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Found 475569 cases in entire database

Case Details (Sorted by Vaccination Date)

This is page 1346 out of 4756

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VAERS ID:113353 (history)  Vaccinated:1998-07-15
Age:1.2  Onset:1998-07-25, Days after vaccination: 10
Gender:Female  Submitted:1998-07-31, Days after onset: 6
Location:Virginia  Entered:1998-08-11, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt sibling devel fever, spots @ 15mo w/MMR;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Chest X-ray, Blood test, Urinalysis
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER 3 L
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 0 L
Administered by: Private     Purchased by: Unknown
Symptoms: Febrile convulsion, Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 7/15/98 and on 7/25/98 pt exp febrile seizure, temp at E.R. of 104.4, and red spots on trunk.

VAERS ID:113363 (history)  Vaccinated:1998-07-15
Age:1.2  Onset:1998-07-16, Days after vaccination: 1
Gender:Female  Submitted:1998-08-05, Days after onset: 20
Location:California  Entered:1998-08-11, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: PCN-sensitivity rash
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS361503A2IMLL
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER0506H0SCRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: On 7/15/98 pt recv vax; on 7/16/98 pt exp swelling of left thigh, also hives.

VAERS ID:113610 (history)  Vaccinated:1998-07-15
Age:0.2  Onset:1998-07-15, Days after vaccination: 0
Gender:Male  Submitted:1998-07-24, Days after onset: 9
Location:Michigan  Entered:1998-08-24, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': MI98082
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09296980IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS360753A0IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.M093810SCLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt devel hives approx 1 1/2hr p/vax rash on face, trunk, legs;denies new food, soap, detergent & no med;given DPH & rash resolved in 1 1/2 days;pt not ill, no fever, did not see MD;inj area all reddened but nothing unusual

VAERS ID:114348 (history)  Vaccinated:1998-07-15
Age:4.9  Onset:1998-07-17, Days after vaccination: 2
Gender:Female  Submitted:1998-07-17, Days after onset: 0
Location:North Carolina  Entered:1998-09-24, Days after submission: 69
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6B8106B6IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: rt deltoid inj granuloma;

VAERS ID:123748 (history)  Vaccinated:1998-07-15
Age:1.4  Onset:1998-07-22, Days after vaccination: 7
Gender:Female  Submitted:1999-05-14, Days after onset: 296
Location:Pennsylvania  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications:
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98071903
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0310H0SCRL
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: p/ pt recv vax approx 7 days later pt exp 2 varicella-like lesions at inject site on rt leg.

VAERS ID:123840 (history)  Vaccinated:1998-07-15
Age:44.9  Onset:1998-07-30, Days after vaccination: 15
Gender:Female  Submitted:1999-05-14, Days after onset: 288
Location:Arizona  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: serum varicella zoster, 7/3, 9/1, 10/27/98, norm
CDC 'Split Type': WAES98081636
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1669E0 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: approx 15 days p/ vax pt exp rash @ inject site w/3 small vesicles.

VAERS ID:112802 (history)  Vaccinated:1998-07-16
Age:0.4  Onset:1998-07-16, Days after vaccination: 0
Gender:Male  Submitted:1998-07-17, Days after onset: 1
Location:California  Entered:1998-07-21, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM852A21 RL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0485H1 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0789D1PO 
Administered by: Other     Purchased by: Public
Symptoms: Screaming
SMQs:, Hostility/aggression (broad)
Write-up: prolonged crying nearly 24hr p/vax;

VAERS ID:112807 (history)  Vaccinated:1998-07-16
Age:4.9  Onset:1998-07-16, Days after vaccination: 0
Gender:Male  Submitted:1998-07-16, Days after onset: 0
Location:South Carolina  Entered:1998-07-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: pulmonary atremia VSD Gortex Patch Grass, weeds, tree, molds
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4558383IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.06251SCLA
Administered by: Private     Purchased by: Private
Symptoms: Asthma, Oedema peripheral, Pallor, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: pt recv vax 10AM & return @ 10:30 pale, itching, sl wheezing, swelling feet & hands;epi, prelone, DPH & claritin given;

