National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

Found 8,467 cases where Patient Died

Case Details

This is page 49 out of 85

Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85   next


VAERS ID: 50849 (history)  
Form: Version 1.0  
Age: 74.0  
Sex: Male  
Location: Foreign  
Vaccinated:1993-02-05
Onset:1993-02-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1027V / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Drug ineffective, Infection, Pneumonia, Sepsis
SMQs:, Lack of efficacy/effect (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-02-10
   Days after onset: 0
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: UNK
Current Illness:
Preexisting Conditions: resp disorder
Allergies:
Diagnostic Lab Data: Blood culture pos streptococcal pneumonia;
CDC Split Type: WAES93027902

Write-up: pt recvd vax on 5FEB93 & was taken to hosp w/bronchopneumonia & died on 10FEB93; pt had pos hemocultures for streptococcal pneumonia;


VAERS ID: 50850 (history)  
Form: Version 1.0  
Age: 97.0  
Sex: Female  
Location: Foreign  
Vaccinated:1993-02-03
Onset:1993-02-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1027V / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-02-03
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: resp disorder
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES93027903

Write-up: pt recvd vax on 3FEB93 @ 10AM & died same day; death was not unexpected, as expressed by MD:


VAERS ID: 50851 (history)  
Form: Version 1.0  
Age: 94.0  
Sex: Female  
Location: Foreign  
Vaccinated:1993-02-04
Onset:1993-02-08
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 1993-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1027V / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Delirium, Pneumonia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-02-09
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: resp problems;
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES93027904

Write-up: pt recvd vax 4FEB93 & devel pneumonia on 8FEB93 & a cerebral event; No details if pt was hospitalized or not; pt died on 9FEB93; COD probably due to a cerebral event & pneumonia;


VAERS ID: 51238 (history)  
Form: Version 1.0  
Age: 1.4  
Sex: Male  
Location: Foreign  
Vaccinated:1992-05-19
Onset:1992-05-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 1993-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 46882 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hypotension, Infection, Meningitis, Muscle twitching, Mydriasis, Respiratory disorder, Sepsis, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (broad), Noninfectious meningitis (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? Yes
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: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES92125124

Write-up: Pt recvd vax MAY92 & on 22MAY92 pt temp rose to 104 & vomited 4 times in 3 hrs; hydrated & chest clear; pt admited to hosp where died of meningococcal meningitis;


VAERS ID: 51681 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Male  
Location: Foreign  
Vaccinated:1993-02-04
Onset:1993-03-02
   Days after vaccination:26
Submitted: 1993-03-15
   Days after onset:13
Entered: 1993-04-08
   Days after submission:23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / 3 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Encephalitis, Infection
SMQs:, Noninfectious encephalitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-03-03
   Days after onset: 1
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: NA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NA
CDC Split Type: 930069101

Write-up: clinical trial report of pt who died 1 mo following 3rd vax; vax were on 6NOV92, 18DEC92 & 4FEB93; hospitalized 2MAR93 w/encephalitis, MRI done, dx as suspected herpes infection, died 3MAR93; autopsy results pending;


VAERS ID: 51682 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
Vaccinated:1993-02-03
Onset:1993-03-07
   Days after vaccination:32
Submitted: 1993-03-19
   Days after onset:12
Entered: 1993-04-08
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 2 - / -

Administered by: Other       Purchased by: Other
Symptoms: Brain oedema, CSF test abnormal, Cerebral infarction, Drug ineffective, Hernia, Infection, Meningitis, Vascular occlusion
SMQs:, Lack of efficacy/effect (narrow), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-03-14
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NA
CDC Split Type: 930069201

Write-up: pt vaxed 23NOV92 & 3FEB93 who was hospitalized 7MAR93 w/bacterial meningitis; devel 2 large cerebral infarctions & died on 14MAR93; H. Influenzae type B was isolated from CSF; autopsy results & Anti-PRP titer pending;


VAERS ID: 54906 (history)  
Form: Version 1.0  
Age: 1.6  
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1993-07-26
Entered: 1993-07-29
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / 2 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Drug ineffective, Infection, Sepsis
SMQs:, Lack of efficacy/effect (narrow), Sepsis (narrow), Opportunistic infections (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO4899

Write-up: died from HIB b sepsis; only other info is atypical progress of BCG vax; No further details available or expected;


VAERS ID: 55618 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:1993-07-27
Onset:1993-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1993-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / UNK - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Brain oedema, Injection site haemorrhage, Injection site inflammation, Petechiae, Pulmonary oedema, Sudden infant death syndrome
SMQs:, Cardiac failure (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-07-28
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Panadol
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES93088202

Write-up: pt recvd vax 27JUL93 & 28JUL93 pt died; COD was SIDS;


VAERS ID: 57347 (history)  
Form: Version 1.0  
Age: 69.0  
Sex: Female  
Location: Foreign  
Vaccinated:1993-10-07
Onset:1993-10-10
   Days after vaccination:3
Submitted: 1993-10-21
   Days after onset:11
Entered: 1993-11-15
   Days after submission:25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / PFIZER/WYETH E3232DA / UNK - / IM

Administered by: Public       Purchased by: Other
Symptoms: Endocarditis, Infection, Sepsis
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-10-16
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NA
Current Illness: unk
Preexisting Conditions: Hx of angina & hypertension;
Allergies:
Diagnostic Lab Data: NA
CDC Split Type: 930222401

Write-up: pt devel septicemia following vax;


VAERS ID: 57504 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:1993-09-14
Onset:1993-09-24
   Days after vaccination:10
Submitted: 1993-10-25
   Days after onset:31
Entered: 1993-11-19
   Days after submission:25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / UNK - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Cardiac failure, Endocrine disorder, Pneumonia, Pulmonary haemorrhage, Pulmonary oedema, Respiratory disorder, Sudden infant death syndrome
SMQs:, Cardiac failure (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Acute central respiratory depression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Neonatal disorders (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-09-24
   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: NA
Current Illness: info not provided;
Preexisting Conditions: info not provided;
Allergies:
Diagnostic Lab Data: NA
CDC Split Type: 930234401

Write-up: pt recvd vax & 10 days p/vax reported as SIDs, autopsy report is pending;


VAERS ID: 58230 (history)  
Form: Version 1.0  
Age: 82.0  
Sex: Male  
Location: Foreign  
Vaccinated:1993-10-18
Onset:1993-10-20
   Days after vaccination:2
Submitted: 1993-10-27
   Days after onset:7
Entered: 1993-12-14
   Days after submission:48
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / PFIZER/WYETH - / UNK - / IM

Administered by: Public       Purchased by: Public
Symptoms: Coronary artery thrombosis
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-10-20
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt had recvd fluvirin in prev years w/no problems;~ ()~~~In patient
Other Medications: Spironolactone/Prostap/Maxolon; Temazepam/frusemide/ASA
Current Illness: carcinoma of prostate, diabetes;
Preexisting Conditions: carcinoma of prostate, diabetes, congestive cardiac failure, asthma;
Allergies:
Diagnostic Lab Data: autopsy results: coronary Thrombosis was COD;
CDC Split Type: 930230001

Write-up: 1 of 2 cancer pts who had been vaxed w/flu vax & recently died; pt vaxed 18OCT & died 20OCT; autopsy result indicated coronary thrombosis was COD;


VAERS ID: 58231 (history)  
Form: Version 1.0  
Age: 80.0  
Sex: Female  
Location: Foreign  
Vaccinated:1993-10-20
Onset:1993-10-23
   Days after vaccination:3
Submitted: 1993-10-27
   Days after onset:4
Entered: 1993-12-14
   Days after submission:48
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / PFIZER/WYETH - / UNK - / IM

Administered by: Public       Purchased by: Public
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-10-23
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt had recvd fluvirin in previous years w/no problem;~ ()~~~In patient
Other Medications: Tamoxifen, Paracetamol PRN;
Current Illness: Carcinoma breast, angina;
Preexisting Conditions: carcinoma breast, angina;
Allergies:
Diagnostic Lab Data: Autopsy results: acute myocardial infarction was COD:
CDC Split Type: 930230002

Write-up: pt vaxed 20OCT93 & died 23OCT: autopsy results indicate that acute myocardial infarction was COD;


VAERS ID: 58302 (history)  
Form: Version 1.0  
Age: 84.0  
Sex: Female  
Location: Foreign  
Vaccinated:1993-11-08
Onset:1993-11-12
   Days after vaccination:4
Submitted: 1993-11-23
   Days after onset:11
Entered: 1993-12-20
   Days after submission:27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / PFIZER/WYETH - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Bronchitis, Condition aggravated
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-11-12
   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: Amoxycillin
Current Illness: Bronchopneumonia
Preexisting Conditions: senile dementia MFR Senile Dementia;
Allergies:
Diagnostic Lab Data: autopsy: acute purulent bronchitis/bronchopnemonia;
CDC Split Type: 930248901

