|
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
|
|
Vaccination: FLU(H1
Manufacturer: SANOFI
PASTEUR
Lot: UP002AA
Dose: 0
Route: IJ
Site: 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: 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
Manufacturer: NOVARTIS
VACCINES AND DIAGNOSTICS
Lot: 98434P1
Dose: IM
Route: RA
Site
FLU(H1
SANOFI
PASTEUR
UP001AA
IM
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
Dose: 0
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.
|
|
ID: 363163
Vaccination Date: 2009-10-22
Age: 16.0
Onset Date: 2009-10-22 Days later: 0
Gender: Female
Submitted: 2009-10-22
State: Ohio
Entered: 2009-10-27
|
|
Vaccination: FLU(H1
Manufacturer: SANOFI
PASTEUR
Lot: UP006AA
Dose
Route: IM
Site: RA
|
|
Administered by:
Public Purchased by: Other
Symptoms:
Fall, Mouth injury, Pregnancy
Write-up:
No symptoms prior-fell face
first after stood up from chair and cut lip. Occurred 10 minute after
vaccine admin.. EMS attended patient. BP 120/80. Transport for lip
sutures and evaluation.. No other sx noted.
|
|
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
Dose: 0
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: 363380
Vaccination Date: 2009-10-21
Age: 21.0
Onset Date: 2009-10-21 Days later: 0
Gender: Female
Submitted: 2009-10-22
State: Virginia
Entered: 2009-10-28
|
|
Vaccination: FLU(H1
Manufacturer: SANOFI
PASTEUR
Lot: UP009AA
Dose: 0
Route: IM
Site: UN
|
|
Administered by:
Public Purchased by: Unknown
Symptoms:
Abdominal pain, Blood thyroid
stimulating hormone, Drug exposure during pregnancy, Flushing,
Gastroenteritis, Headache, Nausea, Pyrexia, Urine analysis normal,
Vomiting
Write-up:
Had headache 9:30 A-then
started throwing up later, otherwise feels fine is 11 weeks pregnant.
Advised to go to ER. 11/02/09 Medical record recieved. OB/GYN record
DOS 10/7. 9 weeks gestation. Vag exam WNL. RH+. Mild HA,
nause/vomiting and abd pain. LMP 7/17/09. EDC 4/23/2010. Corrected
EDC 5/11/2010. 11/17/09 Medical records received for DOS 10/21/09.
After hours care notes. Assessment gastroenteritis vs morning
sickness. 11 Weeks gestation. Vomiting x7 s/p vaccine., Flushed.
Looks ill. Low grade temp.
|
|
VAERS ID: 363535
Vaccination Date: 2009-10-27
Age: 36.0
Onset Date: 2009-10-27 Days later: 0
Gender: Female
Submitted: 2009-10-29
State: Michigan
Entered: 2009-10-29
|
|
Vaccination: FLU(H1
Manufacturer: UNKNOWN
MANUFACTURER
Lot: UP007AA
Dose: 0
Route: IM
Site: LA
|
|
Administered by:
Public Purchased by: Public
Symptoms:
Chills, Drug exposure during
pregnancy, Fatigue, Headache, Nausea, Tremor
Write-up:
Severe uncontrollable chills
and shaking, extreme exhaustion, headache and nausea
|
|
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: 363930
Vaccination Date: 2009-10-26
Age: 33.0
Onset Date: 2009-10-28 Days later: 2
Gender: Female
Submitted: 2009-10-29
State: New
York
Entered: 2009-10-30
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI PASTEUR
UP001AA
0
UN
LA
|
|
Administered by:
Public Purchased by: Public
Symptoms:
Drug exposure during
pregnancy, Oxygen saturation, Rash generalised, Urticaria
Write-up:
Pt. show up in ER with
hives/rash all over body since morning of 10/28/09. Denies SOB. Pt.
is 11 weeks gestation. Rc'd H1N1 vaccine on 10/26/09. BENADRYL every
6 hrs. as needed10/30/2009 MD and Ed records for 10/28/2009. Patient
with c/o's rash and itching. Tx: benadryl Im. DC Dx acute urticaria .
