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  Updated March 28, 2010

 

 

VAERS ID:

359268  

Vaccination Date:

2009-08-25

Age:

29.0  

Onset Date:

2009-09-25   Days later: 31

Gender:

Female  

Submitted:

2009-10-02

State:

Indiana  

Entered:

2009-10-02

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: Unknown

Diagnostic Lab Data: 25 September 2009: Ultrasound revealed the subject had miscarried twins at approximately 8 weeks.

Previous Vaccinations:

Other Medications: Prenatal vitamins (Potassium iodide + Potassium sulphate + Calcium salt + Phosphorus salt + Vitamin A + Ascorbic acid + Niacinamide + Thiamine hydrochloride + Riboflavine + Vitamin D + Manganese salt + Iron salt + Cobalt sulphate + Magnesiu

Preexisting Conditions: Bactrim Allergy; The subject had not previously received influenza vaccine. She had not experienced adverse events following previous vaccinations.

CDC 'Split Type': A0809839A

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU

GLAXOSMITHKLINE BIOLOGICALS

AFLLA259AA

 

UN

UN

Administered by: Private     Purchased by: Other

Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Ultrasound scan abnormal, Uterine dilation and curettage

Write-up: This case was reported by a consumer (also the subject) and described the occurrence of miscarriage in a 29-year-old female subject who was vaccinated with FLULAVAL (GlaxoSmithKline). A physician or other health care professional has not verified this report. The subject's medical history included Bactrim allergy of rash or hives. The subject had not previously received influenza vaccine. She had not experienced adverse events following previous vaccinations. Concurrent medications included Prenatal vitamins. On 25 August 2009 at 10:00 the subject received 1st dose of FLULAVAL (0.5 ml, unknown route) when she was 8 weeks pregnant. On 25 September 2009, 31 days after vaccination with FLULAVAL, the subject experienced miscarriage. The subject went for a routine check up on 25 September 2009 and no heart beat could be found. Ultrasound determined that the subject had miscarried twins at approximately 8 weeks. This case was assessed as medically serious by GSK. The subject was treated with dilatation and curettage as a same day surgical procedure at the hospital.

 

 

VAERS ID:

359924  

Vaccination Date:

2009-09-28

Age:

16.0  

Onset Date:

2009-10-03   Days later: 5

Gender:

Female  

Submitted:

2009-10-07

State:

Kansas  

Entered:

2009-10-07

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: Pregnant

Diagnostic Lab Data:

Previous Vaccinations:

Other Medications:

Preexisting Conditions:

CDC 'Split Type':

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU

SANOFI PASTEUR

U3174EA

0

UN

LA

HEP

MERCK & CO. INC.

1445X

2

UN

LA

HPV4

MERCK & CO. INC.

0087Y

1

UN

RA

IPV

SANOFI PASTEUR

B0476

1

UN

RA

VARCEL

MERCK & CO. INC.

0810Y

1

UN

LA

 

Administered by: Public     Purchased by: Public

Symptoms: Abortion spontaneous

Write-up: 9-28-09 Patient received vaccines. 10-03-09 Patient miscarried/spontaneous abortion at ER. She was 6 weeks pregnant.

 

 

 

 

 

 

 

VAERS ID:

361118  

Vaccination Date:

0000-00-00

Age:

30.0  

Onset Date:

2009-10-01   Days later:

Gender:

Female  

Submitted:

2009-10-15

State:

  

Entered:

2009-10-16

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? No

Hospitalized? Yes, 0 days

    Extended hospital stay? No

Current Illness:

Diagnostic Lab Data:

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Pregnant; Spontaneous abortion

CDC 'Split Type': 2009020906

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

CSL LIMITED

 

 

UN

UN

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Drug exposure during pregnancy

Write-up: Report received from a foreign regulator on 14-OCT-2009. A female patient (age unknown, date of birth: 01/05/1979) received PANVAX H1N1 vaccine (batch unknown) on unknown date. Medical history was not provided. On 01-OCT-2009, within 24 hours of receipt of the vaccine, the patient miscarried. The patient was sent to hospital. Patient outcome is unknown. The regulator assessed the causality as possible.

 

 

 

VAERS ID:

362094  

Vaccination Date:

2009-10-19

Age:

31.0  

Onset Date: 2009-10-20   

Days later:  1

Gender:

Female  

Submitted:

2009-10-21

State:

  Utah  

Entered:

2009-10-21

 

Life Threatening Illness?

Died?

Disability?

Recovered?

ER or Doctor Visit?

Hospitalized?

    Extended hospital stay?

Current Illness:

Diagnostic Lab Data:

Previous Vaccinations:

Other Medications:

Preexisting Conditions:

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

 UP002AA

 0

IJ

RA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Blood human chorionic gonadotropin normal, Drug exposure during pregnancy, Ultrasound pelvis normal, Vaginal haemorrhage

Write-up: Bleeding/Spotting - eventual miscarriage of 6 week pregnancy 10/22/09 Medical records received for date 10/21/09. Pt. seen for c/o vaginal bleeding. Pt. states approx 5 weeks pregnant. Pt. received vax 10/19/09. Assessment: US performed which demonstrated normal endometrial stripe. No evidence of a gestational sac. No free fluid, no adnexal masses. DX:Early pregnancy, either a threatened miscarriage, continuing miscarriage, or ectopic pregnancy. Labs ordered.  

 

VAERS ID:

365779  

Vaccination Date:

2009-10-22

Age:

34.0  

Onset Date:

2009-10-24   Days later: 2

Gender:

Female  

Submitted:

2009-11-06

State:

Ohio  

Entered:

2009-11-06

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? Yes, days

    Extended hospital stay? No

Current Illness: None

Diagnostic Lab Data: Autopsy performed on baby boy. Something triggered my labor to begin and my water broke, and my 16 week old fetus was born dead. LABS & DIAGS: WBC 16.25 (H), RBC 3.43 (L), HGB 10.4 (L), HCT 31.7 (L), HOMOCYSTEINE 3.4 (L), FACTOR V DAN N

Previous Vaccinations:

Other Medications: Prenatal Vitamins

Preexisting Conditions: None. Allergies: Percocet, vicodin, Codeine. PMH: sleep apnea, gall bladder surgery, bresat reduction, lapband, umbilical hernia

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

UNKNOWN MANUFACTURER

 

1

IM

RA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Autopsy, Blood homocysteine, Drug exposure during pregnancy, Haematocrit decreased, Haemoglobin decreased, Intra-uterine death, Labour pain, Muscle spasms, Red blood cell count decreased, Urine analysis normal, White blood cell count increased

Write-up: Started having really bad cramping,(labor pains) was not aware that was the problem, was 15 1/2 weeks pregnant took the H1N1 vaccination. On October 28th my water broke, October 29th, my baby was born dead at 16 weeks. 11/09/09 Medical records received for DOS 10/29/09. Preganat and c/o pf leaking fluid and cramping.Pain scale 7/10. EDD 4/13/2010. Gestational age 16.21. G4P2. .

 

 

VAERS ID: 362694  

Vaccination Date: 2009-10-16

Age: 27.0  

Onset Date: 2009-10-19   Days later: 3

Gender: Female  

Submitted: 2009-10-22

State: Iowa  

Entered: 2009-10-23

 

Vaccination FLU, FLU(H1

Manufacturer NOVARTIS VACCINES AND DIAGNOSTICS, SANOFI PASTEUR

Lot 98434P1, UP001AA

Dose  ,  

Route IM, IM

Site RA, LA

 

Administered by: Private     Purchased by: Public

 

Symptoms:

Drug exposure during pregnancy, Foetal heart rate abnormal, Foetal hypokinesia, Induced labour, Intra-uterine death, Monocyte count increased, Red blood cell count decreased, Ultrasound antenatal screen abnormal, White blood cell count increased

 

Write-up:

A few days after the shot she experienced fetal demise at 30 weeks gestation. 10/26/09 Hospital records and discharge summary received. Service dates 10/21/09 to 10/22/09. Assessment: Status post delivery of intrauterine fetal demise, induced labor, stillborn infant. Estimated delivery date was 11/06/09. 10/26/09 PCP medical records received, includes vaccine records, service dates 6/8/09 to 10/21/09. Some duplication of hospital records. Revised estimated date of delivery 12/31/09. No fetal heart tones, no fetal movement for two days.

 

cleardot

 

 

 

 

 

VAERS ID: 363030  

Vaccination Date: 2009-10-21

Age: 25.0  

Onset Date: 2009-10-24   Days later: 3

Gender: Female  

Submitted: 2009-10-27

State: Texas  

Entered: 2009-10-27

 

Vaccination FLU(H1

Manufacturer SANOFI PASTEUR

Lot UP010AA

Dose0

Route 

Site RA

 

Administered by: Unknown     Purchased by: Unknown

 

Symptoms:

Abdominal pain, Blood sodium decreased, Breech presentation, Caesarean section, Cervix disorder, Cough, Drug exposure during pregnancy, Hepatitis B surface antigen negative, Incisional drainage, Influenza like illness, Lower respiratory tract infection, Lymphocyte count decreased, Neutrophil count decreased, Premature labour, Red blood cell count decreased, Syphilis test negative, Upper respiratory tract infection, Urinary system X-ray, Vaginal haemorrhage, White blood cell count increased

 

Write-up:

GRAVIDA 1 PARA 0 26 WEEK GESTATION RECEIVED SEASONAL FLU 9/17/2009. HAD FLU LIKE SYMPTOMS START 10/9. CALLED DOCTOR AND RECEIVED TAMIFLU, COUGH MED AND Z-PAK. RECEIVED H1N1 10/21/2009.. WENT INTO LABOR 10/24/2009. C-SECTION DONE. DOCTOR FELT LIKE IT WAS FROM A WEAK CERVIX. 10/28/09 Medical records received for DOS 10/9-10/24. Office notes and ED H&P. Promigravida at 26 weeks. Developed cramping/abd pain post upper resp/ILI infection (cough, chest cong) and vaccine. Some vag bleeding. Fully dialted. Intact membranes bulging. fetal heart tones at 140. Footling breech. Emergency c-section w/o complication. Post c-section small amt green incisional d/c noted. No fever. 10/30/2009 received hospital records stating baby boy born per emergency C-section at 26 wks gestation on 10/24/2009. Baby with low Apgar scores, in respiratory distress, initially bagged and then intubated and vent dependent. PE noted chest with retractions, rales throughout lungs. Dx RDS, after stabilized baby tranferred to another facility to NICU.

