|
VAERS ID: |
25702 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Female |
Location: |
Pennsylvania |
Vaccinated: | 1985-06-12 |
Onset: | 1985-08-09 |
Days after vaccination: | 58 |
Submitted: |
0000-00-00 |
Entered: |
1990-08-22 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
769441 / UNK |
- / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Convulsion,
Encephalopathy,
Pyrexia SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (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? Yes
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: EEG, Brain Scan and Lumbar puncture - WNL CDC Split Type: 8603423.01
Write-up: Pt vaccinated with DTP developed fever and one convulsion; hospitalized 3 days; recovered; |
|
VAERS ID: |
25703 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Female |
Location: |
Virginia |
Vaccinated: | 1990-06-26 |
Onset: | 1990-06-26 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-08-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
235944 / UNK |
- / IM |
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
MO / PO |
Administered by: Private Purchased by: Unknown Symptoms: Sudden infant death syndrome SMQs:, Neonatal disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-06-26
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:
Write-up: Pt vaccinated with DTP/OPV (1st set) 6 hrs ltr 20 mins and a feeding found dead. Autopsy report SIDS |
|
VAERS ID: |
25713 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Male |
Location: |
Utah |
Vaccinated: | 1990-05-04 |
Onset: | 1990-05-05 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-08-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES |
OB11061 / UNK |
- / IM |
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Cerebral infarction,
Convulsion,
Hemiplegia SMQs:, Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Generalised convulsive seizures following immunisation (narrow), 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: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt vaccinated with DTP/OPV and developed focal seizures, admitted to hospital had culture negative CSF pleocytosis & discoveredto have middle cerebral artery infarct. Now significant devel delay, hemiparesis |
|
VAERS ID: |
25718 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Female |
Location: |
Illinois |
Vaccinated: | 1990-02-21 |
Onset: | 1990-02-23 |
Days after vaccination: | 2 |
Submitted: |
0000-00-00 |
Entered: |
1990-08-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
271911 / UNK |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Apnoea SMQs:, Acute central respiratory depression (narrow), Respiratory failure (narrow)
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, 2 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: ViraSpinal tap - normal; EEG, Pneumogram, Viral studies, Neuro exam and CBC - normal CDC Split Type: 9000357.01
Write-up: 2 mo old infant was hospitalized for apnea approx 48hrs after immunization, admitted to ICU and placed on a monitor. IV bicarbonate & oxygen administered. Infant reamins in ICU at the time of this report. |
|
VAERS ID: |
25725 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Male |
Location: |
Michigan |
Vaccinated: | 1990-03-06 |
Onset: | 1990-03-06 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-08-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
262912 / UNK |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Anorexia,
Convulsion,
Pallor,
Somnolence,
Stupor SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
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: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: 9000416.01
Write-up: 3 mo old infant immunized 6MAR90 @ 11:30AM later evening mother reported afebrile, pale, lethargic, refustd to eat, having difficulty awaking. Taken to ER. Exp a couple of seizures. Hospitalized at time of this report. |
|
VAERS ID: |
25726 (history) |
Form: |
Version 1.0 |
Age: |
0.5 |
Sex: |
Female |
Location: |
Georgia |
Vaccinated: | 0000-00-00 |
Onset: | 1990-08-11 |
Submitted: |
0000-00-00 |
Entered: |
1990-08-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES |
OB11061 / 3 |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Pyrexia,
Visual disturbance SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: no previous history of reaction to DTP X 2~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CBC Sedrate, CSF normal, blood & CSF cultures negative CDC Split Type:
Write-up: Pt vaccinated with DTP 8-12 hrs later developed fever 101-103 with episodes of brief startle with staring but not thought to be true seizure; observed in hospital 36 hrs, became afebrile and neurologically normal. Given tylenol |
|
VAERS ID: |
25733 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Female |
Location: |
Ohio |
Vaccinated: | 1990-02-19 |
Onset: | 1990-02-19 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-08-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
- / 2 |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Agitation,
Lymphadenopathy,
Pyrexia,
Screaming,
Somnolence SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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, 5 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Rodazymen, lumbar puncture, and Blood cultures - all negative CDC Split Type: 9000436.01
Write-up: Pt vaccinated with DTP experienced a fever of 104, irritability, lethargy and a prolonged cry within several hrs after immunization hospitalized on day 6 25FEB90. Dx as coincidental kawasaki disease. |
|
VAERS ID: |
25762 (history) |
Form: |
Version 1.0 |
Age: |
1.5 |
Sex: |
Unknown |
Location: |
Louisiana |
Vaccinated: | 1990-01-18 |
Onset: | 1990-01-19 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-08-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
259958 / 4 |
- / SC |
Administered by: Private Purchased by: Unknown Symptoms: Grand mal convulsion,
Leukocytosis,
Pyrexia SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Spinal fluid 2 cells; WBC 17000 CDC Split Type: 9000127.01
Write-up: 19 mo old child received DTP/prohibit immunization 18JAN90. At 10PM woke up, at 2AM had grand mal seizure lasting 1 min. Temp 107 hospitalized; normal work up; neurologist consult pending; no prior reaction to 3 prior DTP''s. |
|
VAERS ID: |
25763 (history) |
Form: |
Version 1.0 |
Age: |
0.4 |
Sex: |
Male |
Location: |
South Carolina |
Vaccinated: | 1984-02-08 |
Onset: | 0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
1990-08-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Congenital central nervous system anomaly,
Encephalopathy,
Quadriplegia SMQs:, Congenital, familial and genetic disorders (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), 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? No
Permanent Disability? Yes
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: 9000300.01
Write-up: Plaintiffs allege that as a result of immunization in Feb84 at age 5 months (no mention in litigation of any previous vaccination), infant sustained cerebral palsy, Encephalopathy, & spastic quadriparesis |
|
VAERS ID: |
25764 (history) |
Form: |
Version 1.0 |
Age: |
0.3 |
Sex: |
Male |
Location: |
Nevada |
Vaccinated: | 1983-01-25 |
Onset: | 1983-01-26 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-08-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Convulsion,
Dementia SMQs:, Systemic lupus erythematosus (broad), Dementia (narrow), 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? 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: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: 9000216.01
Write-up: plaintiffs allege that as a result of immunization a 4 mo of age in 1983 (no reference is made to any prior immunization), infant suffered seizures the following day and suffered permanent brain damage. |
|