|
VAERS ID: |
251660 (history) |
Form: |
Version 1.0 |
Age: |
4.0 |
Sex: |
Male |
Location: |
North Carolina |
Vaccinated: | 2006-01-25 |
Onset: | 2006-01-27 |
Days after vaccination: | 2 |
Submitted: |
2006-02-15 |
Days after onset: | 19 |
Entered: |
2006-02-21 |
Days after submission: | 6 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR |
C2207A / 1 |
LA / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Contusion,
Ecchymosis,
Immune system disorder,
Platelet count decreased,
Thrombocytopenic purpura SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)
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? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: The parent reported a three week history of bruising on 1/27/2006. Allergies: Diagnostic Lab Data: CDC Split Type: 200600326
Write-up: Initial report received on 2/10/2006 from an investigator participating in the above mentioned trial under the reference number P3T11. A four year old male subject was diagnosed with probable immune Thrombocytopenic purpura two days after he had received an intramuscular, left arm, first dose injection of Daptacel, lot number C2207AA, on 1/25/2006. The parent had reported a three week history of bruising on 1/27/2006 (two days post vaccination). A physical examination, on that date, revealed small ecchymotic areas on the knees and elbows. the subject had a platelet count of 103 and was referred to a specialist. The investigator considered the event an important medical event (OMIC). At the time of this report, the subject had not recovered. According to the investigator, the event was related to the study vaccine. |
|
VAERS ID: |
252069 (history) |
Form: |
Version 1.0 |
Age: |
1.0 |
Sex: |
Female |
Location: |
Illinois |
Vaccinated: | 2006-02-01 |
Onset: | 2006-02-22 |
Days after vaccination: | 21 |
Submitted: |
2006-02-27 |
Days after onset: | 5 |
Entered: |
2006-02-28 |
Days after submission: | 1 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. |
0771R / UNK |
LA / - |
Administered by: Private Purchased by: Private Symptoms: Ecchymosis,
Epistaxis,
Petechiae,
Platelet count decreased,
Thrombocytopenic purpura SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
Extended hospital stay? No
Previous Vaccinations: Other Medications: NONE Current Illness: bilateral serious otitis Preexisting Conditions: Allergies: Diagnostic Lab Data: Platelet count 2000 02/22/06 at hospital. CDC Split Type:
Write-up: Patient received ProQuad (MMR/varicella) on 2/1/06 and on 2/22/06 presented to pediatricians office with ecchymosis, petechiae and epistaxis, admitted to hospital with diagnosis ITP. |
|
VAERS ID: |
252935 (history) |
Form: |
Version 1.0 |
Age: |
1.26 |
Sex: |
Male |
Location: |
Illinois |
Vaccinated: | 2006-02-28 |
Onset: | 2006-03-05 |
Days after vaccination: | 5 |
Submitted: |
2006-03-13 |
Days after onset: | 8 |
Entered: |
2006-03-17 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR |
U1400DB / 4 |
LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR |
UE795AA / 4 |
LL / IM |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0466R / 1 |
LL / SC |
Administered by: Private Purchased by: Private Symptoms: Bronchiolitis,
Nasal congestion,
Petechiae,
Purpura,
Respiratory distress,
Thrombocytopenia,
Vaccination complication,
Viral infection,
Wheezing SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: Other Medications: On Amoxicillin at the time of immunization Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: WBC 7300, plts 108,000. CXR: perihilar bronchial edema. CDC Split Type:
Write-up: Purpuric rash with thrombocytopenia and wheezing. 10/13/06 Received medical records from hospital which reveal patient admitted 3/12-3/13/06 with final DX: acute bronchiolitis; thrombocytopenia; possible viral illness; & possible MMR reaction. Patient had developed cough for 5 days prior to admit & rash for approx 1 week prior to admit. Wheezing & occasional emesis with cough. No fever. Seen in PCP office 1 day prior to admit & noted to have petechiae & purpura on face & upper chest. Labs at that time revealed mild thrombocytopenia. No improvement by following AM & was admitted to hospital. Admit exam revealed respiratory distress, nasal congestion, wheezing, costal retractions & generalized macular papular rash with petechiae & purpura on face & chest. Responded to nebs & was d/c to home on nebs./ss |
|
VAERS ID: |
253421 (history) |
Form: |
Version 1.0 |
Age: |
1.03 |
Sex: |
Male |
Location: |
Utah |
Vaccinated: | 2006-02-07 |
Onset: | 2006-03-06 |
Days after vaccination: | 27 |
Submitted: |
2006-03-28 |
Days after onset: | 22 |
Entered: |
2006-03-29 |
Days after submission: | 1 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR |
2325AA / 3 |
RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. |
1072R / 3 |
LL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR |
Y0638 / 3 |
RL / IM |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0728R / 1 |
LL / SC |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH |
B08642K / 3 |
RL / IM |
Administered by: Private Purchased by: Unknown Symptoms: Anaemia,
Ecchymosis,
Lymphocyte morphology abnormal,
Platelet count decreased,
Platelet disorder,