 

 

 

 

VAERS ID: 363299  

Vaccination Date: 2009-10-22

Age: 19.0  

Onset Date: 2009-10-26   Days later: 4

Gender: Female  

Submitted: 2009-10-27

State: Vermont  

Entered: 2009-10-27

 

Vaccination FLU(H1

Manufacturer NOVARTIS VACCINES AND DIAGNOSTICS

Lot 1008133P

Dose0

Route IM

Site GM

 

Administered by: Private     Purchased by: Other

 

Symptoms:

Drug exposure during pregnancy, Foetal heart rate abnormal, Intra-uterine death, Nausea, Oligohydramnios, Skin warm, Ultrasound scan abnormal, Vomiting

 

Write-up:

10/5/09 Seasonal flu vaccine. 10/14/09 Normal prenatal exam. 10/20/09 to 10/22/09 AM vomiting, "felt a little warm". 10/22/09 H1N1-afebrile. 10/26/09 Fetal demise at 30 5/7 weeks. 10/29/2009 hospital records for 10/26/-10/27/2009. patient at at 30 5/7 wks gestation, presented with c/o's decreased fetal movement, hx of nausea/vomiting x 2 days which resolved. Per doppler and ultrasound no FHR noted, no amniotic fluid around the baby noted. Tx: induced labor with Misoprostol/epidual anesthesia. Autopsy requested. DC DX Intrauterine Death Unspecified ICD-9 Code 656.40

 

 

  

 

VAERS ID: 363802  

Vaccination Date: 2009-10-15

Age: 18.0  

Onset Date: 2009-10-28   Days later: 13

Gender: Female  

Submitted: 2009-10-29

State: Arizona  

Entered: 2009-10-29

 

Vaccination FLU(H1

Manufacturer SANOFI PASTEUR

Lot UP005AA

Dose 0

Route IM

Site LA

 

Administered by: Public     Purchased by: Other

 

Symptoms:

Alcohol abuse, Antiphospholipid antibodies, Chlamydia identification test positive, Cytomegalovirus test, Drug abuse, Drug exposure during pregnancy, Escherichia urinary tract infection, Foetal heart rate abnormal, Intra-uterine death, Laboratory test, Placenta praevia, Toxicologic test, Ultrasound abdomen normal

 

Write-up:

Intrauterine fetal demise diagnosed on 10/29/09. Last FM felt on 10/28/09. Not clear if this is related to vaccination. Medical records received for DOS 7/09/09-11/04/09. Neg fetal movement and HT in office, Fetal demise 32 weeks. Approx 2 wks s/p vaccine. LMP 02/02/09.. EDD 11/08/09. Prenatal care late. (+) THC use. (+) urine E coli. (+) alcohol use. (+) Chlamydia. 11/09/09 Medical records received. Duplicate of records from 11/06/09

 

 

 

 

 

VAERS ID: 364445  

Vaccination Date: 2009-10-19

Age: 35.0  

Onset Date: 2009-10-20   Days later: 1

Gender: Female  

Submitted: 2009-11-02

State: Georga  

Entered: 2009-11-02

 

Vaccination FLU(H1

Manufacturer SANOFI PASTEUR

Lot UP003AA

Dose 0

Route IM

Site LA

 

Administered by: Unknown     Purchased by: Unknown

 

Symptoms:

Drug exposure during pregnancy, Intra-uterine death, Ultrasound scan abnormal, Uterine dilation and curettage

 

Write-up:

Discovered Intra-uterine Fetal Demise. Probably occurred 1 week prior. 11/05/09 Medical records received for DOS 9/22/09-10/20/09. OB/GYN notes. Patient noted reduced fetal activity. No FHT found on exam in office. Fetal demise at 14 wks 4 days. Uterine fundal height 13 wks. LMP 08/07/09. G3, P2, Proceeded with D&C.

 

 

 

 

 

VAERS ID: 364781  

Vaccination Date: 2009-10-28

Age: 39.0  

Onset Date: 2009-10-29   Days later: 1

Gender: Female  

Submitted: 2009-11-02

State: Texas  

Entered: 2009-11-03

 

Vaccination FLU(H1

Manufacturer UNKNOWN MANUFACTURER

Lot 1007392P

Dose0

Route IM

Site LA

 

Administered by: Private     Purchased by: Unknown

 

Symptoms:

Alpha 1 foetoprotein amniotic fluid normal, Chorioamnionitis, Delivery, Drug exposure during pregnancy, Ectopic pregnancy, Foetal heart rate abnormal, Haemoglobin decreased, Haemorrhage, Induced labour, Intra-uterine death, Pathology test, Placental disorder, Syphilis test negative, Trisomy 21, Ultrasound scan abnormal, Ultrasound scan normal, Umbilical cord abnormality, Umbilical cord around neck

 

Write-up:

At risk pt came in at 39 weeks and 1 day pregnant for H1N1 immunization 10/28/09. On 10/29/09 pt called c/o no fetal movement. Pt brought into office to be monitored and no cardiac movement was noted on sonogram.. Pt had a normal biophysical profile 10-27-09 with normal cardiac movement on 10/27/09. Fetal demise vaginal delivery 10-31-09. 11/04/09 Medical records and discharge summary received for DOS 07/28/2006-10/31/09. Discharge DX: 39 week fetal demise, Rh negative, Abnormal first trimester screen, Advanced maternal age, Tight nuchal chord, Evidence of fetal maternal hemorrhage based on KB stain, Questionable placental abruption. AMA patient with h/o past ectopic pregnancy. Current pregnancy with abnormal first trimester screen. Followed closely. Refused amnio. Normal fetal growth through out. All exams and BPP WNL. Last prenatal visit + fetal movement. Next day fetal movement decreased but then movement resumed. Next day no fetal movement felt. No fetal heart tones detected in office. Sonogram confirmed fetal demise at 39 3/7wks gestation. Labor induced same day. Non viable male infant 7lbs 12 oz delivered vaginally. Very tight nuchal cord. Unable to reduce until fully delivered. No blood in cord. % of placenta very pale. Placental path abnormal. Stable. Discharged to ho

 

 

 

 

VAERS ID: 365036  

Vaccination Date: 2009-10-14

Age: 28.0  

Onset Date: 2009-10-22   Days later: 8

Gender: Female  

Submitted: 2009-10-27

State: Nebraska  

Entered: 2009-11-04

 

Vaccination FLU(H1

Manufacturer SANOFI PASTEUR

Lot UP002AA

Dose 0

Route IM

Site RA

 

Administered by: Private     Purchased by: Private

 

Symptoms:

Drug exposure during pregnancy, Intra-uterine death, Pathology test

 

Write-up:

Intrauterine fetal demise at 26 weeks. 11/5/09 Multiple medical records received for dates 6/17/09 to 10/25/09. DX: Intrauterine pregnancy 27 weeks with fetal demise. Pt seen in office on 10/14/09 pt was 25 weeks prenatal visit WNL. Pt. c/o decreased fetal movement on 10/23/09. Pt. seen in office on 10/25/09 no cardiac activity noted on US. Prenatal records indicate WNL OB visits. Pt received H1N1 vax on 10/14/09. Pt. began OB care 6/17/09.

 

 

 

 

VAERS ID: 365103  

Vaccination Date: 2009-10-28

Age: 33.0  

Onset Date: 2009-10-29   Days later: 1

Gender: Female  

Submitted: 2009-11-04

State: Alabama  

Entered: 2009-11-04

 

 

Vaccination FLU(H1

Manufacturer NOVARTIS VACCINES AND DIAGNOSTICS

Lot 10073801A

Dose 0

Route IM

Site LA

 

 

Administered by: Unknown     Purchased by: Unknown

 

Symptoms:

Abortion spontaneous, Drug exposure during pregnancy, Ultrasound scan vagina abnormal, Uterine dilation and curettage

 

Write-up:

On Wednesday, October 28, 2009, I went to my local health department to get my H1N1 vaccine. Everything went well, or so I thought. The next day, October 29, 2009, I had an appointment with my OB/GYN for a regular check-up. We talked, laughed, etc. and before I left, the nurse practitioner told me she needed to do an ultrasound to hear the baby's heart rate before I could go home. I was 8 weeks pregnant, by the way, so the heart rate could not be heard on the doppler. Anyway, she did the abdominal ultrasound and could not find a heart rate. So, she did the transvaginal ultrasound just to make sure. We could see the baby and the baby was measuring 8 weeks, but there was no heart rate. This was a COMPLETE shock because I was not experiencing any spotting, cramping, etc. So, to say the least, I was totally devastated that I had lost my baby. On Friday, October 30, 2009, I had a suction D&C. I do not know if the H1N1 vaccine was the cause of the miscarriage, but I wanted to let you know that I did have a miscarriage after receiving the vaccine. 11/6/09: Operative Report received for date of service 10/30/09: Dx: Missed abortion. Assessment: Suction Dilation and Curettage: 10 week size uterus. Products of Conception were sent to pathology. Less than 200 ml blood loss. 11/9/09: Ob/GYN records received for dates of service 10/15/09 to 10/29/09: Assessment: No heart beat on doppler, no color flow. Schedule for D & C.