Write-up: pt vaxed 8NOV93 & died 4 days later 12NOV93; autopsy; acute purulent bronchitis/bronchopneumonia;


VAERS ID: 60831 (history)  
Form: Version 1.0  
Age: 3.0  
Sex: Male  
Location: Foreign  
Vaccinated:1993-09-22
Onset:1993-12-02
   Days after vaccination:71
Submitted: 1993-12-02
   Days after onset:0
Entered: 1994-03-21
   Days after submission:109
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH L0144B1 / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Cardiac arrest, Dyspnoea, Pharyngitis, Pseudo lymphoma
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Agranulocytosis (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-12-02
   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: NA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy reported requested;
CDC Split Type: 940030301

Write-up: Pt recvd severe tonsillitis; referred for ENT opinion; Tonsillectomy performed but pt devel resp distress; CSR showed mediastinal mass; pt had cardiac arrest-died 2DEC93; dx as having had a T-cell lymphoma;


VAERS ID: 61040 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1994-02-22
Entered: 1994-03-28
   Days after submission:34
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 3 - / -

Administered by: Private       Purchased by: Private
Symptoms: CSF test abnormal, Drug ineffective, Infection, Meningitis
SMQs:, Lack of efficacy/effect (narrow), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NA
Current Illness:
Preexisting Conditions: MFR COM: Reporting physician is attemping to identify HIBTITER Lot Numbers;
Allergies:
Diagnostic Lab Data: LP: CSF pos for TYpe B; An attempt to perform antibody titers on serum samples & typing on CSF isolate in U.S. is being made by MD;
CDC Split Type: 940037601

Write-up: Pt recvd vax & devel HIB meningitis @ 15 mos; LP pos for type B; pt recvd 3 doses of HBOC @ 2, 4, & 6 months of age; pt subsequently died in 1994; dates of immun & death not reported;


VAERS ID: 61105 (history)  
Form: Version 1.0  
Age: 67.0  
Sex: Male  
Location: Foreign  
Vaccinated:1993-10-13
Onset:1993-10-25
   Days after vaccination:12
Submitted: 1994-03-16
   Days after onset:142
Entered: 1994-03-30
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / PFIZER/WYETH E3232CC1 / UNK - / -

Administered by: Private       Purchased by: Other
Symptoms: Arteritis, Dyspnoea, Guillain-Barre syndrome, Paralysis, Renal failure acute, Vasculitis, Visual disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vasculitis (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-12-11
   Days after onset: 47
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 31 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Inhaler for asthma
Current Illness: hx of asthma since 1958
Preexisting Conditions: hx of asthma since 1958
Allergies:
Diagnostic Lab Data: autopsy recorded acute renal failure, hypersensitivity angitis (microscopic polyarteritis) & influenza vax as COD;
CDC Split Type: 940053901

Write-up: pt vaxed 13OCT93-25OCT vision impaired, paralysis in hands then limbs; hospitalized 11NOV; dx GBS; hospital transfer-had breathing difficulty & acute renal failure died 11DEC93; autopsy dx acute renal failure, hypersensitivity angitis flu


VAERS ID: 61523 (history)  
Form: Version 1.0  
Age: 9.0  
Sex: Female  
Location: Foreign  
Vaccinated:1993-08-24
Onset:1993-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1994-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 - / -
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Lioresal, Lamictal, Trileptal;
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 940021301

Write-up: 25AUG93 1 day p/vax pt exp sudden death; The reporter stated that event was possibly related to the vax; No further will be available;


VAERS ID: 62484 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Foreign  
Vaccinated:1994-04-07
Onset:1994-04-15
   Days after vaccination:8
Submitted: 1994-05-06
   Days after onset:21
Entered: 1994-05-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1582W / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anorexia, Infection, Lung disorder, Lymphadenopathy, Malaise, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: no relevant history;
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES94045034

Write-up: Pt recvd vax 7APR94 & 15APR94 the pt died suddenly; An autopsy is to be carried out to determine COD; Addtl info has been requested;


VAERS ID: 63851 (history)  
Form: Version 1.0  
Age: 6.0  
Sex: Female  
Location: Foreign  
Vaccinated:1994-05-23
Onset:1994-05-23
   Days after vaccination:0
Submitted: 1994-06-22
   Days after onset:30
Entered: 1994-06-27
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
JEV: JAPANESE ENCEPHALITIS (J-VAX) / CONNAUGHT LABORATORIES 3008EJN014 / UNK - / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Coma, Paralysis, Pulmonary haemorrhage, Pyrexia, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1994-05-27
   Days after onset: 4
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: CO5442

Write-up: fell into a faint 5 mins p/vax w/high fever, paralysis, vomiting & unconsciousness;26MAY94 cerebral & pulmonary hemmorrhage by CT scanning;


VAERS ID: 63852 (history)  
Form: Version 1.0  
Age: 6.0  
Sex: Male  
Location: Foreign  
Vaccinated:1994-05-23
Onset:1994-05-23
   Days after vaccination:0
Submitted: 1994-06-22
   Days after onset:30
Entered: 1994-06-27
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
JEV: JAPANESE ENCEPHALITIS (J-VAX) / CONNAUGHT LABORATORIES 3008EJN014 / UNK - / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Coma, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1994-05-30
   Days after onset: 7
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: NONE
CDC Split Type: CO5443

Write-up: fell into a faint 5 mins p/vax w/high fever & unconsciousness;


VAERS ID: 64421 (history)  
Form: Version 1.0  
Age: 1.9  
Sex: Male  
Location: Foreign  
Vaccinated:1994-06-06
Onset:1994-06-09
   Days after vaccination:3
Submitted: 1994-06-27
   Days after onset:18
Entered: 1994-07-05
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Myocarditis, Pharyngitis, Rhinitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1994-06-10
   Days after onset: 1
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: 10JUN94: Lumbar puncture nl, blood cx nl;
CDC Split Type: WAES94067509

Write-up: 09JUN94 pt expd rhino-pharyngitis & was rx''d w/sulphamethoxazole trimethoprim & cetrizine; 10JUN94 pt died; 11JUN94 an autopsy was performed & fulminant myocarditis was found;


VAERS ID: 64581 (history)  
Form: Version 1.0  
Age: 20.0  
Sex: Female  
Location: Foreign  
Vaccinated:1993-11-02
Onset:1993-12-24
   Days after vaccination:52
Submitted: 1994-07-07
   Days after onset:194
Entered: 1994-07-11
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 947A4 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Brain oedema, Confusional state, Convulsion, Encephalitis, Headache, Hypersensitivity, Necrosis
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-12-31
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: in pt: listless, vomit, h/a, fever, unwell p/1st dose hep b given 20SEP93;~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 940059271

Write-up: pt recvd vax & devel severe vomiting & felt unwell; pt went to ER; pt''s mom all tests performed in hosp were neg; 25DEC93 transferred to hosp dx encephalitis (probably viral) was made; 30DEC93 neruro stated illness was allerg react;


VAERS ID: 65895 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Unknown  
Location: Foreign  
Vaccinated:1994-01-24
Onset:1994-07-19
   Days after vaccination:176
Submitted: 1994-07-22
   Days after onset:3
Entered: 1994-08-15
   Days after submission:24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH 35087A / 2 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Drug ineffective, Infection, Malaise, Meningitis, Shock, Somnolence
SMQs:, Anaphylactic reaction (narrow), Lack of efficacy/effect (narrow), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1994-07-21
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: Amoxil
Current Illness:
Preexisting Conditions: MFR COM: the victoria dept of hlth views this as a vax failure; This is considered a full immun sereis based on pt''s age in the reporting country of orgin
Allergies:
Diagnostic Lab Data: H. influenzae B confirmed by BC; serum from pt is being examined to determine if the pt had any immunity problems such as inability to produce antibodies to diphtheriae-results pending;
CDC Split Type: 940163401

Write-up: pt recvd vax 24JAN94 & 19JUL94 became ill 2AM-MD visit 10AM; given Amoxil; seen again 6PM, lethargic; 9PM pt collapsed @ home pronounced brain dead @ 10PM; HIB meningitis confirmed by BC; pt died 21JUL94;