Thrombocytopenic purpura SMQs:, Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Malignant lymphomas (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
Extended hospital stay? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Platelet 4 now 28; HCT 26-28 Lab test of peripheral blood smear 3/8/06 indicated marked increase in reactive lymphocytes- marked thrombocytopenia-platelets-on admit 4 and at DC 7-neutrophils 34-DC CDC Split Type:
Write-up: ITP dx 3/6/06. Admitted hospital, received rhogam. Plt count improved, then decreased. Last count was 28 on 3/26. Also became anemic from rhogam. 05/16/2006-received 8 pages to include DC summary and path report-DOS 3/6/06-C/O bruising easily- DX ITP vs leukemia-f/u with hem oncology at PCMC will be admitted 3/6/06- 06/20/06-5 page office notes received from pediatrician for patient. Note dates 3/2/8/06 indicated that on 3/24/06 platelet count was 23 and HCT was 26. Dr. contacted mother who is sure that the ITP is direct result of immunization patient received prior to his DX of ITP. Hematology at hospital encouraged physician to recheck CBC. on 3/27/06 platelet count and CBC improving. Will recheck hematology if platelet count drops or if he has active bleeding. Note of 3/25/06 mom informed physician that patient is doing well. |
|
VAERS ID: |
253475 (history) |
Form: |
Version 1.0 |
Age: |
24.0 |
Sex: |
Male |
Location: |
Oklahoma |
Vaccinated: | 2006-03-09 |
Onset: | 2006-03-28 |
Days after vaccination: | 19 |
Submitted: |
2006-03-29 |
Days after onset: | 1 |
Entered: |
2006-03-30 |
Days after submission: | 1 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS |
190AA / 1 |
- / IM |
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS |
043BA / 1 |
- / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR |
402642 / 1 |
- / SC |
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS |
AC52B005AA / 1 |
- / IM |
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER |
41909AA / 1 |
- / IM |
Administered by: Military Purchased by: Military Symptoms: Epistaxis,
Petechiae,
Thrombocytopenia SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), 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? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: Other Medications: TST 23082 3/7/06 Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Events- Thrombocytopenia;Symptoms - uncontrollable nose bleed, petechiae; Time - 2000/28Mar06;Treatment - Given platelets by ICU |
|
VAERS ID: |
253619 (history) |
Form: |
Version 1.0 |
Age: |
55.0 |
Sex: |
Male |
Location: |
California |
Vaccinated: | 2006-03-10 |
Onset: | 2006-03-23 |
Days after vaccination: | 13 |
Submitted: |
2006-03-24 |
Days after onset: | 1 |
Entered: |
2006-04-03 |
Days after submission: | 9 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
TDAP: TDAP (ADACEL) / SANOFI PASTEUR |
C245AA / UNK |
UN / UN |
Administered by: Private Purchased by: Unknown Symptoms: Petechiae,
Platelet disorder,
Purpura,
Thrombocytopenia,
Vaccination complication SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
Extended hospital stay? No
Previous Vaccinations: Other Medications: Lipitor/Lexapro/Metoprolol Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Platelets 3 received platelet transfer, received Anti D Dexareturse 40mg pulsed. CDC Split Type:
Write-up: Received vaccine 03/10/06 normal plt count 240 on 3/23/06 plt #3, petechial rash, afebrile. 4/14/06 Received hospital medical records for 3/24-3/26/06 admission w/dx TCP s/p 2 wks after Adacel. Etiology of TCP thought to be meds vs vaccine vs autoimmune mediated ITP. Mult transfusions of plts for recurrent very low plts. After starting dexamethasone & WinRho, improved & was able to be d/c home on steroids. On 3/27 visit to PCP again had very low plts & restarted on steroids. Hematologist felt ITP possibly related to erythroid reaction to temporary hemolysis induced by the anti-D. Continues in f/u w/hematologist/ss |
|
VAERS ID: |
254650 (history) |
Form: |
Version 1.0 |
Age: |
0.33 |
Sex: |
Female |
Location: |
Massachusetts |
Vaccinated: | 2006-04-18 |
Onset: | 2006-04-19 |
Days after vaccination: | 1 |
Submitted: |
2006-04-21 |
Days after onset: | 2 |
Entered: |
2006-04-27 |
Days after submission: | 6 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS |
AC21B034AA / 2 |
RL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR |
UE764AB / 2 |
RL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH |
308638H / 2 |
LL / IM |
Administered by: Private Purchased by: Public Symptoms: Ecchymosis,
Epistaxis,
Leukocytosis,
Melaena,
Otitis media,
Petechiae,
Platelet count decreased,
Thrombocytopenia SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Gastrointestinal haemorrhage (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: Other Medications: Zantac Current Illness: Preexisting Conditions: Gastroesophageal Reflux Medical records state constipation. msv Allergies: Diagnostic Lab Data: Medical record states leukocytosis, decreased platelets. msc CDC Split Type:
Write-up: Thrombocytopenia presumed DX ITP onset of petechial rash within 24 hours of vaccine admin. Medical records state epistaxis, otitis, melena, ecchymosis, raised skin lesions.msv. 60 day Follow-up Information 06-JUL-2006: Thrombocytopenia resolved after Rx with IVIG. |
