|
VAERS ID: |
26846 (history) |
Form: |
Version 1.0 |
Age: |
4.0 |
Sex: |
Female |
Location: |
New York |
Vaccinated: | 1990-11-01 |
Onset: | 1990-11-05 |
Days after vaccination: | 4 |
Submitted: |
1990-11-27 |
Days after onset: | 22 |
Entered: |
1990-11-30 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
1707S / UNK |
LA / IM |
Administered by: Private Purchased by: Private Symptoms: Convulsion,
Hypotonia,
Muscle twitching SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), 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? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: asthmatic bronchitis Allergies: Diagnostic Lab Data: EEG-Abnormal CDC Split Type:
Write-up: Pt vaccinated with MMR/Rubella 4 days after became limp, twitching of hand & leg & clenching of teeth. Noted post ictal for few hrs. Duration of episode few min. |
|
VAERS ID: |
26942 (history) |
Form: |
Version 1.0 |
Age: |
24.0 |
Sex: |
Male |
Location: |
Maryland |
Vaccinated: | 1990-11-26 |
Onset: | 1990-11-27 |
Days after vaccination: | 1 |
Submitted: |
1990-12-05 |
Days after onset: | 8 |
Entered: |
1990-12-10 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
1880S / 2 |
- / SC |
Administered by: Private Purchased by: Private Symptoms: Deafness,
Vestibular disorder SMQs:, Hearing impairment (narrow), 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, 3 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Prilosec, PPD Current Illness: Reflux esophagitis Preexisting Conditions: stuttering Allergies: Diagnostic Lab Data: MRI-Negative CDC Split Type:
Write-up: Pt vaccinated with MMR developed sudden hearing loss rt ear, pt lifts weight regularly, cochleogram consistent w/meniers. |
|
VAERS ID: |
26965 (history) |
Form: |
Version 1.0 |
Age: |
11.0 |
Sex: |
Male |
Location: |
Michigan |
Vaccinated: | 1990-08-16 |
Onset: | 1990-08-30 |
Days after vaccination: | 14 |
Submitted: |
0000-00-00 |
Entered: |
1990-12-11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0218S / 1 |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Albuminuria,
Condition aggravated,
Glomerulonephritis,
Hypertension,
Hypoproteinaemia,
Nephrotic syndrome,
Renal impairment,
Urine analysis abnormal SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Hypertension (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)
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: Culture DEC80 - negative - Strep; Renal biopsy 21MAY81focal glomerulosclerosis. CDC Split Type: WAES90110966
Write-up: Pt vaccinated with MMR developed "flu/cold" symptoms, edema. Admitted to hosp w/nephrotic synd. A renal biopsy performed dx focal glomerulosclerosis made. Treated w/cyclophosphamide, Prednisone, Furosemide & spironolactone. |
|
VAERS ID: |
26998 (history) |
Form: |
Version 1.0 |
Age: |
1.3 |
Sex: |
Female |
Location: |
North Carolina |
Vaccinated: | 1990-11-02 |
Onset: | 1990-11-04 |
Days after vaccination: | 2 |
Submitted: |
1990-11-06 |
Days after onset: | 2 |
Entered: |
1990-12-14 |
Days after submission: | 38 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
285919 / 4 |
LL / IM |
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES |
0A21092 / 1 |
LA / IM |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0696S / 1 |
RA / SC |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
0613K / 3 |
MO / PO |
Administered by: Public Purchased by: Public Symptoms: Agitation,
Asthma,
Bronchiolitis,
Pyrexia SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), 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? 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: NC90005
Write-up: Pt vaccinated with DTP/OPV/MMR/HIB became irritable, crying, wheezing, fever 101, Taken to ER; breathing was stabilized transferred to another hosp dx bronchiolitis not believed to be vaccine related. |
|
VAERS ID: |
27074 (history) |
Form: |
Version 1.0 |
Age: |
1.3 |
Sex: |
Female |
Location: |
Mississippi |
Vaccinated: | 1990-11-15 |
Onset: | 1990-11-15 |
Days after vaccination: | 0 |
Submitted: |
1990-11-19 |
Days after onset: | 4 |
Entered: |
1990-12-17 |
Days after submission: | 28 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
285967 / 4 |
LL / IM |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0016S / 1 |
RL / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
283939 / 3 |
MO / PO |
Administered by: Public Purchased by: Public Symptoms: Pyrexia SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
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: CDC Split Type: MS904
Write-up: Pt vaccinated w/DTP/OPV/MMR developed temp during night after injection called clinic referred to ER. admitted to hosp & placed under seizure precautions. |
