Received Mar 19, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| HEP | HEP B (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | — | — |
| HEPA | HEP A (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | — | — |
| MMR | MEASLES + MUMPS + RUBELLA (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | — | — |
Autistic; This spontaneous report was received from a Physician via vendor and refers to a Child patient of unknown gender. The patient's medical history was not reported. The patient's concurrent conditions were not reported. Concomitant therapies were not reported. The reporter testified the patient was developing perfectly normal until receiving the below school-age vaccines. On an unknown date, the patient was vaccinated with Hepatitis A Vaccine, Inactivated (reported as Hepatitis vaccine), (lot # and expiration date were not reported). On an unknown date, the patient was vaccinated with Hepatitis B Vaccine (Recombinant) (reported as Hepatitis vaccine), (lot # and expiration date were not reported). On an unknown date, the patient was vaccinated with Measles, Mumps, and Rubella (Wistar RA 27-3) Virus Vaccine, Live (lot # and expiration date were not reported) with sterile diluent (Hollister-Stier STERILE DILUENT). All were for prophylaxis. On an unknown date, the patient became autistic. At the reporting time, the outcome of Autistic was unknown. The action taken was not applicable. The causal relationship was not provided. Upon internal review, the event of Autistic was determined to be medically significant. This is one of the several reports from the same reporter. Lot# is being requested and will be submitted if received.
Sterile Diluent