|
VAERS ID: |
114948 (history) |
Form: |
Version 1.0 |
Age: |
54.0 |
Sex: |
Female |
Location: |
Massachusetts |
Vaccinated: | 1996-10-16 |
Onset: | 1996-10-16 |
Days after vaccination: | 0 |
Submitted: |
1998-10-07 |
Days after onset: | 721 |
Entered: |
1998-10-13 |
Days after submission: | 6 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS |
00476P / UNK |
- / - |
Administered by: Public Purchased by: Unknown Symptoms: Blindness,
Depressed level of consciousness,
Hypertonia,
Myasthenic syndrome,
Myelitis,
Optic neuritis,
Pupillary disorder,
Visual disturbance SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Ocular infections (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (narrow)
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? Yes, 6 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: several for heart, diabetes, BP Current Illness: heart, diabetes Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: CT scan, x-rays, spinal tap CDC Split Type:
Write-up: grittiness in both yes on 16OCT96 same evening pt was given flu shot;w/in 6 days pt blind;given pred which improved sight;pt permanently blind;optic nerve dysfunction;pt states optic neuritis followed flu vax;myelitis;myelopathy;spasm;weak |
|
VAERS ID: |
115524 (history) |
Form: |
Version 1.0 |
Age: |
51.0 |
Sex: |
Female |
Location: |
Texas |
Vaccinated: | 1994-10-01 |
Onset: | 1994-11-01 |
Days after vaccination: | 31 |
Submitted: |
1998-07-16 |
Days after onset: | 1352 |
Entered: |
1998-11-02 |
Days after submission: | 109 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH |
- / UNK |
- / - |
Administered by: Other Purchased by: Other Symptoms: Amblyopia,
Headache,
Neuropathy,
Optic atrophy,
Papilloedema,
Vasculitis,
Visual disturbance,
Visual field defect SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Optic nerve disorders (narrow), Lens disorders (broad), Retinal disorders (broad), Vasculitis (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)
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: unk Current Illness: unk Preexisting Conditions: Allergies: Diagnostic Lab Data: fluorescein angiography: late optic disc staining consistent w/disc edema; CDC Split Type: 898299001L
Write-up: A lit report described pt who devel fever w/chills & myalgia 1 day p/vax;4wk post vax exp ear pain, h/a, blurry vision rt eye & lt eye;visual acuity 25/50 in rt eye 20/25 in lt eye;optic discs edematous;vasculopathy r/t neuropathy |
|
VAERS ID: |
115707 (history) |
Form: |
Version 1.0 |
Age: |
49.0 |
Sex: |
Female |
Location: |
Vermont |
Vaccinated: | 0000-00-00 |
Onset: | 1988-10-27 |
Submitted: |
1998-10-23 |
Days after onset: | 3648 |
Entered: |
1998-11-04 |
Days after submission: | 12 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Anorexia,
Asthenia,
Facial palsy,
Guillain-Barre syndrome,
Hyperhidrosis,
Hypokinesia,
Myasthenic syndrome,
Pain,
Paraesthesia,
Speech disorder SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Hearing impairment (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)
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? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: pt recv vax & exp sweat, numbness in feet & hands;pt then put in hosp;GBS 3 days later in ICU;had bell''s palsy;had to learn to talk, eat, walk again;pt states was in perfect health a/shot; |
|
VAERS ID: |
115907 (history) |
Form: |
Version 1.0 |
Age: |
70.0 |
Sex: |
Male |
Location: |
Florida |
Vaccinated: | 1996-10-15 |
Onset: | 1996-12-20 |
Days after vaccination: | 66 |
Submitted: |
1998-11-03 |
Days after onset: | 683 |
Entered: |
1998-11-06 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Deafness permanent,
Ear disorder,
Infection SMQs:, Hearing impairment (narrow)
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: CDC Split Type: U199800755
Write-up: pt recv vax 15OCT96 & 20DEC96 pt noticed a decrease in hearing;24DEC96 pt was seen by MD & informed that there was a 95% decrease in hearing in the right ear & 20% decrease in hearing in the lt ear;poss of an inner ear infect;mild stuffines |
|
VAERS ID: |
116057 (history) |
Form: |
Version 1.0 |
Age: |
49.0 |
Sex: |
Male |
Location: |
Georgia |
Vaccinated: | 1995-11-03 |
Onset: | 1995-11-07 |
Days after vaccination: | 4 |
Submitted: |
1998-10-09 |
Days after onset: | 1066 |
Entered: |
1998-11-09 |
Days after submission: | 31 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH |
4958107 / UNK |
RA / IM |
Administered by: Public Purchased by: Public Symptoms: Guillain-Barre syndrome,
Paraesthesia SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)
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? Yes, 10 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: emphysema Preexisting Conditions: emphysema Allergies: Diagnostic Lab Data: CDC Split Type: GA98079
Write-up: pt recv vax 3NOV95 & reports devel GBS;pt hosp for numbness in fingers & toes;referred to MD; |
