|
VAERS ID: |
25872 (history) |
Form: |
Version 1.0 |
Age: |
33.0 |
Sex: |
Female |
Location: |
Michigan |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
1990-08-31 |
Entered: |
1990-09-11 |
Days after submission: | 11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Pancytopenia SMQs:, Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Bone marrow; currently seen at another hospital CDC Split Type:
Write-up: Pt vaccinated with Hepatitis developed Pancytopenia 2 degrees to dysmyelopoietic synd, pt attributes secondary to Hepatitis vaccine. |
|
VAERS ID: |
25890 (history) |
Form: |
Version 1.0 |
Age: |
42.0 |
Sex: |
Female |
Location: |
New Hampshire |
Vaccinated: | 1990-01-24 |
Onset: | 1990-02-01 |
Days after vaccination: | 8 |
Submitted: |
0000-00-00 |
Entered: |
1990-09-11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
586A4 / 3 |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Abdominal pain,
Amblyopia,
Back pain,
Hypotonia,
Paraesthesia SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: Multiple sclerosis Preexisting Conditions: Allergies: Diagnostic Lab Data: Spinal tap showed elevated protein level. CDC Split Type: EBU900341
Write-up: Pt vaccinated with Hepatitis B 24JAN90, Feb90 developed pain after sitting, primarily in base of coccyx which still persists. 2nd vax given 4MAR90 on 5APR90 worse exacerbation of ms ever experienced. Given Prednisone. See WORM for details. |
|
VAERS ID: |
25892 (history) |
Form: |
Version 1.0 |
Age: |
56.0 |
Sex: |
Female |
Location: |
Virginia |
Vaccinated: | 1990-06-18 |
Onset: | 1990-07-07 |
Days after vaccination: | 19 |
Submitted: |
0000-00-00 |
Entered: |
1990-09-11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
620A4 / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Angioneurotic oedema,
Asthma,
Dysphonia,
Dyspnoea,
Face oedema,
Headache,
Hypersensitivity,
Laryngospasm,
Oedema,
Pruritus,
Pyrexia,
Rash,
Urticaria SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), 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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBU900326
Write-up: Pt vaccinated with Engerix-B 1JUL90, developed edema, itching, rash, swelling (11JUL90). Was put on Atarax & Prednisone. 16JUL90 rash persisted. Reporter indicated events were considered life-threatening. |
|
VAERS ID: |
25908 (history) |
Form: |
Version 1.0 |
Age: |
29.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 1989-12-04 |
Onset: | 1990-02-22 |
Days after vaccination: | 80 |
Submitted: |
0000-00-00 |
Entered: |
1990-09-11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
799 / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Abortion SMQs:, Termination of pregnancy and risk of abortion (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? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBWWMA010621
Write-up: Pt vaccinated to Engerix B suffered a miscarriage on 22FEB90 when 6 weeks pregnant. No hospitallization required. Reporting physician does not know if the event is related to the admin of the vax. |
|
VAERS ID: |
25974 (history) |
Form: |
Version 1.0 |
Age: |
17.0 |
Sex: |
Female |
Location: |
Illinois |
Vaccinated: | 1990-08-21 |
Onset: | 1990-08-22 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-09-17 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
587A4 / 4 |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Rash SMQs:, Anaphylactic reaction (broad), 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? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt vaccinated with Engerix-B developed a rash over her entire body. |
|
VAERS ID: |
25976 (history) |
Form: |
Version 1.0 |
Age: |
20.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 1988-02-28 |
Onset: | 1988-03-14 |
Days after vaccination: | 15 |
Submitted: |
0000-00-00 |
Entered: |
1990-09-17 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (FOREIGN) / MERCK & CO. INC. |
0437N / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Blindness,