VAERS ID: 66508 (history)  
Form: Version 1.0  
Age: 28.0  
Sex: Male  
Location: Foreign  
Vaccinated:1989-11-01
Onset:1990-12-01
   Days after vaccination:395
Submitted: 0000-00-00
Entered: 1994-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Brain oedema, CSF test abnormal, Coma, Drug ineffective, Immune system disorder, Infection, Meningitis, Thinking abnormal
SMQs:, Lack of efficacy/effect (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: ~ ()~~~In patient
Other Medications: Pentamidine aerosol
Current Illness:
Preexisting Conditions: hepatitis B; Thrombocytopenia; Nosebleed; HIV pos; CD4 count dec; drug abuse;
Allergies:
Diagnostic Lab Data: 1987 platelet count 9x 10 9/L; 1988 platelet count 70 x 10 9/L; NOV89 CD4 count 151 cell/MM3; IgG 21; IGA 5.2; IgM 2.5; Beta 2 microglobulin 6.5; DEC90 Autopsy swollen brain & purulent meningitis; Culture- streptococcuspneumovax type 3;
CDC Split Type: WAES94085056

Write-up: pt recvd vax NOV89 & DEC90 pt started to feel generally unwell; devel sx of earache, pt drowsy & incoherent; pt taken to hosp & was deeply comatosed on arrival; drug overdose suspected & resuscitation performed pt died;


VAERS ID: 67195 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Foreign  
Vaccinated:1994-08-11
Onset:1994-08-11
   Days after vaccination:0
Submitted: 1994-10-03
   Days after onset:53
Entered: 1994-10-11
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / IM A

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthma, Dyspnoea, Sudden infant death syndrome
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Neonatal disorders (narrow), Hypersensitivity (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none;
Current Illness: none;
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none;
CDC Split Type: WAES94090729

Write-up: pt recvd vax & in the eve exp 1 episode of wheezing; dx as respiratory distress; pt found dead at 3am morning of 12aug94; cause of death determined to be sids;


VAERS ID: 70595 (history)  
Form: Version 1.0  
Age: 1.2  
Sex: Male  
Location: Foreign  
Vaccinated:1994-10-25
Onset:1994-11-05
   Days after vaccination:11
Submitted: 1995-01-10
   Days after onset:66
Entered: 1995-01-17
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Adrenal haemorrhage, Adrenal insufficiency, Dyspnoea, Infection, Petechiae, Sepsis, Shock, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1994-11-06
   Days after onset: 1
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: no relevant hx
Allergies:
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES94120828

Write-up: pt recvd vax;5nov94 suddenly devel fever 39.8C,tachycardia,v,petechial hemorrhages;pt adm to hosp;on 6nov94 died;COD was septic multiorgan failure;there was a suspiscion of meningococcal toxemia w/ picture of Waterhouse-Friedr synd;


VAERS ID: 71295 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Unknown  
Location: Foreign  
Vaccinated:1994-11-10
Onset:1994-11-12
   Days after vaccination:2
Submitted: 1995-02-02
   Days after onset:82
Entered: 1995-02-06
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO5800

Write-up: pt recvd vax; SIDS; autopsy consistent w/ SIDS; no oth info expected;


VAERS ID: 71297 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Unknown  
Location: Foreign  
Vaccinated:1994-11-03
Onset:1994-11-04
   Days after vaccination:1
Submitted: 1995-02-02
   Days after onset:90
Entered: 1995-02-06
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1994-11-04
   Days after onset: 0
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: CO5802

Write-up: pt recvd vax; SIDS occuring day following 2nd inject;no addtl info expected


VAERS ID: 71497 (history)  
Form: Version 1.0  
Age: 89.0  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1995-02-15
Entered: 1995-02-16
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

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? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC Split Type: EML95038A

Write-up: pt recvd vax; 2 mo afterwards, had a fatal stroke; previously pt had uneventfull flu vax;


VAERS ID: 72139 (history)  
Form: Version 1.0  
Age: 0.7  
Sex: Male  
Location: Foreign  
Vaccinated:1994-05-26
Onset:1994-05-27
   Days after vaccination:1
Submitted: 1995-02-14
   Days after onset:263
Entered: 1995-03-21
   Days after submission:35
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Public       Purchased by: Other
Symptoms: Brain oedema, Cerebral infarction, Cerebral thrombosis, Cerebrovascular accident, Coma, Dehydration, Intracranial pressure increased, Subarachnoid haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1994-05-31
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations: none~ ()~~~In patient
Other Medications: phenobarbitol, valium;
Current Illness:
Preexisting Conditions: hx of sz disorder w/severe developmental delay & glutaric aciduria type 1 before immun;pt had recvd routine immun at 3 mo of age w/ no adverse events
Allergies:
Diagnostic Lab Data: preliminary autopsy revealed R temporal lobe infarction due to sinus thrombosis, dehydration & glutaric acidosis;
CDC Split Type: 950029001

Write-up: pt recvd vax; 27may had fever 42.4C R;had d & v;comatose on 28may;died 31may of R.CVA;autopsy rpt:R. T lob infarct due to transverse sinus thrombosis;dehydration;glutaric acidosis;


VAERS ID: 72359 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1995-03-22
Entered: 1995-03-27
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Unevaluable event
SMQs:

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO5845

Write-up: sudden death following vax (1994); No other details from Danish Committee on ADR, ADR case rpt no 941140;


VAERS ID: 72450 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Foreign  
Vaccinated:1995-02-20
Onset:1995-02-21
   Days after vaccination:1
Submitted: 1995-03-23
   Days after onset:30
Entered: 1995-03-28
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Agitation, Bronchitis, Cough, Infection, Pneumonia, Pyrexia, Sepsis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1995-02-22
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: cough syrup
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: blood test-streptococcus pneumonia;
CDC Split Type: WAES95030780

Write-up: pt recvd vax & had a sl cough & cough medicine was prescribed; On 21FEB95 & exp fever of 38.6 to 38.7; 22FEB95 woke in the morning crying; went to sleep again 1hr later found dead; tracheobronchitis; streptococcus pneumonia, type 10A found


VAERS ID: 74801 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Foreign  
Vaccinated:1993-07-21
Onset:1993-08-05
   Days after vaccination:15
Submitted: 1995-06-08
   Days after onset:672
Entered: 1995-06-13
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Cyanosis, Infection, Meningitis, Pyrexia, Rhinitis, Sepsis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-08-05
   Days after onset: 0
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: unk
Current Illness:
Preexisting Conditions: gastroenteritis
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95051125

Write-up: Pt recv vax 21JUL93 & was vax w/MMR; pt devel meningococcal sepsis on 5AUG93 & was hospitalized; 05AUG93 pt died; The COD was meningococcal septicemia; addtl details are being requested;


VAERS ID: 74952 (history)  
Form: Version 1.0  
Age: 76.0  
Sex: Female  
Location: Foreign  
Vaccinated:1994-10-19
Onset:1994-10-19
   Days after vaccination:0
Submitted: 1995-06-13
   Days after onset:237
Entered: 1995-06-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Cerebral haemorrhage, Paralysis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1994-10-19
   Days after onset: 0
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: Hx of minor cerebral hem 2 yr. prior.
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO5955

Write-up: pt recv vax; devel apoplexia cerebri & died 1 hr later;


VAERS ID: 75898 (history)  
Form: Version 1.0  
Age: 60.0  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1995-06-26
Entered: 1995-07-17
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Drug ineffective, Hepatic failure, Hepatitis, Hypotension, Infection, Pseudo lymphoma
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dexamethasone, Chemotherapy
Current Illness:
Preexisting Conditions: lymphoma/ 1990
Allergies:
Diagnostic Lab Data: HBsAg neg; Hep C antibody neg; HBsAg strongly reactive; Anti-HBc pos; HBe-Ag pos; Hbvdna pos; Anti-HBs neg; Anti-HBc-IgM neg; delta agent neg; hep C test neg;
CDC Split Type: WAES95065060

Write-up: recv HepB series 86,had adequate [conc]antiHBS.1990-tx for lymphoma w/ chemo - AST & ALT rose as dose of med was tapered then pt to Asia; pt presented 5 wk later w/fulminant hepatitis consistent w/reactivation of chronic Hep B;


VAERS ID: 76188 (history)  
Form: Version 1.0  
Age: 0.6  
Sex: Female  
Location: Foreign  
Vaccinated:1995-04-09
Onset:1995-04-11
   Days after vaccination:2
Submitted: 1995-07-25
   Days after onset:105
Entered: 1995-07-28
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Conjunctivitis, Diarrhoea, Epidermal necrosis, Face oedema, Laboratory test abnormal, Pyrexia, Sepsis, Stevens-Johnson syndrome
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1995-04-23
   Days after onset: 12
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: Erythromycin; Mucosolvan; SIlomat
Current Illness:
Preexisting Conditions: asthmatic bronchitis; pt had no known hx of allergies; 1APR95-6APR95 pt usffered fr asthmatic bronchitis & was hospitalized x 3 days tx Erythromycin & Mucosolvan
Allergies:
Diagnostic Lab Data: APR95 glutamic pyruvic serum 110;SGOT 113; Uric acid 38; WBC count 3600; dx toxic epidermal necrolysis
CDC Split Type: 950062481

