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 50 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: 102673 (history)  
Form: Version 1.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1997-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Coma, Furuncle
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? Yes
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:
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97097916

Write-up: an alleged report of boils, coma & death has been recv from info obtained @ natl vax info ctr conference, concerning a pt who recv hep B vax;the COD was not specified;this info was reviewed a few yr ago;addtl info is not expected;


VAERS ID: 103145 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Foreign  
Vaccinated:1997-09-30
Onset:1997-10-02
   Days after vaccination:2
Submitted: 1997-10-10
   Days after onset:8
Entered: 1997-10-15
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 1 - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES M0693 / 1 - / IM L
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / 1 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Somnolence, Sudden infant death syndrome
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Neonatal disorders (narrow), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1997-10-02
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO7539

Write-up: pt recv vax 30SEP97 & pt exp some drowsiness;2OCT97 1AM pt was found not breathing by mom;pt hosp but resuscitation efforts were unsuccessful;autopsy to be done;


VAERS ID: 103156 (history)  
Form: Version 1.0  
Age: 72.0  
Sex: Female  
Location: Foreign  
Vaccinated:1996-07-04
Onset:1996-11-13
   Days after vaccination:132
Submitted: 1997-10-06
   Days after onset:326
Entered: 1997-10-16
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1875A4 / 3 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Antinuclear antibody, Hepatitis, Infection, Jaundice
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (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: 1997-01-29
   Days after onset: 77
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: Doxazosin;Frusemide;Iron sulphage;Nephrovile;One-alpha;sodium hydrogen carbonate;
Current Illness:
Preexisting Conditions: chronic renal failure;
Allergies:
Diagnostic Lab Data: antinuclear factor positive;liver biopsy inconclusive;
CDC Split Type: 970229201

Write-up: pt recv vax 4JUL96 & 13NOV96 pt exp jaundice & was hosp;pt died on 29JAN97 & probable COD was reported as jaundice (NOS);cause of jaundice was unexplained but chronic active hepatitis was suspected;liver biopsy was inconclusive;


VAERS ID: 103596 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1997-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Breast neoplasm, Hepatic function abnormal, Jaundice, Malaise, Peripheral vascular disorder
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Breast tumours of unspecified malignancy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Tamoxifen;chemotherapy & radiotherapy;
Current Illness:
Preexisting Conditions: breast cancer
Allergies:
Diagnostic Lab Data:
CDC Split Type: 970235761

Write-up: pt recv vax & was also noted to be well on no med x/tamoxifen;also noted not to be immunocompromised;several wk p/vax was noted to feel unwell & deteriorated rapidly;pt died at the end of 1996 from breast cancer;


VAERS ID: 103307 (history)  
Form: Version 1.0  
Age: 1.7  
Sex: Female  
Location: Foreign  
Vaccinated:1997-09-26
Onset:1997-10-01
   Days after vaccination:5
Submitted: 1997-10-17
   Days after onset:16
Entered: 1997-10-21
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 2 GM / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / 2 GM / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Coma, Dehydration, Pyrexia, Vomiting, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1997-10-03
   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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Lab tests - MRI and lumbar puncture normal
CDC Split Type: CO7639

Write-up: pt recv vax 26SEP97 & pt exp fever, vomiting;pt presented to ER on 1OCT97 & was hosp because of dehydration & weight loss;the following day 2OCT97 pt went into a coma, pt died on 3OCT97;COD resp failure & dehydration;


VAERS ID: 104249 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Female  
Location: Foreign  
Vaccinated:1997-06-12
Onset:1997-06-13
   Days after vaccination:1
Submitted: 1997-10-24
   Days after onset:133
Entered: 1997-11-05
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / UNK - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 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: 970246121

Write-up: pt was found dead in bed on the morning p/vax;up to the evening before pt had been perfectly well;


VAERS ID: 104609 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
Vaccinated:1997-09-22
Onset:1997-09-22
   Days after vaccination:0
Submitted: 1997-11-05
   Days after onset:44
Entered: 1997-11-12
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / UNK MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pyrexia, Sudden infant death syndrome, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Neonatal disorders (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:
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WAES97101411

Write-up: pt recv vax 22SEP97 & pt devel sl fever from which pt recovered the following day;23SEP97 pt exp 1 episode of vomiting & fever recurred;pt was found dead on 23SEP97 1030PM of SIDS;@ time of report 16OCT97 autopsy result not available;


VAERS ID: 104878 (history)  
Form: Version 1.0  
Age: 84.0  
Sex: Male  
Location: Foreign  
Vaccinated:1997-10-26
Onset:1997-10-27
   Days after vaccination:1
Submitted: 1997-11-20
   Days after onset:24
Entered: 1997-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E71009BC1 / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Laboratory test abnormal, Leukopenia, Pyrexia
SMQs:, Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1997-10-30
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Aspegic/acetylsalicylic acid;Digoxine/DIgoxin;Glyceryltrintrate/glyceryl;Nootropyl/piracetam
Current Illness: immun against influenza;14OCT97 WBC 7460 (70% neutrophils);
Preexisting Conditions: cardiovascular disease, unspecified
Allergies:
Diagnostic Lab Data: 14OCT97 p/vax WBC 7460 (70% neutrophils);WBC p/vax 2370 (17% neutrophils); next day WBC 790 (8% neutrophils);
CDC Split Type: EMF97853

Write-up: pt recv vax 26OCT97 & next day devel a fever adm to hosp when WBC was found to be 2370 (17% neutrophils) & next day this had dropped to 790 (8% neutrophils);tx w/ringer lactate, ATB & neupogen but pt died on 30OCT97;


VAERS ID: 105806 (history)  
Form: Version 1.0  
Age: 66.0  
Sex: Female  
Location: Foreign  
Vaccinated:1997-10-15
Onset:1997-10-18
   Days after vaccination:3
Submitted: 1997-12-22
   Days after onset:65
Entered: 1997-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E71009BD1 / UNK - / SC

Administered by: Other       Purchased by: Other
Symptoms: Anorexia, Asthenia, Malaise
SMQs:, Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1997-11-03
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Amitriptyline/amitripyline;Bendrofluazide/bendroflumsthia;co-proxamol/co-proxamol;omeprazole/omeprazole;pred, quinine sulphate, warfarin
Current Illness: immun against influenza
Preexisting Conditions: 4DEC97 carcinoma in situ stomach; osteoporosis;HTN;angina pectoris;emphysema;obstructive airway dis;alveolitis;resp failure;
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: EML971025H

Write-up: pt recv vax & had sx of gen malaise, weakness & anorexia;3 days p/vax pt died about 2wk later;reporter did not indicate whether had been adm to hosp or that an autopsy had been undertaken;


VAERS ID: 105904 (history)  
Form: Version 1.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1997-12-26
Entered: 1997-12-30
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Malaise
SMQs:

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: unk
Current Illness:
Preexisting Conditions: asthma;emphysema;
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WAES97125097

Write-up: pt recv vax but became ill p/vax & w/in 3 days & died;COD is unk;


VAERS ID: 105905 (history)  
Form: Version 1.0  
Age: 1.8  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1997-12-26
Entered: 1997-12-30
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Encephalitis, Infection
SMQs:, Noninfectious encephalitis (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? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: biopsy brain measles inclusion bodies;
CDC Split Type: WAES97127928

Write-up: pt recv vax 1997 & pt exp encephalitis & was hosp;COD encephalitis, viral & measles inclusions bodies were found @ the brain biopsy;investigation found type 1 virus;


VAERS ID: 106394 (history)  
Form: Version 1.0  
Age: 1.6  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:1996-03-17
Submitted: 1998-01-13
   Days after onset:667
Entered: 1998-01-14
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Meningitis
SMQs:, Noninfectious meningitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-03-17
   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: CO6551

Write-up: pt recv vax & died of HIB meningitis;no immunodeficiency or prematurity;


VAERS ID: 106697 (history)  
Form: Version 1.0  
Age: 0.8  
Sex: Female  
Location: Foreign  
Vaccinated:1997-11-26
Onset:1997-11-26
   Days after vaccination:0
Submitted: 1998-01-14
   Days after onset:49
Entered: 1998-01-21
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / 2 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Atrioventricular block, Cardiac failure
SMQs:, Cardiac failure (narrow), Conduction defects (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1997-11-26
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO7818

Write-up: pt recv vax 26NOV97 & same day pt w/a complicated congenital heart disease & was operated for tracheomalacia;also presented w/the narrowing of the trachea d/t a ring of blood vessels around it;COD heart failure caused by total AV block;


VAERS ID: 107086 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Unknown  
Location: Foreign  
Vaccinated:1997-12-22
Onset:1997-12-26
   Days after vaccination:4
Submitted: 1998-01-29
   Days after onset:34
Entered: 1998-01-30
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Drug ineffective, Infection, Meningitis
SMQs:, Lack of efficacy/effect (narrow), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO7828

Write-up: pt recv vax 22DEC97 & A case of invasive group C meningococcal disease has been reported;exp onset of illness on 26DEC97 cult confirmation is pending;pt hosp;


VAERS ID: 107120 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Foreign  
Vaccinated:1997-12-29
Onset:1997-12-30
   Days after vaccination:1
Submitted: 1997-12-30
   Days after onset:0
Entered: 1998-02-02
   Days after submission:34
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK RL / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pyrexia, Sudden infant death syndrome
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Neonatal disorders (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:
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WAES98011201

Write-up: pt recv vax 29DEC97 & 30DEC97 exp fever of 39.7;tx w/APAP & recovered;pt was fed 330AM & on 31DEC97 was found dead in bed @ 730AM;COD was suspected to be sudden infant death synd;


VAERS ID: 107417 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Foreign  
Vaccinated:1997-12-16
Onset:1997-12-16
   Days after vaccination:0
Submitted: 1998-01-15
   Days after onset:30
Entered: 1998-02-11
   Days after submission:27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 1 - / IM