VAERS ID:112947 (history)  Vaccinated:1998-07-16
Age:3.3  Onset:1998-07-16, Days after vaccination: 0
Gender:Female  Submitted:1998-07-20, Days after onset: 4
Location:Alabama  Entered:1998-07-30, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: lytes, x-rays, UA, per parent all test fine;
CDC 'Split Type': AL987
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4490983IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1004D0SCLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0772L2PO 
Administered by: Public     Purchased by: Public
Symptoms: Febrile convulsion
SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt to ER noc of 16JUL98 w/T102 w/sx;tx in ER;

VAERS ID:113002 (history)  Vaccinated:1998-07-16
Age:1.3  Onset:1998-07-18, Days after vaccination: 2
Gender:Female  Submitted:1998-07-27, Days after onset: 9
Location:North Dakota  Entered:1998-08-03, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: teething, mild temp
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': ND9819
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09367903 LL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES09367903 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0109E  RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0786L2PO 
Administered by: Public     Purchased by: Public
Symptoms: Malaise, Pyrexia, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 18JUL98 started running temp, not feeling well;22JUL had rash on cheeks that subsided p/2 days;devel gen non-raised red rash;felt hot all over x 4 days;did not check temp;saw MD on 26JUL98;stated it was from shots;

VAERS ID:113289 (history)  Vaccinated:1998-07-16
Age:1.0  Onset:1998-07-25, Days after vaccination: 9
Gender:Male  Submitted:1998-07-28, Days after onset: 3
Location:New York  Entered:1998-08-07, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: urticarial-papular rash of chest, back & extremities 12 days p/vax;

VAERS ID:113305 (history)  Vaccinated:1998-07-16
Age:1.3  Onset:1998-07-28, Days after vaccination: 12
Gender:Male  Submitted:1998-08-04, Days after onset: 7
Location:Louisiana  Entered:1998-08-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: eczema
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164803  
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS0425H3  
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1582E0  
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0778A2  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0315H0  
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: hives started 12 days p/vax given 16JUL98;to MD office 4AUG98 w/urticaria since 28JUL98;

VAERS ID:113389 (history)  Vaccinated:1998-07-16
Age:29.3  Onset:1998-07-16, Days after vaccination: 0
Gender:Female  Submitted:1998-07-21, Days after onset: 5
Location:California  Entered:1998-08-12, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': CA980074
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1599E0SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7K919380IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: erythema, tenderness, pain to rt deltoid area s/p Td vax on 16JUL98 measuring 10-11cm x 7-8cm examined by MD;placed on ATB;

VAERS ID:113552 (history)  Vaccinated:1998-07-16
Age:21.1  Onset:1998-07-16, Days after vaccination: 0
Gender:Female  Submitted:1998-08-13, Days after onset: 28
Location:Arizona  Entered:1998-08-21, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications: birth control pills
Current Illness: NONE
Preexisting Conditions: unk
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Agitation, Asthenia, Personality disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: pt recv vax 16JUL98 730PM & felt weak p/lunch;had bouts of uncontrollable laughing & crying in class;no other complaints;feels different;prescribed atarax & valiumprimetime clinic;

VAERS ID:113595 (history)  Vaccinated:1998-07-16
Age:24.2  Onset:1998-07-23, Days after vaccination: 7
Gender:Male  Submitted:1998-08-12, Days after onset: 20
Location:Arizona  Entered:1998-08-24, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0170 LA
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: pt recv vax 16JUL98 AM & seen @ clinic 23JUL98 645PM for c/o dizziness & vomiting x3 episodes;exam by MD concluded nl results;no tx given;