|
VAERS ID: |
116528 (history) |
Form: |
Version 1.0 |
Age: |
2.0 |
Sex: |
Female |
Location: |
Massachusetts |
Vaccinated: | 1998-11-04 |
Onset: | 1998-11-05 |
Days after vaccination: | 1 |
Submitted: |
1998-11-16 |
Days after onset: | 11 |
Entered: |
1998-11-19 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES |
- / UNK |
- / - |
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. |
1541E / 1 |
- / - |
Administered by: Other Purchased by: Other Symptoms: Gait disturbance,
Hypokinesia,
Injection site hypersensitivity,
Injection site mass,
Injection site pain,
Pyrexia,
Vasodilatation SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data;~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: unk Allergies: Diagnostic Lab Data: CDC Split Type: WAES98110829
Write-up: pt recv vax 4NOV98 & 5NOV98 pt exp erythema, warmth, & tenderness @ the inj site, & fever of 102;inj site rxn wax 8x9cm in diameter & was quite hard;Md visit required;given md;walked w/limp d/t inj site rxn;somewhat disabled; |
|
VAERS ID: |
116626 (history) |
Form: |
Version 1.0 |
Age: |
14.0 |
Sex: |
Male |
Location: |
Pennsylvania |
Vaccinated: | 1998-10-21 |
Onset: | 1998-10-22 |
Days after vaccination: | 1 |
Submitted: |
1998-11-18 |
Days after onset: | 27 |
Entered: |
1998-11-23 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES |
- / UNK |
LA / IM |
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. |
1542E / 1 |
RA / IM |
Administered by: Private Purchased by: Private Symptoms: Face oedema,
Injection site hypersensitivity,
Injection site oedema,
Oedema peripheral,
Pain,
Pyrexia,
Vasodilatation,
Vomiting SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: ceclor allergy Allergies: Diagnostic Lab Data: CDC Split Type: WAES98102115
Write-up: pt recv vax 21OCT98 & 22OCT98 pt exp fever & vomiting;23OCT98 pt exp facial & arm swelling & redness;24OCT98 facial swelling & fever had decreased however arm was still red & swollen w/3" inches of erythema & swelling; |
|
VAERS ID: |
116977 (history) |
Form: |
Version 1.0 |
Age: |
61.0 |
Sex: |
Male |
Location: |
California |
Vaccinated: | 1997-10-28 |
Onset: | 1997-11-05 |
Days after vaccination: | 8 |
Submitted: |
1998-11-18 |
Days after onset: | 378 |
Entered: |
1998-12-01 |
Days after submission: | 13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES |
7F81883 / UNK |
- / - |
Administered by: Private Purchased by: Other Symptoms: Asthenia,
Guillain-Barre syndrome,
Neuritis,
Paralysis,
Respiratory disorder SMQs:, Peripheral neuropathy (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Respiratory failure (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 175 days
Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient Other Medications: NONE Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Guillain-Barre nerve synd;acute idiopathic polyneuritis;had weakness, put on respirator;legs & arms paralyzed;pt hosp 15NOV97; |
|
VAERS ID: |
117063 (history) |
Form: |
Version 1.0 |
Age: |
46.0 |
Sex: |
Female |
Location: |
Pennsylvania |
Vaccinated: | 1998-10-26 |
Onset: | 1998-10-26 |
Days after vaccination: | 0 |
Submitted: |
1998-11-24 |
Days after onset: | 29 |
Entered: |
1998-12-04 |
Days after submission: | 10 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKDALE PHARMACEUTICALS |
02888P / 1 |
- / IM |
Administered by: Private Purchased by: Other Symptoms: Deafness,
Dizziness,
Myalgia,
Nausea,
Pain,
Vasodilatation SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Vestibular disorders (broad), Tendinopathies and ligament 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: NONE Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: MRI brain, multiple hearing test;CBC/diff CH2/sed rate, thyroid panel, RPR/ANA;FTA-ABS CDC Split Type: FLU90181198
Write-up: pt recv vax 26OCT98 & same day PM around 8PM had flushed, aching from mid chest up to head;noticed spontaneous hearing loss in lt ear & became dizzy & nauseated; |
|
VAERS ID: |
117188 (history) |
Form: |
Version 1.0 |
Age: |
67.0 |
Sex: |
Female |
Location: |
Virginia |
Vaccinated: | 1998-10-06 |
Onset: | 1998-10-07 |
Days after vaccination: | 1 |
Submitted: |
1998-12-03 |
Days after onset: | 57 |
Entered: |
1998-12-08 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES |
- / UNK |
- / IM |
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. |
0871H / 1 |
- / IM |
Administered by: Other Purchased by: Private Symptoms: Bursitis,
Hypertonia,
Hypokinesia,
Injury,
Myalgia SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypokalaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: unk Allergies: Diagnostic Lab Data: OCT98 diagnostic radiology-no visible damage; CDC Split Type: WAES98101008
Write-up: pt recv vax 6OCT98 & pt raked leaves & next morning pt woke w/extreme muscle soreness & stiffness;pt was unable to lift lt arm or use it;rt arm was not affected;bursitis vs trauma; |
|