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: 1997-12-16
   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: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy results reportedly consistent w/SIDS
CDC Split Type: 898027009L

Write-up: pt died approx 12hr p/vax;results of an autopsy were reportedly consistent w/SIDS;


VAERS ID: 107641 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:1997-01-21
Onset:1997-01-22
   Days after vaccination:1
Submitted: 1997-01-27
   Days after onset:5
Entered: 1998-02-13
   Days after submission:382
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
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: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1997-01-22
   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: 898033003L

Write-up: pt recv vax 21JAN97 & pt died on 22JAN97;


VAERS ID: 107717 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:1996-07-24
Onset:1996-07-25
   Days after vaccination:1
Submitted: 1998-02-12
   Days after onset:567
Entered: 1998-02-13
   Days after submission:1
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) / UNKNOWN MANUFACTURER - / 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: 1996-07-25
   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: CO7848

Write-up: pt recv vax 24JUL96 & was found dead on 25JUL96;autopsy did not list COD;police investigating toxicological exams were performed because a case of child abuse was evoked;committee considered as a sudden SIDS;


VAERS ID: 107854 (history)  
Form: Version 1.0  
Age: 50.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:1998-02-01
Submitted: 1998-02-23
   Days after onset:22
Entered: 1998-02-27
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Haematemesis, Infection, Lung disorder, Pneumonia, Sepsis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (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? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: alcohol abuse
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WAES98027741

Write-up: pt recv vax 1997 & 1FEB98 presented w/hematemesis & signs of chest infect;pt was hosp & died five days later of pneumococcal septicemia;


VAERS ID: 108776 (history)  
Form: Version 1.0  
Age: 4.0  
Sex: Male  
Location: Foreign  
Vaccinated:1998-02-20
Onset:1998-02-21
   Days after vaccination:1
Submitted: 1998-02-21
   Days after onset:0
Entered: 1998-03-20
   Days after submission:27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA496B2 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Dyspnoea, Headache, Stupor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: NONE
Current Illness: NONE
Preexisting Conditions: pt healthy @ time of vax;
Allergies:
Diagnostic Lab Data:
CDC Split Type: 19980070201

Write-up: pt recv vax 20FEB98 & 21FB98 11PM pt devel h/a & important resp sx (breathing difficulties) according to the description made by the parent;p/having water pt vomited & presented repulsed eyes;pt taken to hosp & declared dead by MD;


VAERS ID: 109023 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:1998-03-11
Onset:1998-03-12
   Days after vaccination:1
Submitted: 1998-03-20
   Days after onset:8
Entered: 1998-04-01
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N0113 / 1 - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 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: 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: sl cold but no fever @ time of vax;
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: U1998000750

Write-up: pt recv vax 11MAR98 & presented w/a sl cold but no fever @ the time so was vaccinated;pt given tempra @ bedtime;evening of 11th pt checked @ 3AM was fine;pt not awoke 1045AM morning of 12ht mom checked found pt dead in crib;


VAERS ID: 109051 (history)  
Form: Version 1.0  
Age: 60.0  
Sex: Male  
Location: Foreign  
Vaccinated:1998-03-04
Onset:1998-03-06
   Days after vaccination:2
Submitted: 1998-04-01
   Days after onset:26
Entered: 1998-04-02
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (RABAVERT) / NOVARTIS VACCINES AND DIAGNOSTICS - / 4 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Back pain, Hypokinesia
SMQs:, Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1998-03-10
   Days after onset: 4
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: immunosuppressive drugs
Current Illness:
Preexisting Conditions: stray dog bite on lt leg;stated to be abnormal;
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2962

Write-up: pt recv vax 4MAR98 & 2 days p/vax pt devel a severe backache, loss of motor power in lt leg, inability to walk w/o support;pt died 4 days later, cause unk;


VAERS ID: 109215 (history)  
Form: Version 1.0  
Age: 13.0  
Sex: Male  
Location: Foreign  
Vaccinated:1995-05-01
Onset:1995-06-24
   Days after vaccination:54
Submitted: 1998-03-31
   Days after onset:1011
Entered: 1998-04-03
   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: Anaemia, Aplastic anaemia, Asthenia, Haemorrhage, Infection, Laboratory test abnormal, Leukopenia, Renal failure acute, Thrombocytopenia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (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), Guillain-Barre syndrome (broad), Myelodysplastic syndrome (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1998-02-23
   Days after onset: 975
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 blood vitamin B12 198;epstein Barr virus serology-old infect;JUN95 parvovirus B19 serology old infect;
CDC Split Type: 19980076891

Write-up: JUN95 pt devel asthenia, gen status deterioration & spontaneous hematoma, anemia, neutropenia & thrombopenia & life threatening idiopathic bone marrow aplasia dx;pt died 23FEB98 d/t cerebral aspergillosie, renal failure;bronchiolitis;


VAERS ID: 109992 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Female  
Location: Foreign  
Vaccinated:1998-01-09
Onset:1998-03-26
   Days after vaccination:76
Submitted: 1998-04-16
   Days after onset:20
Entered: 1998-04-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES M1092 / 3 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Dehydration, Diarrhoea, Pneumonia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-03-26
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: U1998001420

Write-up: pt recv vax 9JAN98 & 23MAR98 pt was hosp w/a dx of diarrhea & dehydration;26MAR98 pt died w/COD listed as pneumonia;


VAERS ID: 110235 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
Vaccinated:1998-02-24
Onset:1998-02-25
   Days after vaccination:1
Submitted: 1998-04-22
   Days after onset:55
Entered: 1998-04-27
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / UNK - / -
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-02-26
   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: thrush;
Allergies:
Diagnostic Lab Data: parents refused autopsy
CDC Split Type: 19980103332

Write-up: pt recv vax 24FEB98 & 25FEB98 devel fever 37.6C & tx w/med;26FEB98 pt was put in bed on back;10PM pt parents found pt dead on stomach w/milk in mouth;COD unk;parents refused autopsy;probably unrelated to vax per reporter;


VAERS ID: 110515 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Female  
Location: Foreign  
Vaccinated:1998-03-26
Onset:1998-04-13
   Days after vaccination:18
Submitted: 1998-04-14
   Days after onset:1
Entered: 1998-05-01
   Days after submission:17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH 447374 / 2 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Aspartate aminotransferase increased, Blood creatinine increased, Blood urea increased, Hypoproteinaemia, Hypoxia, Infection, Meningitis, Sepsis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Asthma/bronchospasm (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious meningitis (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1998-04-14
   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: unk
Current Illness: unk
Preexisting Conditions: bronchiolitis JAN98;
Allergies:
Diagnostic Lab Data: 13APR98 serum urea 12.4;serum creatinine 72;C-reative protein 190.3;leukocyte count 3.84;lymph count 2.11;14APR98 serum urea 13.4;serum creat 89AST 81;LDH 864;total protein 46;serum albumin 25;blood ammonia 97;CSF turbid w/210 lymph;
CDC Split Type: 898106007N

Write-up: pt recv vax 26MAR98 & on 13APR98 pt hosp dx of HIB meningitis & septicemia;tx w/IV Rocephin, IV PCN, IV amikacin & mechanical ventilation;pt died on 14APR98;


VAERS ID: 110682 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
Vaccinated:1998-04-20
Onset:1998-04-20
   Days after vaccination:0
Submitted: 1998-05-05
   Days after onset:15
Entered: 1998-05-08
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / UNK - / -
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. N54142 / UNK - / IM
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: 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 (broad), Cardiomyopathy (broad), Neonatal disorders (narrow), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-04-20
   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:
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WAES98042096

Write-up: pt recv vax & the same day pt died while sleeping;during prev hr nothing abn was noticed by parents;dx cardiac arrest;the following day an autopsy was carried out;the findings were not available;clinical dx sudden infant death synd;


VAERS ID: 111214 (history)  
Form: Version 1.0  
Age: 1.6  
Sex: Female  
Location: Foreign  
Vaccinated:1998-03-02
Onset:1998-03-02
   Days after vaccination:0
Submitted: 1998-05-20
   Days after onset:78
Entered: 1998-05-29
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N53931 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Haemorrhage, Pyrexia, Sepsis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: 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: U1998002480

Write-up: pt exp fever, sepsis & hemorrhage w/in 18hr of vax;pt hosp & 5hr later died;COD was meningococcemia;


VAERS ID: 111977 (history)  
Form: Version 1.0  
Age: 78.0  
Sex: Male  
Location: Foreign  
Vaccinated:1997-11-18
Onset:1997-12-01
   Days after vaccination:13
Submitted: 1998-06-16
   Days after onset:196
Entered: 1998-06-19
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Dyspnoea, Injury, Pharyngitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-02-23
   Days after onset: 84
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: Captopril;Digoxin;Furosemide;Isosorbide dinitrate;Nifedipine;Phenprocoumon;sotalol;
Current Illness:
Preexisting Conditions: atrial tachycardia;congestive heart failure;diabetes mellitus;hemorrhoidectomy;hypertensive heart disease;hyperuricemia;pneumonia;pulmonary embolism;transient ischemic attack;
Allergies:
Diagnostic Lab Data: diagnostic lab test massive intracerebral bleeding;
CDC Split Type: WAES98060833

Write-up: 1DEC97 pt devel dyspnea;11DEC97 devel purulent tonsillitis;pt hosp;22FEB98 pt on anticoagulation therapy fell on back of head;CT showed massive intracerebral bleeding w/no chance of operative intervention;23FEB98 pt died;


VAERS ID: 111979 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Male  
Location: Foreign  
Vaccinated:1998-06-11
Onset:1998-06-11
   Days after vaccination:0
Submitted: 1998-06-17
   Days after onset:6
Entered: 1998-06-19
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abnormal faeces, Adrenal insufficiency, Confusional state, Endocrine disorder, Granuloma, Infection, Shock
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), 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), Biliary system related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (broad), Hypoglycaemia (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: an autopsy performed;
CDC Split Type: 19980155361