|
VAERS ID: |
255054 (history) |
Form: |
Version 1.0 |
Age: |
7.0 |
Sex: |
Male |
Location: |
Nebraska |
Vaccinated: | 2006-04-14 |
Onset: | 2006-05-01 |
Days after vaccination: | 17 |
Submitted: |
2006-05-03 |
Days after onset: | 2 |
Entered: |
2006-05-04 |
Days after submission: | 1 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS |
AHAVB090AA / 1 |
LA / - |
Administered by: Private Purchased by: Private Symptoms: Thrombocytopenic purpura SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Immune-mediated/autoimmune disorders (narrow)
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: NONE Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: A0604119A
Write-up: This case was reported by a healthcare professional and described the occurrence of idiopathic thrombocytopenia purpura in a 7 year old male subject who was vaccinated with hepatitis A vaccine inactivated (Havrix) for prophylaxis. The subject had no pre existing medical conditions. There were no concurrent medications. On 4/14/2006 the subject received 1st dose of Havrix in the left arm (lot AHAVB090AA). On 5/1/2006, 17 days after vaccination with Havrix, the subject experienced idiopathic thrombocytopenia purpura. The subject was hospitalised and was treated with intravenous immunoglobulin. The healthcare professional considered the event was clinically significant or requiring intervention (OMIC). At the time of initial reporting, 5/2/2006, the event was ongoing. The healthcare professional considered the event to probably be related to vaccination with Havrix. |
|
VAERS ID: |
255170 (history) |
Form: |
Version 1.0 |
Age: |
1.02 |
Sex: |
Male |
Location: |
Texas |
Vaccinated: | 2006-03-02 |
Onset: | 2006-03-22 |
Days after vaccination: | 20 |
Submitted: |
2006-05-02 |
Days after onset: | 40 |
Entered: |
2006-05-08 |
Days after submission: | 6 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. |
006R / 4 |
LL / IM |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0376R / 1 |
RL / SC |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH |
B08642C / 4 |
RL / IM |
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. |
0908R / 1 |
LL / SC |
Administered by: Private Purchased by: Private Symptoms: Petechiae,
Thrombocytopenia SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: NONE Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: CBC with plt count-93K (lowest) CDC Split Type:
Write-up: Thrombocytopenia and Petechia. Resolved 4/4/06. |
|
VAERS ID: |
258221 (history) |
Form: |
Version 1.0 |
Age: |
1.53 |
Sex: |
Female |
Location: |
Virginia |
Vaccinated: | 2006-05-05 |
Onset: | 2006-05-30 |
Days after vaccination: | 25 |
Submitted: |
2006-06-09 |
Days after onset: | 10 |
Entered: |
2006-06-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR |
Y1030 / 3 |
RL / SC |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0486R / 1 |
RL / SC |
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. |
0073P / 1 |
LL / SC |
Administered by: Unknown Purchased by: Unknown Symptoms: Contusion,
Petechiae,
Platelet count decreased,
Rash,
Thrombocytopenic purpura SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: n/a Current Illness: n/a Preexisting Conditions: n/a Allergies: Diagnostic Lab Data: 3 weeks after vaccination platelet count dropped to 3000 Labs urine clear, pH 5.0, glucose neg blood neg, protein trace, ketones, bili, nitrite and LET neg, urobilinogen 2. Impression Thrombocytopenia NOS. Lab in ER Platelet 9,000, Hgb 12.6 and Hct 38.6, WBC 12.5. Type and cross revealed O positive and negative antibody screen. CDC Split Type:
Write-up: idiopathic thrombocytopenic purpura 06/14/06-4 page office notes received from MD, patient''s pediatrician. Office note for 5/3/06 date of vaccine documented that child missed 15 and 18 month well baby visits. HX included pregnancy complication of beta strep colonization, pregnancy induced HTN, vaginal delivery. Physical exam within normal limits. Visit of 5/31/06 with complaint of rash 5 day duration, parent called office on 5/30/06 with c/o unusual bruising and rash. No fever noted, acting normally appetite and sleep fine, one nosebleed weekend prior to this visit. Physical exam revealed petechiae over torso with various sizes and stages of bruises in unusual places, no active bleeding, respiratory normal, cardiovascular normal, abdomen normal. Liver down 1 cm. Referred to hospital for lab and ER visit. 08/03/06-ER report received. DC DX: ITP Chief Complaint: low platelet count 3,000, bruises and petechia. HX Present Illness: Red spots and easy bruisability began day before ER visit. Urine test at MD office prior to ER visit negative. CBC showed platelet count 3,000. Physical Exam: Temp 36.4, HR 168. Pupils equal reactive to light. TMS are clear bilaterally. One petechia on her left anterior tongue. Tonsils non swollen and no erythema or exudate. Skin shows significant amount of bruising on her extremities bilaterally upper and lower as well as on her back and some petechia noted on her truck, particularly on her anterior chest. No signs of active bleeding, no nose bleeding and no eye bleeding. Small petechia on her right eye. Treated with IV therapy and discharged home from ER. |
|