, dense rt hemiplegia w/sensory loss & mild lt-sided pyramidal signs in the lt leg w/bilateral extensor plantars; MRI, CSF & EP were all positive; CDC Split Type: EBW918081
Write-up: p/2nd dose 2SEP91 pt devel acute MS, 2 wks later bilateral visual blurring MD felt visual loss & myopia; hospitalized 14OCT91 exp neurological deficit; also dysphasia & hemiparesis, walked w/limp, clumsy rt hand, demyelination, encephalomye |
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