|
VAERS ID: |
25068 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Male |
Location: |
Oregon |
Vaccinated: | 1990-01-25 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
585A4 / 3 |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Drug ineffective,
Encephalitis SMQs:, Lack of efficacy/effect (narrow), Noninfectious encephalitis (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? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: no hx of allergies Allergies: Diagnostic Lab Data: 10Jan90 titier test - nonresponder, Herpes varicella was recovered from the brain CDC Split Type: EBU900170
Write-up: nonresponder to a previous 3 dose series with MSD vaccine, encephalitis, Herpes varicella recovered from the brain |
|
VAERS ID: |
25133 (history) |
Form: |
Version 1.0 |
Age: |
50.0 |
Sex: |
Female |
Location: |
Texas |
Vaccinated: | 1990-03-02 |
Onset: | 1990-04-04 |
Days after vaccination: | 33 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
1648R / UNK |
- / IM |
Administered by: Private Purchased by: Private Symptoms: Back pain,
Haematuria SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: NO PREVIOUS KIDNEY PROBLEMS Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: SEVERE BACK PAIN & SEVERE HEMATURIA RESULTED WITHIN 2 DAYS /P 1ST DOSE OF HBV-VACCINE GIVEN OF 2MAR90. 2ND INJECT GIVEN ON 8MAY90. WITHIN 2 DAYS PT C/O BACK PAIN AND HEMATURIA. PHYSICIAN FELT SYMPTOMS FROM VACCINE. |
|
VAERS ID: |
25341 (history) |
Form: |
Version 1.0 |
Age: |
50.0 |
Sex: |
Female |
Location: |
Florida |
Vaccinated: | 1990-04-16 |
Onset: | 1990-04-16 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-10 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
- / UNK |
- / IM |
Administered by: Private Purchased by: Private Symptoms: Face oedema,
Headache,
Leukocytosis,
Nausea,
Oedema,
Pain,
Pruritus,
Pyrexia,
Rash,
Tachycardia,
Urticaria SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Dehydration (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Temp 99.2, WBC 19.3, "20 Lymphs, 4 mono, 5 eosinophils, 8 atypical lymphs." CDC Split Type: EBU900149
Write-up: ABOUT 1 HR P/ VAX, PT EXP H/A, HIVES, PAIN, SWELLING OF TONGUE & OTHER BODY PARTS, & RAPID HEARTBEAT. TX W/ SOLU-MEDROL & BENADRYL. ALSO ER W/NAUSEA, DIFFUSE PRURITUS, ERYTHEMA, TEMP. D/C''D STILL EXP SXS; READM 12OCT90 W/ DELAYED ALLERG RXN |
|
VAERS ID: |
25395 (history) |
Form: |
Version 1.0 |
Age: |
37.0 |
Sex: |
Female |
Location: |
Connecticut |
Vaccinated: | 1989-11-17 |
Onset: | 1989-11-18 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-10 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
585A4 / UNK |
- / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Arthralgia,
Arthritis,
Asthenia,
Myalgia,
Nausea,
Oedema,
Pain,
Pruritus,
Pyrexia,
Serum sickness,
Tremor,
Vomiting SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBU890021
Write-up: Pt received Engerix-B and experienced chronic fatigue syndrome exacerated, fever, unable to sleep, itching over inflamed joints, residual joint aches, joints knees ankles inflamed, all joints painful, muscle pain |
|
VAERS ID: |
25488 (history) |
Form: |
Version 1.0 |
Age: |
26.0 |
Sex: |
Male |
Location: |
Texas |
Vaccinated: | 1990-05-10 |
Onset: | 1990-05-10 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
48049/1884R / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Amblyopia,
Confusional state,
Dizziness,
Extrasystoles,
Eye pain,
Hyperhidrosis,
Myalgia,
Nausea,
Nervousness,
Vertigo,
Vomiting SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Eosinophilic pneumonia (broad), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Hypokalaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: allergy to penicillin, hx of PVC''s Allergies: Diagnostic Lab Data: Holter moniter- pretreatment, no adv. Dysrhythmias CDC Split Type: WAES90050424
Write-up: Pt vaccinated /w 1st dose of Recombivax, developed dizziness, blurred vision, jitteriness, sweating, myalia, vomiting, nause, vertigo, disorientation & pain in eye. Exam revealed Pt''s fundi & intraocular pressure WNL. Pt hospitalized. |
|
VAERS ID: |
25521 (history) |
Form: |
Version 1.0 |
Age: |
47.0 |
Sex: |
Female |
Location: |
Kentucky |
Vaccinated: | 1990-04-05 |
Onset: | 1990-04-09 |