 

 

 

 

 

 

VAERS ID: 365134  

Vaccination Date: 2009-10-23

Age: 34.0  

Onset Date: 2009-10-28   Days later: 5

Gender: Female  

Submitted: 2009-11-04

State: Washington  

Entered: 2009-11-04

 

Vaccination FLU(H1

Manufacturer SANOFI PASTEUR

Lot VP008AA

Dose 0

Route  

Site LA

 

Administered by: Unknown     Purchased by: Unknown

 

Symptoms:

Antithrombin III, Blood fibrinogen, Coagulation test, Cytogenetic analysis, Drug exposure during pregnancy, Foetal-maternal haemorrhage, Full blood count, Intra-uterine death, Kleihauer-Betke test, Parvovirus B19 serology, Stillbirth, Ultrasound abdomen abnormal

 

Write-up:

Fetal Demise. Patient presented on 10/29/09 10:30 PM with decreased fetal movement since 10/28 AM and was diagnosed with intrauterine fetal demise. Work-up to date significant for +K-B indicative of likely fetal-maternal hemorrhage as the cause. 11/5/2009 MR and DC records for 10/30-31/2009. Patient presented with c/o's no fetal movement for past day, 38 wks, EDD 11/12/2009. US verified no fetal movement. no fetal heartbeat. Pregancy complicated with a choroid plexus and marginal cord insertion. Tx: Induced labor :Misoprostol IV then Pitocin. Fetal autopsy requested. DC Dx: stillbirth

 

 

 

 

 

VAERS ID: 365373  

Vaccination Date: 2009-10-17

Age: 32.0  

Onset Date: 2009-10-18   Days later: 1

Gender: Female  

Submitted: 2009-11-05

State: Massachusetts  

Entered: 2009-11-05

 

Vaccination FLU(H1

Manufacturer SANOFI PASTEUR

Lot UP003AA

Dose 0

Route IM

Site LA

 

Administered by: Private     Purchased by: Public

 

Symptoms:

Cervix disorder, Drug exposure during pregnancy, Pregnancy test positive, Smear cervix normal, Vaginal haemorrhage

 

Write-up:

Patient was approx 4 weeks pregnant when received vaccine and started to miscarry following day. 11/6/2009 and 11/9/2009 lab results and OB-GYN visit for 11/3/2009. Patient with c/o's intermittent bright red bleeding in first trimester. Pelvic exam noted a friable cervix. Tx: repeat labs ,rest

 

 

 

 

 

VAERS ID: 365404  

Vaccination Date: 2009-04-11

Age: 23.0  

Onset Date: 2009-11-04   Days later: 207

Gender: Female  

Submitted: 2009-11-05

State: Rhode Island  

Entered: 2009-11-05

 

Vaccination FLU(H1

Manufacturer NOVARTIS VACCINES AND DIAGNOSTICS

Lot 100813 6P

Dose  

Route IM

Site UN

 

Administered by: Unknown     Purchased by: Unknown

 

Symptoms:

Back pain, Drug exposure during pregnancy, Premature labour, Premature rupture of membranes

 

Write-up:

Patient had preterm rupture of membranes at 10:30 pm on the same day the vaccine was administered. She was preterm (35 3/7 wks) and weighed 1860. Mom has a history of IUGR with her first pregnancy. 11/10/09: Hospital Labor and Delivery Records and Prenatal records received for date of service 11/5/09. Dx: Premature delivery Assessment: Gravida 3 Para 1 at 35 3/7 weeks EGA presented to L&D with premature rupture of membranes on date of H1N1 vaccine administration. Baby had reassuring HR during labor. Apgar scores were 8 and 9 at 1 and 5 minutes respectively. Birth weight was 1860 gms. Placenta with 3 vessel cord. Estimated blood loss 100 ml. Abnormal placenta sent to pathology. 11/9/09 Medical records received for dates 11/4/09 OB records. 35wks exam WNL. c/o back pain lying down. FHR 140's.

 

 

 

 

VAERS ID: 365450  

Vaccination Date: 2009-10-26

Age: 24.0  

Onset Date: 0000-00-00   Days later:

Gender: Female  

Submitted: 2009-11-05

State: California  

Entered: 2009-11-05

 

Vaccination FLU, FLU(H1

Manufacturer NOVARTIS VACCINES AND DIAGNOSTICS, SANOFI PASTEUR

Lot 98447PI, UP006AA

Dose 0,  

Route IM, IM

Site RA, LA

 

Administered by: Unknown     Purchased by: Unknown

 

Symptoms:

Drug exposure during pregnancy, Uterine contractions during pregnancy

 

Write-up:

FLUVIRIN W/ THIMERASOL GIVEN TO OB PT. PT NOTIFIED ON 11/5/2009. DENIES ANY ADVERSE EFFECTS. 11/10/2009 Medical records received. OB/GYN office note. DOS 11/3/09. Uterine cramping x4 days. Prodromal labor. Neg bloody/mucous d/c. Comfort measures.

 

 

VAERS ID:

365779  

Vaccination Date:

2009-10-22

Age:

34.0  

Onset Date:

2009-10-24   Days later: 2

Gender:

Female  

Submitted:

2009-11-06

State:

Ohio  

Entered:

2009-11-06

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? Yes, days

    Extended hospital stay? No

Current Illness: None

Diagnostic Lab Data: Autopsy performed on baby boy. Something triggered my labor to begin and my water broke, and my 16 week old fetus was born dead. LABS & DIAGS: WBC 16.25 (H), RBC 3.43 (L), HGB 10.4 (L), HCT 31.7 (L), HOMOCYSTEINE 3.4 (L), FACTOR V DAN N

Previous Vaccinations:

Other Medications: Prenatal Vitamins

Preexisting Conditions: None. Allergies: Percocet, vicodin, Codeine. PMH: sleep apnea, gall bladder surgery, bresat reduction, lapband, umbilical hernia

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

UNKNOWN MANUFACTURER

 

1

IM

RA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Autopsy, Blood homocysteine, Drug exposure during pregnancy, Haematocrit decreased, Haemoglobin decreased, Intra-uterine death, Labour pain, Muscle spasms, Red blood cell count decreased, Urine analysis normal, White blood cell count increased

Write-up: Started having really bad cramping,(labor pains) was not aware that was the problem, was 15 1/2 weeks pregnant took the H1N1 vaccination. On October 28th my water broke, October 29th, my baby was born dead at 16 weeks. 11/09/09 Medical records received for DOS 10/29/09. Preganat and c/o pf leaking fluid and cramping.Pain scale 7/10. EDD 4/13/2010. Gestational age 16.21. G4P2. .

 

 

 

VAERS ID:

366017  

Vaccination Date:

2009-11-05

Age:

36.0  

Onset Date:

2009-11-06   Days later: 1

Gender:

Female  

Submitted:

2009-11-09

State:

Pennsylvania  

Entered:

2009-11-09

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? No

Hospitalized? Yes, 2 days

    Extended hospital stay? No

Current Illness: Chronic Hypertension Renal disease Obesity

Diagnostic Lab Data: 11/25/09: Hospital OB records received for date of service 11/10/09. Labs and Diagnostics: WBC 14.3 (H), RBC 5.36 (H), MCV 76 (L), MCH 26 (L), RDW 21.0 (H), sed rate 35 (H).

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Pregnant. 11/25/09: Hospital OB records received for date of service 11/10/09. NKDA.

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP008AA

0

IM

UN

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Intra-uterine death, Mean cell haemoglobin decreased, Mean cell volume, Red blood cell count increased, Red blood cell sedimentation rate increased, Red cell distribution width increased, Stillbirth, Umbilical cord around neck, White blood cell count increased

Write-up: Fetal demise (in utero death of baby) 11/25/09: Hospital OB records received for date of service 11/10/09. Dx: Stillbirth. Gravida 5, Para 0 at 25 weeks gestation delivered stillborn infant in the vertex position, gender female. Nuchal cord x 2. Apgar scores 0 and 0. Birth weight 448 grams.

 

 

 

 

VAERS ID:

366045  

Vaccination Date:

2009-10-19

Age:

28.0  

Onset Date:

2009-10-28   Days later: 9

Gender:

Female  

Submitted:

2009-11-04

State:

Missouri  

Entered:

2009-11-09

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? No

Hospitalized? No

Current Illness:

Diagnostic Lab Data:

Previous Vaccinations:

Other Medications: Prenatal vitamins

Preexisting Conditions: Had one previous miscarriage in 2004

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

NOVARTIS VACCINES AND DIAGNOSTICS

1007391P

0

IM

RA

 

Administered by: Private     Purchased by: Public

Symptoms: Abortion spontaneous, Drug exposure during pregnancy

Write-up: Received H1N1 on 10-19-09. Miscarried 10-28-09. Received seasonal flu shot approx 2 wks prior. 11/17/09: Prenatal records received. DX: SAB Assessment: This G3 P1, LMP 8/17/09, EDC 5/24/10 experienced a spontaneous abortion on 10/28/09.

 

 

 

VAERS ID:

366156  

Vaccination Date:

2009-10-29

Age:

18.0  

Onset Date:

2009-11-04   Days later: 6

Gender:

Female  

Submitted:

2009-11-09

State:

Texas  

Entered:

2009-11-09

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? Yes, 1 days

    Extended hospital stay? No

Current Illness: Morning sickness-nausea

Diagnostic Lab Data: Labs: CBC, neutrophils high Dx studies: transvaginal US no FHT

Previous Vaccinations:

Other Medications: PHENERGAN PO prn

Preexisting Conditions: Pregnancy 1st trimester PMH: none Allergies: PCN, Morphine

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP010AA

0

IM

LA

 

Administered by: Private     Purchased by: Public

Symptoms: Abortion spontaneous, Full blood count, Neutrophil count increased, Ultrasound scan abnormal, Uterine dilation and curettage

Write-up: Miscarriage/D and C.11/10/2009 MD and hospital records for 11/4 and 11/5-2009. Patient nine weeks pregnant, transvaginal US noted no FHT. Scheduled for D&C 11/5/2009. DC DX S/P suction D&C.

 

 

 

VAERS ID:

366245  

Vaccination Date:

2009-10-24

Age:

34.0  

Onset Date:

2009-11-08   Days later: 15

Gender:

Female  

Submitted:

2009-11-09

State:

D.C.  

Entered:

2009-11-09

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: No

Diagnostic Lab Data: Sonogram 11/13/09 Labs and Diagnostic studies: Ultrasound showed thin endometrial lining consistent with complete miscarriage. Adnexa wnl.

Previous Vaccinations:

Other Medications:

Preexisting Conditions: N/A

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP001AA

0

IJ

RA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Muscle spasms, Ultrasound scan, Ultrasound uterus abnormal, Vaginal haemorrhage

Write-up: Miscarriage 11/13/09 PCP Ultrasound and progress notes for DOS 11/09/09. DX: Miscarriage. Pt developed heavy bleeding and cramping on 11/08/09. The next morning the bleeding decreased. Ultrasound performed to confirm dating and viability. According to the notes from midwifery center, pt had her first OB appt scheduled at time of loss. She miscarried prior to appt, so info is limited. Pt was about 11-12 weeks pregnant.

