|
VAERS ID: |
25031 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Unknown |
Location: |
Unknown |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. |
0140P / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Rash SMQs:, Anaphylactic reaction (broad), 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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: rash skin on legs |
|
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: |
25233 (history) |
Form: |
Version 1.0 |
Age: |
36.0 |
Sex: |
Female |
Location: |
Oregon |
Vaccinated: | 1990-02-05 |
Onset: | 1990-02-05 |
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 |
587A4 / UNK |
LA / IM |
Administered by: Private Purchased by: Private Symptoms: Chills,
Headache,
Lymphadenopathy,
Nausea,
Pharyngitis,
Pyrexia SMQs:, Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: N/A Current Illness: Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: N/A CDC Split Type: EBU900144
Write-up: FOUR HRS AFTER FIRST DOSE OF HEP B VAX, PT EXP FEVER, CHILLS, NAUSEA. EXP HEADACHE ONE DAY AFTER ADMIN OF VAX. FOR THE FOLLOWING 2 WEEKS SHE DEVELPD SEVERE UPPER RESP INFECTION /W/ SEVERE SWOLLEN GLANDS. NO TREATMENT GIVEN. SYMPTOMS ABATED. |
|
VAERS ID: |
25234 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Pennsylvania |
Vaccinated: | 1990-04-26 |
Onset: | 1990-04-26 |
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 |
586A4 / UNK |
- / - |
Administered by: Private Purchased by: Private Symptoms: Paraesthesia,
Vasodilatation SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: N/A Current Illness: Preexisting Conditions: N/A Allergies: Diagnostic Lab Data: N/A CDC Split Type: EBU900155
Write-up: PT APPEARED FLUSHED AND SAID ARM TINGLED IMMEDIATELY AFTER INJECTION. PT NOT EXAMINED BY PHYSICIAN. |
|
VAERS ID: |
25235 (history) |
Form: |
Version 1.0 |
Age: |
44.0 |
Sex: |
Female |
Location: |
Florida |
Vaccinated: | 1990-04-10 |
Onset: | 1990-04-10 |
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: Dermatitis bullous,
Mucous membrane disorder,
Somnolence SMQs:, Severe cutaneous adverse reactions (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), 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? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: NONE Current Illness: Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: N/A CDC Split Type: EBU900161
Write-up: DAY OF VAX., PT BECAME LETHARGIC, DEVELOPED BLISTERS AND REDNESS(INFLAMMATION) OF MUCOUS MEMBRANE OF MOUTH. TREATED WITH BENADRYL. OUTCOME: NO INJURY. |
|
VAERS ID: |
25291 (history) |
Form: |
Version 1.0 |
Age: |
25.0 |
Sex: |
Female |
Location: |
Indiana |
Vaccinated: | 1990-01-15 |
Onset: | 1990-01-19 |
Days after vaccination: | 4 |
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: Urticaria SMQs:, Anaphylactic reaction (broad), Angioedema (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? No
Previous Vaccinations: FIRST VAX~ ()~~~In patient Other Medications: N/A Current Illness: Preexisting Conditions: N/A Allergies: Diagnostic Lab Data: N/A CDC Split Type: EBU900088
Write-up: PT BROKE OUT WITH HIVES 4 DAYS AFTER RECVD FIRST ENGERIX B INOCULATION. HIVES HAVE CONTINUED FOUR WEEKS. ANTIHISTAMINE THERAPY. |
|
VAERS ID: |
25292 (history) |
Form: |
Version 1.0 |
Age: |
41.0 |
Sex: |
Female |
Location: |
North Carolina |
Vaccinated: | 1990-02-09 |
Onset: | 1990-02-09 |
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 |
587A4 / UNK |
LA / IM |
Administered by: Private Purchased by: Private Symptoms: Asthenia,
Hypertonia,
Injection site hypersensitivity,
Myalgia,
Neuritis,
Pain,
Paraesthesia,
Paralysis SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypokalaemia (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? No
Previous Vaccinations: Other Medications: N/A Current Illness: Preexisting Conditions: INDERAL, AND RECOMBIVAX-HB ADMINISTERED 1988. Allergies: Diagnostic Lab Data: N/A CDC Split Type: EBU900091
Write-up: Pt exp discomfort, warmth, edema around inject site; treated with Tylenol and ice; saw ER; devlpd muscle and joint aches; neurologist 22FEB90 diagnosed flu; |
|
VAERS ID: |
25293 (history) |
Form: |
Version 1.0 |
Age: |
31.0 |
Sex: |
Female |
Location: |
North Carolina |
Vaccinated: | 1990-02-28 |
Onset: | 1990-02-28 |
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 |
587A4 / UNK |
- / IM |
Administered by: Private Purchased by: Private Symptoms: Injection site oedema,
Injection site pain,
Injection site reaction SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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? No
Previous Vaccinations: Other Medications: N/A Current Illness: Preexisting Conditions: ALLERG TO PENICILLIN AND CODEINE. 2-9-90 UNDERWENT BILATERAL TUBAL LIGATION. Allergies: Diagnostic Lab Data: N/A CDC Split Type: EBU900092
Write-up: PT ONSET OF EVENTS SAME DAY SHE RECVD ENGERIX-B:REDNESS, WARMTH AT SOI, WITH VERY SLIGHT SWELLING. TREATMENT OF ICE-PACK AND 2 TABLETS OF ADVIL. |
|
VAERS ID: |
25294 (history) |
Form: |
Version 1.0 |
Age: |
35.0 |
Sex: |
Female |
Location: |
Washington |
Vaccinated: | 1990-01-30 |
Onset: | 1990-01-30 |
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 |
585A4 / UNK |
- / IM |
Administered by: Private Purchased by: Private Symptoms: Coordination abnormal,
Face oedema,
Headache,
Influenza,
Nausea SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: ASPIRIN Current Illness: Preexisting Conditions: N/A Allergies: Diagnostic Lab Data: N/A CDC Split Type: EBU900093
Write-up: 11 TO 12 HRS AFTER INJECTION, PT EXP NAUSEA, EQUILIBRIUM DISTURBANCES, HEADACHE ON LEFT SIDE OF HEAD, SOME SWELLING ON LEFT SIDE OF FACE. NO TREATMENT. SIX HRS LATER, NO SYMPTOMS. |
|