|
| VAERS ID: | 40511 | Vaccinated: | 1991-11-13 | | Age: | 34.0 | Onset: | 1992-03-18, Days after vaccination: 126 | | Gender: | Female | Submitted: | 0000-00-00 | | Location: | Foreign | Entered: | 1992-03-23, Days after submission:
| |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: hx of irregular menstrual cycles; | | Diagnostic Lab Data: 26NOV91 Ultrasound-confirmed 5 1/2 wk fetus; JAN91 Ultrasound-grossly abn fetus; | | CDC 'Split Type': CO4137 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | CONNAUGHT LABORATORIES | | | | | |
| Administered by: Unknown Purchased by: Unknown | Symptoms: Abortion,
Foetal disorder
SMQs:, Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow)
| | Write-up: Pt underwent termination of pregnancy; LMP 30SEP91, sl PV bleeding on 10NOV91; Recvd vax on 13NOV91; ultrasound confirmed 5 1/2 wk fetus on 26NOV91; JAN92 ultrasound showed "grossly abn fetus; preg terminated 4FEB92; |
|
|
| VAERS ID: | 128185 | Vaccinated: | 1998-10-05 | | Age: | 37.1 | Onset: | 1998-12-01, Days after vaccination: 57 | | Gender: | Female | Submitted: | 1999-09-10, Days after onset: 282 | | Location: | New York | Entered: | 1999-09-13, Days after submission: 3
| |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: mitral valve prolapse (1978); urinary tract infect | | Diagnostic Lab Data: | | CDC 'Split Type': 1998024794 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | UNKNOWN MANUFACTURER | | 0 | | | | HEPA | SMITHKLINE BEECHAM | | 1 | | | |
| Administered by: Private Purchased by: Other | Symptoms: Abortion
SMQs:, Termination of pregnancy and risk of abortion (narrow)
| | Write-up: p/vax pt could possible be preg, starting 10/4/98; pt devel flu; MD stated that pt had a spontaneous abortion |
|
|
| VAERS ID: | 179730 | Vaccinated: | 2001-11-06 | | Age: | 48.0 | Onset: | 2001-11-11, Days after vaccination: 5 | | Gender: | Female | Submitted: | 2001-12-23, Days after onset: 42 | | Location: | California | Entered: | 2002-01-07, Days after submission: 15
| |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: Progestrone,Estrpgen, Folic Acid, ASA | | Current Illness: URI | | Preexisting Conditions: NONE | | Diagnostic Lab Data: Sonogram | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | EVANS VACCINES | E73100LA | 0 | | LA | |
| Administered by: Public Purchased by: | Symptoms: Abortion
SMQs:, Termination of pregnancy and risk of abortion (narrow)
| | Write-up: 11/11/2001-Seven weeks into her pregnancy, the patient had a spontaneous abortion. |
|
|
| VAERS ID: | 217805 | Vaccinated: | 2001-11-20 | | Age: | 19.0 | Onset: | 2001-11-22, Days after vaccination: 2 | | Gender: | Female | Submitted: | 2004-03-12, Days after onset: 841 | | Location: | Alaska | Entered: | 2004-03-12, Days after submission: 0
| |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? Yes, 3 days | | Extended hospital stay? No |
| Previous Vaccinations: | | Other Medications: NONE | | Current Illness: NONE | | Preexisting Conditions: Group B streptococcus UTI; | | Diagnostic Lab Data: WBC elevated, lab test abn | | CDC 'Split Type': AK200424 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | UNKNOWN MANUFACTURER | Unknown | 0 | | RA | |
| Administered by: Unknown Purchased by: Unknown | Symptoms: Abortion,
Back pain,
Headache,
Laboratory test abnormal,
Nausea,
Vomiting,
White blood cell disorder
SMQs:, Acute pancreatitis (broad), Haematopoietic leukopenia (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Termination of pregnancy and risk of abortion (narrow)
| | Write-up: Headache, lower back pain, nausea, vomiting, loss of unborn child. Lasted for two weeks; resulted in hospitalization. Nurse follow up on 05/18/04: spontaneous rupture of membranes. |
|
|
| VAERS ID: | 225155 | Vaccinated: | 2003-10-08 | | Age: | 36.0 | Onset: | 2003-12-04, Days after vaccination: 57 | | Gender: | Female | Submitted: | 2004-08-30, Days after onset: 269 | | Location: | Foreign | Entered: | 2004-08-09, Days after submission: 21
| |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: Pregnant, LMP date: 9/20/03; No relevant history reported. | | Diagnostic Lab Data: | | CDC 'Split Type': E200303410 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | UNKNOWN MANUFACTURER | | | | | |
| Administered by: Unknown Purchased by: Unknown | Symptoms: Abortion,
Unintended pregnancy
SMQs:, Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)
| | Write-up: Case upgraded to serious on 7/30/04 for other seriousness criteria: Spontaneous abortion. Case reported by a health care professional. Case involves an inadvertent administration of vaccine during pregnancy. It was reported that a 36 year old female received influenza vaccine (batch not reported) at her occupational health department. The patient then discovered that she was pregnant and so contacted the reporter for advise. Further information requested. Case to remain open. Follow up 7/30/04: LMP date 9/20/03. Date of vaccination 8/10/03 but manufacturer not confirmed as not given in reporting surgery. Gestational age therefore reported as 3 weeks, however likely to be 1 week if conception assumed to be 2 weeks post LMP date. Expected delivery date was 6/29/04. However patient experienced a spontaneous abortion commencing on 4/12/03. Case will be followed up. (OMIC) Follow up 25/8/04 ASPP received from HA. |
|
|
