|
VAERS ID: |
48447 (history) |
Form: |
Version 1.0 |
Age: |
45.0 |
Sex: |
Female |
Location: |
New Jersey |
Vaccinated: | 1992-02-10 |
Onset: | 1992-02-10 |
Days after vaccination: | 0 |
Submitted: |
1992-12-21 |
Days after onset: | 315 |
Entered: |
1992-12-24 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
- / UNK |
- / - |
Administered by: Other Purchased by: Other Symptoms: Amblyopia,
Arthralgia,
Drug ineffective,
Infection,
Keratitis,
Leukocytosis,
Myalgia,
Rheumatoid arthritis SMQs:, Rhabdomyolysis/myopathy (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Optic nerve disorders (broad), Corneal disorders (narrow), Eosinophilic pneumonia (broad), Conjunctival disorders (narrow), Ocular infections (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad), 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? No
Previous Vaccinations: pt exp reaction, unclassified w/DTP;~ ()~~~In patient Other Medications: Birth Control Pills, Vitamins Current Illness: Preexisting Conditions: allergy feathers; allergy wool; allergy animals; allergy anaprox; allergy talwin; Allergies: Diagnostic Lab Data: No relevant data; CDC Split Type: WAES92120183
Write-up: Pt recvd vax in FEB92 & following vax exp german measles, arthralgia, arthritis, palindromic rheumatism, fibromyalgia, blurred vision, & dry eyes; was unable to exercise because body went into tremors; lab eval MAR91 showed high WBC; |
|
VAERS ID: |
48504 (history) |
Form: |
Version 1.0 |
Age: |
1.6 |
Sex: |
Female |
Location: |
New York |
Vaccinated: | 1990-09-04 |
Onset: | 1990-09-13 |
Days after vaccination: | 9 |
Submitted: |
1992-12-26 |
Days after onset: | 835 |
Entered: |
1992-12-31 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
1568S / UNK |
- / - |
Administered by: Private Purchased by: Other Symptoms: Convulsion,
Gaze palsy,
Malaise,
Pain,
Paralysis,
Pyrexia,
Rash maculo-papular SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: NONE Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: 10 days p/vax pt listless, worst case measles on face-everywhere very big; called MD; pt running temp it became very high that noc-convuls; next day eye rolling back up into head; pt was in pain & could not move eye; double elevator palsey |
|
VAERS ID: |
49204 (history) |
Form: |
Version 1.0 |
Age: |
1.3 |
Sex: |
Male |
Location: |
Illinois |
Vaccinated: | 1987-03-02 |
Onset: | 1987-03-25 |
Days after vaccination: | 23 |
Submitted: |
1992-12-09 |
Days after onset: | 2086 |
Entered: |
1992-12-11 |
Days after submission: | 2 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
1366M / 1 |
- / - |
Administered by: Other Purchased by: Other Symptoms: Amblyopia,
Eye disorder,
Neuropathy,
Paralysis SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Optic nerve disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: infection, ear Allergies: Diagnostic Lab Data: MAR87 CT Scan-nl; CDC Split Type: WAES87040441
Write-up: Pt recvd MMR vax 2MAR87 & 25MAR87 pt devel lt sixth cranial nerve palsy; presented to MD 8APR87 & exam revealed lt esotropia of 40 & amblyopia of lt eye; CT scan neg; f/u info revealed pt had occlusion therapy for amblyopia in lt eye; |
|
VAERS ID: |
49737 (history) |
Form: |
Version 1.0 |
Age: |
1.3 |
Sex: |
Male |
Location: |
Illinois |
Vaccinated: | 1992-07-30 |
Onset: | 1992-08-18 |
Days after vaccination: | 19 |
Submitted: |
1993-02-04 |
Days after onset: | 170 |
Entered: |
1993-02-08 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HIBV: HIB (HIBTITER) / PFIZER/WYETH |
M155JA / 4 |
RA / IM |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0489V / 1 |
LA / SC |
Administered by: Private Purchased by: Unknown Symptoms: Asthenia,
Diabetes mellitus,
Hyperbilirubinaemia,
Hyperglycaemia,
Hyperkalaemia,
Leukocytosis,
Somnolence,
Weight decreased SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), 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, 4 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: NONE Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: CBC, Chem 20, Glucose 322, Potassium 6.9; WBC-17.4; Hematocrit-41.5; MCV 78.4; glucose 322; creatinine 0.4; NA 133; K 6.9; T. bilirubin 1.5VH; calcium 10.3; SGOT 71; LDH 1820; Alkaline phos 216; triglycerides 890; CDC Split Type:
Write-up: 16AUG92 pt had not eaten very well for a few days & very lethargic not even enough energy to walk; 17AUG92 started throwing up when ate anything; lost over 10% of body weight; seen by MD 18AUG92; dx as diabetic; |
|
VAERS ID: |
49943 (history) |
Form: |
Version 1.0 |
Age: |
1.3 |
Sex: |
Female |
Location: |
Illinois |
Vaccinated: | 1991-07-31 |
Onset: | 1991-07-31 |
Days after vaccination: | 0 |
Submitted: |
1992-08-12 |
Days after onset: | 378 |
Entered: |
1993-02-16 |
Days after submission: | 188 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
302969 / 4 |
LL / - |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0851T / 2 |
LA / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
630612 / 3 |
MO / PO |
Administered by: Private Purchased by: Unknown Symptoms: Crying,
Hypoventilation,
Myasthenic syndrome,
Somnolence SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Malignancy related conditions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Hypokalaemia (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: pt exp rxn on 6FEB91 @ 10 1/2 mo w/DTP #3;~ ()~~~In patient Other Medications: Current Illness: t100.2 Preexisting Conditions: developmental delay Allergies: Diagnostic Lab Data: MRI, EEG, PT, OT & speech evaluations CDC Split Type:
