Age: 1.25
Sex: M
Vaccine: DTAP, OPV
Symptoms: Social avoidant behaviour, Speech disorder
Clinical narrative: This case was reported by a lawyer and described the occurrence of neurological injury in a male subject who was vaccinated with hepatitis B vaccine and or unidentified hepatitis B vaccine for prophylaxis. 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 was attributed to toxic mercury exposure. The following information was received via medical records: The subject was vaccinated with diphtheria and tetanus toxoids and acellular pertussis vaccine on 1/28/88. The subject was also vaccinated with live attenuated oral poliomyelitis vaccine, MMR (strain not specified) and Haemophilus influenza type B vaccine for prophylaxis. The subject began to babble at 10 to 11 months of age, but at 2 years old was no longer saying distinct words and indicated needs by crying or pulling caregiver's hand. Motor milestones were normal, with delays in language and social development. He exhibited poor eye contact and preferred solitary play. Between 5/10/92 and 5/14/92, the subject was admitted to the hospital and underwent a comprehensive medical evaluation. He was diagnosed with pervasive developmental disorder and probable moderate to severe mental retardation. Speech/language evaluation suggested severe speech and language delays. The subject was described as hyperactive and difficult to manage. His receptive communication skills were in the nine month old age range. Between May 1992 and July 1992, he was medically evacuated from overseas due to concerns including severe asthma and developmental delays. He was subsequently diagnosed with autism. The subject received concurrent therapy with prednisone and theophylline for asthma. On 3/19/01, the subject was diagnosed with a seizure disorder. In July 2001, diagnoses included a psychomotor retardation and attention deficit hyperactivity disorder. On 7/26/01, the subject underwent a neurodevelopmental evaluation for concerns including autism and significant neurobehavioral disturbances. At the time of examination, behavioral problems included violent behavior, aggression, hitting, destructiveness, and unpredictability. He continued to converse in single words with verbal reasoning described as rudimentary at best. Past medications included Ritalin, Risperdal, Adderall, Prozac, Mellaril, Zyprexa, and Trileptal; however it was noted that he experienced seizures on the major tranquilizers which were discontinued. At the time of examination, medications included Ativan, Depakote, and Clonidine. On 9/25/01, the subject's problem list included 1) severe pervasive development disorder (autistic) since age of 2 years old and getting worse, 2) severe mental retardation and attention deficit hyperactivity disorder, 3) reactive airway disease, 4) seizures. Medications at that time included Risperdal and Depakote. On that date the subject received his initial vaccination with hepatitis B vaccine, and received his second Engerix B vaccination on 11/21/01.