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This is VAERS ID 327723

(NOTE: This result is from the 6/14/2018 version of the VAERS database)

Case Details

VAERS ID: 327723 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Female  
Location: Foreign  
   Days after vaccination:32
Submitted: 2008-10-08
   Days after onset:707
Entered: 2008-10-09
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Familial risk factor, Type 1 diabetes mellitus, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (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, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Allergy to plants; Food allergy
Preexisting Conditions: Immunisation
Diagnostic Lab Data: body weight measurement, 16Nov06, weight loss of 3 kg
CDC Split Type: WAES0810USA00578

Write-up: Information has been received from a health authority (reference number PC20080285) concerning a 17 year old female who on 23-MAR-1998 was vaccinated with the second dose of MMR II (batch number not reported). Suspect therapy included the third dose of GENHEVAC B (batch number Y6283-1) on 29-SEP-2008, a dose of REVAXIS (batch number Z6308-1) in 2006, the booster dose of DT POLIO (batch number not reported) in January 1996, the fourth dose of TETRACOQ (batch number not reported) in December 1990, the second dose of ENGERIX-B (other manufacturer) on 21-FEB-2006 and a dose of INFANRIX (Batch number 20772B9, other manufacturer) in May 2001. The patient was hospitalized on 16-NOV-2006 for weight loss of 3 kg with "cardinal syndrome" which led to suspicion of mellitus diabetes. She was discharged on 22-NOV-2006 on LEVEMIR 5 and NOVORAPID 8/5/9 units. Date of onset of diabetes was reported to be in late October 2006. The patient was diagnosed with "de novo" insulin-dependent diabetes and "cardinal syndrome". She recovered with sequelae. The patient has a history of allergy to cereals, plants (grass), family history of gestational diabetes in her mother during pregnancy, Von Willebrand disease in her sister and previous vaccinations including the first dose of ENGERIX B (batch number AHBVB118A8, other manufacturer) on 20-JAN-2006, 3 doses of TETRACOQ (batch number not reported) in September, October and November 1989, the first dose of MMR II (batch number not reported) on 29-JAn-1991. She received a dose of GARDASIL (batch number NG22310) on 18-JAN-2008. Type I diabetes mellitus was considered to be disabling. Other business partner numbers included: E2008-09103.

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