|
|
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.
|
|
|
|
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. |
|
|
