National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/7/2022 release of VAERS data:

This is VAERS ID 92042

Government Disclaimer on use of this data



Case Details

VAERS ID: 92042 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: North Dakota  
Vaccinated:1996-10-16
Onset:1996-10-16
   Days after vaccination:0
Submitted: 1996-10-30
   Days after onset:14
Entered: 1996-11-18
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Military       Purchased by: Military
Symptoms: Headache, Hypotension, Laboratory test abnormal, Pyrexia, Sepsis, Shock, Tachycardia, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Vitamin B complex multivitamin
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: initial CBC results unk;f/u CBC results: WBX 18,000;platelets 109,000, SGOT 100;potassium 2;
CDC Split Type: 896304020L

Write-up: pt recv vax 16OCT95 & w/in 45min devel hypotension (80/35), tachycardia (pulse rate 100-110, resp 20), severe h/a, fever (initially 37.3 C), hypokalemia;n/v;pt acted like was in septic shock;adm to hosp;


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=92042


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166