 

 

 

VAERS ID:

366407  

Vaccination Date:

2009-11-05

Age:

28.0  

Onset Date:

2009-11-05   Days later: 0

Gender:

Female  

Submitted:

2009-11-10

State:

Michigan  

Entered:

2009-11-10

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: No

Diagnostic Lab Data: laboratory tests: beta HCG tests confirmed miscarriage on 11/9/09 11/13/09 Medical records received for date 10/16/09 Labs: 11/6/09 Beta HCG 709(+), repeat 11/9/09 109, decreased. 12/3/09 Medical records received for date 11/6/09. Diag/La

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Pregnant, 6 weeks 11/13/09 Medical records received for date 10/16/09 PMH: none FHO: congenital heart defect, spina bifida.

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP076AA

1

IM

RA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Laboratory test abnormal, Pregnancy test positive, Vaginal haemorrhage

Write-up: Miscarriage 11/13/09 Medical records received for date 10/16/09. Annual GYN exam WNL pt. desire pregnancy G1P1. 12/3/09 Medical records received for date 11/6/09. DX: miscarriage. Pt called OB offices to state pt is 7 weeks pregnant and began bleeding x1 day ago. Bleeding now increased. Pt. states received H1N1 vax x1 day ago, sx. began shortly after vax.

 

 

 

 

VAERS ID:

366538  

Vaccination Date:

2009-10-27

Age:

26.0  

Onset Date:

2009-10-29   Days later: 2

Gender:

Female  

Submitted:

2009-11-10

State:

Kansas  

Entered:

2009-11-10

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: No

Diagnostic Lab Data:

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Pregnant -- 1st trimester

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

NOVARTIS VACCINES AND DIAGNOSTICS

1008135P

0

IM

UN

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Depression, Drug exposure during pregnancy, Haemorrhage, Muscle spasms, Pelvic pain

Write-up: Received H1N1 vaccine on 10/27/09. Started bleeding on 10/29/09 and miscarried on 11/1/09. 11/17/09 Medical records received from date 11/6/09. DX: SAB, depression. F/u appt from SAB past weekend.(+) bleeding/cramping. OV 11/9 c/o pelvic pain, bleeding. DX: SAB.

 

  

 

VAERS ID:

367837  

Vaccination Date:

2009-10-23

Age:

38.0  

Onset Date:

2009-10-26   Days later: 3

Gender:

Female  

Submitted:

2009-11-16

State:

Idaho  

Entered:

2009-11-16

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness:

Diagnostic Lab Data: Diag/Labs: bloodwork WNL

Previous Vaccinations:

Other Medications:

Preexisting Conditions: 32 weeks pregnant

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP001AA

0

IM

RA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion threatened, Bed rest, Blood test normal, Drug exposure during pregnancy, Pain, Pallor, Premature labour, Pyrexia, Uterine contractions during pregnancy

Write-up: Body Aches, Fever, went to MD 10/27/2009 given Tylenol 3 for discomfort. On 10/28/2009 tried to miscarry due to dehydration and fever. On bedrest for 3 days. Doing fine now. 11/24/09 Medical records received for dates 10/28/09. DX: Pre term labor 32 wks gest. Presenting c/o receiving H1N1 vax approx 5 days ago per pt. 3 days later pt. states c/o severe body aches, now presenting with consistent uterine contractions every 5 min. Pt. is 32wks pregnant, G4 P2. Assessment: pt. appears pale, uncomfortable, (+)pre-term labor. Pt sent to L&D for eval.

 

 

 

VAERS ID:

366634  

Vaccination Date:

2009-10-26

Age:

30.0  

Onset Date:

2009-11-01   Days later: 6

Gender:

Female  

Submitted:

2009-11-11

State:

Kansas  

Entered:

2009-11-11

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? No

Hospitalized? No

Current Illness: no

Diagnostic Lab Data: positive preg test 10/27/2009,

Previous Vaccinations:

Other Medications: Questran powder Elavil

Preexisting Conditions: patient was taking Amitryptiline, Questran powder at the time of vaccination

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP010AA

0

IM

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Pregnancy test negative

Write-up: Patient miscarried embryo

 

 

 

VAERS ID:

367015  

Vaccination Date:

2009-10-26

Age:

28.0  

Onset Date:

2009-10-28   Days later: 2

Gender:

Female  

Submitted:

2009-11-12

State:

Missouri  

Entered:

2009-11-12

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: None

Diagnostic Lab Data: Hcg blood tests and ultrasounds. Labs: CBC wnl, CMP chloride high DX studies: Transvaginal US abnormal no sign of inrauterine gestational sac

Previous Vaccinations:

Other Medications: None

Preexisting Conditions: None PMH: depression

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

NOVARTIS VACCINES AND DIAGNOSTICS

1007391P

1

IM

RA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abdominal pain, Abortion spontaneous, Blood chloride increased, Blood human chorionic gonadotropin, Drug exposure during pregnancy, Full blood count normal, Haemorrhage, Metabolic function test, Muscle spasms, Ultrasound scan abnormal

Write-up: I was 6 weeks pregnant and I started cramping and bleeding within two days of receiving the vaccine. I went to my obgyn on Wednesday and on Thursday I was in Urgent Care and having a complete miscarriage. 11/19/09 Medical records received for date 10/30/09. DX: probable complete abortion. F/u for SAB. pt began to bleed on 10/26 and increased bleeding on 10/29. Decreased beta HCG. 12/7/2009 Ed records for 10/29/2009, RLQ abd pain, heavy vaginal bleeding with clots

 

 

 

VAERS ID:

367049  

Vaccination Date:

2009-10-15

Age:

28.0  

Onset Date:

2009-10-25   Days later: 10

Gender:

Female  

Submitted:

2009-11-13

State:

Michigan  

Entered:

2009-11-13

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: no

Diagnostic Lab Data: none. 11/20/09: Medical records received for dates of service 10/22/09. Labs and diagnostics: OB US-Abnormal.

Previous Vaccinations:

Other Medications: prenatal vitamins

Preexisting Conditions: none. 11/20/09: Medical records received for dates of service 10/22/09. PMH: None.

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP002AA

0

IM

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Vaginal haemorrhage

Write-up: miscarriage. 11/20/09: Medical records received for dates of service 10/22/09. Dx. Threatened abortion. OB US shows IUP with no cardiac activity, date discrepancy of 4 weeks for crown-rump length. Repeat study within a week is advised. 11/24/09: Medical records received for dates of service 11/19/09: Dx: Miscarriage. Gravida 3, Para 2 experienced vaginal spotting/bleeding and miscarried on 10/25/09.

 

 

 

VAERS ID:

367426  

Vaccination Date:

2009-10-28

Age:

33.0  

Onset Date:

2009-11-01   Days later: 4

Gender:

Female  

Submitted:

2009-11-15

State:

Maine  

Entered:

2009-11-15

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: No

Diagnostic Lab Data: Ultrasound on Thursday 11/5/2009 showed spontaneous abortion with heartbeat stopping 1 week post vaccination.

Previous Vaccinations:

Other Medications:

Preexisting Conditions: No. PMH: Chicken pox Allergies: Seasonal

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

UNKNOWN MANUFACTURER

 

0

IJ

RA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion missed, Abortion spontaneous, Drug exposure during pregnancy, Muscle spasms, Ultrasound scan abnormal, Vaginal haemorrhage

Write-up: I was 6 weeks 4 days pregnant 4 days post vaccination I began cramping and spotting and ultimately miscarried my pregnancy. I had an normal and healthy ultrasound at 6 weeks 2 days. A strong heart beat was readily detected. There was no evidence of an unhealthy pregnancy. 11/16/09 Medical records received for DOS 110/21-11/8. OB recodes. Final DX: Missed abortion. 1st trimester spotting. FHT noted on 11/2. 11/8 bleeding continued. Missed AB. LMP 9/9/09, EDD 6/22/10.

 

 

 

VAERS ID:

367455  

Vaccination Date:

2009-10-26

Age:

34.0  

Onset Date:

2009-10-29   Days later: 3

Gender:

Female  

Submitted:

2009-11-15

State:

Florida  

Entered:

2009-11-15

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? Yes, 1 days

    Extended hospital stay? No

Current Illness: none, I was 12 weeks pregnant with a normal pregnancy.

Diagnostic Lab Data: Labs: CBC: rbc, hgb and hct low, BMP normal Dx studies: none 12/14/09 OB/GYN Records received. Service dates 9/22/09 to 11/30/09. LABS and DIAGNOSTICS: Surgical Pathology Dx - Uterine contents consistant with missed abortion.

Previous Vaccinations:

Other Medications:

Preexisting Conditions: none PMH: none Allergies: NKDA 12/14/09 OB/GYN Records received. Service dates 9/22/09 to 11/30/09. Chlamydia Trachomatis infection. Abnormal PAP, Colposcopy, LEEP. Missed abortion.

CDC 'Split Type': 1008132P

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

NOVARTIS VACCINES AND DIAGNOSTICS

1008132P

0

IJ

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Abortion spontaneous incomplete, Dizziness, Drug exposure during pregnancy, Dry mouth, Dysarthria, Evacuation of retained products of conception, Eye pain, Fatigue, Full blood count, Haematocrit decreased, Haemoglobin decreased, Impaired work ability, Intra-uterine death, Metabolic function test normal, Migraine, Pathology test, Pelvic pain, Photophobia, Red blood cell count increased, Sunburn, Uterine dilation and curettage, Uterine spasm, Vaginal haemorrhage

Write-up: My water broke and I miscarried my baby. I had to undergo a D&C and my doctor told me I bled buckets of blood. I needed a transfusion but was not given one. Since then I am extremely dizzy, have severe migraine headaches, I'm always exhausted, have had slurred speech, have dry mouth, and my eyes hurt really bad. I can not be in the light without sunglasses and long sleeves because the light hurts my eyes so bad I can't see and the sun burns my skin. I am yet to return to work and it's been two weeks since my miscarriage. I'm going to mark that patient died because I had a healthy fetus with a strong visable heartbeat and two days after receiving the vaccine I miscarried my baby. 11/17/2009 ED record for 10/29/2009, patient with c/o's vaginal bleeding, pelvic pain and "passing tissue". Patient is 12 weeks pregnant. D&C performed. DX Sp Abortion. 12/14/09 OB/GYN Records received. Service dates 9/22/09 to 11/30/09. Assessment: Spontaneous Abortion, incomplete. Patient started to have some cramping, losing fluid, bleeding heavy. Suction Dilation and Curettage

 

 

 

 

VAERS ID:

368210  

Vaccination Date:

2009-11-04

Age:

39.0  

Onset Date:

2009-11-09   Days later: 5

Gender:

Female  

Submitted:

2009-11-17

State:

California  

Entered:

2009-11-17

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? No

Hospitalized? Yes, 1 days

    Extended hospital stay? No

Current Illness: No.