Write-up: pt recv vax 11JUN98 & same day had abn feces & disoriented;1130PM was found dead; a poss intrauterine infect torch synd was evoked;autopsy showed sx of epi deficit, shocked organs, cerebral granulomas & enlarged thymic gland;


VAERS ID: 112043 (history)  
Form: Version 1.0  
Age: 49.0  
Sex: Male  
Location: Foreign  
Vaccinated:1997-01-01
Onset:0000-00-00
Submitted: 1998-06-17
Entered: 1998-06-23
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (IMOVAX) / PASTEUR MERIEUX INST. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: CSF test abnormal, Hypotonia, Infection, Neuropathy, Paralysis
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: U199800296

Write-up: pt recv vax JAN97 & 6wk later pt devel neuro sx starting w/unilateral brachial paresis, leading to hypotonic telekinesis;in spite of ICU pt died on the 10th day p/admission;the dx of rabies was confirmed by virus antigen ID from pt CSF;


VAERS ID: 112735 (history)  
Form: Version 1.0  
Age: 36.0  
Sex: Male  
Location: Foreign  
Vaccinated:1997-03-20
Onset:1997-03-21
   Days after vaccination:1
Submitted: 1998-07-14
   Days after onset:479
Entered: 1998-07-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / 2 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: CSF test abnormal, Guillain-Barre syndrome, Infection, Myopathy, Neuropathy, Paralysis, Respiratory disorder, Sepsis
SMQs:, Rhabdomyolysis/myopathy (narrow), Peripheral neuropathy (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1997-10-15
   Days after onset: 207
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: tobacco user w/hx of appendectomy in 1964, peritonitis in 1964, hemmorrhoidectomy in 1995, scabies MAR97;
Allergies:
Diagnostic Lab Data: 1997 protein CSF 165;MAR97 protein CSF 107;blood lymphocyte count lymphocyte dec 30/3;
CDC Split Type: WAES97080021

Write-up: pt exp inc weakness of muscles w/distal paresis of legs & tingling paresthesia;dx GBS made p/lab eval of CSF;pt had F-waves latencies in upper & lower rt limbs;cranial nerve dysfunction;sepsis, resp insufficiency d/t acute resp distress syn


VAERS ID: 112778 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Foreign  
Vaccinated:1998-07-07
Onset:1998-07-08
   Days after vaccination:1
Submitted: 1998-07-16
   Days after onset:8
Entered: 1998-07-21
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / 4 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Febrile convulsion, Otitis media, Pyrexia, Respiratory disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-07-11
   Days after onset: 3
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 to be performed;
CDC Split Type: 19980177891

Write-up: 1 day p/vax 8JUL98 pt devel fever & 10JUL98 OM dx;11JUL98 pt was found dead in his bed;COD unk-autopsy will be performed;MD assumed poss COD aspiration p/febrile convuls;@ present MD assessed child death as unrelated to vax;


VAERS ID: 112821 (history)  
Form: Version 1.0  
Age: 48.0  
Sex: Male  
Location: Foreign  
Vaccinated:1998-06-24
Onset:1998-07-03
   Days after vaccination:9
Submitted: 1998-07-22
   Days after onset:19
Entered: 1998-07-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (RABAVERT) / NOVARTIS VACCINES AND DIAGNOSTICS 388 / 4 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Confusional state, Convulsion, Encephalitis, Eye disorder, Guillain-Barre syndrome, Hyporeflexia, Hypoxia, Myelitis
SMQs:, Asthma/bronchospasm (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1998-07-22
   Days after onset: 19
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: NONE
Current Illness: dog bite
Preexisting Conditions: category III dog bite on dorsum of hand 10JUN98;the pet dog which was pre vaccinated, had bitten two other members of the same family & died p/7 days;
Allergies:
Diagnostic Lab Data: all lab parameters WNL except creatinine 2.1mg;the brain of the dog had not been sent for analysis to confirm/r/o rabies;
CDC Split Type: 3515

Write-up: pt devel weakness r/t post vax disseminated encephalomyelitis, gen areflexia;behavioral problems more talkative, disoriented to time, place & person;resp efforts reduced 02 sat fell to 85% placed on artificial ventilation;sz;rt eye frozen;


VAERS ID: 112822 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Foreign  
Vaccinated:1998-06-27
Onset:1998-06-28
   Days after vaccination:1
Submitted: 1998-07-01
   Days after onset:3
Entered: 1998-07-23
   Days after submission:22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH 453990 / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Anaphylactoid reaction, Dysphagia, Sudden infant death syndrome, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Neonatal disorders (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-06-28
   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: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy-results pending;
CDC Split Type: 898183061A

Write-up: pt recv vax 27JUN98 & was found dead 19 hr post vax;traces of vomit were found in mouth & nose;potential causes of death being pursued are anaphylactic shock, sudden infant death synd & choking on vomit;autopsy results are pending;


VAERS ID: 113475 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Foreign  
Vaccinated:1998-03-03
Onset:1998-07-04
   Days after vaccination:123
Submitted: 1998-08-07
   Days after onset:34
Entered: 1998-08-18
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES M1092 / UNK RL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-07-04
   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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: U199800463

Write-up: pt recv vax 3MAR98 & died on 4JUL98;the description of the circumstances is not available;@ this time 7AUG98 no details regarding COD are known;


VAERS ID: 113509 (history)  
Form: Version 1.0  
Age: 30.0  
Sex: Female  
Location: Foreign  
Vaccinated:1998-04-30
Onset:1998-07-06
   Days after vaccination:67
Submitted: 1998-08-17
   Days after onset:42
Entered: 1998-08-19
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / UNK - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Blood creatinine increased, Cyanosis, Hepatic function abnormal, Infection, Leukocytosis, Myocarditis, Myopathy, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (narrow), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Tumour lysis 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? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations: pt exp inj site rxn & had dialysis p/vax;~ ()~~~In patient
Other Medications:
Current Illness: tx w/ATB unk cause;
Preexisting Conditions: swelling of wrist & knee joints during the past few months;allergies not reported;
Allergies:
Diagnostic Lab Data: 31JUL98 alk phos 181, 236;C-reactive protein .8;creatine phos 1268 & 8033;creatinine 1.4;glucose155;myoglobin 31108;K 5.4;quick''s test liver func 44;SGOT 149 & 395;SGPT 98 & 190;
CDC Split Type: 19980205361

Write-up: pt recv by mistake Infanrix-HIB instead of IPV;6JUL98 exp bronchitis;blood count nl;sed rate inc;thoracic pain & insensibility of lt arm;13JUL98 circulatory failure;dx myocarditis, anuria,rhabdomyolysis & pneumonia;peripheral cyanosis;


VAERS ID: 114016 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:1998-08-08
Onset:1998-08-08
   Days after vaccination:0
Submitted: 1998-09-01
   Days after onset:24
Entered: 1998-09-10
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Dyspnoea, Infection, Malaise, Pyrexia, Respiratory disorder, Sepsis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (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: 1998-08-08
   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: ampicillin;vitamin K;
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WAES98088752

Write-up: pt recv vax 8AUG98 & was reported as unwell & on exam noted to be struggling w/resp;pt given ATB;highest reported T38.2R;despite intervention child cont to deteriorate & dies 140PM;COD infect, resp, acute & septicemia;


VAERS ID: 114207 (history)  
Form: Version 1.0  
Age: 33.0  
Sex: Male  
Location: Foreign  
Vaccinated:1997-06-01
Onset:1997-07-07
   Days after vaccination:36
Submitted: 1998-09-11
   Days after onset:431
Entered: 1998-09-16
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Aplastic anaemia, Ecchymosis, Epistaxis, Gingival bleeding, Infection, Laboratory test abnormal, Leukaemia, Pancytopenia
SMQs:, Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic erythropenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Gingival disorders (narrow), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Haematological malignant tumours (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-06-11
   Days after onset: 339
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiatal hernia;tuberculosis primo-infect (2yr old);no family hx of blood or auto-immuen disease;
Allergies:
Diagnostic Lab Data: 1997-anti HBC antibodies negative;CBC pancytopenia;HLA typing A24/B38/B44/DRB1 1301 0801/DPB1 0301 1001/DQB1 0402 0603;
CDC Split Type: 19970231171

Write-up: 7JUL97 pt exp gums bleeding, ecchymosis & epistaxis;pt hosp inER dx aplasia bone marrow;lab test revealed pancytopania & low level reticulocytes;pt devel immunosuppressant tx induced acute lymphoproliferative synd causing pt death;


VAERS ID: 114280 (history)  
Form: Version 1.0  
Age: 76.0  
Sex: Unknown  
Location: Foreign  
Vaccinated:1997-05-01
Onset:1997-05-06
   Days after vaccination:5
Submitted: 1998-09-16
   Days after onset:498
Entered: 1998-09-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 028011 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Aspartate aminotransferase increased, Blood alkaline phosphatase increased, Hepatocellular damage, Immunoglobulins increased, Infection, Jaundice cholestatic, Sepsis, Shock
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (narrow), 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), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Digitoxin;Erythropoietin;Ferrous gluconate;Furosemide;
Current Illness:
Preexisting Conditions: chronic renal failure;rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: 8APR97 serum alkaline phosphatase-205;serum aspartate aminotransferase 29;6MAY97 serum alk phos 514;serum asparate aminotransferase 185;lab test EBV IgG & IgM positive;blood cult E coli & enterococcae;serum direct bilirubin max value
CDC Split Type: WAES98090386

Write-up: 5 days post vax lab test showed elevated liver enzymes (SGOT-185, AP 514);devel inc jaundice & 23MAY97 adm to hosp;positive IgG & IgM for EBV;30MAY97 showed acute hepatocellular necrosis, intrahepatic cholestasis;septic shock;liver injury