Days after vaccination: | 4 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
591A4 / 4 |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Back pain,
Dizziness,
Drug ineffective,
Dyspnoea,
Hepatic function abnormal,
Hypokalaemia,
Nausea,
Pallor,
Vomiting SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Lack of efficacy/effect (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Ogen, Prinzide, Synthroid, Vivactil Current Illness: Gallbladder removed 30 yrs ago; Preexisting Conditions: Hypothyroid, Hypertension; Allergic to Codeine, sulfa; Allergies: Diagnostic Lab Data: LDH inc, GGTP inc, SGOT inc, Liver func Abnorm, CAT SCAN of ADBOMEN was negative CDC Split Type: EBU900128
Write-up: Pt given Engerix-B experienced dizziness, non responder, feeling of faintness, flank pain rt side, nausea became very pale, decreased potassium, and back pain rt side. Was admitted to hospital given Phenergan 25 mg & Demerol to relieve pain |
|
VAERS ID: |
25522 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Iowa |
Vaccinated: | 1990-06-08 |
Onset: | 1990-06-11 |
Days after vaccination: | 3 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
587A4 / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Oedema peripheral,
Pruritus,
Rash SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Hormones Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: EBU900241
Write-up: Pt received lst does of Engerix-B on 8-JUN-90 & was hospitalized on 11-JUN-90 w/significant swelling of both hands also experienced itching of hands, rash on arms & hands club like fingers |
|
VAERS ID: |
25523 (history) |
Form: |
Version 1.0 |
Age: |
21.0 |
Sex: |
Female |
Location: |
Pennsylvania |
Vaccinated: | 1990-03-09 |
Onset: | 1990-03-11 |
Days after vaccination: | 2 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM |
533A4 / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Headache,
Vertigo,
Vestibular disorder SMQs:, Vestibular disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Anti-HBS dosage was performed on17-Feb-990, prior to vaccination, the results were negative. Results to test to detect anti-influenza virus antibodies was negative. Audiometric test were normal. CT scan was negative. CDC Split Type: EBWWMA010775
Write-up: Headache. Labyrinthitis. Developed headache & vertigo 48 hrs after vaccination. Hospitalized. Acute labyrinthitis diagnosed. |
|
VAERS ID: |
25536 (history) |
Form: |
Version 1.0 |
Age: |
92.0 |
Sex: |
Male |
Location: |
Pennsylvania |
Vaccinated: | 1990-02-09 |
Onset: | 1990-03-22 |
Days after vaccination: | 41 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-16 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
1647R / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Anorexia,
Arthritis,
Blood creatine phosphokinase increased,
Chills,
Confusional state,
Dehydration,
Haematuria,
Hepatic function abnormal,
Myasthenic syndrome,
Oedema,
Pain,
Purpura,
Pyrexia,
Synovitis,
Tremor,
Urinary incontinence,
Urine analysis abnormal SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dementia (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (narrow), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Diabetes mellitus, allergies to codeine, sulfa drugs Allergies: Diagnostic Lab Data: BUN- 30, WBC- 12600, platelet- 695000, ESR- 110, Hct-29, Hgl-10.3 EXTENSIVE SEE WORM CDC Split Type: WAES90040623
Write-up: Pt dev pain in arms & legs which inc til unable to walk. T to 105, shaking, chills, arthritis, incontinent, poor oral intake. Rt wrist edematous /w pain on mvmt, erythema & effusion. Extensive pt hx & hospital course |
|
VAERS ID: |
25570 (history) |
Form: |
Version 1.0 |
Age: |
52.0 |
Sex: |
Male |
Location: |
Pennsylvania |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (FOREIGN) / MERCK & CO. INC. |
- / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Pancreatitis SMQs:, Acute pancreatitis (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? 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: no relevant history Allergies: Diagnostic Lab Data: CDC Split Type: WAES90061089
Write-up: Pt (surgeon) was vacc. /w Heptavax-B & was subsequently hospitalized /w pancreatitis. There was no concomitant medication. Additonal detail are beig requested |
|