Diagnostic Lab Data: 11/10/2009 path report on placenta: acute chorioamnionitis, mature placenta with trivascular umbilical cord, intrauterine demise at 35 weeks. Female infant weight 5# 7 oz., no obvious deformity, tight nuchal cord, tight body cord. Patien

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Pregnancy - 35 weeks.

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP006AA

0

IJ

UN

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Chorioamnionitis, Drug exposure during pregnancy, Foetal heart rate abnormal, Gestational diabetes, Intra-uterine death, Pathology test, Pregnancy with advanced maternal age, Stillbirth, Umbilical cord around neck

Write-up: Stillbirth. 11/18/09 and 11/19/09 DC summary and hospital records received for date 11/9/09 to 11/10/09. DX: fetal demise, stillbirth. Pt. found to have no fetal cardiac activity via US. 36wk pregnant Pt. states felt movement in AM. Pt states received H1N1 vax on 11/6. Pt. had late PNC, GDM, AMA. At time of delivery, infant normal in appearance, but noted a tight nuchal cord, tight body cord at time of delivery.

 

 

 

VAERS ID:

368354  

Vaccination Date:

2009-11-04

Age:

30.0  

Onset Date:

2009-11-05   Days later: 1

Gender:

Female  

Submitted:

2009-11-18

State:

North Carolina  

Entered:

2009-11-18

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: No illness

Diagnostic Lab Data: Labs & Diags: U/S- viable IUP.

Previous Vaccinations:

Other Medications: none

Preexisting Conditions: 11 weeks pregnant. PMH:G2P1 Allergies: Unk

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

UNKNOWN MANUFACTURER

 

 

IM

 

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abdominal pain, Abortion missed, Abortion threatened, Drug exposure during pregnancy, Muscle spasms, Ultrasound scan normal, Vaginal haemorrhage

Write-up: Abdominal cramps and vaginal bleeding diagnosed as threatened abortion in ER. 1/20, 11/24 and 11/30 Medical records received for DOS 11/15/09 Final DX: Missed abortion Presented w/pelvic cramping and dark red vaginal bleeding w/some clots.

 

 

 

VAERS ID:

368469  

Vaccination Date:

2009-11-13

Age:

31.0  

Onset Date:

2009-11-15   Days later: 2

Gender:

Female  

Submitted:

2009-11-18

State:

D.C.  

Entered:

2009-11-18

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: none

Diagnostic Lab Data: Doctor's office conducted cenogram and confirmed my miscarriage at 11 weeks!!! 12/07/09 Diagnostics/Labs: RBC 4.06 (L), Beta-HCG 14339; (11/18/09) ultrasound: findings consistent with spontaneous abortion in progress 12/08/09 Diagnostics

Previous Vaccinations:

Other Medications:

Preexisting Conditions: 12/08/09 NKDA; C-section.

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

UNKNOWN MANUFACTURER

 

0

IJ

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abdominal pain, Abortion spontaneous, Cervix haemorrhage uterine, Drug exposure during pregnancy, Ultrasound antenatal screen abnormal

Write-up: MISCARRAIGE AT 11 WEEKS OF PREGNANCY. First sign of blood on 11/15 late afternoon, then major cramping on 11/16 around 8 a.m, followed by major blood discharge on 11/16 around noon. 12/07/09 ER records received for DOS 11/18/09. Pt. presented with vaginal bleeding, abdominal pain, onset three days ago. G2 P1, EDD: 06/04/10. Seen by Ob MD in office, US in office showed miscarriage, pt told to follow up if symptoms worse. DC DX: spontaneous miscarriage-complete 12/08/09 Medical records received for DOS 11/16/09, 11/30/09. Pt. presented on 11/16/09 with h/o vaginal bleeding, which had stopped by time of exam.

 

 

 

VAERS ID:

368482  

Vaccination Date:

2009-10-22

Age:

29.0  

Onset Date:

2009-11-10   Days later: 19

Gender:

Female  

Submitted:

2009-11-18

State:

Ohio  

Entered:

2009-11-18

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: No

Diagnostic Lab Data: Ultrasounds 11/12/09 & 11/18/09 confirming miscarriage.. Labs & Diags: CBC WNL

Previous Vaccinations:

Other Medications:

Preexisting Conditions: PMH:G2P1, arthritis. LMP 8/21/09. Allergies: NKA

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

NOVARTIS VACCINES AND DIAGNOSTICS

1008131P

0

IJ

RL

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Foetal heart rate abnormal, Full blood count normal, Ultrasound scan, Vaginal haemorrhage

Write-up: Found out I miscarried on 11/10/09. I was around 12 weeks. They said the fetus was about 6 weeks developed when it died. That date was around when I got the vaccine. I don't know if they are related but wanted to report it. 11/20/09 Medical records received for DOS 11/13/09. Final DX: Miscarriage. 12 weeks gestation, spotting. Bright red blood followed by brownish discharge and later mucous discharge at cervical os. No FHT noted.

 

 

 

VAERS ID:

368742  

Vaccination Date:

2009-11-05

Age:

26.0  

Onset Date:

2009-11-09   Days later: 4

Gender:

Female  

Submitted:

2009-11-19

State:

Colorado  

Entered:

2009-11-19

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: None

Diagnostic Lab Data: HCG (HUMAN CHORIONIC GONADOTROPIN), SERUM, QUANTITATIVE 11/6/2009-6407 11/13/2009-8196 11/16/2009-2745

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Pregnancy

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

UNKNOWN MANUFACTURER

 

0

IJ

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Blood human chorionic gonadotropin, Drug exposure during pregnancy, Haemorrhage

Write-up: Spotting and Bleeding ended in miscarriage.

 

 

 

VAERS ID:

368839  

Vaccination Date:

2009-10-22

Age:

36.0  

Onset Date:

2009-11-16   Days later: 25

Gender:

Female  

Submitted:

2009-11-19

State:

Nevada  

Entered:

2009-11-19

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? No

Hospitalized? No

Current Illness: none

Diagnostic Lab Data: Prenatal ultrasound showing a fetus with no heartbeat or blood supply. Labs & Diags: Beta hCG Quant 1364 (=3-5 wks)

Previous Vaccinations:

Other Medications: prenatal vitamins

Preexisting Conditions: Pregnancy PMH: migraine, LMP 9/14. Ovarian cyst. Allergies: NKA

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

UNKNOWN MANUFACTURER

 

0

 

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion missed, Abortion spontaneous, Drug exposure during pregnancy, Foetal heart rate abnormal, Intra-uterine death, Muscle spasms, Prenatal screening test abnormal, Uterine haemorrhage

Write-up: Prenatal ultrasound revealed a fetus with no heartbeat or blood supply. My OBGYN diagnosed a miscarriage. 11/24 and 11/24/09 Medical records received for DOS 11/16/09. Final DX: Missed abortion, spontaneous abortion. Planned Cytotec, but spontaneously aborted w/cramping and bleeding w/clots. U/S revealed empty uterus. ICD9 Code: 632.0., 637.10

 

 

 

VAERS ID:

369088  

Vaccination Date:

2009-10-22

Age:

32.0  

Onset Date:

2009-11-01   Days later: 10

Gender:

Female  

Submitted:

2009-11-20

State:

North Carolina  

Entered:

2009-11-20

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? No

Hospitalized? No

Current Illness: no

Diagnostic Lab Data: D&C surgery following miscarriage dx study: US done 11/18/2009 noted fetal demise

Previous Vaccinations:

Other Medications: prenatal vitamins only

Preexisting Conditions: pregnant PMH: Migraines Allergies: NKDA

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

UNKNOWN MANUFACTURER

UP003AA

1

IJ

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Immediate post-injection reaction, Intra-uterine death, Pregnancy test positive, Ultrasound antenatal screen abnormal, Uterine dilation and curettage

Write-up: Miscarriage immediately following vaccine, requiring D & C surgery. No fetal heart rate and fetal failure to progress. 12/10/2009 OB-GYN prenatal records for 11/11/2009, EDC 6/27/2010 Prenatal labs wnl, Pregnancy test + 12/10/2009 and 12/18/2009 MR for 11/19/2009 dx 6.5 wk embryonic demise, D&C performed

 

 

 

VAERS ID:

369200  

Vaccination Date:

2009-10-19

Age:

33.0  

Onset Date:

2009-10-20   Days later: 1

Gender:

Female  

Submitted:

2009-11-20

State:

Wisconsin  

Entered:

2009-11-20

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? Yes, 2 days

    Extended hospital stay? No

Current Illness: No illness at time of vaccine. Pregnancy was strong both on ultrasound and heard heart tones.

Diagnostic Lab Data: 12/07/2009 LABS and DIAGNOSTICS: Ultrasound: Fetal demise, Serum HCG 651, WET prep-moderate clue cells.

