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This is VAERS ID 27350

Case Details

VAERS ID: 27350 (history)  
Form: Version 1.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Submitted: 0000-00-00
Entered: 1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Angioneurotic oedema, Asthenia, Asthma, Dyspnoea, Erythema multiforme, Lung disorder, Rash maculo-papular, Urticaria
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Pulmonary function 1990 Bronchospasm; Lung biopsy - 1990- interstitial lung disease.
CDC Split Type: WAES90120585

Write-up: Pt vaccinated with Heptavax-B developed angioneurotic edema, urticaria, pruritus, bronchospasm, episodes of flushing, arthralgia, erythematous macular rash thought to be erythema multiforme. Seen in ER given cortisone. Wheezing persisted.

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