Write-up: pt recv vax & 2 days later devel fever; 12APR95 pt devel an erythematous macular rash all over the body; seen by MD w/ gen maculopapular rash & high fever (39C); devel bleb-like lesions, high fever, loose stools; hospitalized w/Steven John


VAERS ID: 76377 (history)  
Form: Version 1.0  
Age: 50.0  
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:1994-05-25
Submitted: 1995-07-31
   Days after onset:432
Entered: 1995-08-04
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anorexia, Coma, Dyspnoea, Extrapyramidal disorder, Neuropathy, Pneumonia, Respiratory disorder
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Immune-mediated/autoimmune disorders (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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: mononucleosis
Allergies:
Diagnostic Lab Data:
CDC Split Type: 950065141

Write-up: 25MAY94 3 wk p/vax had an episode of mononucleosis this pt was hospitalized w/dx of Parkinson''s synd; pt transferred to another hosp; dx parkinson was confirmed; extra pyramidal synd, lt cerebellar dyspnea; pt died


VAERS ID: 76575 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Foreign  
Vaccinated:1995-06-27
Onset:1995-07-02
   Days after vaccination:5
Submitted: 1995-08-02
   Days after onset:31
Entered: 1995-08-08
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Coagulopathy, Hepatic cirrhosis
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Haemorrhage laboratory terms (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1995-07-04
   Days after onset: 2
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: cirrhosis, liver; alpha-1 antitrypsin deficiency
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95071678

Write-up: pt recv vax & on 02JUL95 pt hospitalized & died on 04JUL95 disseminated intravascular coagulation;


VAERS ID: 76657 (history)  
Form: Version 1.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:1995-07-01
Submitted: 1995-08-14
   Days after onset:44
Entered: 1995-08-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Gangrene
SMQs:

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 950068901

Write-up: pt recv vax & died some days later from gas gangrene;Md assessed the event as probable unrelated & is awaiting the result of the autopsy;


VAERS ID: 76787 (history)  
Form: Version 1.0  
Age: 1.6  
Sex: Unknown  
Location: Foreign  
Vaccinated:1995-05-10
Onset:1995-06-29
   Days after vaccination:50
Submitted: 1995-08-18
   Days after onset:50
Entered: 1995-08-23
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Encephalitis, Infection, Meningism, Meningitis, Neoplasm, Strabismus, Vomiting
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (narrow), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular motility disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological tumours of unspecified malignancy (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES95080780

Write-up: pt recv vax;on 29jun95 pt exp v;10 days later,pt devel strabismus & meningism;pt was hosp on 8jul95 & subsequently died;COD not provided;30JAN96-f/u indicates Coxsackie-B viral infect caused pt''s encephalitis,dx w/ medullablastoma of men


VAERS ID: 79864 (history)  
Form: Version 1.0  
Age: 69.0  
Sex: Female  
Location: Foreign  
Vaccinated:1995-10-23
Onset:1995-10-24
   Days after vaccination:1
Submitted: 1995-11-23
   Days after onset:30
Entered: 1995-12-05
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E527AC1 / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1995-10-24
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Warfarin, Metformin, Iburpofen, Digoxin, Hypovase, Gilbenclamide
Current Illness: unreported
Preexisting Conditions: unreported
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: REG95474

Write-up: pt recvd vax & had a sudden unexplained death one day p/vax; a post mortem was not carried out;reporter does not think the flu vax contributed to death;


VAERS ID: 80176 (history)  
Form: Version 1.0  
Age: 71.0  
Sex: Female  
Location: Foreign  
Vaccinated:1995-10-12
Onset:1995-10-20
   Days after vaccination:8
Submitted: 1995-12-14
   Days after onset:55
Entered: 1995-12-20
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / 2 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiac failure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: vasotec, frusemide
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES95115097

Write-up: pt recvd vax;on 20oct95 pt collapsed & died;COD was lt ventricular failure;reporting MD did not give causalty statement;


VAERS ID: 80178 (history)  
Form: Version 1.0  
Age: 83.0  
Sex: Female  
Location: Foreign  
Vaccinated:1995-10-16
Onset:0000-00-00
Submitted: 1995-12-14
Entered: 1995-12-20
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / 2 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Coronary artery disease, Malaise, Myocardial ischaemia, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Other ischaemic heart disease (narrow)

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: nitrazepam; Bumetanide/KCL;
Current Illness:
Preexisting Conditions: myocardial ischaemia; insomnia;edema;malignant lymphoma;carcinoma,squamous cell;
Allergies:
Diagnostic Lab Data: autopsy on oct95, signs of coronary thrombosis & evidence of myocardial ischemia;
CDC Split Type: WAES95115073

Write-up: pt recvd vax;pt became very ill 1 day p/ vax;vomited dark brown fluid;found dead 23oct95;post mortem showed signs of coronary thrombosis 2-3 days prior to death;evidence of myocardial ischemia;probable COD was coronary artery disease;


VAERS ID: 80958 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
Vaccinated:1995-12-11
Onset:1995-12-12
   Days after vaccination:1
Submitted: 1996-01-15
   Days after onset:34
Entered: 1996-01-19
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES L0077 / 1 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Sudden infant death syndrome, Unevaluable event
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1995-12-12
   Days after onset: 0
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: CO6428

Write-up: found dead by mom in the morning the day p/vax, lying on the back, & lightly clothed; post mortem carried out on 14DEC95-nil found;


VAERS ID: 83441 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
Vaccinated:1995-10-19
Onset:1995-10-20
   Days after vaccination:1
Submitted: 1996-01-29
   Days after onset:101
Entered: 1996-02-01
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER 90569 / UNK - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 90175 / UNK - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER 525100 / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Sudden infant death syndrome, Unevaluable event
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1995-10-20
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: nka;med hx unk
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO6451

Write-up: SIDS-Found dead in the abd position in bed am p/vax;no other relevant hx;mom noticed nothing unusual prior to event


VAERS ID: 83442 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:1995-09-13
Onset:1995-09-14
   Days after vaccination:1
Submitted: 1996-01-29
   Days after onset:137
Entered: 1996-02-01
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 6022P2 / UNK - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1995-09-14
   Days after onset: 0
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: CO6452

Write-up: SIDS, found dead in the evening of 14Sep95, approx 28 hrs /p immunization. No further info such as autopsy report is available yet.


VAERS ID: 83443 (history)  
Form: Version 1.0  
Age: 7.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1996-01-26
Entered: 1996-02-01
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (IMOVAX) / PASTEUR MERIEUX INST. - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Agitation, Drug ineffective, Infection, Pyrexia
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (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: ~ ()~~~In patient
Other Medications: given rabies immune globulin
Current Illness: bite to rt eyelid
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PE at ER alert & cooperative
CDC Split Type: CO6450

Write-up: pt sleeping in tent,attacked by rabid desert fox,bite on rt eyelid,to ER 48 hrs later;exam pt alert&cooperative;tx /w RIG & HDCV;2wk later to hosp D/T irritability,T;admitted dx rabies;died 48 hrs later despite extensive medical tx.