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Asthma 12/07/2009 PMH: Partial hydatidiform mole, asthma, mitral valve prolapse, varicella, seasonal allergies, and adenoidectomy. 12/08/2009 PMH: Molar pregnancy, Mitral valve disorder, asthma, varicella, seasonal allergies 12/18/09 PMH: Asthma, NKDA

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP002AA

 

IM

 

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abdominal pain, Abortion complete, Asthma, Decreased appetite, Drug exposure during pregnancy, Emotional disorder, Induced labour, Intra-uterine death, Muscle spasms, Myalgia, Placental disorder, Sleep disorder, Smear site unspecified abnormal, Ultrasound scan abnormal, Ultrasound uterus abnormal, Urine human chorionic gonadotropin negative, Uterine dilation and curettage, Vaginal haemorrhage, Vomiting

Write-up: Day after vaccine muscles were extremely sore. Three weeks later had ultrasound that showed fetal death at time and date of vaccine administered. 11/23/2009 received Immunization record received DOS 09/21/2009 - 10/19/2009. Patient received influenza (seasonal) vaccinaton on 09/21/2009 and influenza (H1N1) on 10/19/2009. 12/07/2009 received in-patient hospital records (H&P, operative report and labs) DOS 11/14/2009 -11/16/2009. Dx: Missed abortion/miscarriage Patient presented with vaginal bleeding, abdominal pain, intermittent headache, nausea and anxiety. The patient had experienced intermittent abdominal cramping throughout pregnancy, but on morning of admission, the abdominal cramping was worse and the patient experienced brownish vaginal discharge which progressed to red spotting. No fetal heartones were heard and a misoprostol induction was performed with fetal delivery (ultrasound est. 13 wks, 3 days) and then the patient underwent a suction D&C. due to retained placenta. The patient was treated with Ancef. 12/08/2009 received out-patient clinic and duplicate hospital records 09/21/2009 -12/07/2009. Patient complaint hyper emesis, asthma symptoms. Clinic notes reflect GA 9weeks/4 days on 09/21/2009 and GA 13 weeks/4 days on 10/19/2009. ``` records received 12/15/09. Hospital rec (operative report) and clinic records received for 11/14/09- 11/23/09 DX: Complete abortion, Habitual abortion Post hospital clinic record- Patient (gravida 7, para 4, 1 molar pregnancy, 1 miscarriage) presents with moderate cramping (no bleeding) 9 days post surgery and c/o not eating or sleeping well, not feeling well emotionally. Third pregnancy loss in 1 year that was uneventful. Option of further testing discussed. Started on Ambien at bedtime. /rem ``` records received 12/18/09. Hospital rec (anesthesia) for DOS 11/14/09 DX: Retained placenta Procedure -Suction D&C. Anesthesia-epidural.

 

 

 

VAERS ID:

369211  

Vaccination Date:

2009-10-14

Age:

34.0  

Onset Date:

2009-10-19   Days later: 5

Gender:

Female  

Submitted:

2009-11-20

State:

Massachusetts  

Entered:

2009-11-20

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: Pregnant

Diagnostic Lab Data:

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Asthma

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU

UNKNOWN MANUFACTURER

 

0

 

LA

FLU(H1N1)

UNKNOWN MANUFACTURER

 

0

 

RA

 

Administered by: Private     Purchased by: Unknown

Symptoms: Drug exposure during pregnancy, Foetal heart rate decreased, Intra-uterine death

Write-up: Low fetal heart rate on 10/19/2009 followed by fetal death by 10/29/2009

 

 

 

VAERS ID:

369212  

Vaccination Date:

2009-10-30

Age:

30.0  

Onset Date:

2009-11-02   Days later: 3

Gender:

Female  

Submitted:

2009-11-20

State:

California  

Entered:

2009-11-20

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? No

Hospitalized? No

Current Illness: no

Diagnostic Lab Data:

Previous Vaccinations:

Other Medications:

Preexisting Conditions: allergic to pcn, 10 weeks, 5 days pregnant

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU

UNKNOWN MANUFACTURER

 

0

IM

LA

FLU(H1N1)

UNKNOWN MANUFACTURER

 

0

IM

RA

 

Administered by: Private     Purchased by: Unknown

Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Foetal heart rate abnormal, Ultrasound scan abnormal, Uterine dilation and curettage

Write-up: missed miscarriage, no fetal heartbeat on ultrasound, D&C performed

 

 

 

VAERS ID:

369214  

Vaccination Date:

2009-11-09

Age:

26.0  

Onset Date:

2009-11-16   Days later: 7

Gender:

Female  

Submitted:

2009-11-20

State:

Missouri  

Entered:

2009-11-20

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? No

Hospitalized? No

Current Illness: NO

Diagnostic Lab Data:

Previous Vaccinations: ~Influenza (H1N1) (Influenza (H1N1) (UNKNOWN MANUFACTURER))~UN~0.00~

Other Medications: NOTHING BESIDES PRENATAL VITAMINS

Preexisting Conditions: NO HEALTHY 26 YR OLD

CDC 'Split Type':

 

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

UNKNOWN MANUFACTURER

 

 

 

 

 

Administered by: Private     Purchased by: Unknown

Symptoms: Contraindication to vaccination, Drug exposure during pregnancy, Intra-uterine death

Write-up: SHE JUST FOUND OUT SHE WAS PREGNANT, WORKS AT A HOSPITAL, WAS TOLD THAT PREG WOMEN ARE AT RISK. sHE GOT THIS SHOT TO PROTECT HER BABY NOT KNOWING THAT THERE HAS BEEN NO TESTING ON PREGNANT WOMEN OR FETUSES.WHAT SHE THOUGHT WAS A GOOD THING TURNED OUT TO B THE WORST. THE GOV KILLED HER BABY.

 

 

 

VAERS ID:

369343  

Vaccination Date:

2009-11-18

Age:

32.0  

Onset Date:

2009-11-18   Days later: 0

Gender:

Female  

Submitted:

2009-11-23

State:

Virginia  

Entered:

2009-11-23

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness:

Diagnostic Lab Data: 11/30/09 Labs/diagnostics: US reveals no IUP consistent with complete AB

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Pregnancy; 11/30/09 PMH: NKDA; no history of previous miscarriages.

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

NOVARTIS VACCINES AND DIAGNOSTICS

10127802

0

IJ

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abdominal pain, Abortion spontaneous, Drug exposure during pregnancy, Ultrasound uterus, Ultrasound uterus abnormal, Vaginal haemorrhage

Write-up: Miscarriage of pregnancy. 11/30/09 Medical records from OB office received for DOS 11/19/2009 Presented with vaginal bleeding and cramping. G 1, P 0, 5 weeks gestation. DX: Abortion spontaneous/complete

 

 

 

VAERS ID:

369511  

Vaccination Date:

2009-10-22

Age:

38.0  

Onset Date:

2009-10-25   Days later: 3

Gender:

Female  

Submitted:

2009-11-12

State:

Montana  

Entered:

2009-11-23

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? No

Hospitalized? No

Current Illness: Cough; wheezing; dyspnea

Diagnostic Lab Data:

Previous Vaccinations:

Other Medications: Zoloft; Wellbutrin; prenatal vitamin

Preexisting Conditions:

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP001AA

0

IM

 

 

Administered by: Private     Purchased by: Public

Symptoms: Abortion spontaneous, Complication of pregnancy, Drug exposure during pregnancy, Vaginal haemorrhage

Write-up: Pregnancy miscarriage at 91/2 weeks spotting started 10/25/09 ultrasound determined pregnancy failed to progress post 91/2 wks; corresponding to date of vaccination.

 

 

 

AERS ID:

369868  

Vaccination Date:

2009-11-17

Age:

31.0  

Onset Date:

2009-11-19   Days later: 2

Gender:

Female  

Submitted:

2009-11-24

State:

Texas  

Entered:

2009-11-24

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness:

Diagnostic Lab Data: 11/25/09 Lab and Diagnostic studies: 11/17/09: transvaginal ultrasound: confirmed pregnancy of 6 weeks. 12/21/09 LABS and DIAGNOSTICS: Pelvic sonogram- no fetal cardiac activity visualized. No intrauterine pregnancy. Endometrial wall thi

Previous Vaccinations:

Other Medications:

Preexisting Conditions: 7weeks 1Day Pregnant 11/25/09 Allergies: codeine phosphate reaction with vomiting.

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP017AA

 

 

 

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Abortion spontaneous incomplete, Drug exposure during pregnancy, Muscle spasms, Ultrasound scan vagina abnormal, Urine human chorionic gonadotropin negative, Uterine contractions during pregnancy, Uterine haemorrhage, Vaginal haemorrhage, White blood cell count increased

Write-up: Miscarriage. went to Emergency Room. 11/25/09 OB notes for DOS 11/17/09. DX: Miscarriage On 11/16/09, Pt developed vaginal bleeding, cramping and contractions. Pt admitted to ED and a transvaginal ultrasound was done. On 11/17/09 Pt was seen by her OB. Pt miscarried on 11/19/09. ```records received 12/21/09. ER report and H&P received for DOS 11/19/09. DX: Incomplete spontaneous abortion Patient (gravida 1, para 0) presents c/o worsening vaginal bleeding of one week duration and cramping. Patient treated with morphine, oxygen and IV fluids. Symptoms improved. Plan D&C. ```records received 12/29/09. Duplicate ER report and H&P for 11/19/09. No additional information provided./rem

 

 

 

VAERS ID:

369958  

Vaccination Date:

2009-10-29

Age:

35.0  

Onset Date:

2009-10-31   Days later: 2

Gender:

Female  

Submitted:

2009-11-24

State:

Arizona  

Entered:

2009-11-24

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: No. I was given a seasonal flu and an H1N1 flu shot after a positive pregnancy test

Diagnostic Lab Data: Ultrasound performed; Blood panel taken including Hcg and Progesterone levels 12/1/09 Medical records received for date 11/2/09. Diag/Lab: US no sac seen. 12/2/09 Medical records received for date 10/29/09. Diag/Lab: (+)UPT.

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Asthma, Pregnancy

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU

UNKNOWN MANUFACTURER

 

 

 

 

FLU(H1N1)

UNKNOWN MANUFACTURER

 

 

 

 

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Acne, Breast tenderness, Drug exposure during pregnancy, Fatigue, Haemorrhage, Laboratory test, Muscle spasms, Pregnancy test positive, Pregnancy test urine positive, Rhinitis allergic, Ultrasound scan

Write-up: Miscarriage - cramping, bleeding. Doctor visit the following morning determined pregnancy no longer viable. 12/1/09 Medical records received for date 11/2/09. GYN DX: threatened AB vs missed AB. Pt presented w/ c/o vaginal bleeding/cramping states positive pregnancy test approx 6wks pregnant. 12/2/09 Medical records received for date 10/29/09. DX:menstral disorder, acne, allergic rhinitis. pt given H1N1 vax and seasonal flu vax. Presented ot office w/ c/o possible pregnancy has c/o breast tenderness, fatigue urinary complaints

 

  

 

VAERS ID:

370087  

Vaccination Date:

2009-10-22

Age:

26.0  

Onset Date:

0000-00-00   Days later:

Gender:

Female  

Submitted:

2009-11-25

State:

New Hampshire  

Entered:

2009-11-25

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? Yes, days

    Extended hospital stay? No

Current Illness: no

Diagnostic Lab Data: Labs & Diags: Cytology: Neg for intraepithelial lesion or malignancy.

