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VAERS ID: 25053 (history)  
Age:   
Gender: Unknown  
Location: New York  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4898032 / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Injection site reaction
SMQs:

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: B034189091

Write-up: several patients experienced raised red welts & skin irritation at the site of inject several days /p receiving Td. The only complaints came from clinic patients who generally receive injections frequently.


VAERS ID: 25054 (history)  
Age: 45.0  
Gender: Female  
Location: Maine  
Vaccinated:1989-11-22
Onset:1989-11-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TTOX: TETANUS TOXOID (NO BRAND NAME) / PFIZER/WYETH - / - - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Injection site mass, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Augmentin 500mg TID
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: B034089162

Write-up: pt developed erytema, edema & induration w/ warmth in a 13 X 11 cm area surrounding the injection site after receiving TTF vaccine


VAERS ID: 25055 (history)  
Age: 54.0  
Gender: Female  
Location: Foreign  
Vaccinated:1989-11-01
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 - / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hepatic function abnormal, Hepatocellular damage, Nausea, Neoplasm malignant
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological malignant tumours (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: On medication for the treatment of tuberculosis 25 yrs ago. At that time developed raised liver fx test which returned to normal
Diagnostic Lab Data:
CDC Split Type: EBWWMA010375

Write-up: Hepatic pain. Increase liver fx test. Nause clear cell carcinoma of the rt kidney. Rt nephrectomy. Experienced hepatic pain & increased liver function tests /p Engerix-B therapy.


VAERS ID: 25056 (history)  
Age: 58.0  
Gender: Female  
Location: Foreign  
Vaccinated:1990-02-15
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 - / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hepatic cirrhosis, Malaise
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
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: ESR - 54mm, 21Mar90 ESR - 78 mm, 27Mar-90 ESR - 100mm, Alk Phoshatase - 965ul/l, Bili - 23 mmol/l, AST - 99 IU/l, ALBUMIN - 39 g/l, Tot Protein - 80 g/l, Lab showed positive antimitochondrial antibody in range over 1/1289, Paraprotein - S
CDC Split Type: EBWWMA010757

Write-up: Primary biliary cirrhosis, Raised ESR, mild malaise, Recvd 4th dose 15Feb90 found to have rising ESR developed malaise. Repeated blood tests in March showed elvated ESR.


VAERS ID: 25057 (history)  
Age:   
Gender: Unknown  
Location: Foreign  
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 (ENGERIX-B) / SMITHKLINE BEECHAM - / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anaphylactoid reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: EBWWMA010557

Write-up: anaphylactic shock - life threatening


VAERS ID: 25058 (history)  
Age: 14.0  
Gender: Male  
Location: Foreign  
Vaccinated:1989-02-28
Onset:1990-03-04
   Days after vaccination:369
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 189A4 / - - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Convulsion, Electroencephalogram abnormal, Headache
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Typhoid vaccine 17-Jan-89, Cholera vaccine 17-Jan-89
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 11May89 EEG revealed abnormalities
CDC Split Type: EBWWMA009706

Write-up: convulsion which lasted for 5 min. (potentially life-threating) Prolonged headache, 5 days /p dose fo Engerix-B had "fit". Convulsion lasted 5 min. did not reoccurr. Recoverd 11May89 revealed EEG abnormalities


VAERS ID: 25059 (history)  
Age: 0.2  
Gender: Female  
Location: Pennsylvania  
Vaccinated:1990-06-15
Onset:1990-06-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259964 / - - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 259964L / - - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Screaming
SMQs:, Hostility/aggression (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: screaming for 5-6 hrs /p DTP/OPV


VAERS ID: 25060 (history)  
Age: 50.0  
Gender: Male  
Location: Foreign  
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 (ENGERIX-B) / SMITHKLINE BEECHAM - / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Angina pectoris, Angioneurotic oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Other ischaemic heart disease (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: cardiac drugs for angina, Diltiazem HCL, Rythmodan & Aspirin.
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: EBWWMA010964

Write-up: Urticaria, angioedema, angina, pt noticed on same day of immun. a urticarial/angio-edema eruption. Vaccinatin course was D/C, has residual effects.


VAERS ID: 25061 (history)  
Age:   
Gender: Female  
Location: Foreign  
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 (ENGERIX-B) / SMITHKLINE BEECHAM - / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anaphylactoid reaction, Dyspnoea, Rash
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: EBWWMA010778

Write-up: Rash, "Anaphylactic shock" (potentically life threating). Developed rash & breathlessness a few min. /p vaccination.


VAERS ID: 25062 (history)  
Age: 1.5  
Gender: Female  
Location: Colorado  
Vaccinated:1990-06-26
Onset:1990-06-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9MO1012 / - LL / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Agitation, Anorexia, Pyrexia, 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
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 18 mon. female w/ DPT 11:00am in lt thigh. 48 hrs /p T 101-103 w/ irritability refused to bear weight or sit up. Refusing solid food but drinking Pedolyte well. Peak T 103, Excessive sleepiness the past 48 hrs.


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