|
VAERS ID: |
31011 (history) |
Form: |
Version 1.0 |
Age: |
1.3 |
Sex: |
Male |
Location: |
Florida |
Vaccinated: | 1990-03-02 |
Onset: | 1990-03-12 |
Days after vaccination: | 10 |
Submitted: |
1991-05-10 |
Days after onset: | 423 |
Entered: |
1991-06-05 |
Days after submission: | 26 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
1673R / 1 |
LL / - |
Administered by: Private Purchased by: Other Symptoms: Delirium,
Encephalopathy,
Red blood cell sedimentation rate increased SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient Other Medications: NONE Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: brain CT showed cortical atrophy 7 enlarged ventricles for age; ESR 85, CAT SCAN leukoencephalopathy; poss no true damage to myelin but only edema; CDC Split Type:
Write-up: 10 days post vax pt stopped walking, overnight; could not crawl, turn fr back to front or front to back, or hold up head; ESR ele @ 85, brain CT showed cortical atrophy & enlarged ventricles for age; Admitted to hosp; poss edema |
|
VAERS ID: |
33004 (history) |
Form: |
Version 1.0 |
Age: |
1.3 |
Sex: |
Male |
Location: |
New Jersey |
Vaccinated: | 1990-04-12 |
Onset: | 1990-04-26 |
Days after vaccination: | 14 |
Submitted: |
0000-00-00 |
Entered: |
1991-06-03 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
2260R / 1 |
- / SC |
Administered by: Unknown Purchased by: Unknown Symptoms: CSF test abnormal,
Convulsion,
Encephalitis,
Extensor plantar response,
Febrile convulsion,
Hemiplegia,
Infection,
Stupor SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: None Current Illness: Preexisting Conditions: Hx of asthma Allergies: Diagnostic Lab Data: WBC - 4/26, 13.4; Hemoglobin - 4/26, 9.3; Hematocrit - 4/26, 28.9;Neutrophils - 4/26, 16%; Bands - 4/26, 1%; Lymphocites - 70%; ESR - 4/26 - 7; WBC - 4/27, 11.4; Neutrophils - 4/27, 36%; Bands - 4/27, 4%; See worm... CDC Split Type: WAES90050250
Write-up: 12Apr90 pt vax; 26apr90 devel fever, focal rt sided seizures for 25-30 minutes. Tx w/ Valium and admitted to ER. MD felt that seizures due to viral infection or vax. Tx w/ Ferusal for iron deficiency anemia. See worm... |
|
VAERS ID: |
33011 (history) |
Form: |
Version 1.0 |
Age: |
18.0 |
Sex: |
Female |
Location: |
Ohio |
Vaccinated: | 1989-12-16 |
Onset: | 1989-12-16 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1991-06-03 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
- / UNK |
- / - |
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Asthenia,
Pain,
Pruritus,
Rash,
Urticaria SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: None Current Illness: Preexisting Conditions: None Allergies: Diagnostic Lab Data: None CDC Split Type: WAES90050624
Write-up: 16Dec89 pt vax; devel rash on arms & wrists w/ burning and itching. Devel gen urticaria & fatigue. Tx w/ pres drugs w/out effect. Prescribed cortisone pt refused. Sx persisted as of 18Jul90. |
|
VAERS ID: |
33160 (history) |
Form: |
Version 1.0 |
Age: |
1.3 |
Sex: |
Female |
Location: |
Pennsylvania |
Vaccinated: | 1990-05-31 |
Onset: | 1990-06-09 |
Days after vaccination: | 9 |
Submitted: |
0000-00-00 |
Entered: |
1991-06-03 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0891S / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Febrile convulsion,
Influenza,
Rash maculo-papular SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Unknown Current Illness: Preexisting Conditions: No relevant hx Allergies: Diagnostic Lab Data: No relevant data CDC Split Type: WAES90060553
Write-up: 31May90 pt vax; devel maculopapular eruption. 09Jun90 exp febrile convulsion. Dx of viral syndrome & reaction vax considered. |
|
VAERS ID: |
33169 (history) |
Form: |
Version 1.0 |
Age: |
30.0 |
Sex: |
Female |
Location: |
Connecticut |
Vaccinated: | 1990-04-27 |
Onset: | 1990-05-13 |
Days after vaccination: | 16 |
Submitted: |
0000-00-00 |
Entered: |
1991-06-03 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
1762P / 2 |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Arthralgia,
Arthritis,
Hypokinesia,
Myalgia,
Pain,