VAERS ID: 114488 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Foreign  
Vaccinated:1998-09-09
Onset:1998-09-09
   Days after vaccination:0
Submitted: 1998-09-24
   Days after onset:15
Entered: 1998-09-29
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1000E / UNK - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Acidosis, Agitation, Hypoxia, Pyrexia, Stupor, Sudden infant death syndrome, Syncope, Tachycardia, Unevaluable event
SMQs:, Torsade de pointes/QT prolongation (broad), Asthma/bronchospasm (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1998-09-12
   Days after onset: 3
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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: autopsy-hypoxic encephalopathy following out of hosp cardiac arrest;
CDC Split Type: WAES98091172

Write-up: pt recv vax 9SEP98 & 6hr post vax pt parents found pt collapsed & unresponsive;pt adm to ICU & was ventilated for 3 days;12SEP98 pt died;pt COD sudden infant synd;


VAERS ID: 114919 (history)  
Form: Version 1.0  
Age: 12.0  
Sex: Female  
Location: Foreign  
Vaccinated:1998-05-29
Onset:1998-06-24
   Days after vaccination:26
Submitted: 1998-10-06
   Days after onset:104
Entered: 1998-10-13
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Delirium, Diarrhoea, Hepatic failure, Hepatitis, Nausea, Renal failure, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Hepatitis, non-infectious (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), 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), Dementia (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (narrow), 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: 1998-06-29
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Aspro 500 vitamins C
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 19980241481

Write-up: pt recv vax 29MAY98 & 24JUN pt devel cardiac failure, hepatic failure (cytolysis & hepatic encephalopathy) causing death five days later on 29JUN98;vax induced fulminant hepatitis or aspirin induced reye''s synd or metabolic disease;


VAERS ID: 114920 (history)  
Form: Version 1.0  
Age: 24.0  
Sex: Male  
Location: Foreign  
Vaccinated:1998-08-24
Onset:1998-09-02
   Days after vaccination:9
Submitted: 1998-10-06
   Days after onset:34
Entered: 1998-10-13
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 56706 / UNK - / IM
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-09-02
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Epilepsy
Allergies:
Diagnostic Lab Data:
CDC Split Type: 19980242181

Write-up: pt recv vax & 10 days post vax pt exp epileptic fit & died;


VAERS ID: 115531 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Female  
Location: Foreign  
Vaccinated:1993-07-19
Onset:1993-07-29
   Days after vaccination:10
Submitted: 1998-10-29
   Days after onset:1918
Entered: 1998-11-02
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Infection, Meningitis
SMQs:, Noninfectious meningitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WAES98101925

Write-up: A lit reference described a pt who recv vax 19JUL93 & pt devel meningitis & died;pt exp was felt to be life-threatening;


VAERS ID: 116385 (history)  
Form: Version 1.0  
Age: 70.0  
Sex: Female  
Location: Foreign  
Vaccinated:1998-10-19
Onset:1998-10-20
   Days after vaccination:1
Submitted: 1998-11-13
   Days after onset:24
Entered: 1998-11-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-10-20
   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:
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: EML981919

Write-up: pt recv vax & died suddenly the day p/vax 19OCT98;


VAERS ID: 116521 (history)  
Form: Version 1.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1998-11-11
Entered: 1998-11-19
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hepatic function abnormal, Hepatic necrosis, Hepatocellular damage, Immunoglobulins increased, Infection, Jaundice cholestatic, Pyrexia, Shock
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), 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), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (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: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WAES98110210

Write-up: pt recv vax & exp septic shock, hepatocellular necrosis, fever sl malaise, liver enzymes inc, inc immunoglobulins, epstein-barr virus positive & intrahepatic cholestasis;COD septic shock;


VAERS ID: 116569 (history)  
Form: Version 1.0  
Age: 1.4  
Sex: Female  
Location: Foreign  
Vaccinated:1998-11-09
Onset:1998-11-09
   Days after vaccination:0
Submitted: 1998-11-17
   Days after onset:8
Entered: 1998-11-20
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 111011A / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Cardiac failure, Cardiovascular disorder
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (narrow), 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), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: aortic valve stenosis
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WAES98110919

Write-up: pt recv vax 9NOV98 & 3hr post vax pt exp sudden death;DOC unk;


VAERS ID: 117066 (history)  
Form: Version 1.0  
Age: 63.0  
Sex: Male  
Location: Foreign  
Vaccinated:1998-11-10
Onset:1998-11-14
   Days after vaccination:4
Submitted: 1998-12-02
   Days after onset:18
Entered: 1998-12-04
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiac arrest, Cardiovascular disorder, Pneumonia
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), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-11-14
   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: diabetes, blind
Allergies:
Diagnostic Lab Data:
CDC Split Type: U199800857

Write-up: pt recv vax 10NOV98 & was taken to hospital by amb 4AM on 14NOV98 & died 1hr later;COD pneumonia & was told that the pneumonia brought on a heart attack;


VAERS ID: 117199 (history)  
Form: Version 1.0  
Age: 26.0  
Sex: Male  
Location: Foreign  
Vaccinated:1996-08-01
Onset:1996-09-01
   Days after vaccination:31
Submitted: 1998-11-30
   Days after onset:820
Entered: 1998-12-08
   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: Malignant melanoma
SMQs:, Skin malignant tumours (narrow), Non-haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-11-23
   Days after onset: 83
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: pt exp in JUL96 mult subcutaneous metastasic nodules;~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: naevus exersis 1994;
Allergies:
Diagnostic Lab Data:
CDC Split Type: 19980284641

Write-up: pt recv vax AUG96 & SEP96 malignant melanoma was dx;pt was hosp OCT96 & recv 2 courses of chemotherapy;died on 23NOV96;


VAERS ID: 117767 (history)  
Form: Version 1.0  
Age: 22.0  
Sex: Male  
Location: Foreign  
Vaccinated:1998-11-06
Onset:1998-11-13
   Days after vaccination:7
Submitted: 1998-12-22
   Days after onset:39
Entered: 1998-12-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (RABAVERT) / NOVARTIS VACCINES AND DIAGNOSTICS 406 / 4 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Myasthenic syndrome, Paralysis, Urinary retention
SMQs:, Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1998-11-25
   Days after onset: 12
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: dog bite, date unk
Allergies:
Diagnostic Lab Data:
CDC Split Type: 3740

Write-up: pt recv vax 7NOV98 & 13NOV98 pt devel ascending paralysis;pt died 25NOV98;


VAERS ID: 117860 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
Vaccinated:1998-11-27
Onset:1998-11-28
   Days after vaccination:1
Submitted: 1998-12-21
   Days after onset:23
Entered: 1999-01-04
   Days after submission:14
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: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-11-28
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: U199800908

Write-up: pt died suddenly the day p/vax;the death was probably linked to bedding conditions;pt had been well tolerated apart from a sl fever 38C observed the morning after, for which recv APAP;


VAERS ID: 117861 (history)  
Form: Version 1.0  
Age: 0.8  
Sex: Female  
Location: Foreign  
Vaccinated:1998-09-28
Onset:1998-12-10
   Days after vaccination:73
Submitted: 1998-12-22
   Days after onset:12
Entered: 1999-01-04
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES M1092 / UNK RL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cachexia
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1998-12-10
   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: U199800912

Write-up: pt recv vax 28SEP98 & reportedly died on 10DEC98 from malnutrition;The description of the circumstances is not yet available;


VAERS ID: 118067 (history)  
Form: Version 1.0  
Age: 15.0  
Sex: Male  
Location: Foreign  
Vaccinated:1994-10-19
Onset:1995-06-05
   Days after vaccination:229
Submitted: 1999-01-06
   Days after onset:1311
Entered: 1999-01-11
   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: Abdominal pain, Alanine aminotransferase increased, Encephalopathy, Hepatic failure, Hepatic necrosis, Hepatitis, Jaundice, Laboratory test abnormal, Pyrexia, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Hepatitis, non-infectious (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: 1993 viral meningeal syndrome;no relevant family history
Allergies:
Diagnostic Lab Data: ALAT 6000;Anti-EA epstein Barr virus IGM dubious result;anti-smooth muscle antibodies positive;liver biopsy severe necrotic hepatitis w/poss cirrhogenous evolution appearance like an auto immune hepatitis
CDC Split Type: 19990000101

Write-up: pt recv vax 19OCT94 & 5JUN95 pt devel abd pain & vomited which spontaneously x/some paracetamol intakes (never more than 2mg day) regressed;JUL95 pt exp fever & abd pain followed by icterus;dx acute cytolytic hepatitis had PT 70 & ALAT 6000


VAERS ID: 118271 (history)  
Form: Version 1.0  
Age: 67.0  
Sex: Female  
Location: Foreign  
Vaccinated:1998-10-22
Onset:1998-11-02
   Days after vaccination:11
Submitted: 1999-01-19
   Days after onset:78
Entered: 1999-01-22
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Anorexia, Asthenia, Diarrhoea, Pharyngitis, Pneumonia, Rhinitis, Sepsis
SMQs:, Agranulocytosis (broad), Pseudomembranous colitis (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), 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: 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: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: severe COPD, severe oxygen dependent, chronic dementia
Allergies:
Diagnostic Lab Data: WBC-increased; Blood culture-positive pneumcoccus; Chest X-ray; EKG
CDC Split Type: U199900043

Write-up: Pt recv vax on 10/22/98; on 11/2/98 pt exp a cold, not eating, diarrhea, weakness; pt to hosp 11/3;dx=acute left lobar pneumonia; tx=IV antibiotics; pt expired on unspecified day


VAERS ID: 118382 (history)  
Form: Version 1.0  
Age: 0.7  
Sex: Female  
Location: Foreign  
Vaccinated:1999-01-07
Onset:1999-01-09
   Days after vaccination:2
Submitted: 1999-01-22
   Days after onset:13
Entered: 1999-01-27
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N55712 / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Coma, Electroencephalogram abnormal, Infection, Laboratory test abnormal
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (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: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: 1/13/99-EEG flat; Lab tests-CMV-IgM
CDC Split Type: U199900048

