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This is VAERS ID 259002

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 259002
VAERS Form:
Age:56.0
Gender:Female
Location:Illinois
Vaccinated:2006-06-12
Onset:2006-06-17
Submitted:2006-06-29
Entered:2006-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
JEV: JAPANESE ENCEPH. (J-VAX) / AVENTIS PASTEUR, INC. EJN222A / 1 RA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid, Claritin, Fosamax
Current Illness: None
Preexisting Conditions: Hypothyroidism, osteopenia, allergic rhinitis, No known drug allergies.
Allergies:
Diagnostic Lab Data: Platelet count 3,000 on 17 June 2006. Platelet count 160,000 on 21 June 2006 after IVIG and steroid treatment.
CDC 'Split Type':

Write-up:Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids.


Changed on 12/8/2009

VAERS ID: 259002 Before After
VAERS Form:
Age:56.0
Gender:Female
Location:Illinois
Vaccinated:2006-06-12
Onset:2006-06-17
Submitted:2006-06-29
Entered:2006-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
JEV: JAPANESE ENCEPH. (J-VAX) JAPANESE ENCEPHALITIS (JE-VAX) / AVENTIS PASTEUR, INC. AVENTIS PASTEUR EJN222A / 1 RA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid, Claritin, Fosamax
Current Illness: None
Preexisting Conditions: Hypothyroidism, osteopenia, allergic rhinitis, No known drug allergies. allergies.PMH:
Allergies:
Diagnostic Lab Data: Platelet count 3,000 on 17 June 2006. Platelet count 160,000 on 21 June 2006 after IVIG and steroid treatment. Labs on admission: WBC 4.9, platelets day 2 at 21,000. 10% reactive lymphocytes and increase from 7% on day of admission. UA mo
CDC 'Split Type':

Write-up:Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited China. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.


Changed on 6/13/2012

VAERS ID: 259002 Before After
VAERS Form:
Age:56.0
Gender:Female
Location:Illinois
Vaccinated:2006-06-12
Onset:2006-06-17
Submitted:2006-06-29
Entered:2006-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / AVENTIS PASTEUR SANOFI PASTEUR EJN222A / 1 RA / -

Administered by: Unknown Military      Purchased by: Unknown Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid, Claritin, Fosamax
Current Illness: None
Preexisting Conditions: Hypothyroidism, osteopenia, allergic rhinitis, No known drug allergies.PMH: allergies. PMH:
Allergies:
Diagnostic Lab Data: Platelet count 3,000 on 17 June 2006. Platelet count 160,000 on 21 June 2006 after IVIG and steroid treatment. Labs on admission: WBC 4.9, platelets day 2 at 21,000. 10% reactive lymphocytes and increase from 7% on day of admission. UA mo moderate blood.
CDC 'Split Type':

Write-up:Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited China. foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.


Changed on 6/14/2014

VAERS ID: 259002 Before After
VAERS Form:
Age:56.0
Gender:Female
Location:Illinois
Vaccinated:2006-06-12
Onset:2006-06-17
Submitted:2006-06-29
Entered:2006-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / SANOFI PASTEUR EJN222A / 1 RA / -

Administered by: Military      Purchased by: Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid, Claritin, Fosamax
Current Illness: None
Preexisting Conditions: Hypothyroidism, osteopenia, allergic rhinitis, No known drug allergies. PMH:
Allergies:
Diagnostic Lab Data: Platelet count 3,000 on 17 June 2006. Platelet count 160,000 on 21 June 2006 after IVIG and steroid treatment. Labs on admission: WBC 4.9, platelets day 2 at 21,000. 10% reactive lymphocytes and increase from 7% on day of admission. UA moderate blood.
CDC 'Split Type':

Write-up:Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.


Changed on 5/14/2017

VAERS ID: 259002 Before After
VAERS Form:
Age:56.0
Gender:Female
Location:Illinois
Vaccinated:2006-06-12
Onset:2006-06-17
Submitted:2006-06-29
Entered:2006-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / SANOFI PASTEUR EJN222A / 1 RA / -

Administered by: Military      Purchased by: Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid, Claritin, Fosamax
Current Illness: None
Preexisting Conditions: Hypothyroidism, osteopenia, allergic rhinitis, No known drug allergies. PMH:
Allergies:
Diagnostic Lab Data: Platelet count 3,000 on 17 June 2006. Platelet count 160,000 on 21 June 2006 after IVIG and steroid treatment. Labs on admission: WBC 4.9, platelets day 2 at 21,000. 10% reactive lymphocytes and increase from 7% on day of admission. UA moderate blood.
CDC 'Split Type':

Write-up:Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.


Changed on 9/14/2017

VAERS ID: 259002 Before After
VAERS Form:(blank) 1
Age:56.0
Gender:Female
Location:Illinois
Vaccinated:2006-06-12
Onset:2006-06-17
Submitted:2006-06-29
Entered:2006-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
JEV: JAPANESE ENCEPHALITIS (JE-VAX) / SANOFI PASTEUR EJN222A / 1 2 RA / -

Administered by: Military      Purchased by: Military
Symptoms: Epistaxis, Petechiae, Platelet count decreased, Thrombocytopenic purpura

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid, Claritin, Fosamax
Current Illness: None
Preexisting Conditions: Hypothyroidism, osteopenia, allergic rhinitis, No known drug allergies. PMH:
Allergies:
Diagnostic Lab Data: Platelet count 3,000 on 17 June 2006. Platelet count 160,000 on 21 June 2006 after IVIG and steroid treatment. Labs on admission: WBC 4.9, platelets day 2 at 21,000. 10% reactive lymphocytes and increase from 7% on day of admission. UA moderate blood.
CDC 'Split Type':

Write-up:Nosebleed on morning of 17 June 2006; petechiae developed on evening of 17 June 2006, so patient went to ER; Idiopathic Thrombocytopenic Purpura was diagnosed. She was admitted and treated with platelet transfusion, IVIG, and IV corticosteroids. 7/18/06-Presented to ED with petechial rash. Plt on admission 3000. Admitting DX thrombocytopenia. PMH: hypothyroidism and osteopenia. Recently visited foreign country. Received 1st dose of encephalitis vaccine on 6/6/06 and 2nd dose 6/12/06 with 3rd dose scheduled week of 6/25/06. Hematology and Infectious Disease consults requested. PSH: Status post repair of deviated septum in 1994 with hemorrhage status post right 5th to hammer toe repair. Skin biopsy 1 week prior to this admission no firm diagnosis with possible diagnosis of lichen sclerosis. Current Meds: Fosamax and Synthroid. PE normal with petechia on the oral mucosa and 2 sits of what appear to have been blood blisters the overlying mucosa of which is torn. 7/26/06-a DC summary is not dictated for a stay of 48 hours or <. Med Rec will fax DC face sheet that includes DC DX. 8/1/06-DC DX received from hospital: Principal DX: Other and unspecified complication of medical care. Secondary DX: immune thrombocytopenic purpura and unspecified acquired hypothyroidism.


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