Previous Vaccinations:

Other Medications: Prenatal Vitamins

Preexisting Conditions: Pregnant PMH: blighted ovum. G3P1 Allergies: unk

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP009AA

 

IJ

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion missed, Drug exposure during pregnancy, Intra-uterine death, Ultrasound scan abnormal, Ultrasound uterus abnormal, Uterine dilation and curettage

Write-up: Went for normal prenatal ultrasound at 11weeks 4days pregnant at OB office and found that my baby was only measuring 8weeks 3days which is when i recieved my H1N1 vaccine!!! I suffered a missed miscarriage and had to have a d&c because of it. 12/1/09 medical records received for DOS 11/13-12/1/09 OB telephone notes. Final DX: Fetal demise, partial hydatidiform mole. On U/S fetal demise at approx 8 weeks. Previous ultrasound at initial visit showed fetal growth appropx 1 week behind. Molar pregnancy. D&C.

 

 

 

VAERS ID:

370091  

Vaccination Date:

2009-11-09

Age:

30.0  

Onset Date:

2009-11-20   Days later: 11

Gender:

Female  

Submitted:

2009-11-25

State:

South Carolina  

Entered:

2009-11-25

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? No

Hospitalized? No

Current Illness: none

Diagnostic Lab Data:

Previous Vaccinations:

Other Medications:

Preexisting Conditions: none

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU

UNKNOWN MANUFACTURER

 

0

IJ

RA

FLU(H1N1)

UNKNOWN MANUFACTURER

 

0

IJ

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Contraindication to vaccination, Drug exposure during pregnancy, Vaginal haemorrhage

Write-up: 7 Weeks pregnant - spotting started at 12:15pm. Pregnancy lost 11:30 PM.

 

 

 

VAERS ID:

370108  

Vaccination Date:

2009-11-09

Age:

39.0  

Onset Date:

2009-11-16   Days later: 7

Gender:

Female  

Submitted:

2009-11-22

State:

Unknown  

Entered:

2009-11-25

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? Yes, 1 days

    Extended hospital stay? No

Current Illness:

Diagnostic Lab Data: None Labs: CBC, CMP, UA wnl, Dx studies: Pelvic US abnormal

Previous Vaccinations:

Other Medications: Routine prenatal vitamins

Preexisting Conditions: As above she is Gravida 8, Para 4 - 0- 3- 4 PMH: Migraines, + for multiple c-sections and miscarriages Allergies: Zomig

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP010AA

 

IM

UN

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abdominal pain, Abortion spontaneous, Antibiotic therapy, Drug exposure during pregnancy, Foetal heart rate abnormal, Full blood count normal, Malaise, Metabolic function test normal, Nausea, Pyrexia, Ultrasound pelvis, Ultrasound pelvis abnormal, Urine analysis normal, Uterine dilation and curettage, Vomiting

Write-up: Patient admitted for spontaneous abortion 12 weeks into pregnancy. She had received the H1N1 vaccine approximately 1 week earlier. She is Gravida 8, Para 4 - 0- 3- 4. The attending asked that this report be filed at the patients demands. 12/8 and 12/9/2009 MR, ED records for 11/20/2009, operative reports for 11/18 and 11/21/2009. Patient was 12 weeks pregnant, had US done on 11/16/2009 which noted no FHT, patient had a D&C on 11/18/2009. Presented to ED on 11/20/2009 with c/o's fever, malaise, nausea/vomiting and severe abdominal pain, a repeat Pelvic US was done which noted retained products of conception, a repeat D&C was done, and tx'd with IV ABX 12/31/2009 OB-GYN prenatal visits.

 

 

 

VAERS ID:

370156  

Vaccination Date:

2009-11-18

Age:

34.0  

Onset Date:

2009-11-20   Days later: 2

Gender:

Female  

Submitted:

2009-11-25

State:

Massachusetts  

Entered:

2009-11-25

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness:

Diagnostic Lab Data: ```records received, ED record for 11/21/2009 Dx study: US noted 6 wk fetus with no FHT

Previous Vaccinations:

Other Medications:

Preexisting Conditions: ```records received, ED record for 11/21/2009 PMH High Cholesterol Allergies: NKDA

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP025AA

0

 

 

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Ultrasound scan abnormal, Vaginal haemorrhage

Write-up: Miscarriage on 11/20/09. 12/2/09 OB medical records received, no other info provided. MR encounter date 11/23/09. (+)HCG test 11/11/09 LMP 9/25/09. ```records received, ED record for 11/21/2009 patient pregnant EDC 7/2/2010 with 3 day hx of c/o's vaginal bleeding, resultedin Spontaneous abortion

 

 

 

VAERS ID:

370219  

Vaccination Date:

2009-11-18

Age:

34.0  

Onset Date:

2009-11-19   Days later: 1

Gender:

Female  

Submitted:

2009-11-25

State:

California  

Entered:

2009-11-25

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: no

Diagnostic Lab Data: Lab test and ultrasound 12/1/09 Diag/Lab records received for date 11/21/09. US (+) single gestational sac w/ yolk seen, not fetal poles at this time. Clinical dates of 7wks 1 day gestation. Beta HCG 5692.66(H).

Previous Vaccinations:

Other Medications: none

Preexisting Conditions: no

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP015AA

1

IJ

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Abortion threatened, Beta globulin, Blood human chorionic gonadotropin increased, Contraindication to vaccination, Drug exposure during pregnancy, Haemorrhage, Muscle spasms, Pregnancy, Ultrasound scan abnormal, Vaginal haemorrhage

Write-up: I was 7 weeks pregnant and started to cramp/bleed the next day and was dignosed with a miscarriage on Friday evening at the hospital. Rec'd H1N1 inactivated shot. 12/30/09 ER records received for date 11/21/09. DX: threatened miscarriage. CC: vaginal spotting, pelvic pain. Labs same as prev. abstract and MR.

 

 

 

VAERS ID:

370289  

Vaccination Date:

2009-10-23

Age:

32.0  

Onset Date:

2009-11-23   Days later: 31

Gender:

Female  

Submitted:

2009-11-26

State:

California  

Entered:

2009-11-26

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? No

Current Illness: No

Diagnostic Lab Data: Ultrasound Confirmed by Obstetrician

Previous Vaccinations:

Other Medications: Prenatal Vitamins

Preexisting Conditions: Pregnant

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP002AA

 

UN

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Ultrasound abdomen

Write-up: Miscarriage. 12/04/09 Antenatal record received for DOS 10/27/09. IUP: 6 weeks. EDD: 06/18/10; Additional record for DOS 11/23/09: Diagnosis: missed SAB.

 

 

 

VAERS ID:

370350  

Vaccination Date:

2009-11-09

Age:

38.0  

Onset Date:

2009-11-11   Days later: 2

Gender:

Female  

Submitted:

2009-11-27

State:

California  

Entered:

2009-11-27

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? Yes, 1 days

    Extended hospital stay? No

Current Illness: None. I am an RN in an Emergency Room 5 1/2 months pregnant. Vaccine supplied by work

Diagnostic Lab Data: TORCH Panel, elevated wbc 15.9 11/30/09 and 12/2/09 Hospital and medical records received for date 11/11/09.Diag/Labs: US (+)fetal demise of 22wks 1 day. Pathology report on fetus WNL and placenta(+)moderate acute villitis, acute chorioamn

Previous Vaccinations:

Other Medications: Received the regular flu shot approx 4 weeks previous. For lot number and manufacturer....Med Center can be contacted

Preexisting Conditions: 22 weeks pregnant

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

NOVARTIS VACCINES AND DIAGNOSTICS

101326

1

IJ

UN

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Band neutrophil count increased, Chills, Chorioamnionitis, Drug exposure during pregnancy, Induced labour, Intra-uterine death, Laboratory test, Muscle spasms, Neutrophil count increased, Pyrexia, Streptococcal identification test positive, Ultrasound uterus abnormal, White blood cell count increased

Write-up: I was 22 weeks pregnant. I work nights, I came home from work and took a nap at noon and woke up at 3:30pm with the chills and feverish. Started to have cramps at 4:30Pm, went to the hospital to be told my baby had died. This was confirmed by ultrasound. I was induced at 10:15 pm that night and delivered my baby boy approx 1hr 45 min later. I had a normal and healthy developing pregnancy until this time. I had an ultrasound at 9am on 11/11/09 for a routine anatomy scan...no problems detected......hours later...suffered a great loss of my pregnancy. 11/30/09 and 12/2/09 Hospital and medical records received for date 11/11/09. Medical records are OB records dated from 8/24/09 pt was10wks pregnant w/o complications at start of OB care. Pt. felt ill experienced cramping at 22wks, US confirmed no cardiac activity. Pt induced, demised male infant delivered.

 

 

 

VAERS ID:

370354  

Vaccination Date:

2009-11-09

Age:

30.0  

Onset Date:

2009-11-25   Days later: 16

Gender:

Female  

Submitted:

2009-11-27

State:

Kansas  

Entered:

2009-11-27

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? Yes

Hospitalized? Yes, 1 days

    Extended hospital stay? No

Current Illness: None

Diagnostic Lab Data: The hospital did labs on the fetus. Have not gotten results.

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Hypothyroidism PMH : Hypothyroidism Allergies: NKDA

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

NOVARTIS VACCINES AND DIAGNOSTICS

10127604

0

IJ

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abdominal pain upper, Abortion spontaneous, Drug exposure during pregnancy, Haemorrhage, Laboratory test, Ultrasound antenatal screen abnormal, Ultrasound scan abnormal, Uterine dilation and curettage

Write-up: I began to have pain and cramping in my stomach during the week of Monday, November 16, 2009. The pain and cramping increased on Sunday, November 22, 2009. I had bleeding and cramps on Wednesday, November 25, 2009. I called my doctor and he told me to come in that morning. I had a sonogram after which I was told that I miscarried my baby. I was about 4 weeks pregnant.11/30/2009 OB-GYN records and MR for 11/25/2009. OB records note patient preganant with EDC 6/17/2010. on 11/25/2009 had D&C, c/o' uterine cramping, US verified non viable fetus.