Write-up: Pt recv vax on 1/7/99; on 1/9/99 pt exp coma


VAERS ID: 118500 (history)  
Form: Version 1.0  
Age: 86.0  
Sex: Male  
Location: Foreign  
Vaccinated:1998-11-05
Onset:1998-11-19
   Days after vaccination:14
Submitted: 1999-01-25
   Days after onset:67
Entered: 1999-01-28
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Drug ineffective, Infection, Malaise, Pneumonia, Respiratory disorder
SMQs:, Lack of efficacy/effect (narrow), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1998-12-12
   Days after onset: 23
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WAES99011244

Write-up: pt recv vax & 30NOV98 pt was adm to hosp where on 12DEC98 pt died of pneumonia;pt was in good health @ time of vax;


VAERS ID: 119190 (history)  
Form: Version 1.0  
Age: 1.7  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1999-02-18
Entered: 1999-02-22
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Delirium, Encephalitis, Immunoglobulins decreased, Laboratory test abnormal, Neuropathy, Oral candidiasis, Rash, Sepsis
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Sepsis (narrow), 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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: mild thrush & manila diaper rash;
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: brain biopsy-sparse lymphocytic meningoencephalitis, neuronal/oligodendroglial loss;reactive astrocytosis;diagnostic lab test profound depression of CD8 lymphocytes;IgG antibody low;lab test high complement fixing antibody titer ($g1:1024)
CDC Split Type: WAES99020300

Write-up: lit ref-pt recv vax & approx 8.5mo p/vax pt dx w/measles inclusion body encephalitis (MIBE);brain biopsy revealed sparse lymphocytic meningoencephalitis, moderate neuronal & oligodendroglia loss & reactive astrocytosis w/in cortex;


VAERS ID: 119332 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
Vaccinated:1999-02-01
Onset:1999-02-01
   Days after vaccination:0
Submitted: 1999-02-22
   Days after onset:21
Entered: 1999-02-24
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / 1 - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiovascular disorder, Congenital anomaly, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Congenital, familial and genetic disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: suspected cardiopathy
Allergies:
Diagnostic Lab Data:
CDC Split Type: 19990042431

Write-up: pt recv vax 1FEB99 & 1 day later pt found w/resp difficulties (dyspnea) & taken to local hosp;pt died on the way;autopsy results not yet available;it has been suggested the event may be d/t congenital cause like suspected cardiopathy;


VAERS ID: 119333 (history)  
Form: Version 1.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:1999-02-10
Onset:1999-02-11
   Days after vaccination:1
Submitted: 1999-02-19
   Days after onset:8
Entered: 1999-02-24
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / 1 - / -
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiac arrest, Dyspnoea, Encephalitis, Hepatitis, Hypotonia, Hypoxia, Infection
SMQs:, Torsade de pointes/QT prolongation (broad), Hepatitis, non-infectious (narrow), Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 19990042291

Write-up: 2 days p/vax pt devel an encephalitis;pt hosp;16FEB99 @ time of the report pt was still hosp;the reporter considers the event to be possibly r/t vax;


VAERS ID: 119425 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1999-02-08
Entered: 1999-02-26
   Days after submission:18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH - / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Drug ineffective, Infection, Pneumonia
SMQs:, Lack of efficacy/effect (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: unk~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: hodgkin''s disease, devel pulmonary fibrosis & resp insufficiency p/ bleomycin tx
Allergies:
Diagnostic Lab Data: serology: positive for S. pneumoniae, serotype 14;
CDC Split Type: 899040091A

Write-up: pt recv vax in 1996 or 1997 & recently devel pneumonia;serology indicated that the causative organism was S. pneumoniae, serotype 14;pt died;


VAERS ID: 120443 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:1998-04-20
Onset:1998-04-20
   Days after vaccination:0
Submitted: 1999-03-11
   Days after onset:325
Entered: 1999-03-18
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / UNK - / -
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N54142 / UNK - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: 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 (broad), Cardiomyopathy (broad), Neonatal disorders (narrow), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-04-20
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: U199800161

Write-up: pt recv vax 20APR98 & early afternoon pt died when was sleeping;nothing abn was observed by parents between the vax & death;dx cardiac arrest;autopsy carried out 21APR98;child died w/in 5hr of vax;dx SIDS:


VAERS ID: 120810 (history)  
Form: Version 1.0  
Age: 0.26  
Sex: Male  
Location: Foreign  
Vaccinated:1999-03-08
Onset:1999-03-10
   Days after vaccination:2
Submitted: 1999-03-26
   Days after onset:16
Entered: 1999-03-31
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Condition aggravated, Diarrhoea, Pyrexia, Respiratory disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-03-12
   Days after onset: 2
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: no autopsy was or will be performed;
CDC Split Type: 1999006745

Write-up: pt recv vax & 2 days later devel fever 38C & vomiting;PE nl & tx w/meds;11MAR99 vomiting was still present & diarrhea;12MAR99 mom discovered pt dead, on back w/ regurgitation near him;MD called;final DX: inhalation following regurgitation


VAERS ID: 121021 (history)  
Form: Version 1.0  
Age: 32.0  
Sex: Female  
Location: Foreign  
Vaccinated:1997-06-11
Onset:1998-08-01
   Days after vaccination:416
Submitted: 1999-03-31
   Days after onset:242
Entered: 1999-04-08
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / UNK - / -
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI) / CONNAUGHT LABORATORIES M0510L / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hepatic neoplasm, Laboratory test abnormal, Peritoneal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (narrow), Liver tumours of unspecified malignancy (narrow), Non-haematological tumours of unspecified malignancy (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-11-05
   Days after onset: 96
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: oral contraceptives
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: U199900196

Write-up: 13 mon p/vax hepatic tumor ID w/ultrasound;initial dx focal nodular hyperplasia in pt tx w/long term oral contraceptive;f/u revealed pt died probably from complication of liver biopsy;died 5NOV98 from intra-abd hemorrhage p/ liver puncture


VAERS ID: 121057 (history)  
Form: Version 1.0  
Age: 80.0  
Sex: Female  
Location: Foreign  
Vaccinated:1998-09-22
Onset:1998-09-23
   Days after vaccination:1
Submitted: 1999-04-06
   Days after onset:195
Entered: 1999-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / 1 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Myocardial infarction, Pyrexia, Renal failure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), 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), Embolic and thrombotic events, arterial (narrow), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), 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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: chronic bronchitis;cor pulmonale;
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WAES99040063

Write-up: pt recv vax 22SEP98 & the following day pt exp fever & was hosp next day;19OCT98 pt died;COD myocardial infarction & renal failure;the reporting MD felt that fever,myocardial infarction, and renal failure was poss r/t vax;


VAERS ID: 121959 (history)  
Form: Version 1.0  
Age: 23.0  
Sex: Female  
Location: Foreign  
Vaccinated:1998-12-22
Onset:1998-12-22
   Days after vaccination:0
Submitted: 1999-05-06
   Days after onset:134
Entered: 1999-05-07
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Amnesia, Anaphylactoid reaction, Asthenia, Bone disorder, Confusional state, Depressed level of consciousness, Ear disorder, Epistaxis, Haemorrhage, Hallucination, Hypoglycaemia, Hypokinesia, Injury, Somnolence, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), 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), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-12-22
   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: Insulin
Current Illness:
Preexisting Conditions: Type 1 Diabetes
Allergies:
Diagnostic Lab Data: exam by coroner revealed presence of blood flowing from ears & nose luxation & hyperlaxity of the cervical spine;rib cage crushed; fracture of lt femur;glycemia too low; absence of glucose in urine
CDC Split Type: 19990096151

Write-up: pt recv vax 22DEC98 & did not stay in office for required 30min post vax;appeared drowsy & even slept while waiting for a friend @ another medical clinic;pt seem confused;diff raising hand & appeared sluggish & weak;pt had auto accident;


VAERS ID: 123161 (history)  
Form: Version 1.0  
Age: 0.7  
Sex: Male  
Location: Foreign  
Vaccinated:1999-05-18
Onset:1999-05-18
   Days after vaccination:0
Submitted: 1999-05-25
   Days after onset:7
Entered: 1999-05-28
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / 2 - / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Asphyxia, Cardiac arrest, Cardiovascular disorder, Coagulopathy, Cyanosis, Delirium, Electroencephalogram abnormal, Gastrointestinal haemorrhage, Hepatocellular damage, Hypotonia, Hypoventilation, Hypoxia, Laboratory test abnormal, Mydriasis, Neuropathy, Pupillary disorder, Skin disorder, Stupor
SMQs:, Torsade de pointes/QT prolongation (broad), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hostility/aggression (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1999-05-25
   Days after onset: 7
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: pt exp vomiting & fever w/dose 1 DTAP/polio/HIB;~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: premature delivery 33wk, ventricular septal defect w/ pulmonary stenosis; Fallot tetralogy; rt sided pelvic kidney
Allergies:
Diagnostic Lab Data: 5/18/99 CXR no aspiration;EEG no activity, severe brain damage;pupilary reflex non-reactive & dilated;no cardiological cause found, no edemas; numerous lab tests, see f/u 9/1/99,csf-inc 3 methyl glutaric acid & glutaric acid titres
CDC Split Type: 19990112591

Write-up: 2hr p/vax pt exp flaccid muscle tone, cyanosis, eyes gazed upward;weak resp, artificial resp given, brain damage detected & neurological condition;pupils dilated, light-rigid;liver damage;DIC,& intestinal hemorrhage;dx circulatory arrest


VAERS ID: 124768 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1999-05-28
Entered: 1999-06-15
   Days after submission:18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER 330083 / UNK - / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / UNK - / -

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: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: autopsy: COD listed as cot death but a link w/vax was also apparently mentioned;
CDC Split Type: 899152156A

Write-up: pt recv vax & died 5 days p/vax;the reporter stated that autopsy results listed COD as cot death but a link w/vax was also apparently mentioned;