|
VAERS ID: |
27096 (history) |
Form: |
Version 1.0 |
Age: |
5.0 |
Sex: |
Female |
Location: |
Montana |
Vaccinated: | 1990-11-14 |
Onset: | 1990-11-28 |
Days after vaccination: | 14 |
Submitted: |
1990-12-10 |
Days after onset: | 12 |
Entered: |
1990-12-18 |
Days after submission: | 8 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
271961 / 1 |
LA / IM |
HIBV: HIB (HIBTITER) / PFIZER/WYETH |
- / 1 |
- / - |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0217S / 1 |
RA / IM |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
275925 / 1 |
MO / PO |
Administered by: Public Purchased by: Public Symptoms: Asthenia,
Guillain-Barre syndrome SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? Yes
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: Allergies: Diagnostic Lab Data: had EMG consistant /w Guillain Barre, Had negative spinal tap , CAT scan CDC Split Type:
Write-up: Guillian Barre Syndrome requiring intubation. Pt is still in hosp as of 10Dec90, Developed weakness on 28Nov90 |
|
VAERS ID: |
27119 (history) |
Form: |
Version 1.0 |
Age: |
1.4 |
Sex: |
Female |
Location: |
Maryland |
Vaccinated: | 1990-10-25 |
Onset: | 1990-10-26 |
Days after vaccination: | 1 |
Submitted: |
1990-11-09 |
Days after onset: | 14 |
Entered: |
1990-12-19 |
Days after submission: | 40 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HIBV: HIB (HIBTITER) / PFIZER/WYETH |
M670FC / 1 |
RL / - |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
13135 / 1 |
LL / - |
Administered by: Private Purchased by: Private Symptoms: Coordination abnormal,
Pyrexia,
Rash maculo-papular SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (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? Yes
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: CBC-Negative; CT Scan - Normal CDC Split Type:
Write-up: Pt vaccinated with MMR/HIB developed acute cerebella ataxia, maculopapular rash, fever of 102. |
|
VAERS ID: |
27133 (history) |
Form: |
Version 1.0 |
Age: |
30.0 |
Sex: |
Female |
Location: |
Montana |
Vaccinated: | 1990-07-23 |
Onset: | 1990-07-27 |
Days after vaccination: | 4 |
Submitted: |
0000-00-00 |
Entered: |
1990-12-19 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. |
46852 / 2 |
- / SC |
Administered by: Private Purchased by: Unknown Symptoms: Antinuclear antibody,
Arthralgia,
Blindness,
Headache,
Multiple sclerosis,
Myalgia,
Optic neuritis,
Pyrexia,
Visual disturbance SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Ocular infections (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)
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: multivitamins Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: WAES90090493
Write-up: Pt vaccinated with MRVAX developed fever of 100.5, headache, muscle & joint pain, visual disturbances, lost the vision in rt eye. Dx optic neuritis. Also slightly elevated ANA. Subsequently dx as multiple sclerosis. |
|
VAERS ID: |
27145 (history) |
Form: |
Version 1.0 |
Age: |
21.0 |
Sex: |
Female |
Location: |
Wisconsin |
Vaccinated: | 1990-11-26 |
Onset: | 1990-12-03 |
Days after vaccination: | 7 |
Submitted: |
1990-12-12 |
Days after onset: | 9 |
Entered: |
1990-12-21 |
Days after submission: | 9 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
1794F / 1 |
LA / SC |
Administered by: Public Purchased by: Public Symptoms: Chills,
Injection site mass,
Pain,
Pyrexia,
Rash SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 2 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph CDC Split Type: WI90055
Write-up: Pt c/o of chills all day, T103.6, arm had great deal of pain, developed a streaky rash on inside of lt arm, to body, arm became hard, red & swollen. Went to ER. |
|
VAERS ID: |
27169 (history) |
Form: |
Version 1.0 |
Age: |
2.0 |
Sex: |
Female |
Location: |
Rhode Island |
Vaccinated: | 1990-12-10 |
Onset: | 1990-12-11 |
Days after vaccination: | 1 |
Submitted: |
1990-12-14 |
Days after onset: | 3 |
Entered: |
1990-12-26 |
Days after submission: | 12 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HIBV: HIB (HIBTITER) / PFIZER/WYETH |
M025FC / 1 |
- / IM |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
1879S / 1 |
- / IM |
Administered by: Public Purchased by: Public Symptoms: CSF test abnormal,
Convulsion,
Meningitis,
Pyrexia SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), 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: Ceclor Current Illness: Mild serious otitis Preexisting Conditions: partially resolved otitis media Allergies: Diagnostic Lab Data: CSF Culture positive - H. Influenza CDC Split Type:
Write-up: Pt vaccinated with MMR/HIB developed fever, possible convulsion, bacterial meningitis. |
|