|
|
|
|
VAERS ID:
363977
Vaccination Date:
2009-10-28
Age:
33.0
Onset Date:
2009-10-28 Days later: 0
Gender:
Female
Submitted:
2009-10-30
State:
Louisiana
Entered:
2009-10-30
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI
PASTEUR
UPOOAA
0
IM
LA
|
|
Administered by:
Unknown Purchased by: Unknown
Symptoms:
Chest discomfort,
Contraindication to vaccination, Dizziness, Drug exposure during
pregnancy, Dysphagia, Dyspnoea, Painful respiration, Pharyngeal
oedema, Throat tightness, Vaccination complication
Write-up:
Throat from vocal folds to
clavicle was closing, difficulty breathing, difficulty swallowing,
slight dizziness - arrived at ER at approx. 3:30 - was given 50 mg of
Benadryl & monitored for approx 1.25 hours - breathing returned
to normal - instructed to self administer 25-50 mg of Benadryl as
needed at 6 hour intervals - took 25 mg at approx. 10:00 and was
fine, then had same severity of onset as initial reaction at approx..
4:00 a.m. (10-29-09) and had to take 50 mg to get breathing back to
normal. Went to ob/gyn next morning (10-29-09)for 9:00 a.m. and was
given a cortisone shot to help with the recurring reactions, also had
baby examined through fetal ultrasound and fetal heartbeat monitor.
Had to take 25mg of Bendadryl at approx. 10:00 p.m. that night b/c
entire lung area (sternum, ribs & thoracic spine) was under
severe pressure and it hurt to breathe. After 1/2 hour, pain subsided
- after 45 minutes could lay down to try to sleep. No further
reractions so far today (10/30/09 @ 12:10 p.m.) but instructed by
ob/gyn to keep the Benadryl with me at all times b/c allergic
reactions can last for up to 2 weeks. I HAVE NO ALLERGIES TO EGGS!
11/02/09 and 11/03/09 Medical records received for DOS 10/28/09.
Final DX: Adverse reaction to influenza vaccine. 20 week gestation
patient developed feeling of throat swelling 1hr s/p vaccine. PE
unremarkable. Benadryl and observation x1hr. Pos fetal heart tones.
No change in sx. Discharged.
|
|
VAERS ID:
363983
Vaccination Date:
2009-10-30
Age:
27.0
Onset Date:
2009-10-30 Days later: 0
Gender:
Female
Submitted:
2009-10-30
State:
Massachusetts
Entered:
2009-10-30
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI
PASTEUR
UP009AA
0
UN
LA
|
|
Administered by:
Private Purchased by: Other
Symptoms:
Anxiety, Drug exposure during
pregnancy, Feeling abnormal, Immediate post-injection reaction,
Immunisation reaction, Pulse abnormal, Tachycardia, Throat irritation
Write-up:
Immediately after receiving
H1N1 immunization the patient c/o "burning of her throat and
feeling funny". Pt is 9 wks pregnant. Pt placed in supine
position and administered apple juice. BP 106/60 palpable, P 88 and
thready, R-22 unlabored. Taken to ED via ambulance. 11/2/09 Emergency
Department Records received from date of service 10/30/09. Dx:
Medication Reaction. Assessment: 9 week pregnant woman presented
after getting H1N1 vaccine and immediately had some throat irritation
and "burning" and became anxious and tachycardic. There was
no syncope or feeling of throat closing, no stridor or urticaria, no
SOB or abd. pain. No evidence of allergic reaction on physical exam.
