Age: 37.0
Sex: F
Vaccine: TDAP
Symptoms: Anaemia, Blood glucose increased, Drug exposure during pregnancy, Haematocrit decreased, Haemoglobin decreased
Clinical narrative: A 37-year-old female patient who was known to be pregnant at the time, had received a 0.5 mL intramuscular left deltoid injection of ADACEL (Lot# C2994BA) on 21 August 2008. The patient is a refugee and was receiving the ADACEL as mandatory vaccination. The patient had no past medical history; however, it was "unknown" what the patient's past obstetrical history involves. It was also "unknown" if the patient was taking any other medications at the time of the ADACEL vaccination. It was not reported whether the patient had completed any prenatal testing's at the time of this report. The date of the patient's last menstrual period was not reported, but her expected date of delivery was reported as 04 January 2009. Primary care physician and OBGYN physician contact information was reported as "unknown." The patient has not experienced any adverse events since receiving the ADACEL vaccination on 21 August 2008. Follow-up information was received from an health care professional on 13 November 2008. The patient arrived from a foreign country in February 2008. The date of the patient's last menstrual period was 01 April 2008 and, as previously reported, expected delivery date is 04 January 2009. The patient's past obstetric history included six previous pregnancies that resulted in six live births with no congenital anomalies. Concomitant medications included prenatal vitamins. An ultrasound performed on 04 September 2008 was normal. Current pregnancy history includes ongoing tobacco use (10 per day) and anemia. The patient had admitted to occasional alcohol use, but the reporter was uncertain if the patient meant before pregnancy or during pregnancy. It was indicated that the patient had not experienced any adverse events since receiving ADACEL however, clarification of onset date of anemia will be requested (on 29 September 2008, hemoglobin value was 10.0 and hematocrit was 29.0). Follow up information was received from an health care professional on 05 January 2009. The patient was diagnosed with anemia on 29 September 2008. The patient was treated with prenatal vitamins. The patient had a PPD test performed on 21 August 2008 (manufacturer, lot number, route and site was not provided). The result was negative. On 16 December 2008 the patient delivered vaginally without any pregnancy or labor and delivery complications. The patient had a baby boy at 37.2 weeks gestation. The baby was 5 lbs. 15 oz. with an APGAR score of 7 at one minute and 8 at five minutes. The patient did not have any congenital anomalies. Follow-up report received on 27 February 2009 from a physician. The patient's Hgb level was 12.2 on 15 December 2008 which was prior to delivery. Per the reporter, the patient recovered from the anemia; however a recovery date was not provided. The case was reviewed by the reporter and he had no additional information to add at this time. No further information is expected. Follow-up information received on 27 March 2009 from a physician. The reporter thought that the patient may have moved out of state. No additional information was available at the time of reporting. Documents held by sender: None.