Paraesthesia SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Unknown Current Illness: Preexisting Conditions: Allergy Atarax. Allergies: Diagnostic Lab Data: No relevant data CDC Split Type: WAES90061004
Write-up: 27Apr90 pt vax; 13May90 pt devel mild aching in rt arm. 09Jun90 exp arthralgia of rt leg, behind knee. 18Jun90 exp arthralgia in both arms, & paresthesia radiating down from elbow to last two fingers. Sx impaired ability to walk/stairs. |
|
VAERS ID: |
33187 (history) |
Form: |
Version 1.0 |
Age: |
1.5 |
Sex: |
Female |
Location: |
New Jersey |
Vaccinated: | 1983-01-07 |
Onset: | 1983-01-15 |
Days after vaccination: | 8 |
Submitted: |
0000-00-00 |
Entered: |
1991-05-31 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Convulsion,
Pyrexia SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Unknown Current Illness: Preexisting Conditions: No relevant hx Allergies: Diagnostic Lab Data: No relevant data CDC Split Type: WAES90060351
Write-up: 07Jan83 pt vax; 15Jan83 devel high fever & exp convulsion. At age 9 pt seen by MD for hypersensitivity. |
|
VAERS ID: |
33189 (history) |
Form: |
Version 1.0 |
Age: |
1.7 |
Sex: |
Male |
Location: |
Texas |
Vaccinated: | 1988-06-01 |
Onset: | 1988-06-01 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1991-05-31 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Encephalopathy,
Pyrexia SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: None Current Illness: Preexisting Conditions: No relevant hx Allergies: Diagnostic Lab Data: No relevant data CDC Split Type: WAES90060387
Write-up: Jun88 pt vax; devel encephalopathy & high fever lasting 3-4 days. Tx w/ antibiotics. |
|
VAERS ID: |
33351 (history) |
Form: |
Version 1.0 |
Age: |
1.4 |
Sex: |
Male |
Location: |
Pennsylvania |
Vaccinated: | 1990-07-13 |
Onset: | 1990-07-17 |
Days after vaccination: | 4 |
Submitted: |
0000-00-00 |
Entered: |
1991-06-03 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Coordination abnormal,
Encephalitis,
Gait disturbance,
Pyrexia,
Somnolence SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: UNK Current Illness: Preexisting Conditions: No relevant hx Allergies: Diagnostic Lab Data: No relevant data CDC Split Type: WAES90070697
Write-up: Pt recvd MMR vax 13JUL90; On 17JUL90 pt devel encephalitis w/fever, sleepiness, & loss of balance; The following day unsteady gait & loss of balance persisted, & was hospitalized for observation overnight; Pt recovered; |
|
VAERS ID: |
33513 (history) |
Form: |
Version 1.0 |
Age: |
1.8 |
Sex: |
Female |
Location: |
Nebraska |
Vaccinated: | 1990-08-31 |
Onset: | 1990-09-09 |
Days after vaccination: | 9 |
Submitted: |
0000-00-00 |
Entered: |
1991-06-03 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
1313S / 1 |
- / - |
Administered by: Other Purchased by: Other Symptoms: Dementia,
Encephalitis,
Hemiplegia,
Herpes simplex,
Infection,
Neuropathy,
Personality disorder,
Visual field defect SMQs:, Peripheral neuropathy (narrow), Dementia (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Optic nerve disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK Current Illness: Preexisting Conditions: No relevant hx Allergies: Diagnostic Lab Data: MRI 26SEP90: significant damage to lt hemisphere of brain; MRI 07OCT91: brain-severe brain atrophy; EEG 14MAY92 abnormal; CDC Split Type: WAES90100863
Write-up: Pt recvd MMR vax 31AUG90; On 09SEP90 pt was hospitalized w/focal encephalitis believed due to herpes virus infect;16OCT90 pt cont to exp bilateral blindness,devel delay,&a stroke synd involving rt side of body;MD didn''t attribute exp to vax |
|
VAERS ID: |
33522 (history) |
Form: |
Version 1.0 |
Age: |
1.3 |
Sex: |
Female |
Location: |
Virginia |
Vaccinated: | 1990-01-27 |
Onset: | 1990-02-05 |
Days after vaccination: | 9 |
Submitted: |
0000-00-00 |
Entered: |
1991-06-03 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Convulsion,
Pyrexia SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: UNK Current Illness: Preexisting Conditions: No relevant hx Allergies: Diagnostic Lab Data: No relevant data CDC Split Type: WAES90101130
Write-up: Pt recvd MMR/DTP on 27JAN90; 9 days following vax pt exp a sz; |
|