Pt. discharged to home. 11/16/09 Prenatal records received. Normal
prenancy. EDC 6/7/10. No further notation.
|
|
VAERS ID:
364088
Vaccination Date:
2009-10-30
Age:
33.0
Onset Date:
2009-10-30 Days later: 0
Gender:
Female
Submitted:
2009-10-30
State:
South
Carolina
Entered:
2009-10-30
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI
PASTEUR
UP008AA
0
IM
RA
|
|
Administered by:
Public Purchased by: Unknown
Symptoms:
Aura, Drug exposure during
pregnancy, Headache, Vision blurred, Visual impairment
Write-up:
At 12:30pm, pt reported
blurred vision and aura/black spot around objects. Vision changes
followed by headache from 1:00-1:30. By 2pm all symptoms resolved.
|
|
VAERS ID:
364217
Vaccination Date:
2009-10-27
Age:
37.0
Onset Date:
2009-10-27 Days later: 0
Gender:
Female
Submitted:
2009-11-01
State:
Massachusetts
Entered:
2009-11-01
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
NOVARTIS
VACCINES AND DIAGNOSTICS
100813 2P
IJ
|
|
Administered by:
Unknown Purchased by: Unknown
Symptoms:
Drug exposure during
pregnancy, Urticaria
Write-up:
HIVES 11/2/2009 records from
OB-GYN MD stating patient called to MD office stating had hives post
vaccination, patient took Benadryl and hives cleared.
|
|
VAERS ID:
364275
Vaccination Date:
2009-10-22
Age:
33.0
Onset Date:
2009-10-22 Days later: 0
Gender:
Female
Submitted:
2009-11-02
State:
Kentucky
Entered:
2009-11-02
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI
PASTEUR
UP008AA
0
IM
LA
|
|
Administered by:
Unknown Purchased by: Unknown
Symptoms:
Adverse event, Drug exposure
during pregnancy, Erythema, Feeling hot, Heart rate increased,
Hypoaesthesia
Write-up:
Adverse event began
approximately 2 hours after vaccine was given. Patient stated that
her body and face became really hot and red. She also felt that her
pulse was racing. She had some numbness on her left side. All had
been resolved by the next day. 11/3/09 Medical records received from
OB from 5/09 to 10/28/09. OB records received. Noted pt had H1N1
vaccine.. Normal pregnancy progression.
|
|
VAERS ID:
364385
Vaccination Date:
2009-10-19
Age:
23.0
Onset Date:
2009-10-20 Days later: 1
Gender:
Female
Submitted:
2009-10-26
State:
Ohio
Entered:
2009-11-02
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI
PASTEUR
UP002AA
0
IJ
AR
|
|
Administered by:
Private Purchased by: Public
Symptoms:
Drug exposure during
pregnancy, Injection site anaesthesia, Paraesthesia
Write-up:
fingers tingly and injection
site was numb
|
|
VAERS ID:
364387
Vaccination Date:
2009-10-19
Age:
26..0
Onset Date:
2009-10-20 Days later: 1
Gender:
Female
Submitted:
2009-10-26
State:
Ohio
Entered:
2009-11-02
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI
PASTEUR
UP002AA
0
UN
AR
|
|
Administered by:
Private Purchased by: Public
Symptoms:
Drug exposure during
pregnancy, Injection site anaesthesia, Local reaction, Paraesthesia
Write-up:
Fingers tingly and injection
site was numb. To ER - local reaction on 10/20/09. 11/4/09: Emergency
Department Records received for date of service 10/19/09.. Dx: Left
hand numbness Assessment: This 12 week pregnant female pesented the
day after receiving the H1N1 vaccine in the left deltoid, with left
arm and hand pain and numbness. No redness, swelling, SOB, rash or
pain around the injection site. Pt. discharged to home.
|
|
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
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI
PASTEUR
UP003AA
0
IM
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
Manufacturer
Lot
Dose
Route
Site
FLU(H1
UNKNOWN
MANUFACTURER
1007392P
0
IM
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:
364937
Vaccination Date:
2009-10-30
Age:
26.0
Onset Date:
2009-10-30 Days later: 0
Gender:
Female
Submitted:
2009-11-02
State:
Massachusetts
Entered:
2009-11-04
|
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
NOVARTIS
VACCINES AND DIAGNOSTICS
1008132
0
UN
LA
|
|
|
Administered by:
Private Purchased by: Private
Symptoms:
Blood glucose increased, Drug
exposure during pregnancy, Haematocrit decreased, Syncope
Write-up:
After injection pt fainted -
?anxiety or hypoglycemia. No rash or shortness of breath. Pt was 30
wks preg. O2 given BP 60/40 Pulse 42. Pt recovered. Taken to hospital
for fetal monitoring. 11/10/09 Medical records received for date
10/30/09. DX: syncope after H1N1 vax. Pt. sent to hosp. for fetal
monitoring 30wks gestation. Assessment: FHR(+) WNL. Pt. denies and
c/o. DC home.