VAERS ID: 82015 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Male  
Location: Foreign  
Vaccinated:1995-12-12
Onset:1995-12-13
   Days after vaccination:1
Submitted: 1996-01-17
   Days after onset:35
Entered: 1996-02-07
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH 0001 / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1995-12-13
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy-sudden infant death synd
CDC Split Type: 896017021L

Write-up: pt recvd vax 12DEC95 & the next day the pt died;autopsy dx sudden infant death synd;the report of this adverse event was recvd for Wyeth-Lederle UK who received it from CSN AEPPS


VAERS ID: 83029 (history)  
Form: Version 1.0  
Age: 87.0  
Sex: Male  
Location: Foreign  
Vaccinated:1995-10-31
Onset:0000-00-00
Submitted: 1996-02-20
Entered: 1996-02-26
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Anaemia, Asthenia, Haemorrhage, Pulmonary oedema, Renal interstitial fibrosis, Skin disorder, Urinary tract disorder
SMQs:, Cardiac failure (narrow), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (narrow), Tubulointerstitial diseases (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: angina pectoris
Allergies:
Diagnostic Lab Data: autopsy: bone marrow exam-nl;lt kidney & lt bowel haematoma;pulmonary edema;polycystic renal disease (chronic nephritis intersitial);
CDC Split Type: CO6462

Write-up: pt recvd vax & w/in 13 days exp asthenia & numerous cutaneous hematomas;hospitalized on 13NOV95;anemia dx,haemoglobin=5G/dL;antibody anti-factor VIII positive?no recent transfusion;died on 24NOV95 acute pulmonary edema;


VAERS ID: 83031 (history)  
Form: Version 1.0  
Age: 60.0  
Sex: Male  
Location: Foreign  
Vaccinated:1995-11-21
Onset:1995-11-26
   Days after vaccination:5
Submitted: 1996-02-20
   Days after onset:86
Entered: 1996-02-26
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Bronchitis, Cardiovascular disorder, Respiratory disorder
SMQs:, Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1995-11-26
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: atrovent, digoxin dak tabs;capoten, seroxat
Current Illness:
Preexisting Conditions: cardiac disease
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO6464

Write-up: resp insufficiency & bronchitis w/cardiac disease;died-unrelated to drug;


VAERS ID: 83643 (history)  
Form: Version 1.0  
Age: 15.0  
Sex: Male  
Location: Foreign  
Vaccinated:1995-09-02
Onset:1995-11-04
   Days after vaccination:63
Submitted: 1996-03-06
   Days after onset:123
Entered: 1996-03-13
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1749C6 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Aplastic anaemia, Purpura, Thrombocytopenia
SMQs:, Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic erythropenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 960027961

Write-up: pt recv vax & later was dx with idiopathic bone marrow aplasia;pt was hospitalized in NOV95 recv vax 4months prior;bone marrow aplasia poss related to Engerix-B;


VAERS ID: 83737 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:1996-01-05
Onset:1996-01-05
   Days after vaccination:0
Submitted: 1996-02-29
   Days after onset:55
Entered: 1996-03-19
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER 807E9 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH W773 / 1 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER 064061A / 1 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Cardiac arrest
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-01-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Digoxin drops PO, spironolactone & ASA;
Current Illness: congenital heart deformity, asplenia;
Preexisting Conditions: Pt''s PAR are related by blood(cousins); pt was born w/ "vitium cordis";underwent unspecified cardiac surgery, & was s/p enterobacter sepsis;was asplenic;has been hospitalized since birth;
Allergies:
Diagnostic Lab Data:
CDC Split Type: 896061001L

Write-up: pt recvd vax;suffered a cardiac arrest & died; no autopsy performed;the event was assessed as "probably not drug related";


VAERS ID: 83810 (history)  
Form: Version 1.0  
Age: 48.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1996-03-14
Entered: 1996-03-22
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hepatic failure, Hepatitis, Infection
SMQs:, Hepatitis, non-infectious (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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: ~ ()~~~In patient
Other Medications: Augmentin, Cyclizine, Temazepam, Trimethoprim
Current Illness: infection nos
Preexisting Conditions: no relevant medical history
Allergies:
Diagnostic Lab Data: Hepatitis C virus neg;
CDC Split Type: 960029441

Write-up: pt recvd vax & devel a non-specific fulminant hepatitis 1wk post 3rd dose of vax;pt was seen by MD w/non-specific illness which was treated an infect;later med switched;w/in a few hrs pt was adm to hosp w/advanced liver failure;


VAERS ID: 84626 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1996-04-04
Entered: 1996-04-08
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 3101921 / 2 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Apnoea, Cardiac arrest, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Cardiomyopathy (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO6539

Write-up: pt recv vax & devel fever-not controllable-102;parents tried to control the fever w/non-specified meds;pt adm to hosp 24hrs post vax;pt had cardio-resp arrest which responded successfully once to regular maneuvers then irreversible cardiac


VAERS ID: 85412 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Foreign  
Vaccinated:1996-03-26
Onset:1996-03-29
   Days after vaccination:3
Submitted: 1996-04-26
   Days after onset:27
Entered: 1996-04-30
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asphyxia, Blood thromboplastin decreased, Lung disorder, Respiratory disorder, Unevaluable event
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Haemorrhage laboratory terms (broad), Acute central respiratory depression (broad), Hostility/aggression (broad), Respiratory failure (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Phenobarbital
Current Illness:
Preexisting Conditions: convulsion;strabismus;
Allergies:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES96041707

Write-up: pt recv vax 26MAR96 & pt was found dead in a prone position in bed;the COD was unk;no further details were provided;


VAERS ID: 86604 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1996-06-03
Entered: 1996-06-05
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES L0418 / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Unevaluable event
SMQs:

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO6622

Write-up: the day p/vax pt died;results of autopsy are awaited;


VAERS ID: 86605 (history)  
Form: Version 1.0  
Age: 69.0  
Sex: Male  
Location: Foreign  
Vaccinated:1996-04-19
Onset:1996-04-23
   Days after vaccination:4
Submitted: 1996-05-31
   Days after onset:38
Entered: 1996-06-05
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiac arrest, Shock
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), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Respiratory failure (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1996-04-23
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Metformin;ASA;Glyceryl trinitrate
Current Illness:
Preexisting Conditions: diabetes mellitus;angina pectoris;
Allergies:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES96055089

Write-up: pt recv vax 19APR96 & 23APR96 pt collapsed & died unexpectedly in home;COD was cardiac arrest;no post mortem was carried out;the agency reported that vax given 4 days prior was coincidental in view of recent onset of angina;


VAERS ID: 87568 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Male  
Location: Foreign  
Vaccinated:1996-03-06
Onset:0000-00-00
Submitted: 1996-07-01
Entered: 1996-07-05
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM B1875A4 / UNK LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hepatic failure, Hepatitis, Hepatocellular damage, Infection, Laboratory test abnormal, Leukopenia, Pyrexia, Thrombocytopenia
SMQs:, Hepatitis, non-infectious (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-06-09
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: 23MAY96 Basophils .01;eosinophils .08;ESR-1; HR 1;hemoglobin 15.4; 24MAY96 hepatitis A IGM antibodies neg;infective mononeucleosis neg;23MAY96 lymphocytes 1.95;mean corp hemoglobin 29.8;mean corp hemoglobin conc 34.3;mean corp volume 44.8;
CDC Split Type: 960088261

Write-up: pt recv vax 6MAR96 & died of acute fulminant hepatic failure secondary to glandular fever on 9JUN96;pt hosp;MD felt probably unrelated to vax & that glandular fever may be implicated;poss viral infect (non hepatitis A/B) poss EBV;


VAERS ID: 89158 (history)  
Form: Version 1.0  
Age: 70.0  
Sex: Female  
Location: Foreign  
Vaccinated:1995-10-31
Onset:1995-11-01
   Days after vaccination:1
Submitted: 1996-08-14
   Days after onset:286
Entered: 1996-08-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Drug ineffective, Infection, Injection site inflammation, Injection site oedema, Laboratory test abnormal, Pneumonia, Pyrexia, Sepsis
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? Yes
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: atrovent, Berotec, Duovent, medrol, Novatec, Lasix, Adalat retard, Cordarone
Current Illness:
Preexisting Conditions: emphysema;hypertension, arterial;osteoporosis;myopathy;hypoagammaglobulinemia;immunosuppression,
Allergies:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES96072394

Write-up: pt recv vax 31OCT95 & exp a local inflammatory rxn w/edema during 2 days following vax (felt to be r/t vax);22JUL96 pt hosp for high fever;3 consecutive blood cult were positive for pneumococcus & pt dx w/pneumococcal septicemia;


VAERS ID: 89262 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Female  
Location: Foreign  
Vaccinated:1996-03-01
Onset:1996-03-03
   Days after vaccination:2
Submitted: 1996-08-21
   Days after onset:170
Entered: 1996-08-23
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. - / UNK - / -

Administered by: Other       Purchased by: Unknown
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-03-03
   Days after onset: 0
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: autopsy;
CDC Split Type: CO6660

Write-up: pt recv vax & died 2 days post vax;autopsy was nl, so the sudden death could not be explained;


VAERS ID: 89355 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:1994-03-01
Submitted: 1996-08-20
   Days after onset:902
Entered: 1996-08-27
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
BCG: BCG (TICE) / ORGANON-TEKNIKA - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: CSF test abnormal, Drug ineffective, HIV infection, Infection, Meningitis, Pseudo lymphoma, Pyrexia, Tuberculosis
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), Opportunistic infections (narrow)

