Sex: M
Vaccine: HEP, MMR
Symptoms: Neurological symptom, Speech disorder
Clinical narrative: This case was reported by a lawyer and described the occurrence of nerve injury in a male subject of unspecified age who was vaccinated with hepatitis B vaccine, live attenuated oral poliomyelitis vaccine, hepatitis B vaccine, live attenuated MMR, strain not specified, and diphtheria and tetanus toxoids and acellular pertussis vaccine for prophylaxis. Previous and/or concurrent vaccination included diphtheria and tetanus toxoids and acellular pertussis vaccine (manufacturer unspecified, unknown) given on 6/6/89, 8/11/89, and 8/29/90; live MMR (strain not specified) (manufacturer unspecified, unknown) given on 5/16/90and 8/10/94; live attenuated oral poliomyelitis vaccine (unknown) given on 5/16/90 and 8/10/94. On an unspecified date the subject received unspecified dose of hepatitis B vaccine. According to the legal complaint, at an unspecified time after vaccination with hepatitis B vaccine, the subject experienced serious and permanent neurological injuries which were attributed to toxic mercury exposure. The following information was received via medical records: On 3/7/94, he was evaluated for speech and language because he doesn't like to talk at all. At the time of this visit, the subject was five years old. At this time, he communicates primarily in single words described as babbling and mumbling. The speech-language pathologist considered that the subject had significantly delayed speech, language, social pragmatic skills. ON 5/8/96, he was evaluated by developmental pediatrician. At this visit, it was reported that he was crawling at 9 month, walking alone at 18 months, and cruising just before one year. After starting kindergarten, he was diagnosed with autism. Following this visit, he was diagnosed with moderate mental retardation and autism. On 3/30/00 the subject was evaluated by a physician for autism. It was noted that the principal concern was tantrums and other behavioral issues. It was reported that the 25 year old mother of the subject had an uncomplicated pregnancy that ended in a normal spontaneous vaginal delivery. She denied any illnesses, exposure to toxins, use of drugs, alcohol, or tobacco. The infant was discharged home. No significant medical problems in the months that followed. It was reported that he may have walked at 18 months. He never developed speech beyond a few simple words. In the past, he was treated with Ritalin with little effect. The family history was reported as unremarkable and no history of neurologic disease including mental retardation of the maternal family. The mother did not know about the paternal side of the family but stated that he was a slow learner. The major findings included frontal bossing and a questionable hypertelorism. He does not speak spontaneously, but when he is spoken to, he is echolalic. Cranial nerves appear intact. No obvious motor deficits. The subject was diagnosed with pervasive developmental disorder, although it is not severe in all regards. Etiology was undetermined. MRI of the brain was suggested as well as laboratory test and genetic test. On 4/4/00, he was seen by a physician who stated that his examination confirmed slight dysmorphisms and favor diagnosis of PPD NOS.