Write-up: Pt had to be held all day; didn''t move or cry if held, screamed if laid down; pt given APAP & slept 12 hrs that noc even p/3 hr nap; pauses between breaths were so long that I would shake her & muscles go inc weaker; motor skills of 4 mons; |
|
VAERS ID: |
51402 (history) |
Form: |
Version 1.0 |
Age: |
4.0 |
Sex: |
Male |
Location: |
Michigan |
Vaccinated: | 1992-10-15 |
Onset: | 1992-10-31 |
Days after vaccination: | 16 |
Submitted: |
1993-03-29 |
Days after onset: | 149 |
Entered: |
1993-04-01 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0803V / 2 |
- / SC |
Administered by: Public Purchased by: Public Symptoms: Ascites,
Generalised oedema,
Hypoproteinaemia,
Nephrotic syndrome,
Oliguria,
Pleural effusion,
Pneumonia,
Thrombocythaemia SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Proteinuria (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad)
Life Threatening? Yes
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: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: 22NOV92: Serum cholesterol 588, platelet count 703,000; 12APR93 urinalysis: trace of blood, platelet count 680,000; CDC Split Type: WAES93030975
Write-up: Pt recvd vax 15OCT92 & on 31OCT92 devel nephrotic synd & was hospitalized; addtl info has been requested; |
|
VAERS ID: |
51593 (history) |
Form: |
Version 1.0 |
Age: |
11.0 |
Sex: |
Male |
Location: |
Florida |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
1993-03-26 |
Entered: |
1993-04-05 |
Days after submission: | 9 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Condition aggravated,
Convulsion,
Dyspnoea,
Hypotonia,
Mental retardation severity unspecified,
Otitis media,
Speech disorder,
Stupor SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), 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: Other Medications: Current Illness: high fever, vomiting, hot spot Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt was born no w/no medical problems then all of a sudden got sz, vomiting, fever, cranky, limp, ill, ear infect, gum were clunch together, had trouble talking, breathing, stares in space; |
|
VAERS ID: |
51595 (history) |
Form: |
Version 1.0 |
Age: |
42.0 |
Sex: |
Male |
Location: |
Colorado |
Vaccinated: | 1992-11-03 |
Onset: | 1992-12-10 |
Days after vaccination: | 37 |
Submitted: |
0000-00-00 |
Entered: |
1993-04-05 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0513 / UNK |
- / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Arthralgia,
Diabetes mellitus,
Hyperglycaemia,
Immune system disorder,
Laboratory test abnormal,
Myalgia SMQs:, Rhabdomyolysis/myopathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), 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: NONE Current Illness: Preexisting Conditions: autoimmune like sx; Allergies: Diagnostic Lab Data: glucose & HGB a/c elevated; all other test including CBC, KDA, pancreatic CT Scan, eye exam, PE nl; CDC Split Type:
Write-up: devel diabetes; p/MMR vax devel myalgias, arthralgias, approx 6 wks later had diabetic sx & blood glucose of 440; cont to have diabetes; No prev hx; No family hx; |
|
VAERS ID: |
51892 (history) |
Form: |
Version 1.0 |
Age: |
35.0 |
Sex: |
Female |
Location: |
Nevada |
Vaccinated: | 1991-05-31 |
Onset: | 1991-06-07 |
Days after vaccination: | 7 |
Submitted: |
1993-04-13 |
Days after onset: | 676 |
Entered: |
1993-04-16 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. |
16585 / 1 |
RA / IM |
Administered by: Private Purchased by: Other Symptoms: Arthralgia,
Hypokinesia,
Lymphadenopathy,
Myalgia,
Myasthenic syndrome,
Nuchal rigidity,
Oedema peripheral,
Osteoarthritis SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad), 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? No
Previous Vaccinations: NONE~ ()~~~In patient Other Medications: TB tine test 20MAY91; Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: tested for lyme''s disease, ANA, rheumatic factor, CRP-all neg; CDC Split Type:
Write-up: 7JUN91 devel sore throat, malaise, lymphadenopathy, stiff neck, fever; 12JUN92 awoke w/rash; 14JUN91 awake w/severe aching/pain in hands, ankles, rt big toe; 16JUN91 awoke w/swollen hands & fingers, wrists, ankles; pt cont to exp arthralgia |
|
VAERS ID: |
54330 (history) |
Form: |
Version 1.0 |
Age: |
45.0 |
Sex: |
Female |
Location: |
New Jersey |
Vaccinated: | 1992-02-10 |
Onset: | 1992-02-10 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1993-06-03 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
0861T / UNK |
- / - |
Administered by: Other Purchased by: Other Symptoms: Arthralgia,
Arthritis,
Conjunctivitis,
Lymphadenopathy,
Osteoarthritis,
Photophobia,
Pruritus,
Tongue oedema SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Systemic lupus erythematosus (broad), Oropharyngeal allergic conditions (narrow), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Arthritis (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? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Oral contraceptive, nos; Anaprox; Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: 1992 Bone scan nl; CDC Split Type: WAES92040928
Write-up: Pt recvd vax 10FEB92 because had no antibodies to rubella; a few hrs following vax pt noted tongue was thick & itchy; burning of conjuctiva & light hurt eyes; acute rubella synd pinpoint rash, low grade temp & swollen glands; exp joint pain |
|