|
VAERS ID: |
26390 (history) |
Form: |
Version 1.0 |
Age: |
40.0 |
Sex: |
Female |
Location: |
California |
Vaccinated: | 1990-05-25 |
Onset: | 1990-05-25 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
591A4 / UNK |
LA / IM |
Administered by: Unknown 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? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Hx of rash /w Immune Globulin Allergies: Diagnostic Lab Data: CDC Split Type: EBU900227
Write-up: Pt noticed rash on upper chest, back, arms @ 9:30pm on day of vax. /W in 1 wk rash cleared |
|
VAERS ID: |
26391 (history) |
Form: |
Version 1.0 |
Age: |
33.0 |
Sex: |
Female |
Location: |
California |
Vaccinated: | 1990-05-25 |
Onset: | 1990-05-26 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
591A4 / UNK |
LA / IM |
Administered by: Unknown 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? Yes 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: EBU900228
Write-up: 24 hrs /p vax pt noticed rash on her upper chest, back arms. Rash resolved /p treatment /w antihistamines and topical hydrocortisone lotion |
|
VAERS ID: |
26392 (history) |
Form: |
Version 1.0 |
Age: |
23.0 |
Sex: |
Female |
Location: |
California |
Vaccinated: | 1990-06-07 |
Onset: | 1990-06-07 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
591A4 / UNK |
RA / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Asthenia,
Dizziness,
Pain,
Somnolence SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypoglycaemia (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: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBU900229
Write-up: A few seconds /p vax pt felt shooting pain down rt arm. 15 min /p inject felt general weakness, lightheadedness, weakness in rt arm & felt spacy. /p treament /w Tylenol & ice pack was 90% improved by the next day. |
|
VAERS ID: |
26393 (history) |
Form: |
Version 1.0 |
Age: |
33.0 |
Sex: |
Female |
Location: |
California |
Vaccinated: | 1990-06-01 |
Onset: | 1990-06-01 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
591A4 / UNK |
LA / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Dizziness SMQs:, Anticholinergic syndrome (broad), 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: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBU900230
Write-up: Pt received vax 1st dose @ 8:00pm that day called Urgent care because pt experiencing lightheadness & dizziness |
|
VAERS ID: |
26394 (history) |
Form: |
Version 1.0 |
Age: |
74.0 |
Sex: |
Male |
Location: |
Washington |
Vaccinated: | 1990-05-24 |
Onset: | 1990-06-06 |
Days after vaccination: | 13 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
597A4 / UNK |
- / IM A |
Administered by: Unknown Purchased by: Unknown Symptoms: Hepatic function abnormal SMQs:, Liver related investigations, signs and symptoms (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: Hypertesion, Hemodiaysis pt dialyzed 3X per wk in dialysis unit Allergies: Diagnostic Lab Data: Lab results form 6Jun90 showed increased liver enzymes (tests on 3May90 were normal) Liver enzumes LDH-76 & 245 on 3May90 & 6Jun90 respectively; SGOT- 11 & 277 resepectively, SGPT- 13 & 753 respectively CDC Split Type: EBU900231
Write-up: Pt received vax & it was noted that no mannitol or albumin had been adm. Currently pt is not ill |
|
VAERS ID: |
26395 (history) |
Form: |
Version 1.0 |
Age: |
43.0 |
Sex: |
Female |
Location: |
Iowa |
Vaccinated: | 1990-05-25 |
Onset: | 1990-05-26 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
587A4 / UNK |
LA / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Abdominal pain,
Diarrhoea,
Face oedema,
Nausea,
Pyrexia,
Rash,
Urticaria SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (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: EBU900232
Write-up: /P vax pt had T 101, as of 11Jun90 diarrhea X 2 wks, body rash & swollen ears & eyes, /w stomach cramps |
|
VAERS ID: |
26409 (history) |
Form: |
Version 1.0 |
Age: |
24.0 |
Sex: |
Female |
Location: |
Maryland |
Vaccinated: | 1990-06-06 |
Onset: | 1990-06-06 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
591A4 / UNK |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Chills,
Dysgeusia,
Hyperhidrosis,
Pain,
Paraesthesia,
Rash,
Thirst,
Vasodilatation SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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: Gets diarrhea when eats yogurt. Allergies: Diagnostic Lab Data: CDC Split Type: EBU900233
Write-up: Pt vaccinated w/Engerix-B developed feeling funny, inject site tender, chest pain, rt arm pain, rash at site of inject, sweating, medicine taste in mouth, excessive thirst, acute rx to vax, rt art leg tingling, felt cold, felt hot, chills. |
|
VAERS ID: |
26410 (history) |
Form: |
Version 1.0 |
Age: |
33.0 |
Sex: |
Female |
Location: |
Texas |
Vaccinated: | 1990-06-06 |
Onset: | 1990-06-07 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
587A4 / UNK |
RA / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Back pain,
Lymphadenopathy,
Myalgia SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), 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? 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: EBU900234
Write-up: Pt received vax /w Engerix B , next day had onset of back pain, lt side, lymph nodes lt neck tender/enlarged, pulled muscle. |
|
VAERS ID: |
26411 (history) |
Form: |
Version 1.0 |
Age: |
19.0 |
Sex: |
Female |
Location: |
Kansas |
Vaccinated: | 1990-05-31 |
Onset: | 1990-06-05 |
Days after vaccination: | 5 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
591A4 / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Unevaluable event SMQs:
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: Catapres, vitamins Current Illness: Preexisting Conditions: renal failure, hemodialysis patient Allergies: Diagnostic Lab Data: test for Hepatitis b surface antigen- slightyly positive CDC Split Type: EBU900235
Write-up: tested slightly postive for Hepatitis B antigen /p receiving Engerix B vax |
|
VAERS ID: |
26412 (history) |
Form: |
Version 1.0 |
Age: |
20.0 |
Sex: |
Male |
Location: |
New Jersey |
Vaccinated: | 1990-06-13 |
Onset: | 1990-06-13 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-10-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
587A4 / UNK |
LA / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Oedema SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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: hurt back lifting Preexisting Conditions: hay fever, stomach ulcers, Allergies: Diagnostic Lab Data: CDC Split Type: EBU900236
Write-up: 5 hrs post vax thumb & middle finger became swollen lt hand, Seen in ER, Dr in hosp indicated the nerve was probably injured therefore swelling occurred |
|