Sex: M
Vaccine: HEP
Symptoms: Cough, Dental caries, Disturbance in attention, Drug toxicity, Dyspnoea
Clinical narrative: This case was reported by a lawyer and described the occurrence of mercury poisoning in a female pt who received hep B vaccine injection for prophylaxis. This report was received as the result of litigation. Immunization records were provided. A physician or other health care professional has not verified this report. On 8/9/97, the pt received the initial dose of hep B vaccine. The pt received immunization with hep B pediatric dose on 10/4/97 and 3/10/98; IPV on 10/14/97 and 1/15/98; OPV on 9/14/98; MMR II on 9/14/98; HIB vaccine on 10/14/97, 1/15/98, 3/10/98 and 9/14/98; DTaP on 10/14/97, 1/15/98, 3/10/98 and 9/14/98; and chicken pox vaccine on 12/6/98. A PPD skin test was performed on 10/22/98 and yielded negative findings. According to the attorney, the pt "through thimerosal-containing vaccinations administered in the first two years of life, was poisoned by the cumulative doses of mercury in thimerosal. As a result of the mercury in the thimerosal-containing vaccinations, the pt now suffers and in the future will continue to suffer from to toxic neurological effects of mercury poisoning" (OMIC). Follow up on 05/19/04 states: "Following the reported onset of metal poisoning, the pt experienced heart murmur, dyspnea, wheezing, multiple upper respiratory infections, viral bronchiolitis, acute febrile illness, right subconjunctival hematoma, forehead contusion, cough, fever, "rampant dental caries" requiring restorative outpt surgeries. These were not reported as adverse events due to vaccine administration, but were found during the course of review of the pt's medical records. Therefore, they are not listed as adverse events." Follow Up: On 15JUNE1998, the child was assessed an no developmental problems were noted. The child was described as anxioius. On 02NOV1999, the child was evaluated as possibly having develoopmental delays. He was unable to combine 2 words and unable to follow two part directions. He was noted to constantly hum and make unintelligible jabber. He exhibited problems with concentration/ distraction and had wandering eye movement. Tiptoe walking was observed. The patient was referred to a specialty clinic. On 10January2000, the patient's mother mentioned that she felt the child might have a hearing problem because the child acted like he could not hear. He was still humming constantly. On 08MAY2000, assessment by a devlopmental specialist revealed taht the child had met the infant motor milestones at the appropriate age. He had delays in his speech and language milestones. He had not exhibited regression or los of skills. He had sleep problems described as banging his head against the mattress. The patient had tactile problems manifest by head and neck definsivenes, resistnace to grooming activities. His auditory problems included hypersensitivity, neglect and inconsistent hearing responses. He was noted to have hand flapping, rocking, toe walking and climbing body movements. His self injurious behaviors included teth grinding and head banging. He had emotional lability, excessive responses, lack of fear response and tantrums. He exhibited excesive shyness/clinginess, aloofness, and preference for solitary play. Evaluators assessed the child as having autism. On 01 September 2000, the child was assessed and noted to have an inability to sit still, and to have loud outbursts He continued to make constant noises. He still experienced sleep problems described as constantly waking up and being restless. He also exhibited hyperactivity, tantrums, and was not eating well. The metnal health assessment revealed feelings of anger, sadness, fear, sulleness and anxiety. His behavior was overactive, listless, impulsive and self abusive. His social interaction was described as withdrawn, clinging excessively. He uses nonverbal communication rather than verbal. He was referred to a specialist to discuss concerns with mercury a/o lead. On 26September2001, the child returned for assessment.  He was combative during the examination and moved constantly. He toe walked but will walk heel to toe at times. On 09April2002, the child was described as having mental retardation. IQ score was not provided.  Follow up on 07/28/04 states: "The child was evaluated on 03/25/03 when he was 5 years, seven months of age. Using the Preschool Language Scale-3, his auditory comprehension score was 50, equivalent to a 21 month old, his expressive communication score was 50, equivalent to a 23 month old, his total language score was 50, equivalent to a 22 month old. Despite being "severely delayed" in his language, he was described as showing significant improvement in language and speech skills. An evaluation on 04/01/03 showed that the child still had a significant delay in his fine motor skills. "Progress was noted, but delays were also identified in areas of sensory integration and self-care." As of April 2004, the child was still undergoing therapy to increase fine motor skills. Following the reported onset of metal poisoning, the pt experienced heart murmur, dyspnea, wheezing, multiple upper respiratory infections included pharyngitis, bronchitis, viral bronchiolitis, acute febrile illness, right subconjunctival hematoma, forehead contusion, cough, fever, "rampant dental caries" requiring restorative outpt surgeries. These were not reported as adverse events due to vaccine administration, but were found during the course of review of the pt's medical records. Therefore, they are not listed as adverse events."