VAERS ID: 127252 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Female  
Location: Foreign  
Vaccinated:1999-07-28
Onset:1999-07-29
   Days after vaccination:1
Submitted: 1999-07-29
   Days after onset:0
Entered: 1999-08-16
   Days after submission:18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER 330084 / UNK - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 459887 / UNK - / IM

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: 1999-07-29
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: very premature birth (5ob, 3oz @ 4.3 mo age); bowel surgery, chronic lung disease of prematurity
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: 899210227A

Write-up: a pharmacist rpt that pt recv vax; pt was vax just prior to planned discharge from hosp; before the pt could be discharged, pt exp cardiac arrest & died;


VAERS ID: 127779 (history)  
Form: Version 1.0  
Age: 7.0  
Sex: Female  
Location: Foreign  
Vaccinated:1998-03-12
Onset:1998-03-23
   Days after vaccination:11
Submitted: 1999-08-26
   Days after onset:520
Entered: 1999-08-31
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / 1 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hepatic function abnormal, Hepatic neoplasm malignant, Infection, Laboratory test abnormal, Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Liver malignant tumours (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological malignant tumours (narrow)

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: vax hx: DTIPV x3, MMR x1, HIBV x1, BCG x1
Current Illness:
Preexisting Conditions: metal allergy;pt sibling had hep A,
Allergies:
Diagnostic Lab Data: transaminases sl increased;serum hepatitis A antibody test-negative;serum hepatitis B surface antigen test-undetectable;HHV6 IgG & IgM-pos; VZV IgG-56U/ml; sl inc liver values on admit to hosp
CDC Split Type: WAES99081493

Write-up: pt exp infect w/fever;5/5/98 tumor in liver was palpated;pt dx w/hepatocellular carcinoma stage IV w/pulmonary metastasis & hosp;pt was in pre-final state;transaminase level had sl inc up to 40 then nl again;Hep A serology repeatedly neg;


VAERS ID: 128456 (history)  
Form: Version 1.0  
Age: 2.0  
Sex: Female  
Location: Foreign  
Vaccinated:1998-05-05
Onset:1998-08-04
   Days after vaccination:91
Submitted: 1999-09-21
   Days after onset:413
Entered: 1999-09-24
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / 2 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anaemia, Arthritis, Dermatomyositis, Dysphagia, Ear disorder, Gait disturbance, Myopathy, Rash, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (narrow), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-09-14
   Days after onset: 406
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: unk
Allergies:
Diagnostic Lab Data: ophthalmoscopy-nl; physical exam-nl; CBC-nl
CDC Split Type: WAES99090767

Write-up: pt exp lameness lt lower limb;no dx;3/99 seen by rheumatologist-dx oligoarthritis & sideropenic anemia;erythema of face & fingers, microcalcifications of ears, weight loss, swallowing diff, muscular disorder;dx dermatomyositis


VAERS ID: 128743 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:1999-09-21
Onset:1999-09-22
   Days after vaccination:1
Submitted: 1999-09-27
   Days after onset:5
Entered: 1999-09-29
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 GM / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 GM / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Gastrointestinal disorder, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-09-22
   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: esophageal reflux; no relevant family hx; pt born at term (3.5kg); no problem w/BCG
Allergies:
Diagnostic Lab Data:
CDC Split Type: 1999025154

Write-up: a mild esophageal reflux was noticed by MD; next morning fever & a droopy appearance (asthenia) was noticed; at noon sudden death occurred; an autopsy is scheduled;


VAERS ID: 128972 (history)  
Form: Version 1.0  
Age: 1.9  
Sex: Female  
Location: Foreign  
Vaccinated:1998-05-05
Onset:1998-08-04
   Days after vaccination:91
Submitted: 1999-10-05
   Days after onset:427
Entered: 1999-10-07
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anorexia, Arthralgia, Asthenia, Bronchitis, Calcium metabolism disorder, Condition aggravated, Dermatomyositis, Dysphagia, Gastroenteritis, Hypokinesia, Hypoxia, Myasthenic syndrome, Rash, Red blood cell sedimentation rate increased, Weight decreased
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), 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), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (broad), 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: 1999-09-14
   Days after onset: 406
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: no problem w/ prev vax~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: limping left lower limb since 1997
Allergies:
Diagnostic Lab Data:
CDC Split Type: 1999026010

Write-up: pt exp muscle weakness when walked, diff standing up, asthenia, anorexia & weight dec;calcifications of ear lobes;erythema of face & fingers;dx dermatomyositis;later hosp;assisted resp necessary


VAERS ID: 129505 (history)  
Form: Version 1.0  
Age: 67.0  
Sex: Male  
Location: Foreign  
Vaccinated:1996-10-01
Onset:1997-05-01
   Days after vaccination:212
Submitted: 1999-10-15
   Days after onset:897
Entered: 1999-10-19
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Hyperreflexia, Hypertonia, Hypokinesia, Muscle atrophy, Myasthenic syndrome, Neuropathy, Paralysis
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Hypokalaemia (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: pt recv Genehevax B vax 3/96 & hep b 4/96 & vaxigrip 3/96;
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 1999026821

Write-up: p/vax pt hosp w/suspicion of amyotrophic lateral sclerosis;PE & electro investigations confirmed & dx amyotrophic lateral sclerosis w/some atypia;Coujoror-Sjorgren''s synd suspected;recv vax 11/96 devel fatigue & toes bending;walking diff;


VAERS ID: 129614 (history)  
Form: Version 1.0  
Age: 33.0  
Sex: Female  
Location: Foreign  
Vaccinated:1997-12-01
Onset:1999-08-01
   Days after vaccination:608
Submitted: 1999-10-18
   Days after onset:78
Entered: 1999-10-21
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Gastrointestinal haemorrhage, Hepatic neoplasm
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Liver tumours of unspecified malignancy (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WAES99031426

Write-up: p/vax pt devel a liver tumor;pt died after experiencing an intra-abdominal hemorrhage as a result of a liver puncture;MD felt the tumor was not r/t vax;


VAERS ID: 130280 (history)  
Form: Version 1.0  
Age: 49.0  
Sex: Female  
Location: Foreign  
Vaccinated:1999-10-01
Onset:1999-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1999-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Brain stem syndrome, Coma, Encephalitis, Headache, Somnolence
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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: 1999-10-03
   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: Neoral, Azathioprine, Pred, septrin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: MPU199900466

Write-up: p/vax pt hosp & died;pt recv vax 2 days prior to adm to hosp;pt reported to have felt unwell w/h/a & drowsiness;adm to hosp in coma & progressed to brain stem death;no post mortem performed & poss COD encephalitis;


VAERS ID: 131353 (history)  
Form: Version 1.0  
Age: 10.0  
Sex: Male  
Location: Foreign  
Vaccinated:1999-10-21
Onset:1999-10-24
   Days after vaccination:3
Submitted: 1999-11-19
   Days after onset:26
Entered: 1999-11-24
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 2 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, CSF test abnormal, Cardiac arrest, Coma, Confusional state, Convulsion, Electroencephalogram abnormal, Encephalitis, Headache, Infection, Laboratory test abnormal, Meningitis, Nausea, Nuchal rigidity, Paraesthesia, Pyrexia, Somnolence
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1999-11-04
   Days after onset: 11
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: UNK
Allergies:
Diagnostic Lab Data: 10/28/99 electroencephalography-severe cerebral distrubances;MRI intraparenchymatous lesions evoked dx of herpetic infect process;herpes;lyme negative;mycoplasm IG=12;10/30/99 electroenephalography-confirmed aggravation of cerebral lesions;
CDC Split Type: WAES99111051

Write-up: p/vax pt w/drowsiness & cephalagia;hosp & fever & tonic clonic convuls;no motor deficiency but paresthesia & meningism (nausea & neck stiffness);pt confused;to ICU exp cardiac & resp arrest;state IV coma;dx meningoencephalitis;pt died


VAERS ID: 131605 (history)  
Form: Version 1.0  
Age: 10.0  
Sex: Male  
Location: Foreign  
Vaccinated:1999-10-21
Onset:1999-10-24
   Days after vaccination:3
Submitted: 1999-11-22
   Days after onset:29
Entered: 1999-12-01
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

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: 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: unk
CDC Split Type: WAES99111359

Write-up: p/vax pt exp meningoencephalitis;11/4/99 pt died;COD was infectious meningoencephalitis;


VAERS ID: 132039 (history)  
Form: Version 1.0  
Age: 57.0  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1999-12-02
Entered: 1999-12-03
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Depressed level of consciousness, Muscle atrophy, Muscle spasms, Myasthenic syndrome, Neuropathy
SMQs:, Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 1999031046

Write-up: p/vax ptc/o lower limbs muscle weakness & cramps legs;dx amyotrophic lateral aclerosis;progressive aggravation then occurred & Rilutek started;


VAERS ID: 132229 (history)  
Form: Version 1.0  
Age: 76.0  
Sex: Female  
Location: Foreign  
Vaccinated:1999-08-31
Onset:1999-09-06
   Days after vaccination:6
Submitted: 1999-11-30
   Days after onset:85
Entered: 1999-12-07
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Infection, Leukocytosis, Pyrexia, Renal failure, Sepsis, Shock, Thrombocytopenia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (narrow), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-09-16
   Days after onset: 10
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: unk
Current Illness:
Preexisting Conditions: myocardial infarction;cardiac pacemaker device placement;CAD;hyperlipdemia;
Allergies:
Diagnostic Lab Data: blood culture-+ for staphylococcus;CXR-infiltrations in upper lobe;coloscopy;sonography;CT
CDC Split Type: WAES99111580

Write-up: p/vax pt devel a high grade fever & was adm to hosp;9/16/99 pt died;dx was staphylococcemia;COD was bacterial sepsis;MD felt fever & sepsis were not r/t vax;pt also had thrombocytopenia, leukocytosis.Pt died because of final circulatory &


VAERS ID: 132593 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Unknown  
Location: Foreign  
Vaccinated:1999-11-01
Onset:1999-12-01
   Days after vaccination:30
Submitted: 1999-12-15
   Days after onset:14
Entered: 1999-12-17
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 1910C6 / UNK - / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 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: Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type: 19990322751

Write-up: Age 1 yr, Nov 99, vac recv''d w/ five-fold vac for diptheria, tetanus, pertussis, poliomyelitis and hemophilus influenzae type b prophylexia. Manufacturer in question. 3 to 4 wks after vac, death occurred. No autopsy. Further info requested.