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: JUN94 CSF-cell count 1,335, protein 1.38, glucose 2.9, ffew colonies of propionibacterium acnes; Ziehl-Neelsen no acid fast bacilli;CT head-abscess formation-around the drain of the Ommaya reservoir;
CDC Split Type: 2046

Write-up: pt dx w/meningitis: lymphoma NOV93;antibodies to HIV were detected;MAR94 meningitis lymphomatosa dx;JUN94 pt readmitted to hosp d/t high fever, analysis of CSF showed pleocytosis;abscess formation;tuberculous meningitis dx;acid fast bacilli


VAERS ID: 89357 (history)  
Form: Version 1.0  
Age: 44.0  
Sex: Female  
Location: Foreign  
Vaccinated:1996-05-10
Onset:1996-07-01
   Days after vaccination:52
Submitted: 1996-08-26
   Days after onset:56
Entered: 1996-08-29
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (IMOVAX) / PASTEUR MERIEUX INST. - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Unevaluable event
SMQs:

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO6662

Write-up: pt bitten by kitten 3MAY96 rabies post-exposure prophylaxis started 10MAY96 w/RIG & rabies vax;apparently completed series;died unexpectedly JUL96;autopsy negative x/for some pulmonary congestion;


VAERS ID: 89686 (history)  
Form: Version 1.0  
Age: 24.0  
Sex: Female  
Location: Foreign  
Vaccinated:1996-08-13
Onset:1996-08-13
   Days after vaccination:0
Submitted: 1996-09-06
   Days after onset:24
Entered: 1996-09-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiovascular disorder, Coma, Encephalitis, Endocarditis, Laboratory test abnormal, Renal impairment, Respiratory disorder, Sepsis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-08-28
   Days after onset: 15
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: no relevant history
Allergies:
Diagnostic Lab Data: AUG96 total serum bilirubin 35; total serum bilirubin 86;total serum bilirubin 120; inc transaminases & bilirubin; sl inc protein & cells in CSF;Crainocerebral computer tomogram revealed no pathological findings;
CDC Split Type: WAES96081481

Write-up: pt recv vax 13AUG96 & 14AUG96 pt exp GI disturbances of n/v & pain in limbs;hosp on 14AUG96;17or 18AUG96 exp fever of 40 & exanthema described as small spots sl papular;exp neurological sx such as double vision & inc disorientation;


VAERS ID: 90088 (history)  
Form: Version 1.0  
Age: 40.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1996-09-18
Entered: 1996-09-23
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Drug ineffective, Hepatitis, 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? Yes
   Date died: 0000-00-00
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: 960134531

Write-up: pt recv vax & was a non-responder & has died from hep B;MD thinks that the vax was Igm positive & prev serum will be looked at;


VAERS ID: 90259 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1996-09-24
Entered: 1996-09-27
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Injury
SMQs:, Accidents and injuries (narrow), Hostility/aggression (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-07-19
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96091432

Write-up: pt recv vax & died suddenly 9 days following vax;COD unk;no further details were provided;


VAERS ID: 90433 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1996-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 2 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Delirium, Encephalitis, Immune system disorder, Infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
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: 960137711

Write-up: pt recv vax & 6-12mo later devel herpes encephalitis;@ time of vax pt had recently had a mastectomy & in the MD opinion was probably immunocompromised;pt was left w/residual brain damage & died 3yr later;


VAERS ID: 92041 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
Vaccinated:1996-11-08
Onset:1996-11-08
   Days after vaccination:0
Submitted: 1996-11-13
   Days after onset:5
Entered: 1996-11-18
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Coma, Cyanosis, Infection, Mydriasis, Paralysis flaccid, Pneumonia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-11-08
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 960164931

Write-up: pt recv vax 8NOV96 & in the evening pt suffered from cyanosis, hypotonia, pallor, & vomiting & pt has adm to hosp where died;


VAERS ID: 92233 (history)  
Form: Version 1.0  
Age: 14.0  
Sex: Female  
Location: Foreign  
Vaccinated:1994-08-10
Onset:1995-03-01
   Days after vaccination:203
Submitted: 1996-11-19
   Days after onset:629
Entered: 1996-11-22
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 3 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Amenorrhoea, Coma, Hepatic neoplasm, Hepatic neoplasm malignant, Hepatomegaly, Laboratory test abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Liver malignant tumours (narrow), Liver tumours of unspecified malignancy (narrow), Fertility disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Non-haematological malignant tumours (narrow), Non-haematological tumours of unspecified malignancy (narrow)

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: JUN95 alpha fetoprotein 21000;JUL95 alpha fetoprotein 200;JAN96 alpha fetoprotein;liver biopsy malignant hepatoma JUN95;liver CT scan malignant hepatoma;Liver echography malignant hepatoma;
CDC Split Type: 960167511

Write-up: pt recv 3 doses vax JUN94, JUL94, AUG94 & exp amenorrhea;3mo later MD discovered liver neoplasm;echography, CT scan & biopsy performed & malignant hepatoma dx;pt hosp & chemotherapy started;relapse JAN96;exp hepatic coma w/liver trans


VAERS ID: 92821 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Foreign  
Vaccinated:1996-02-12
Onset:1996-02-16
   Days after vaccination:4
Submitted: 1996-12-02
   Days after onset:290
Entered: 1996-12-12
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-02-16
   Days after onset: 0
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: 960172211

Write-up: pt recv vax & exp sudden infant death;the reporter considers the event to be unlikely r/t the vax;


VAERS ID: 92868 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1996-12-11
Entered: 1996-12-16
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES L0749 / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES L0749 / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Agitation, Sudden infant death syndrome
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Neonatal disorders (narrow), 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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO7021

Write-up: sudden death of a baby 25hr p/vax;no prev sx x/baby a bit fussy;


VAERS ID: 92874 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Unknown  
Location: Foreign  
Vaccinated:1996-10-28
Onset:1996-11-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 1996-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES M5302 / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Sudden infant death syndrome
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Cardiomyopathy (broad), Neonatal disorders (narrow), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
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: CO7028

Write-up: pt recv vax & bay was found lifeless in bed in the morning, some hr p/feeding & bath as usual, ICU w/o success & death;


VAERS ID: 93590 (history)  
Form: Version 1.0  
Age: 15.0  
Sex: Female  
Location: Foreign  
Vaccinated:1995-02-23
Onset:1995-03-03
   Days after vaccination:8
Submitted: 1997-01-03
   Days after onset:672
Entered: 1997-01-07
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTIPV: DT + IPV (FOREIGN) / PASTEUR MERIEUX INST. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hepatitis, Hepatocellular damage, Pyrexia
SMQs:, Hepatitis, non-infectious (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-09-04
   Days after onset: 550
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: WAES96121641

Write-up: 03mar95 pt became febrile & was tx by MD w/ amoxicillin. 19apr95 a 2nd course of amoxicillin was initiated. 23apr96 pt devel hepatitis & was hosp for observation.pt devel liver dysfunction & was transferred to another hosp; pt died


VAERS ID: 93635 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:1996-11-13
Submitted: 1997-01-03
   Days after onset:51
Entered: 1997-01-10
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES L0749 / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Agitation, Sudden infant death syndrome
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Neonatal disorders (narrow), 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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO7021

Write-up: SIDS-sudden death of a baby 25hr p/2nd vax;no prev sx x/baby a bit fussy;


VAERS ID: 94616 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Female  
Location: Foreign  
Vaccinated:1996-11-30
Onset:1996-11-30
   Days after vaccination:0
Submitted: 1997-01-30
   Days after onset:61
Entered: 1997-02-03
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Agitation, Apnoea, Cardiac failure, Congenital anomaly, Pain, Pyrexia, Respiratory disorder
SMQs:, Cardiac failure (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Congenital, familial and genetic disorders (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Respiratory failure (narrow), 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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: mucous
Preexisting Conditions: mucous, nasal, clear;pt older sister died w/no apparent cause @ 1mo of age;
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97018903

Write-up: p/vax was crying & given APAP for fever & pain;1hr later pt died;MD initial assessment was that death r/t vax;also suspected d/t genetic;17JAN97 MD stated pt died from resp failure & heart failure;pt sibling died from same problem;


VAERS ID: 94917 (history)  
Form: Version 1.0  
Age: 21.0  
Sex: Female  
Location: Foreign  
Vaccinated:1996-12-12
Onset:1996-12-26
   Days after vaccination:14
Submitted: 1997-01-31
   Days after onset:36
Entered: 1997-02-13
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1875A4 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthma, Bronchitis, Cerebrovascular accident, Dizziness, Intracranial aneurysm, Subarachnoid haemorrhage, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (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: ~ ()~~~In patient
Other Medications: Mercilon;Contraceptive
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP nl; CVX nl;
CDC Split Type: 970023341