|
|
|
VAERS ID:
364955
Vaccination Date:
2009-10-20
Age:
30.0
Onset Date:
2009-10-20 Days later: 0
Gender:
Female
Submitted:
2009-10-21
State:
Oregon
Entered:
2009-11-04
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI
PASTEUR
UP002AA
0
IM
RA
|
|
Administered by:
Private Purchased by: Public
Symptoms:
Drug exposure during
pregnancy, Vomiting
Write-up:
Pt started vomiting not long
after receiving vaccination and called office to inform doctor. A prescription
was called in for PHENERGAN and pt is doing much better, no more
vomiting. 11/5/09 OB records received for dates 6/30/09 to
10/9/09.EDC: 2/15/09. G3P1 No information provided pertaining to H1N1
vaccine.
|
|
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
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI
PASTEUR
UP002AA
0
IM
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:
365044
Vaccination Date:
2009-10-26
Age:
28.0
Onset Date:
2009-10-27 Days later: 1
Gender:
Female
Submitted:
2009-10-29
State:
California
Entered:
2009-11-04
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI
PASTEUR
UP002AA
0
UN
LA
|
|
Administered by:
Private Purchased by: Private
Symptoms:
Dizziness, Drug exposure
during pregnancy, Eye swelling, Hypoaesthesia facial, Hypoaesthesia
oral, Paraesthesia
Write-up:
Given injection 4 PM, woke up
midnight numbness on left side of face including eyebrow, eye or not
lips. Was not droopy. Became lightheaded. Eye felt swollen like she
couldn't close it but it did close. Next day also felt tingling in
left arm and some on right. Mom is pregnant. 11/09/09: OB Record
received for dates of service 10/27/09: Facial numbness. Assessment:
Had H1N1 vaccine the day before OB visit. Presented with facial
numbness. If no improvement will refer to PCP for tx.
|
|
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
Manufacturer
Lot
Dose
Route
Site
FLU(H1
NOVARTIS
VACCINES AND DIAGNOSTICS
10073801A
0
IM
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
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI
PASTEUR
VP008AA
0
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:
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
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
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:
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
Manufacturer
Lot
Dose
Route
Site
FLU(H1
SANOFI
PASTEUR
UP003AA
0
IM
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
Manufacturer
Lot
Dose
Route
Site
FLU(H1
NOVARTIS
VACCINES AND DIAGNOSTICS
100813 6P
IM
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
Manufacturer
Lot
Dose
Route
Site
FLU
NOVARTIS
VACCINES AND DIAGNOSTICS
98447PI
0
IM
RA
FLU(H1
SANOFI
PASTEUR
UP006AA
IM
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.
|
start
of pasted information
|
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: |
366539 |
Vaccination Date: |
2009-10-26 |
|
Age: |
17.0 |
Onset Date: |
2009-10-26 Days later: 0 |
|
Gender: |
Female |
Submitted: |
2009-11-10 |
|
State: |
Pennsylvania |
Entered: |
2009-11-10 |
|
|
Life Threatening Illness? No |
|
Died? No |
|
Disability? No |
|
Recovered? Yes |
|
ER or Doctor Visit? Yes |
|
Hospitalized? No |
|
Current Illness: no. Only preganat. |
|
Diagnostic Lab Data: unsure what it
was from. but i didn't feel like that until i got the swine flu
shot. Labs: CBC, CMP normal |
|
Previous Vaccinations: |
|
Other Medications: |
|
Preexisting Conditions: PMH:
pregnant Allergies: NKDA |
|
CDC 'Split Type': |
|
|
Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
|
FLU(H1N1) |
NOVARTIS VACCINES AND DIAGNOSTICS |
1008131P |
1 |
IM |
LA |
|
|
Administered by: Unknown Purchased
by: Unknown |
|
Symptoms: Abdominal pain upper,
Decreased appetite, Drug exposure during pregnancy, Full blood
count normal, Headache, Metabolic function test, Nausea,
Vomiting |
|
Write-up: A few hours after i got
the swine flu shot i got a really bad headache which lasted more
then a week. Also i was feeling nausea and geting stomach craps.
