National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 265307

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 265307
VAERS Form:
Age:0.6
Gender:Male
Location:Louisiana
Vaccinated:2006-09-14
Onset:2006-10-05
Submitted:2006-10-24
Entered:2006-10-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (UNKNOWN MFR) / UNKNOWN MANUFACTURER - / 2 LL / IM
HEP: HEP B (UNKNOWN MFR) / UNKNOWN MANUFACTURER - / 3 LL / IM
MNC: MENINGOCOCCAL CONJUGATE VACCINE / UNKNOWN MANUFACTURER - / 2 RL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Pancytopenia, Thrombocytopenia, Contusion, Haemorrhage

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No previous illnesses
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Bone marrow=neg
CDC 'Split Type':

Write-up:bruising, peticuli,bleeding. Took to er and he had a platlet count of 2,000. He was admitted and given two rounds of IVIG. He was not responsive and had a bone marrow biopsy and it was neg. 6 days later his platlets rose to 523,000. Being treated by hemat"ologist. Diagnosed with pancytopenia.


Changed on 12/8/2009

VAERS ID: 265307 Before After
VAERS Form:
Age:0.6
Gender:Male
Location:Louisiana
Vaccinated:2006-09-14
Onset:2006-10-05
Submitted:2006-10-24
Entered:2006-10-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (UNKNOWN MFR) DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 LL / IM
HEP: HEP B (UNKNOWN MFR) HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - UE931 / 3 LL / IM
MNC: MENINGOCOCCAL CONJUGATE VACCINE MENINGOCOCCAL CONJUGATE (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 RL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Pancytopenia, Thrombocytopenia, Contusion, Haemorrhage

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No previous illnesses
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Bone marrow=neg Bone Marrow: Dyserythropoiesis with increase in megacaryocytes myeloid hypoplasia. Labs WBC 6.19, Hb 11.6, Plt 305, ANC 1050.
CDC 'Split Type':

Write-up:bruising, peticuli,bleeding. Took to er and he had a platlet count of 2,000. He was admitted and given two rounds of IVIG. He was not responsive and had a bone marrow biopsy and it was neg. 6 days later his platlets rose to 523,000. Being treated by hemat"ologist. hematologist. Diagnosed with pancytopenia. DOS 10/6-10/10/16 DC DX: pancytopenia resolving, coombs negative anemia, thrombocytopenia, IPT suspected. Cytogenetics prelimary report:no chromosomal abnormalities were identified. Follow-up visit 10/25/06-doing fine since DC, had URI 2 weeks before low platelet count. Assessment: recovered from ITP status post IVIG, most likely after viral infection.


Changed on 5/11/2010

VAERS ID: 265307 Before After
VAERS Form:
Age:0.6
Gender:Male
Location:Louisiana
Vaccinated:2006-09-14
Onset:2006-10-05
Submitted:2006-10-24
Entered:2006-10-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 LL / IM
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UE931 / 3 LL / IM
MNC: MENINGOCOCCAL CONJUGATE (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 RL / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 RL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Pancytopenia, Thrombocytopenia, Contusion, Haemorrhage

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No previous illnesses
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Bone marrow=neg Bone Marrow: Dyserythropoiesis with increase in megacaryocytes myeloid hypoplasia. Labs WBC 6.19, Hb 11.6, Plt 305, ANC 1050.
CDC 'Split Type':

Write-up:bruising, peticuli,bleeding. Took to er and he had a platlet count of 2,000. He was admitted and given two rounds of IVIG. He was not responsive and had a bone marrow biopsy and it was neg. 6 days later his platlets rose to 523,000. Being treated by hematologist. Diagnosed with pancytopenia. DOS 10/6-10/10/16 DC DX: pancytopenia resolving, coombs negative anemia, thrombocytopenia, IPT suspected. Cytogenetics prelimary report:no chromosomal abnormalities were identified. Follow-up visit 10/25/06-doing fine since DC, had URI 2 weeks before low platelet count. Assessment: recovered from ITP status post IVIG, most likely after viral infection.


Changed on 2/14/2017

VAERS ID: 265307 Before After
VAERS Form:
Age:0.6 0.62
Gender:Male
Location:Louisiana
Vaccinated:2006-09-14
Onset:2006-10-05
Submitted:2006-10-24
Entered:2006-10-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 LL / IM
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UE931 / 3 LL / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 RL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Pancytopenia, Thrombocytopenia, Contusion, Haemorrhage

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No previous illnesses
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Bone marrow=neg Bone Marrow: Dyserythropoiesis with increase in megacaryocytes myeloid hypoplasia. Labs WBC 6.19, Hb 11.6, Plt 305, ANC 1050.
CDC 'Split Type':

Write-up:bruising, peticuli,bleeding. Took to er and he had a platlet count of 2,000. He was admitted and given two rounds of IVIG. He was not responsive and had a bone marrow biopsy and it was neg. 6 days later his platlets rose to 523,000. Being treated by hematologist. Diagnosed with pancytopenia. DOS 10/6-10/10/16 DC DX: pancytopenia resolving, coombs negative anemia, thrombocytopenia, IPT suspected. Cytogenetics prelimary report:no chromosomal abnormalities were identified. Follow-up visit 10/25/06-doing fine since DC, had URI 2 weeks before low platelet count. Assessment: recovered from ITP status post IVIG, most likely after viral infection.


Changed on 9/14/2017

VAERS ID: 265307 Before After
VAERS Form:(blank) 1
Age:0.62
Gender:Male
Location:Louisiana
Vaccinated:2006-09-14
Onset:2006-10-05
Submitted:2006-10-24
Entered:2006-10-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 3 LL / IM
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UE931 / 3 4 LL / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 3 RL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Pancytopenia, Thrombocytopenia, Contusion, Haemorrhage

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No previous illnesses
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Bone marrow=neg Bone Marrow: Dyserythropoiesis with increase in megacaryocytes myeloid hypoplasia. Labs WBC 6.19, Hb 11.6, Plt 305, ANC 1050.
CDC 'Split Type':

Write-up:bruising, peticuli,bleeding. Took to er and he had a platlet count of 2,000. He was admitted and given two rounds of IVIG. He was not responsive and had a bone marrow biopsy and it was neg. 6 days later his platlets rose to 523,000. Being treated by hematologist. Diagnosed with pancytopenia. DOS 10/6-10/10/16 DC DX: pancytopenia resolving, coombs negative anemia, thrombocytopenia, IPT suspected. Cytogenetics prelimary report:no chromosomal abnormalities were identified. Follow-up visit 10/25/06-doing fine since DC, had URI 2 weeks before low platelet count. Assessment: recovered from ITP status post IVIG, most likely after viral infection.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=265307&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166