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This is VAERS ID 327723

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 327723
VAERS Form:
Age:17.0
Gender:Female
Location:Foreign
Vaccinated:2006-09-29
Onset:2006-10-31
Submitted:2008-10-08
Entered:2008-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (GENHEVAC B) / SANOFI PASTEUR Y6283 / 2 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Weight decreased, Familial risk factor, Type 1 diabetes mellitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Allergy to plants; Food allergy
Preexisting Conditions: Immunisation
Allergies:
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.


Changed on 9/14/2017

VAERS ID: 327723 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Foreign
Vaccinated:2006-09-29
Onset:2006-10-31
Submitted:2008-10-08
Entered:2008-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (GENHEVAC B) / SANOFI PASTEUR Y6283 / 2 3 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Weight decreased, Familial risk factor, Type 1 diabetes mellitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Allergy to plants; Food allergy
Preexisting Conditions: Immunisation
Allergies:
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.


Changed on 2/14/2018

VAERS ID: 327723 Before After
VAERS Form:1
Age:17.0
Gender:Female
Location:Foreign
Vaccinated:2006-09-29
Onset:2006-10-31
Submitted:2008-10-08
Entered:2008-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (GENHEVAC B) / SANOFI PASTEUR Y6283 / 3 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Weight decreased, Familial risk factor, Type 1 diabetes mellitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Allergy to plants; Food allergy
Preexisting Conditions: Immunisation
Allergies:
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.


Changed on 6/14/2018

VAERS ID: 327723 Before After
VAERS Form:1
Age:17.0
Gender:Female
Location:Foreign
Vaccinated:2006-09-29
Onset:2006-10-31
Submitted:2008-10-08
Entered:2008-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (GENHEVAC B) / SANOFI PASTEUR Y6283 / 3 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Weight decreased, Familial risk factor, Type 1 diabetes mellitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Allergy to plants; Food allergy
Preexisting Conditions: Immunisation
Allergies:
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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