I also had little/no appetite. 11/19/09 Medical records
received. OB records. Recent OV 11/16/09 pt. 19wks pregnant, (+)FHR.
Normal visit WNL exam. Pt received H1N1 IM vax on 10/26/09. Pt.
seen in ER on 10/30/09 w/ c/o N/V x3 days, generalized HA, abd
cramping. DX: IUP, vomiting. Diag/Labs: none received.
11/19/2009 ED records for 10/30/2009, patient pregnant presents
with c/o's nausea/vomiting, headache, abdominal cramping. Tx:
IVF, Zofran |
|
|
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: |
367309 |
Vaccination Date: |
2009-10-21 |
|
Age: |
19.0 |
Onset Date: |
2009-10-26 Days later: 5 |
|
Gender: |
Female |
Submitted: |
2009-11-13 |
|
State: |
Arizona |
Entered: |
2009-11-13 |
|
|
Life Threatening Illness? No |
|
Died? No |
|
Disability? No |
|
Recovered? Yes |
|
ER or Doctor Visit? No |
|
Hospitalized? No |
|
Current Illness: pr |
|
Diagnostic Lab Data: Platelet
values: 10/28-155, 10/30-138, 10/31-128, 11/1-132, 11/2-138,
11/3 -166 11/17/09 Hospital records received from date 10/26/09
Diagnostics/Lab: BMP and LFT WNL, platelets 152(L) |
|
Previous Vaccinations: |
|
Other Medications: ferrous sulfate
324mg po tid, ascorbic acid 500mg daily, prenatal vitamins
daily, calcium citrate with vitamin D po BID |
|
Preexisting Conditions: pregnancy,
anemia |
|
CDC 'Split Type': IHS808101 |
|
|
Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
|
FLU(H1N1) |
SANOFI PASTEUR |
UP006AA |
0 |
IM |
RA |
|
|
Administered by: Unknown Purchased
by: Unknown |
|
Symptoms: Abdominal pain, Drug
exposure during pregnancy, Laboratory test normal, Labour
induction, Liver function test normal, Platelet count decreased,
Proteinuria, Thrombocytopenia |
|
Write-up: Patient presented to
obstetric care unit at 36+ weeks of pregnancy complaining of
abdominal pain. Ruled by provider to be unlikely due to
pregnancy or gallbladder but no definative diagnosis made.
Comprehensive labs were drawn. Lab returned showing PLT count of
152 (prior lab 8/31/09 - 210). Patient was held for 24 hour
observation and a few days later held for observation again due
to decreased plts and proteinuria. She was admitted for
induction of labor the following day. Platelets continued to
decrease during that time until 11/3 when levels began to
resolve. Patient was discharged without further follow-up for
thrombocytopenia. 11/17/09 Hospital records received from date
10/26/09. DX: Abdominal pain. Pt c/o abdominal pain, 36 weeks
pregnant. Assessment: WNL, FHR(+) |
|
|
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 |
|
Previous Vaccinations: |
|
Other Medications: |
|
Preexisting Conditions: none PMH:
none Allergies: NKDA |
|
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,
Dizziness, Drug exposure during pregnancy, Dry mouth, Dysarthria,
Eye pain, Fatigue, Full blood count, Haematocrit decreased,
Haemoglobin decreased, Impaired work ability, Intra-uterine
death, Metabolic function test normal, Migraine, Pelvic pain,
Photophobia, Red blood cell count increased, Sunburn, Uterine
dilation and curettage, 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 |
|
|
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: |
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, 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: |
368448 |
Vaccination Date: |
2009-10-19 |
|
Age: |
21.0 |
Onset Date: |
2009-10-20 Days later: 1 |
|
Gender: |
Female |
Submitted: |
2009-11-17 |
|
State: |
Massachusetts |
Entered: |
2009-11-18 |
|
|
Life Threatening Illness? No |
|
Died? No |
|
Disability? No |
|
Recovered? No |
|
ER or Doctor Visit? No |
|
Hospitalized? No |
|
Current Illness: No |
|
Diagnostic Lab Data: 11/19/09:
Primary care records received for date of service 11/11/09. |
|
Previous Vaccinations: |
|
Other Medications: |
|
Preexisting Conditions: No.