Write-up: devel stroke-like illness & died 13 days p/vax;pt devel mild bronchitis/bronchospasm for which was tx w/ATB & low dose steroids;25DEC96 pt felt dizzy & then collapsed;pt taken to hosp & died on 26DEC96;poss subarachnoid hemorrhage;


VAERS ID: 94918 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Foreign  
Vaccinated:1996-07-10
Onset:1996-07-19
   Days after vaccination:9
Submitted: 1997-02-10
   Days after onset:206
Entered: 1997-02-13
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Injury
SMQs:, Accidents and injuries (narrow), Hostility/aggression (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? No
Previous Vaccinations:
Other Medications: unk
Current Illness:
Preexisting Conditions: reflux, gastroesophageal
Allergies:
Diagnostic Lab Data: 1996 viral serology negative;blood cult negative;
CDC Split Type: WAES97020157

Write-up: pt recv vax 10JUL96 & 19JUL96 pt suddenly died;lab eval by viral serology revealed a neg result CMV, influenza, rickettsias mycoplasma, HIV, RSV, ECHO virus, coxsackie virus, EBV;blood cult neg;COD cranial trauma;


VAERS ID: 95179 (history)  
Form: Version 1.0  
Age: 50.0  
Sex: Male  
Location: Foreign  
Vaccinated:1993-11-09
Onset:1993-11-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1997-02-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 2 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Atelectasis, Glomerulonephritis, Hepatic function abnormal, Hypoxia, Immune system disorder, Respiratory disorder, Shock, Vasculitis
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Vasculitis (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (narrow)

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: alk phos 217;alk phos 287;blood-PH 7.48;carbon dioxide pressure 34.7;carbon dioxide pressure 49;CT scan:lung atelectasis of the lower & medium R lobes;t37.5C;CXR atelectasis of the lower & medium rt lobes;CXR mottling in the basal area lung
CDC Split Type: 970023451

Write-up: CXR showed atelectasis;dx ARDS pt mechanically ventilated;mean systemic arterial pressure was 108;liver function impaired;pt died d/t intractable hypoxemia & shock;acute glomerulonephritis found;hepatocellular necrosis;immune depositi


VAERS ID: 95219 (history)  
Form: Version 1.0  
Age: 20.0  
Sex: Female  
Location: Foreign  
Vaccinated:1996-12-20
Onset:1996-12-20
   Days after vaccination:0
Submitted: 1997-02-25
   Days after onset:67
Entered: 1997-02-27
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Asthma, Condition aggravated
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-12-22
   Days after onset: 2
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: Theophylline, Formoterol, Beclomethasone, Salbutamol
Current Illness:
Preexisting Conditions: pt suffering from severe chronic asthma & tex w/med;
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO7094

Write-up: pt recv vax 20DEC96 & several hr p/vax pt exp asthma attack;pt suffering from chronic asthma & was treated w/med;21DEC96 the attack became resistant to med & pt hosp;p/a transient improvement, attack could not be stopped & pt died in ICU


VAERS ID: 95222 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
Vaccinated:1996-07-10
Onset:1996-07-11
   Days after vaccination:1
Submitted: 1997-02-25
   Days after onset:229
Entered: 1997-02-27
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Other       Purchased by: Other
Symptoms: Agitation, Nervousness, Sudden infant death syndrome
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Neonatal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-07-11
   Days after onset: 0
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: episode of bronchitis 30APR96 tx w/ATB;28MAY96 pt hosp d/t bronchial infect w/stridor & parents not able to care for pt well enough;dx hernia;
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO7091

Write-up: pt recv vax 11JUL96 & the following day pt was found dead in bed;it was reported that the pt was born in the 34th wk of pregnancy of arabian origin;pt appeared to be nervous & agitated;


VAERS ID: 96333 (history)  
Form: Version 1.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:1997-02-27
Onset:0000-00-00
Submitted: 1997-03-12
Entered: 1997-03-20
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
BCG: BCG (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Condition aggravated, Infection, Injection site haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Dengue hemorragic fever;
Allergies:
Diagnostic Lab Data:
CDC Split Type: 970056241

Write-up: pt recv vax 27FEB97 & the same day p/vax pt devel bleeding @ one inj site;tx in a hosp;5MAR97 pt was supossed to visit the MD but was found dead by mom;COD was dengue fever;health authorities have r/o vax as COD;


VAERS ID: 96421 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Male  
Location: Foreign  
Vaccinated:1997-03-10
Onset:1997-03-10
   Days after vaccination:0
Submitted: 1997-03-13
   Days after onset:3
Entered: 1997-03-24
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 2 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Chromosome abnormality, Convulsion
SMQs:, Systemic lupus erythematosus (broad), Congenital, familial and genetic disorders (narrow), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow), 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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Trisomic;pt was born full term but a chromosome study was performed & revealed trisomy 21;8FEB97 pt also recv a dose of BCG;
Allergies:
Diagnostic Lab Data: Chromosome 47 XY;APGAR 8,9 w/down synd 8FEB97;
CDC Split Type: 970057021

Write-up: pt recv vax 10MAR97 & 1-2 hr p/vax when returning home, pt exp convuls & resp arrest;pt was brought to hosp & died;


VAERS ID: 96748 (history)  
Form: Version 1.0  
Age: 56.0  
Sex: Male  
Location: Foreign  
Vaccinated:1992-10-22
Onset:1992-10-22
   Days after vaccination:0
Submitted: 1997-04-08
   Days after onset:1629
Entered: 1997-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER E2216FA / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Asthma, Depressed level of consciousness, Hypertension, Myelitis, Myocardial infarction, Paraesthesia, Pneumonia, Sepsis
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-07-09
   Days after onset: 1356
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: HTN status:ongoing 18MAR97;18MAR97 asthma-fairly severe;18MAR97 acute myocardial infarction;
Allergies:
Diagnostic Lab Data: NONE reported;
CDC Split Type: EML97178

Write-up: pt recv vax devel paresthesia & weakness of the legs, w/unsteadiness;no specific dx found poss post vax transverse myelitis which affect spinal cord;COD septicemia, bronchopneumonia & infected trophic ulcer;spinal cord damage, influenza vax


VAERS ID: 97082 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Foreign  
Vaccinated:1996-04-24
Onset:1996-05-18
   Days after vaccination:24
Submitted: 1997-04-17
   Days after onset:334
Entered: 1997-04-22
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / 1 - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / 1 - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Agitation, Anorexia, Somnolence, Sudden infant death syndrome
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Neonatal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-05-18
   Days after onset: 0
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: CO7160

Write-up: pt recv vax 24APR96 & 18MAY96 pt woke up crying, seemed hungry but fell asleep a/eating anything;3hr later pt was found dead;autopsy showed no cause of death & indicated SIDS;


VAERS ID: 97182 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Foreign  
Vaccinated:1996-02-28
Onset:1996-03-06
   Days after vaccination:7
Submitted: 1997-04-17
   Days after onset:406
Entered: 1997-04-22
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Myocarditis, Pneumonia, Sudden infant death syndrome
SMQs:, Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Neonatal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-03-06
   Days after onset: 0
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: CO7154

Write-up: pt recv vax 28FEB96 & it was reported that on 6MAR96 pt suddenly died;there were no immed rxn to vax reported;autopsy results showed a microscopic mild pneumonia & a local irritation of myocardium;COD suspected to be SIDS;


VAERS ID: 97164 (history)  
Form: Version 1.0  
Age: 74.0  
Sex: Female  
Location: Foreign  
Vaccinated:1996-10-08
Onset:1996-10-19
   Days after vaccination:11
Submitted: 1997-04-24
   Days after onset:187
Entered: 1997-04-25
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71251 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Encephalitis, Herpes simplex, Infection, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO7196

Write-up: pt recv vax 8OCT96 & 19OCT96 pt was found in a state of collapse;adm to hosp into ICU w/dx of herpes simplex encephalitis;tx w/Acyclovir & supportive care & remains hosp as of the initial report date 7JAN97;


VAERS ID: 97228 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Foreign  
Vaccinated:1996-08-06
Onset:1996-08-06
   Days after vaccination:0
Submitted: 1996-08-15
   Days after onset:9
Entered: 1997-04-28
   Days after submission:256
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 1 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-08-06
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 897105001L

Write-up: pt recv vax 6AUG96 & later that day, pt died;COD was reported as sudden infant death synd;


