Sex: M
Vaccine: HEP
Symptoms: Audiogram normal, Autism, Autism spectrum disorder, Developmental delay, Disturbance in social behaviour
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 Engerix B, Dtap, Hib, OPV, MMR II, Varivax for prophylaxis. The subject was vaccinated with Engerix-B on 09 July 1996, with hepatitis B vaccine (Manufacturer unspecified) on 13 August 1996, and with Engerix-B on 29 March 1997. According to information provided by the reporting attorney, on 29 March 1997 the subject received the third dose of Engerix B (unknown). In February 2000, the subject received the "first diagnosis" of pervasive developmental disorder. Other alleged injuries included autism and neurodevelopmental disorder. According to the legal complaint, the subject experienced" serious and permanent neurological injuries" which was "alleged to be caused by Thimerosal." The events of autism and pervasive developmental disorder were assessed as medically serious by manufacturer. Follow-up information was received on 30 March 2007 via medical records. The subject was born to a 44-year-old mother at 38 weeks gestation. Post delivery, the subject experienced skipped/irregular heartbeats and poor feedings. In 1999, he was enrolled in a special education program that included occupational and speech therapy. He underwent a developmental evaluation on 28 July 1999, which assessed his overall development to be "very significantly delayed". A pediatrician's notes dated 20 December 1999 indicated that the subject experienced progressed in speech, language, and motor skills. A neurological evaluation was performed on 25 February 2000 for encephalopathy. According to the subject's mother, concerns began at approximately one year of age, at which time the subject experienced episodes of stiffening "with excitement", without alteration of consciousness. He also experienced delayed walking at 16 months old, and delayed talking until "well after" two and a half years old. In addition to stiffening with excitement, stereotypes included staring, running back and forth, poor eye contact, and other problems with social interactions. The neurologist's impression was that the subject "fits within the spectrum of pervasive developmental disorder (PDD)". with problems including developmental dysphasia that was "disproportionate for his academic abilities which may also be significantly limited". The neurologist advised the mother that the disorder was unrelated to her pregnancy, labor and delivery, or subsequent home environment. On 28 November 2000, concerns including "still not talking, doses not follow directions", and a diagnosis of autism was noted. In February 2001, psychological testing revealed that the subject performed "significantly below his age expectation his intellectual abilities". According to the Childhood Autism Rating Scale, he fell into the severely autistic range. A subsequent developmental education profile in March 2001 indicated "some gains in the area of special education, although the gains have not been rapid, they have been steady". At the time of evaluation, he scored an age-equivalency of 23 months in the area of receptive language, and at 22 months in the area of fine motor skills.