11/19/09: Primary care records received for date of service
11/11/09. |
|
CDC 'Split Type': |
|
|
Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
|
FLU(H1N1) |
SANOFI PASTEUR |
UP003AA |
0 |
IM |
UN |
|
|
Administered by: Private Purchased
by: Other |
|
Symptoms: Chills, Cough, Drug
exposure during pregnancy, Hypertension, Nuclear magnetic
resonance imaging brain abnormal, Pain, Pre-eclampsia, Premature
labour, Proteinuria, Pyrexia, Scan brain |
|
Write-up: Fever, chills, aches,
cough within 12 hours of vaccine admin. Pregnant 30 weeks.
Treated with TAMIFLU 75 bid x 5 (she did take for 48 hrs). Had
persistent cough. Developed severe preeclampsia. BP 220/120 at
34 weeks + Proteinuria. Individual 4# 2 ounce boy born healthy.
11/19/09: Primary care records received for date of service
11/11/09. Dx: Severe preeclampsia. Assessment: Admitted with
severe preeclampsia. Given magnesium sulfate. Induced the next
day but had C-Section for fetal distress. Baby boy born at 4
lbs. 2 ozs. Apgars 3 and 8 after initial positive pressure
ventilation. Discharged on labetolol. Labs and diagnostics: CT/MRI-some
swelling of the brain. PMH: Allergy to PCN |
|
|
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!!! |
|
Previous Vaccinations: |
|
Other Medications: |
|
Preexisting Conditions: none |
|
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,
Cervix haemorrhage uterine, Drug exposure during pregnancy,
Muscle spasms, Ultrasound scan |
|
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. |
|
|
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 |
|
Previous Vaccinations: |
|
Other Medications: prenatal vitamins
only |
|
Preexisting Conditions: pregnant |
|
CDC 'Split Type': |
|
|
Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
|
FLU(H1N1) |
UNKNOWN MANUFACTURER |
|
0 |
IJ |
AR |
|
|
Administered by: Unknown Purchased
by: Unknown |
|
Symptoms: Abortion spontaneous, Drug
exposure during pregnancy, Immediate post-injection reaction,
Uterine dilation and curettage |
|
Write-up: Miscarriage immediately
following vaccine, requiring D & C surgery. No fetal heart rate
and fetal failure to progress. |
|
|
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 |
|
CDC 'Split Type': |
|
|
Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
|
FLU(H1N1) |
SANOFI PASTEUR |
UP002AA |
|
IM |
|
|
|
Administered by: Unknown Purchased
by: Unknown |
|
Symptoms: Abdominal pain, Asthma,
Drug exposure during pregnancy, Induced labour, Intra-uterine
death, Myalgia, 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. |
|
|
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. |
|
|
VAERS 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. |
|
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, Drug
exposure during pregnancy, Muscle spasms, Ultrasound scan vagina
abnormal, Uterine contractions during pregnancy, Uterine
haemorrhage, Vaginal haemorrhage |
|
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. |
|
|
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: |
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. |
|
|
|
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. |
|
|
|
|
|
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. |
|
|
|
|
|
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. |
|
|
|
|
|
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. |
|
|
|
|
|
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. |
|
|
|
|
|
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) |
|
|
|
|
|
|
|
end
of pasted information
|
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
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
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:
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
|
|
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1
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.
|
|