VAERS ID: 132590 (history)  
Form: Version 1.0  
Age: 54.0  
Sex: Male  
Location: Foreign  
Vaccinated:1996-09-12
Onset:1996-09-13
   Days after vaccination:1
Submitted: 1999-12-14
   Days after onset:1187
Entered: 1999-12-20
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 3 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Dysphagia, Gait disturbance, Hypertonia, Hypokinesia, Muscle spasms, Myasthenic syndrome, Neuropathy, Speech disorder
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Malignancy related conditions (narrow), Dystonia (broad), Parkinson-like events (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-07-01
   Days after onset: 1021
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 2/24/97 EMG suspected radicular or anterior cornual lesion; 3/11/97 EMG peripheral neurogenous lesion (anterior legs)
CDC Split Type: 1999031046-1

Write-up: 2/1, 3/11, and 9/12/96 pt vac. w/Engerix B. 1996 spring exp. abn. vision. 9/13/96 devel. leg cramps. Oct 96 severe walking diff. w/lower limb muscle weakness. Hosp.3/97 w/ALS. Oct 98 lower limb spasmodism,motor deficit,speech dis,diff.swall


VAERS ID: 132628 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Unknown  
Location: Foreign  
Vaccinated:1999-11-29
Onset:1999-11-29
   Days after vaccination:0
Submitted: 1999-12-06
   Days after onset:7
Entered: 1999-12-20
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER 39975 / UNK - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2970 / 1 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Blood creatinine increased, Coma, Encephalitis, Flatulence, Hypovolaemia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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: UNK
Allergies:
Diagnostic Lab Data: Ph-6.82,PCO2-11.4, PQ2-1.294,Hco3-1.9,02 sat-92.1,creatinine-.9,urea-44
CDC Split Type: 1999032DRZ1

Write-up: The same day of vaccination, the child developed flatulence, vomiting and fever.The following day was hospitalized with poss. encephalitis and coma.


VAERS ID: 132629 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:1999-11-29
Onset:1999-11-30
   Days after vaccination:1
Submitted: 1999-12-03
   Days after onset:3
Entered: 1999-12-20
   Days after submission:17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER 39975 / 1 - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2970 / 1 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER 164 / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Coma, Convulsion, Encephalitis, Hypotension, Pyrexia
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-11-30
   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:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: PH-7.02; PCO2-25.1mmHg; PO2-70.3mmHg; HCO3-14mmHg; O2 sat-52.4%; urea-67 IU; blood pressure was 60/30.
CDC Split Type: 1999032073-1

Write-up: 28 hours after vaccination, child was hospitalized due to convulsions, suspected brain convulsions and coma. Blood pressure was 70/30 and pulse rate was 200/min. Fever. Final diagnosis of encephalitis with severe coma.


VAERS ID: 132630 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:1999-11-29
Onset:1999-11-30
   Days after vaccination:1
Submitted: 1999-12-03
   Days after onset:3
Entered: 1999-12-20
   Days after submission:17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER 39975 / UNK - / -
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2970 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Blood creatinine increased, Coma, Convulsion, Encephalitis, Hypotension, Hypoventilation, Hypoxia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 1999032087-1

Write-up: 28 hours after vaccination, child was hospitalized due to convulsions and coma. Blood pressure was 60/30, and respiratory rate was 8/minute. Final diagnosis of encephalitis was made. See original report for Lab test values.


VAERS ID: 132312 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1999-12-01
Entered: 1999-12-21
   Days after submission:20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPIHI: DT+IPV+HIB+HEPB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiovascular disorder, Hepatitis, Malaise, Necrosis
SMQs:, Hepatitis, non-infectious (narrow), Cardiomyopathy (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: ~ ()~~~In patient
Other Medications:
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC Split Type: 1999031518-1

Write-up: pt vax w/ Engerix B (10mcg)-hepatitus B, Pentacoq-diptheria, tetanus pertussis, poliomyelitis, haemophilus. Sometime later pt was unwell. 1 day later, pt died. Autopsy - necrosis of cardiac valve pillar, appearance of lobular hepatitis.


VAERS ID: 133144 (history)  
Form: Version 1.0  
Age: 2.0  
Sex: Female  
Location: Foreign  
Vaccinated:1999-11-23
Onset:1999-11-23
   Days after vaccination:0
Submitted: 1999-12-30
   Days after onset:37
Entered: 2000-01-07
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / 3 - / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. R0020 / 2 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Chromosome abnormality, Cyanosis, Exophthalmos, Haemolytic anaemia, Infection, Pneumonia
SMQs:, Haemolytic disorders (narrow), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Congenital, familial and genetic disorders (narrow), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Hyperthyroidism (narrow), Ocular infections (broad), Hypotonic-hyporesponsive episode (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: 1999-11-23
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Edward''s syndrome, hemolytic anemia, exophthalmos, viral pneumonia
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES99122062

Write-up: 11/23/99:Pt recv''d 2nd dose Hep B & 3rd dose DTaP.One hr later, pt was found cyanotic & artificial respiration did not help. Pt died & no autopsy was performed.


VAERS ID: 133374 (history)  
Form: Version 1.0  
Age: 2.0  
Sex: Female  
Location: Foreign  
Vaccinated:1999-11-23
Onset:1999-11-23
   Days after vaccination:0
Submitted: 2000-01-18
   Days after onset:56
Entered: 2000-01-20
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 200053VH / 3 - / IM
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anaemia, Cyanosis, Exophthalmos, Hyperbilirubinaemia, Myopathy, Premature labour
SMQs:, Rhabdomyolysis/myopathy (narrow), Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Hyperthyroidism (narrow), Ocular infections (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-11-23
   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:
Current Illness:
Preexisting Conditions: prematurity, anemia, Fena-Shokeir syndrome, exophthalmus, lagophthalmus,hyperbilirubinemia, myopathy proximal
Allergies:
Diagnostic Lab Data:
CDC Split Type: 20000010521

Write-up: Death, cyanosis. The first and second vaccines were well tolerated. 11/23/99, pt rcvd the 3rd Infarix and 2nd Gen-H-B. Same day the infant experienced cyanosis and couldn''t be respirated anymore. See comments.


VAERS ID: 133745 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Foreign  
Vaccinated:2000-01-17
Onset:2000-01-17
   Days after vaccination:0
Submitted: 2000-01-31
   Days after onset:14
Entered: 2000-02-04
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER Y4403 / 2 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 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: 2000-01-20
   Days after onset: 3
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: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES00019706

Write-up: 4 mo old died following vaccine administration. Event reported to FR Food & Drug Admn. Lot was ordered sealed. Additional info requested.Child''s cause of death was determined to be SIDS.


VAERS ID: 133790 (history)  
Form: Version 1.0  
Age: 85.0  
Sex: Female  
Location: Foreign  
Vaccinated:1999-10-06
Onset:1999-10-07
   Days after vaccination:1
Submitted: 2000-02-03
   Days after onset:119
Entered: 2000-02-08
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 63350 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cerebrovascular disorder, Diabetes mellitus, Paralysis, Peripheral vascular disorder
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), 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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-11-21
   Days after onset: 45
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: Insulin, Phenprocoumon
Current Illness:
Preexisting Conditions: h/o relapsing CVA, diabetes mellitis & peripheral arterial occlusive dis.
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES00012578

Write-up: 10/7, pt showed paralysis of all limbs & was hospitalized. 11/21, the pt died of apoplexis. Reporter felt that it was unlikely related to the vax. No further details available.


VAERS ID: 134354 (history)  
Form: Version 1.0  
Age: 30.0  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2000-02-23
Entered: 2000-02-29
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (TD-RIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK AR / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Dyskinesia, Malaise, Paralysis
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 20000044861

Write-up: In 1997 or 1998, pt recvd TD-Rix. 1 day later he experienced malaise, dyskinesia (involuntary, uncoordinated motion) & paralysis (unspecified). Pt was incapacitated for a longer period. Information received on 28 July 1999 reported the outcome of the vaccines as unknown. The reporter didn''t specify that causality. She stated that additional information will not be available as the vaccinee changed the physician. Case, reference number 2000004486-1, is a spontaneous report referring to a male vaccines aged approximately 10 years. The vaccine''s past medical history is not reported. Allergies are unknown. In 1998 (31 January or 20 June) the vaccines received Td-Rix. One day later he experienced distinct malaise, dyskinesia (involuntary uncoordinated motion) and paralysis of the upper extremity. The vaccines was incaperiated for a longer period. Information received on 05 April 2000 didn''t report the outcome of the vaccine. The reporter assessed the causality as possibly related to vaccination with Td-Rix. She stated that additional information will not be available as the vaccinee changed the physician and did not come for a check.