Deafness,
Ear disorder,
Eye disorder,
Glaucoma,
Headache,
Retinal detachment,
Sinusitis,
Uveitis,
Visual disturbance SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (broad), Glaucoma (narrow), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (narrow), Hearing impairment (narrow), Ocular infections (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune 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: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: WAES90080943
Write-up: Pt vaccinated with Heptavax-B experienced visual & other symptoms such as headaches, seen by Ophthalmologist. Dx as having Vogt-Koyanagi-Harada''s synd treated w/steroid eye drops. Approx 1wk later rt eye was diminished to only count fingers |
|
VAERS ID: |
25982 (history) |
Form: |
Version 1.0 |
Age: |
32.0 |
Sex: |
Female |
Location: |
Minnesota |
Vaccinated: | 1990-03-12 |
Onset: | 1990-03-13 |
Days after vaccination: | 1 |
Submitted: |
1990-09-14 |
Days after onset: | 184 |
Entered: |
1990-09-20 |
Days after submission: | 6 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
- / UNK |
- / - |
Administered by: Private Purchased by: Other Symptoms: Chills,
Diarrhoea,
Myalgia,
Nausea,
Pyrexia,
Vomiting SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: HGB 15.7, WBC 17,600, UA normal CDC Split Type:
Write-up: Pt vaccinated with Recombivax developed myalgia, rigors, nausea, vomitting, temp 101.6, 12 hrs after 2nd does. |
|
VAERS ID: |
25987 (history) |
Form: |
Version 1.0 |
Age: |
28.0 |
Sex: |
Male |
Location: |
Arizona |
Vaccinated: | 1990-08-31 |
Onset: | 1990-09-02 |
Days after vaccination: | 2 |
Submitted: |
1990-09-17 |
Days after onset: | 15 |
Entered: |
1990-09-20 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
600A4 / 2 |
RA / IM |
Administered by: Private Purchased by: Private Symptoms: Injection site pain,
Injection site reaction,
Rash SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), 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: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt vaccinated with Engerix B experienced localized swelling, erythema, pain ,severe |
|
VAERS ID: |
26008 (history) |
Form: |
Version 1.0 |
Age: |
30.0 |
Sex: |
Female |
Location: |
New Hampshire |
Vaccinated: | 1990-06-20 |
Onset: | 1990-06-21 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-09-20 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
46558 / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Diarrhoea,
Headache,
Nausea,
Visual disturbance,
Visual field defect,
Vomiting SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Noninfectious diarrhoea (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: WAES90081135
Write-up: PT VACCINATED WITH RECOMBIVAX 36 HRS FOLLOWING THE INJECTION DEVELOPED BLURRED VISION, NAUSEA, VOMITING, & DIARRHEA. TWELVE HRS LATER, LOST PERIPHERAL VISION IN RT EYE AND DEVELOPED SEVERE HEADACHE. AFTER 72 HRS SYMPTOMS SUBSIDED. |
|
VAERS ID: |
26029 (history) |
Form: |
Version 1.0 |
Age: |
33.0 |
Sex: |
Female |
Location: |
Ohio |
Vaccinated: | 1990-05-26 |
Onset: | 1990-08-05 |
Days after vaccination: | 71 |
Submitted: |
0000-00-00 |
Entered: |
1990-09-20 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
1883R / 2 |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Abdominal pain,
Alanine aminotransferase increased,
Aspartate aminotransferase increased,
Blood lactate dehydrogenase increased,
Dysphagia,
Hepatitis,
Nausea,
Pharyngitis SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (broad), Agranulocytosis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Previous Vaccinations: ELEVATED LIVER ENZYMES~ ()~~~In patient Other Medications: ERYTHROMYCIN Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: WAES90080967
Write-up: PT VACCINATED WITH RECOMBIVAX HB GIVEN 2 DOSES LATER EXPERIENCED SEVERE STOMACH CRAMPS. LAB EVALUATION REVEALED ABNROMAL LIVER ENZYMES. PT LIVER ENZYMES REMAINED ELEVATED. ADDITIONAL DETAILS ARE BEING REQUESTED. |
|