 

 

 

VAERS ID:

370372  

Vaccination Date:

2009-11-09

Age:

35.0  

Onset Date:

2009-11-25   Days later: 16

Gender:

Female  

Submitted:

2009-11-28

State:

California  

Entered:

2009-11-28

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? No

Hospitalized? No

Current Illness: No

Diagnostic Lab Data: DX studies: U/S: abnormal, no fetal heartbeat.

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Allergies: NKDA

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

NOVARTIS VACCINES AND DIAGNOSTICS

1007391P

 

IM

 

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Foetal heart rate abnormal, Ultrasound antenatal screen abnormal

Write-up: Miscarriage - diagnosed during ultrasound, but baby appears to have stopped growing about 1 week after vaccine was given. 12/08/09 MR received for DOS 12/07/09. DX: Missed abortion not resolving spontaneously. Pt presented with no complaints. Pt did not have spontaneous abortion, so was referred to Gynecology services. 12/08/09 MR received for DOS 11/30/09. Pt was examined using ultrasound and heart beat was absent consistent with fetal demise. Pt with nausea, but did not have any bleeding or cramping. Assessment: missed abortion. Dr. discussed D&C with Pt, but Pt refused intervention. Pt was to follow up in 1 wk. 12/08/09 MR received for DOS 11/09/09. Pt presented for first OB visit. Pt received H1N1 vaccine.

 

 

 

VAERS ID:

370375  

Vaccination Date:

2009-11-20

Age:

29.0  

Onset Date:

2009-11-27   Days later: 7

Gender:

Female  

Submitted:

2009-11-28

State:

Alaska  

Entered:

2009-11-28

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? No

Hospitalized? No

Current Illness: No

Diagnostic Lab Data: Took an HCG test 11/27 my numbers are decreasing. 12/01/09 Dx studies for DOS 11/20/09 and 11/30/09: HCG reassured pregnancy, US: normal

Previous Vaccinations:

Other Medications:

Preexisting Conditions: 12/01/09 PMH: HA, depression, mastoidectomy.

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

1007391P

1

 

 

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Anxiety, Blood human chorionic gonadotropin, Ultrasound antenatal screen normal, Vaginal haemorrhage

Write-up: I am starting to miscarry. 12/01/09 ED notes for DOS 11/20/09 and OB visit records for DOS 11/30/09 DX: Vaginal bleeding Pt presented c/o vaginal bleeding. Pt anxious about the pregnancy. US: positive heart beats, and HCG confirmed viable fetus.

 

 

 

VAERS ID:

370389  

Vaccination Date:

2009-10-22

Age:

32.0  

Onset Date:

2009-10-24   Days later: 2

Gender:

Female  

Submitted:

2009-11-28

State:

Indiana  

Entered:

2009-11-28

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? No

Hospitalized? No

Current Illness: no.

Diagnostic Lab Data: Labs & Diags: Beta HCG 35075, HCG quant- 43037 (3-5 weeks). U/S non-viable pregnancy.

Previous Vaccinations:

Other Medications:

Preexisting Conditions: PMH: UTIs, MVA as child w/hospitalization

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UP007AA

 

IM

RA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Foetal growth retardation, Intra-uterine death

Write-up: Fetus stopped growing at 6 weeks, 3 days. I found out on 11/14 at 9 weeks, 5 days. Natural miscarriage began on 11/25/09.11/30/09 Medical records received. OB/GYN notes. DOS range 11/3-11/30 Primigravida. LMP 9/9/09. EDD 6/15/10. Beta HCG decreased. Prob early SAB. U/S notes not likely to be a viable pregnancy.

 

 

VAERS ID:

370390  

Vaccination Date:

2009-10-26

Age:

29.0  

Onset Date:

2009-10-30   Days later: 4

Gender:

Female  

Submitted:

2009-11-28

State:

Maine  

Entered:

2009-11-28

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? Yes

Hospitalized? Yes, 5 days

    Extended hospital stay? No

Current Illness: NO

Diagnostic Lab Data: 12/08/09 Diagnostics: Pathology: second trimester placenta; fetal membranes and umbilical cord: fetal membranes with mild acute chorioamnionitis, placenta with accelerated villous maturation Labs: wnl; cultures; negative 12/09/09 Antepart

Previous Vaccinations:

Other Medications:

Preexisting Conditions: 25 weeks Pregnant 12/08/09 PMH: penicillin allergy; wisdom teeth extraction; obesity; PCOS

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU

SANOFI PASTEUR

U3208AA

 

 

 

FLU(H1N1)

NOVARTIS VACCINES AND DIAGNOSTICS

100813

 

 

 

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Alpha 1 foetoprotein amniotic fluid normal, Amniorrhoea, Drug exposure during pregnancy, Premature labour

Write-up: Was having a normal healthy pregnancy and my water broke 5 days after having the seasonal flu shot and H1N1 shot and had my baby 3 months early at 25 weeks and 5 days. 12/08/09 Hospital records received for DOS: 10/30/09-11/03/09 G1 P0 presented with premature rupture of membranes at 25 weeks gestation; c/o crampiness, clear fluid leakage; cervical dilation 12/09/09 Antepartum records (Stephens Memorial) received for DOS 08/21/09-10/19/09

 

 

 

VAERS ID:

370406  

Vaccination Date:

2009-11-02

Age:

27.0  

Onset Date:

2009-11-04   Days later: 2

Gender:

Female  

Submitted:

2009-11-29

State:

Minnesota  

Entered:

2009-11-29

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? No

Hospitalized? Yes, 2 days

    Extended hospital stay? No

Current Illness: none

Diagnostic Lab Data: I had the nasal swabs done, torch screen (after birth) they swabbed both baby side and mothers side of placenta (awaiting results) and they also took samples for chromosomal testing 12/01/09 DOS 11/04/09 Lab and Diagnostic studies for DO

Previous Vaccinations:

Other Medications:

Preexisting Conditions: I am allergic to erythromycin, Anaprox and IV compazine 12/01/09 - PMH: thrombocytopenia, cellulitis July 09.

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

NOVARTIS VACCINES AND DIAGNOSTICS

90663

1

IM

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion threatened, Body temperature increased, Chromosomal analysis, Drug exposure during pregnancy, Influenza serology negative, Intra-uterine death, Platelet count decreased, Pyrexia, Stillbirth, Ultrasound scan, Vaginal haemorrhage

Write-up: At about 2pm I started bleeding, went into the triage to be evaluated, they sent me home at about 545 PM and within an hr home my water broke. Went back to hosp, was admitted and was put on isolation precautions cause of risk of H1N1. My seasonal and influenza A swabs came back negative but because I was hospitalized they had to send the swabs out but they still kept me on precautions, I delivered a still born baby at 0650 on 11/5/09. 12/01/09 DOS 11/04/09 - DX: Fetal death 15 week pregnant Pt c/o vaginal watery fluid, possible water breaking, and some vaginal bleeding. On examination: Pt had fever. Fetus was still viable. Pt's physician considered the prognosis of pregnancy poor due to placental fluid loss and possible infection. Pt lost fetus later the next day.

 

 

 

VAERS ID:

370412  

Vaccination Date:

2009-11-06

Age:

31.0  

Onset Date:

2009-11-08   Days later: 2

Gender:

Female  

Submitted:

2009-11-29

State:

New Jersey  

Entered:

2009-11-29

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? No

Hospitalized? No

Current Illness: none

Diagnostic Lab Data: ultra sound,

Previous Vaccinations:

Other Medications:

Preexisting Conditions: pregnant with 3rd child was 9 weeks and 3 days

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

SANOFI PASTEUR

UT014AA

0

IJ

RA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Ultrasound scan, Ultrasound scan abnormal, Uterine dilation and curettage

Write-up: I had gotten an ultra sound at 9 weeks the baby looked great with a healthy heartbeat, when I had gotten anther ultrasound it showed the baby stopped growing at 9 weeks and 5 days with no heartbeat. Which would have been 2 days prior to recieving the H1N1 vaccine. I am having a D&C done due to the miscarriage. 12/1/09 Medical records received for date 10/27/09 11/27/09. OB records indicate 2 OB OV, no complications noted.

 

 

 

VAERS ID:

370424  

Vaccination Date:

2009-11-24

Age:

32.0  

Onset Date:

2009-11-28   Days later: 4

Gender:

Female  

Submitted:

2009-11-29

State:

California  

Entered:

2009-11-29

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? No

ER or Doctor Visit? No

Hospitalized? No

Current Illness: No

Diagnostic Lab Data: HCG quant level decreased from 11 to 4.

Previous Vaccinations:

Other Medications:

Preexisting Conditions: Pregnant

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU(H1N1)

UNKNOWN MANUFACTURER

 

0

IJ

LA

 

Administered by: Unknown     Purchased by: Unknown

Symptoms: Abortion spontaneous, Drug exposure during pregnancy

Write-up: MISCARRIAGE 11/30 and 12/1 Medical records received for DOS 11/16- 12/4 LMP 10/23/09. C/O odor, pain and discharge on 11/16. HCG + on 11/25. 11/30 c/o cramping, bleeding, passing mucous tissue. Miscarriage. HCG level decreased from 11 to 4.

 

 

 

VAERS ID:

370426  

Vaccination Date:

2009-11-17

Age:

32.0  

Onset Date:

2009-11-26   Days later: 9

Gender:

Female  

Submitted:

2009-11-30

State:

California  

Entered:

2009-11-30

 

Life Threatening Illness? No

Died? No

Disability? No

Recovered? Yes

ER or Doctor Visit? No

Hospitalized? No

Current Illness: None

Diagnostic Lab Data: 12/14/09 Labs: hCG 163 on 11/25/09; hCG 20 on 11/30/09.

Previous Vaccinations:

Other Medications:

Preexisting Conditions: None 12/04/09 PMH: NKDA; exercise induced asthma; mononucleosis; eczema

CDC 'Split Type':

 

Vaccination

Manufacturer

Lot

Dose

Route

Site

FLU

UNKNOWN MANUFACTURER

AFLUA4580A

 

IM

LA

FLU(H1N1)

UNKNOWN MANUFACTURER

100923

 

IM

RA