VAERS ID: 134451 (history)  
Form: Version 1.0  
Age: 0.6  
Sex: Male  
Location: Foreign  
Vaccinated:1996-02-15
Onset:1996-03-09
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2000-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 2 LL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 RL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Brain oedema, CSF test abnormal, Cardiac arrest, Cerebrovascular disorder, Congenital anomaly, Delirium, Febrile convulsion, Hypoxia, Immune system disorder, Laboratory test abnormal, Pyrexia, Sepsis
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Congenital, familial and genetic disorders (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-04-07
   Days after onset: 29
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: Hyperparathyroidism, sleep apnea, immunodeficiency congenital
Allergies:
Diagnostic Lab Data: CT-cerebral atrophy; EEG-suspected state after epileptic status; C-reactive protein-46.8; CSF-pressure increased but otherwise normal
CDC Split Type: 1198023FEB

Write-up: On 2/15/96,pt recv''d Hib-Titer & DTAP-HBV-IPV as part of an investigational trial. On 3/9/96,pt dvlped fever and febrile convulsions.He was hospitalized on 3/10/96 w/ cerebral edema. A dx of hypoxic cerebral damage,prolonged fever convuls.,


VAERS ID: 134580 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Female  
Location: Foreign  
Vaccinated:1999-12-08
Onset:1999-12-17
   Days after vaccination:9
Submitted: 2000-03-01
   Days after onset:75
Entered: 2000-03-07
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / SC
MNC: MENINGOCOCCAL (MENINGITEC) / PFIZER/WYETH - / UNK - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: CSF test abnormal, Convulsion, Hernia, Pneumonia
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (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: 1999-12-18
   Days after onset: 1
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: Cerebrospinal fluid-protein rasied (1.2g/l)
CDC Split Type: 20000052892

Write-up: 9 days post vax, pt exp convulsions. Overnight neurological status worsened, pt died early 11/18. Cause of death: convulsion NOS. Post-mortem: bronchopneumonia, tonsillar herniation. Final brain post-mortem awaited. No further info avail.


VAERS ID: 150037 (history)  
Form: Version 1.0  
Age: 71.0  
Sex: Male  
Location: Foreign  
Vaccinated:1998-11-23
Onset:1998-11-23
   Days after vaccination:0
Submitted: 2000-02-21
   Days after onset:455
Entered: 2000-03-14
   Days after submission:22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / 2 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Infection, Injection site hypersensitivity, Pruritus, Pulmonary fibrosis, Sepsis
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Hypersensitivity (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: 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:
Other Medications: UNK
Current Illness:
Preexisting Conditions: bacterial sepsis, pulmonary fibrosis
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES98121651

Write-up: On the same day the pt received his vax, he presented with a 2 to 3 cm bullous injury at the injection site. He also developed injection site redness, generalized itching, and secondary infection of the bullae. The pt was treated with glucocortisoids, methylprednisolone, and loratidine. As of 12/29/98, the pt''s condition persisted. In January or February 1999, he was hosptalized for an underlying condition of lung fibrosis and septicemia with acinetobacter. He later died, but the reporter felt that his death was related to his underlying medical conditions and not to the vax.


VAERS ID: 150146 (history)  
Form: Version 1.0  
Age: 84.0  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2000-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. 753042 / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Adrenal haemorrhage, Chills, Epistaxis, Meningitis, Pulmonary oedema, Sepsis
SMQs:, Cardiac failure (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Noninfectious meningitis (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: post-mortem lab work revealed that the pt had meningitis
CDC Split Type: MPU2000001230

Write-up: After receiving his flu vax, pt developed a nosebleed. The pt had never had a nose bleed before and was reported to be fit and healthy prior to vax. He developed rigors and was hospitalized. His condition deteriorated and he was admitted to intensive care. The pt died 3 days after receiving the vax. A post-mortem revealed the cause of death to be septicemia, bilateral adrenal hemorrhage, and pulmonary edema.


VAERS ID: 150250 (history)  
Form: Version 1.0  
Age: 82.0  
Sex: Male  
Location: Foreign  
Vaccinated:1999-09-09
Onset:1999-10-04
   Days after vaccination:25
Submitted: 2000-03-15
   Days after onset:163
Entered: 2000-03-21
   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. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Aplastic anaemia, Bone marrow depression, Bronchitis, Cerebral atrophy, Emphysema, Epistaxis, Hypotension, Mouth haemorrhage, Petechiae, Pulmonary hypertension, Respiratory failure, Thrombocytopenia
SMQs:, Anaphylactic reaction (narrow), 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), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (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), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Myelodysplastic syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-10-09
   Days after onset: 5
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: Therapy with platelet concentrates and corticosteroids
Current Illness: Relapsing thrombocytompenic purpura, compensated renal insufficiency, senile dementia.
Preexisting Conditions: Relapsing thrombocytopenic purpura since 1994, compensated renal insufficiency, senile dementia, and history of cerebra infarction.
Allergies:
Diagnostic Lab Data: Thrombocyte count - 3 giga/l. Maximum platelet after substitution was 22 giga/l. Normal lab findings: leukocytes, hemoglobin, differential blood count, PTT. HGB - 7.1 g/dl. Bone marrow biopsy showed hypoplastic myelodysplastic syndrome with differential dx of aplastic anemia/toxic marrow lesion. EEG-nml. Chest x-ray showed emphysema, bronchitis, pulmonary hypertension signs and aortic sclerosis. Cranial CT revealed cerebral atrophy with no hemorrhage.
CDC Split Type: WAES00031015

Write-up: Information has been received from a health care professional concerning an 82 year old male pt who on 9/9/1999 was vaccinated and on 10/4/1999, the pt presented with oral bleeding and petechia of both forelegs. It was noted thrombocyte count was 3 giga/1. The pt was admitted to the hospital. It was noted that he suffered from epistaxis for several months before this incident. Inspite of therapy with platelet concentration and corticosteroids, the pt''s condition worsened and he died on 10/9/1999 due to respiratory failure and hypotension. An autopsy was refused by the relatives. (It was noted that the maximum count after platelet substitution was 22 giga/1.)


VAERS ID: 150994 (history)  
Form: Version 1.0  
Age: 42.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2000-04-11
Entered: 2000-04-19
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic failure, Hepatic necrosis, Hepatitis, Sepsis
SMQs:, Liver related investigations, signs and symptoms (narrow), 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), Sepsis (narrow), Opportunistic infections (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: NONE
Current Illness:
Preexisting Conditions: Hepatic transplant, biliary cirrhosis.
Allergies:
Diagnostic Lab Data: Hepatic biopsy: significant ballooning degeneration and piecemeal necrosis with positive immunostaining for HBcAG. INR 2.0. Serum alanine aminotransferase and serum aspartate aminotransferase - increased. Serum hepatitis B surface Ab - undetectable. Serum hepatitis B surface Ab and DNA test were 256 IU/L and $g2000 pg/ml respectively. Serum hepatitis B surface antigen test - positive and seronegative.
CDC Split Type: WAES00038606

Write-up: Multiple organ failure, bacterial sepsis, hepatic failure, hepatitis B. Reported in the Canadian Journal of Gastroenterology vol. 14, February 2000, page 51A that a pt experienced acute de novo HBV infection 2 years post-liver transplantation despite protective anti HBs titers post-vaccination with rarely a determinant mutated strain of HBV. This pt with primary biliary cirrhosis and HBsAg and HbcAb seronegative received an allograft from a donor (liver transplantation). The donor was HBsAg negative and anti-HBc positive. The pt was IZ against HBV with a polyclonal vax (manufacturer unk) post liver transplantation. One year post-liver transplantation anti-HBs titer was 256 IU/L. The pt developed an increase serum aminotransferase and worsening liver function with an INR of 2.0 two years post liver transplantation. HbsAg was now positive, anit-HBs undetectable and serum HBV-DNA greater than 2000 pg/ml. Significant ballooning degeneration and piecemeal necrosis with positive immunostaining for HbcAg was revealed by liver biopsy. The pt developed increasing liver failure, sepsis and terminal multi-organ failure. Subsequent genotypic analysis of the HBV by cycle sequencing of PCR product revealed mutations in the ''a'' determinant. Met 133 Thr (ATG to ACG) and ASN 131 Thr.


VAERS ID: 151747 (history)  
Form: Version 1.0  
Age: 27.0  
Sex: Male  
Location: Foreign  
Vaccinated:2000-04-10
Onset:2000-04-12
   Days after vaccination:2
Submitted: 2000-05-05
   Days after onset:23
Entered: 2000-05-09
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI) / CONNAUGHT LABORATORIES - / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-04-12
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: carbamazepine
Current Illness:
Preexisting Conditions: epilepsy
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: U2000003150

Write-up: It was reported that a 27 year old male was vaccinated Typhoid vax on 04/10/2000. Post vax, 04/12/2000, the pt was found dead at his home. He had previous illness, but it was reported that the pt was receiving Carbamazephine for epilepsy. A post mortem examination was performed and the cause of death is unknown. No information is expected.


VAERS ID: 151796 (history)  
Form: Version 1.0  
Age: 0.25  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2000-05-08
Entered: 2000-05-10
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 16746A9 / 1 - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER M09834 / 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: 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: 20000128861

Write-up: Two hours post vax, this child died. The probable cause of death is sudden infant death.


VAERS ID: 151926 (history)  
Form: Version 1.0  
Age: 0.25  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2000-05-12
Entered: 2000-05-15
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM - / UNK - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: History: infection (not specified) one week prior to vax.
Allergies:
Diagnostic Lab Data: Autopsy
CDC Split Type: WAES20000134272

Write-up: At a time as yet unknown, the vaccinee received vax. One day post vax, the vaccinee was found dead lying in prone position in the bed. An autopsy was performed, but gave no indication to a pathological cause. The autopsy report is not yet available. The eventual dx was sudden infant death syndrome. The most recent information was received on 05/10/00. The reporter did not specify the causality. He mentioned that the infant had no infection on the vaccinal day. Further information has been requested.


VAERS ID: 152002 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Foreign  
Vaccinated:2000-05-04
Onset:2000-05-04
   Days after vaccination:0
Submitted: 2000-05-15
   Days after onset:11
Entered: 2000-05-17
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 16746A9 / UNK RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R09834 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asphyxia, 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), Hostility/aggression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-05-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy results not available
CDC Split Type: U2000003310

Write-up: Death, heart arrest, asphyxia. It was reported that a 2 month-old male was injected, on 05/04/2000 with vax. The physician performed the vax after a well-done check-up of the medical history and he considered the child to be in good health. The child arrived to the First Aid already died. Signs of asphyxia were reported. We are waiting for further information (report by anatomic pathologist).


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=50&PERPAGE=100&DIED=Yes


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