|
VAERS ID: |
25026 (history) |
Form: |
Version 1.0 |
Age: |
1.0 |
Sex: |
Male |
Location: |
Washington |
Vaccinated: | 1990-01-12 |
Onset: | 1990-01-14 |
Days after vaccination: | 2 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES |
229974 / UNK |
- / IM |
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES |
9A11092 / UNK |
- / IM |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
244970 / UNK |
MO / PO |
Administered by: Unknown Purchased by: Unknown Symptoms: Unevaluable event SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-01-14
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: child found dead in bed 14Jan90. Had full check up 12Jan90 with immunizations DPT/HIB/Oral Polio |
|
VAERS ID: |
25028 (history) |
Form: |
Version 1.0 |
Age: |
2.0 |
Sex: |
Male |
Location: |
Tennessee |
Vaccinated: | 1989-05-24 |
Onset: | 1990-06-24 |
Days after vaccination: | 396 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES |
8L01022 / UNK |
- / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Meningitis SMQs:, Noninfectious meningitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-06-25
Days after onset: 1
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt admitted with H-Flu meningitis on 24Jun90. Pt expired on 25Jun90. Pt received HIB vaccine at 18 months of age. |
|
VAERS ID: |
25036 (history) |
Form: |
Version 1.0 |
Age: |
1.5 |
Sex: |
Female |
Location: |
Maryland |
Vaccinated: | 0000-00-00 |
Onset: | 1990-06-29 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES |
9B11095 / UNK |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Pyrexia,
Syncope SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Within 5-10 of injection pt pased out/fainted temp 100.8 |
|
VAERS ID: |
25153 (history) |
Form: |
Version 1.0 |
Age: |
1.5 |
Sex: |
Female |
Location: |
North Dakota |
Vaccinated: | 1989-12-07 |
Onset: | 1989-12-07 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
262915 / UNK |
- / - |
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES |
- / UNK |
- / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
- / UNK |
- / - |
Administered by: Private Purchased by: Private Symptoms: Pyrexia,
Tremor SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: N/A CDC Split Type: 8902932.01
Write-up: 1.5 HOURS AFTER PT RECEIVED DTP/OPV/PROHIBIT IMMUNIZATION, SHE DEVELPD FEVER TO 103.4. CHILD WAS SPONGED IN ER AND GIVEN TYLENOL. MOTHER STATES SHE GETS SHAKY WHEN UPSET. NO OTHER PROBLEMS. |
|
VAERS ID: |
25162 (history) |
Form: |
Version 1.0 |
Age: |
2.0 |
Sex: |
Male |
Location: |
Maryland |
Vaccinated: | 1989-10-18 |
Onset: | 1989-10-18 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
229976 / UNK |
- / - |
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES |
8L01023 / UNK |
- / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
253940 / UNK |
- / - |
Administered by: Private Purchased by: Private Symptoms: Arthralgia,
Pyrexia,
Vomiting SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: 9000090.01
Write-up: FEVER TO 105, PAIN IN JOINTS AND VOMITING LASTIN 3 DAYS AFTER RECEIVING DTP/OPV/HIB-V(CONNAUGHT) IMMUNIZATION. |
|
VAERS ID: |
25283 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Male |
Location: |
California |
Vaccinated: | 1990-06-12 |
Onset: | 1990-06-15 |
Days after vaccination: | 3 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-10 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
271964 / UNK |
- / IM |
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES |
9L01043 / UNK |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Cyanosis,
Hypotonia,
Screaming SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: high pitched cry, Hypotonia < 10 seconds /w bluish lips |
|
VAERS ID: |
25493 (history) |
Form: |
Version 1.0 |
Age: |
1.5 |
Sex: |
Male |
Location: |
Texas |
Vaccinated: | 1989-10-30 |
Onset: | 1990-04-08 |
Days after vaccination: | 160 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES |
9A11088 / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Drug ineffective SMQs:, Lack of efficacy/effect (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, ? days
Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Holoprsecephaly, diabetes insipdus, seizure disorder, gastroesophageal reflux, Temp. instability, severe developmental delay. Allergies: Diagnostic Lab Data: Pneumonia; blood culture positive /w Hepitis influenzae type b CDC Split Type:
Write-up: vaccine failure |
|
VAERS ID: |
25515 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Male |
Location: |
Arizona |
Vaccinated: | 1990-06-20 |
Onset: | 1990-06-20 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
HIBV: HIB (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: Pyrexia SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Suprax 100 mg qd Current Illness: Preexisting Conditions: chronic otitis media on Abx suppression Allergies: Diagnostic Lab Data: exam- no source of infection, urine - neg. CDC Split Type:
Write-up: Temp 105 F, slow to come down with Tylenol & baths. Immunization given in a.m. Rxn in p.m. of same day. Had gotten DPT/OPV/MMR/HIB vaccine that day |
|
VAERS ID: |
25534 (history) |
Form: |
Version 1.0 |
Age: |
4.0 |
Sex: |
Female |
Location: |
New York |
Vaccinated: | 1987-12-09 |
Onset: | 1990-06-25 |
Days after vaccination: | 929 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-16 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH |
181666 / UNK |
- / - |
Administered by: Private Purchased by: Unknown Symptoms: Drug ineffective,
Infection SMQs:, Lack of efficacy/effect (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-06-25
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: 9001160.01
Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87 |
|
VAERS ID: |
25562 (history) |
Form: |
Version 1.0 |
Age: |
1.5 |
Sex: |
Female |
Location: |
Pennsylvania |
Vaccinated: | 1990-07-14 |
Onset: | 1990-07-15 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / 2 |
LL / IM |
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES |
- / UNK |
- / - |
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
MO / PO |
Administered by: Private Purchased by: Private Symptoms: Injection site reaction,
Pyrexia SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NO PRIOR SIGNIFICANT RXN W/ OTHER DOSE OF DTP/OPV. 1ST DOSE OF HIB~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: NONE CDC Split Type:
Write-up: LOCAL RXN ON L LEG AT SITE OF DTP. TEMP 103.4 |
|
Link To This Search Result:
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