National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 7/16/2021 release of VAERS data:

This is VAERS ID 176444



Case Details

VAERS ID: 176444 (history)  
Form: Version 1.0  
Age: 5.0  
Sex: Male  
Location: Unknown  
Vaccinated:2000-08-07
Onset:2000-08-10
   Days after vaccination:3
Submitted: 2001-10-17
   Days after onset:433
Entered: 2001-10-18
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 956A2 / 1 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1346 / 1 LL / SC
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0401K / 2 RA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1349J / 1 LA / SC

Administered by: Other       Purchased by: Other
Symptoms: Difficulty in walking, Erythema, Orchitis, Pain, Scrotal oedema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound-test results not provided
CDC Split Type: 20010241221

Write-up: On 8/7/00, the child received his 1st injection of Infanrix. On that date, he also received his 2nd injection of MMRII and his 1st injections of varicella and IPOL. On 8/10/00, the pt experienced left testicular swelling, mild erythema of the left scrotum with generalized tenderness and swelling. The pt walks with legs slightly abducted. The pt''s dx was orchitis. The pt''s mother stated that "we can only conclude that it was a reaction to the vaccine". He was seen by a pediatric urologist who reported "that there had not been a documented case of this type of reaction in a juvenile in over 17 years". The reporter considered the pt''s experience to have resulted in a significant disability. Follow-up information from a nurse, stated "she vaguely recalled this child''s experience and believed he had seen a pediatric urologist who was not the primary physician treating the pt for this experience". The nurse also stated "she thought it was the urologist who felt the child''s orchitis was related to MMRII vaccination, though she was not certain of this". She also stated "that she believed the child walked with his legs abducted due to the testicular swelling and orchitis and this was not a separate experience but again she could not definitively state this without checking the pt''s chart". Outcome of the orchitis was not provided.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=176444


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166