|
VAERS ID: |
26664 (history) |
Form: |
Version 1.0 |
Age: |
47.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 1990-09-28 |
Onset: | 1990-09-29 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-11-15 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Amnesia,
Asthenia,
Dizziness,
Hypotension,
Lymphadenopathy,
Malaise,
Nausea,
Syncope SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBW908372
Write-up: Pt vaccinated with Engerix-B 24 hrs post 2nd dose felt unwell & drained, then fainted. Taken to hospital. Felt nauseated, neck, groins & axilla were tender. Condition lasted x4 days. See WORM for more details. |
|
VAERS ID: |
26691 (history) |
Form: |
Version 1.0 |
Age: |
38.0 |
Sex: |
Female |
Location: |
Wisconsin |
Vaccinated: | 1984-11-15 |
Onset: | 1984-11-15 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-11-20 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (FOREIGN) / MERCK & CO. INC. |
- / UNK |
- / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Asthenia,
Delirium,
Gait disturbance,
Hyperreflexia,
Myalgia,
Myasthenic syndrome,
Neuropathy,
Paraesthesia,
Peroneal nerve palsy SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: No past hx until Hepatitis Vaccine Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt vaccinated with Hepatitis B developed severe progressive demyelinizing disease. |
|
VAERS ID: |
26692 (history) |
Form: |
Version 1.0 |
Age: |
38.0 |
Sex: |
Female |
Location: |
Wisconsin |
Vaccinated: | 1988-06-15 |
Onset: | 1988-06-30 |
Days after vaccination: | 15 |
Submitted: |
0000-00-00 |
Entered: |
1990-11-20 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (FOREIGN) / MERCK & CO. INC. |
2040N / UNK |
- / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Asthenia,
Coordination abnormal,
Depression,
Encephalitis,
Headache,
Lymphocytosis,
Myalgia,
Neuropathy,
Pain,
Paraesthesia,
Somnolence,
Thinking abnormal,
Vomiting SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: No past hx of problems Allergies: Diagnostic Lab Data: other causes ruled out. CDC Split Type:
Write-up: Pt vaccinated with Hepatitis B vaccine severe progressive encephalomyelitis with chronic demyelinizing disease. |
|
VAERS ID: |
26693 (history) |
Form: |
Version 1.0 |
Age: |
32.0 |
Sex: |
Female |
Location: |
Wisconsin |
Vaccinated: | 1989-01-05 |
Onset: | 1989-01-19 |
Days after vaccination: | 14 |
Submitted: |
0000-00-00 |
Entered: |
1990-11-20 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
0142P / UNK |
- / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Hyperreflexia,
Hyporeflexia,
Multiple sclerosis,
Optic neuritis,
Pain,
Paraesthesia SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (narrow), Demyelination (narrow), Ocular infections (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: no previous problems Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt vaccinated with Recombivax developed progressive demyelinizing disease. |
|
VAERS ID: |
26832 (history) |
Form: |
Version 1.0 |
Age: |
32.0 |
Sex: |
Female |
Location: |
North Carolina |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-11-27 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Headache,
Vasculitis SMQs:, Vasculitis (narrow), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Arteriography OCT90 cerebral vasculitis. CDC Split Type: WAES90101403
Write-up: Pt vaccinated with Recombivax in 1987 or 88 in Oct90 was hospitalized with headache. Cerebral arteriography revealed diffuse cerebral vasculitis. At the time of the report the pt headache had resolved. |
|
VAERS ID: |
26833 (history) |
Form: |
Version 1.0 |
Age: |
41.0 |
Sex: |
Female |
Location: |
Pennsylvania |
Vaccinated: | 1988-01-26 |
Onset: | 1988-01-26 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-11-27 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (FOREIGN) / MERCK & CO. INC. |
- / UNK |
- / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Coordination abnormal,
Multiple sclerosis,
Paraesthesia,
Vasodilatation SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Demyelination (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Hx neuritis, retrobulbar Allergies: Diagnostic Lab Data: MRI-Multiple Central Nervous system lesions. CDC Split Type: WAES90100119
Write-up: Pt vax /w Hept-B experienced warm, flushing sensation, numbness, & tingling in the lt arm. Was hospitalized for dysequilibrium & paresthesias & dx with Multiple sclerosis. |
|
VAERS ID: |
26836 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Male |
Location: |
Alaska |
Vaccinated: | 1990-10-24 |
Onset: | 1990-10-24 |
Days after vaccination: | 0 |
Submitted: |
1990-11-06 |
Days after onset: | 13 |
Entered: |
1990-11-28 |
Days after submission: | 22 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
283913 / 1 |
RL / IM |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
1880R / 2 |
LL / IM |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
277941 / 1 |
MO / PO |
Administered by: Public Purchased by: Unknown Symptoms: Convulsion,
Pyrexia,
Tremor SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Lumbar puncture - results normal CDC Split Type:
Write-up: Pt vaccinated with DTP/OPV/Recomb developed fever of 103, convulsions, fine tremor. |
|
VAERS ID: |
26894 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Rhode Island |
Vaccinated: | 1990-10-13 |
Onset: | 1990-10-13 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-12-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
4908183 / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Headache,
Pyrexia,
Syncope,
Vomiting SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Lumbar puncture to t/o Mennigitis - Crytococcal antigen CDC Split Type:
Write-up: Pt vaccinated with Hepatitis -B two hrs later developed vomitting, fainting, severe, headache, & fever 101.6. |
|
VAERS ID: |
26988 (history) |
Form: |
Version 1.0 |
Age: |
50.0 |
Sex: |
Male |
Location: |
Florida |
Vaccinated: | 1990-02-27 |
Onset: | 1990-03-01 |
Days after vaccination: | 2 |
Submitted: |
0000-00-00 |
Entered: |
1990-12-10 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
5A6A4 / UNK |
LA / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Neck pain,
Pyrexia,
Red blood cell sedimentation rate increased,
Sepsis SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow), Opportunistic infections (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBU900489
Write-up: Pt vaccinated with Engerix-B developed gram negative sepsis suspected, low grade gever then 102 , pain in neck, pain in shoulder girdle, pain in upper thighs, sedimentation rate 138. |
|
VAERS ID: |
26964 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Male |
Location: |
Arkansas |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-12-11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (FOREIGN) / MERCK & CO. INC. |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Anorexia,
Asthenia,
Chills,
Cough,
Dizziness,
Dysuria,
Headache,
Malaise,
Nervousness,
Pollakiuria,
Pyrexia,
Vasodilatation SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: WAES90110652
Write-up: Pt vaccinated with Heptavax-B in 1987 developed pneumonia & bronchial spasms. On 8NOV90 developed fatigue, malaise, a fever, chills, sensation of warmth, irritability, anorexia,headache,dizziness,coughing,flushing,urinary freq & dysuria. |
|