VAERS ID: 97517 (history)  
Form: Version 1.0  
Age: 1.1  
Sex: Male  
Location: Foreign  
Vaccinated:1997-03-12
Onset:1997-03-12
   Days after vaccination:0
Submitted: 1997-05-08
   Days after onset:56
Entered: 1997-05-09
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES L1169 / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES M0395 / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Acidosis, Anaemia, Hyperglycaemia, Hyperventilation, Hypoproteinaemia, Hypoxia, Overdose, Renal failure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Drug abuse and dependence (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (narrow), Respiratory failure (broad), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CRP increased & WBC 34,000, oliguria, reduced creatinie, worse anemia, renal failure was unsuccessfull treated w/dialysis & pt died on 26MAR97 (14 days psot vax);dx renal failure;possibility aminophenazone toxicity suspected;
CDC Split Type: CO7243

Write-up: pt exp sl fever 37.8;430PM pt began to cry & exp tachypnea;pt was hosp 5PM;@ the admission blood test showed acidosis, major hyperglycemia, hyponatremia, hypoprotidemia, & hypoxemia;WBC 20,000;CBC nl;diabetes suspected not confirmed;


VAERS ID: 98075 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Male  
Location: Foreign  
Vaccinated:1997-04-08
Onset:1997-04-10
   Days after vaccination:2
Submitted: 1997-05-16
   Days after onset:36
Entered: 1997-05-19
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Infection, Respiratory disorder
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1997-04-10
   Days after onset: 0
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: CO7281

Write-up: pt recv vax 8APR97 & 2 days post vax pt suddenly died;the autopsy showed a lower resp infect;


VAERS ID: 98129 (history)  
Form: Version 1.0  
Age: 36.0  
Sex: Female  
Location: Foreign  
Vaccinated:1997-04-04
Onset:0000-00-00
Submitted: 1997-04-01
Entered: 1997-05-21
   Days after submission:49
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, CSF test abnormal, Cardiac arrest, Encephalitis, Gastrointestinal haemorrhage, Hepatocellular damage, Infection
SMQs:, Torsade de pointes/QT prolongation (broad), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 970106931

Write-up: 1wk p/vax pt showed a state of confusion & therefore a psychiatric illness was assumed first;d/t pathological findings of the CSF-puncture an encephalitis was suspected & pt transferred to hosp;virus etiology but the MD felt vasculitis;


VAERS ID: 98455 (history)  
Form: Version 1.0  
Age: 36.0  
Sex: Male  
Location: Foreign  
Vaccinated:1997-03-20
Onset:1997-03-22
   Days after vaccination:2
Submitted: 1997-05-27
   Days after onset:65
Entered: 1997-06-02
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 310011 / 5 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: CSF test abnormal, Dysgeusia, Guillain-Barre syndrome, Hyporeflexia, Neuropathy, Paraesthesia, Paralysis, Tongue disorder
SMQs:, Peripheral neuropathy (narrow), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: Appendectomy;Peritonitis;Hemorrhoidectomy;Scabies;
Allergies:
Diagnostic Lab Data: 30MAR97 CSF 107-protein inc;1997 CSF 165;MAR97 CSF GBS;30MAR97 CSF lymphocytes decreased;TPHA negative;electrodiagnostic eval revealed characteristic demyelination w/abn F-waves & reduced nerve-conduction velocity;
CDC Split Type: WAES97050795

Write-up: 36hr p/vax pt exp a metallic taste & furred feeling on tongue;1wk p/vax pt exp distal paresis of legs & tingling paresthesia;pt hosp 31MAR97 to 5APR97;hosp again exp dec patellar tendon reflexes & achilles tendon reflex;GBS, demyelination


VAERS ID: 98469 (history)  
Form: Version 1.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:1996-08-13
Onset:1996-08-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 1997-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: CSF test abnormal, Coma, Encephalitis, Herpes simplex, Pyrexia, Rash maculo-papular, Renal impairment, Sepsis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-08-28
   Days after onset: 11
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: AUG96 CSF sl inc cells (leukocytes);CSF protein;
CDC Split Type: WAES97051525

Write-up: pt recv vax 13AUG96 & 17AUG96 pt devel exanthem consisting of small spots that were sl papular, & a fever of 40;18AUG96 pt devel diplopia;20AUG96 pt comatose, renal function abn;suspected herpes encephalitis;pt die d/t sepsis (s. aureus);


VAERS ID: 98496 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
Vaccinated:1995-02-13
Onset:1995-02-16
   Days after vaccination:3
Submitted: 1997-06-03
   Days after onset:837
Entered: 1997-06-04
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Injection site pain, Pyrexia, Somnolence, Sudden infant death syndrome
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Neonatal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1995-02-16
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: cold & breathing difficulties;rhinitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO7310

Write-up: SIDS;pt recv vax & pt died 3 days post vax;pt had cold & breathing diff @ the time of vax;


VAERS ID: 99045 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Foreign  
Vaccinated:1995-09-09
Onset:1996-04-15
   Days after vaccination:219
Submitted: 1997-06-05
   Days after onset:416
Entered: 1997-06-17
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Infection, Injection site hypersensitivity, Pneumonia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-04-15
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ditanrix ped;
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 970132592

Write-up: pt recv vax 9SEP95 pt was 11mo old & pt died for unspecified causes, 7mo later (APR 96);event considered unrelated to the vax;


VAERS ID: 99129 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Foreign  
Vaccinated:1997-03-07
Onset:1997-03-20
   Days after vaccination:13
Submitted: 1997-06-18
   Days after onset:89
Entered: 1997-06-19
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 3103412 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiac arrest, Sudden infant death syndrome, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Neonatal disorders (narrow), Respiratory failure (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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO7341

Write-up: pt recv vax 7MAR97 & 13 days later pt reportedly was hosp & died following a refractory cardiac arrest which was preceeded by vomiting;a suspected dx of SIDS was reported;


VAERS ID: 100264 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:1997-05-01
Onset:1997-05-03
   Days after vaccination:2
Submitted: 1997-07-15
   Days after onset:73
Entered: 1997-07-16
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / 1 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1997-05-03
   Days after onset: 0
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: CO7413

Write-up: it was reported that pt recv vax 1MAY97 & 3MAY97 pt died;


VAERS ID: 101219 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1997-07-29
Entered: 1997-08-04
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / 1 - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO7414

Write-up: pt recv vax & w/in 24hr of vax pt was found dead;


VAERS ID: 101287 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1997-08-05
Entered: 1997-08-06
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO7472

Write-up: pt recv vax & was found dead within 14 hr of vax


VAERS ID: 101473 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Female  
Location: Foreign  
Vaccinated:1997-07-02
Onset:1997-07-04
   Days after vaccination:2
Submitted: 1997-08-05
   Days after onset:32
Entered: 1997-08-08
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Cyanosis
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), Acute central respiratory depression (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1997-07-04
   Days after onset: 0
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: No relevant history
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97079604

Write-up: pt recv vax 4JUL97 & mom inform staff of child''s death on 21JUL97;circumstances:parents found baby to not be breathing on the morning of 4JUL97 & rushed to hosp;pt seen by MD apneic & cyanosed w/no pulse;COD cardiorespiratory arrest


VAERS ID: 101589 (history)  
Form: Version 1.0  
Age: 1.6  
Sex: Female  
Location: Foreign  
Vaccinated:1996-05-02
Onset:1996-05-11
   Days after vaccination:9
Submitted: 1997-08-06
   Days after onset:452
Entered: 1997-08-11
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
PER: PERTUSSIS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1996-05-11
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: autopsy fulfills all criteria for SIDS;
CDC Split Type: WAES97072078

Write-up: pt recv vax 2MAY96 & exp no immed rxn p/vax; 11MAY96 pt died;autopsy protocol states that apart from being too old pt fulfils all criteria for sudden infant death synd (SIDS);reporter felt that COD was not f/t therapy w/MMR;


VAERS ID: 101607 (history)  
Form: Version 1.0  
Age: 24.0  
Sex: Male  
Location: Foreign  
Vaccinated:1995-01-01
Onset:1995-10-26
   Days after vaccination:298
Submitted: 1997-07-24
   Days after onset:637
Entered: 1997-08-12
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 3 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Marrow hyperplasia, Pseudo lymphoma
SMQs:, Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: APR94 malignant lymphoma stage IIA (rich in T cells);AUG94 remission of the lymphoma;
Allergies:
Diagnostic Lab Data:
CDC Split Type: 970172251

Write-up: pt in APR94 exp malignant lymphoma stage IIA;AUG94 remission occurred;DEC94 & JAN95 pt recv 3 doses vax;26OCT95 lymphoma relapse occurred;DEC95 bone marrow attack noticed;pt died on unspecified date;


Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=49&PERPAGE=100&DIED=Yes


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166