National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 359436

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 359436 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Foreign  
Submitted: 2009-10-05
Entered: 2009-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Blood test, Dyspnoea, Ear pain, Fatigue, Fontanelle bulging, Headache, Infection, Lumbar puncture normal, Malaise, Meningism, Nausea, Nephritis, Nuclear magnetic resonance imaging normal, Pyrexia, Toothache, Ultrasound scan abnormal, Urine analysis
SMQs:, Acute renal failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Neonatal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Lumbar puncture, Sep1991, normal; After vaccination with DTP-HIB-POLIO: Sonogram of the skull was borderline. After vaccination with TWINRIX PEDIATRIC: Several blood and urine examinations; magnetic resonance tomography without pathological findings
CDC Split Type: D0063028A

Write-up: This case was reported by a foreign regulatory authority (# DE-PEI-PEI2009020984) and described the occurrence of nephritis in a 5-month-old female subject (born 02 April 1991) who was vaccinated with TWINRIX pediatric (GlaxoSmithKline). Previous vaccination with Diphtheria + tetanus + pertussis + polio + haemophilus influenzae vaccine given on 03 July 1991 and 31 July 1991 was well tolerated. On 4 September 1991 the subject received 3rd dose of combined Diphtheria + tetanus + pertussis + polio + haemophilus influenzae vaccine (unknown manufacturer, unknown route, probably right thigh). At an unspecified time after vaccination with Diphtheria + tetanus + pertussis + polio + haemophilus influenzae the subject experienced fever and bulging fontanelle. Meningism was suspected but not confirmed. Next vaccinations with TWINRIX pediatric given on 06 May 2002 and 17 June 2002 were well tolerated. On 6 January 2004 the subject received 3rd dose of TWINRIX pediatric (unknown route, unknown upper arm). At an unspecified time after vaccination with TWINRIX adult, the subject experienced recurrent nephritis, infection, headache, ear pain, toothache, unclear fatigue and nausea. Ambulatory treatment was necessary. The subject was hospitalised. At the time of reporting the events were resolved. After the next vaccination with Diphtheria + tetanus + pertussis + polio + haemophilus influenzae vaccine these events did not recur. On 30 April 2007, 26 June 2007 and 16 November 2007 the subject received GARDASIL (Sanofi Pasteur MSD, intramuscular, left upper arm). An unspecified time after vaccination the subject experienced felling of illness, headache, nausea and recurrent dyspnoea. No further information has been provided. No further information will be available.

New Search

Link To This Search Result:

Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166