VAERS ID:113606 (history)  Vaccinated:1998-07-16
Age:0.3  Onset:0000-00-00
Gender:Female  Submitted:1998-08-19
Location:New York  Entered:1998-08-24, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4477881 LL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURERN02921 RL
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: mom c/o persistent nodule @ site of IPV rt thigh 2 to 3mm;pt had larger erythematous nodule @ the site;

VAERS ID:113986 (history)  Vaccinated:1998-07-16
Age:0.6  Onset:1998-07-17, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:1998-09-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': TX98116
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09258802IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1191E1IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS0496H2IMRL
Administered by: Private     Purchased by: Public
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: mom c/o knot in child lower rt thigh;advised mom to keep cool compresses on legs 3-4times a day;HIB vax given in lower rt thigh;

VAERS ID:113990 (history)  Vaccinated:1998-07-16
Age:11.6  Onset:1998-07-18, Days after vaccination: 2
Gender:Male  Submitted:1998-08-03, Days after onset: 16
Location:Texas  Entered:1998-09-08, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': TX98123
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1595E1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: 2 days p/vax pt rt breast became edematous;afeb;no other s/s;

VAERS ID:114790 (history)  Vaccinated:1998-07-16
Age:1.2  Onset:1998-07-16, Days after vaccination: 0
Gender:Male  Submitted:1998-07-27, Days after onset: 11
Location:Oregon  Entered:1998-10-08, Days after submission: 73
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Urine, spinal tap, X-rays, blood work, EEG-all normal results
CDC 'Split Type': OR9819
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER09164703IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2405A22IMRL
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER0216H3IMRL
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER028640SCLA
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER0789B2PO 
Administered by: Public     Purchased by: Public
Symptoms: Apnoea, Dyspnoea, Oedema genital, Rash, Stupor
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 7/16/98;1hr later pt exp respiratory difficulty;pt recv CPR;pt to E.R.&released.Later in day pt exp respiratory difficulty &dec of consciousness;pt to hosp for 6 days;fever (105);full body rash&edema of genitals;tx=antibiotic

VAERS ID:115219 (history)  Vaccinated:1998-07-16
Age:2.0  Onset:0000-00-00
Gender:Unknown  Submitted:1998-09-17
Location:West Virginia  Entered:1998-10-23, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WV9816
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4411013IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0889D0SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1076D0SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up:

VAERS ID:116029 (history)  Vaccinated:1998-07-16
Age:24.0  Onset:1998-07-23, Days after vaccination: 7
Gender:Male  Submitted:1998-10-26, Days after onset: 95
Location:Florida  Entered:1998-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD skin test 23JUN98
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 19980211951
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2588A20IMRA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Malaise
SMQs:, Guillain-Barre syndrome (broad)
Write-up: pt recv vax 16JUL98 & 23JUL98 devel fatigue & malaise;pt was seen in ER on 31JUL98 & advised to see a neurologist;

VAERS ID:116864 (history)  Vaccinated:1998-07-16
Age:62.0  Onset:1998-07-31, Days after vaccination: 15
Gender:Female  Submitted:1998-11-23, Days after onset: 115
Location:Washington  Entered:1998-11-25, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98080830
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: pt recv vax 16JUL98 & 31JUL98 pt devel joint pain in legs;3AUG98 pt exp numbness, tingling & pain in fingers;5AUG98 MD felt that adverse exp were r/t therapy w/rubella vax;

VAERS ID:117357 (history)  Vaccinated:1998-07-16
Age:39.6  Onset:1998-07-17, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Michigan  Entered:1998-12-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': MI98136
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER 3 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site oedema, Injection site pain, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: swelling w/some tenderness @ inj site;swelling in lt axilla, approx 20mm tender to touch;

VAERS ID:120205 (history)  Vaccinated:1998-07-16
Age:39.0  Onset:1998-07-17, Days after vaccination: 1
Gender:Female  Submitted:1998-09-09, Days after onset: 54
Location:New York  Entered:1999-03-03, Days after submission: 175
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Penicillin
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 898253110A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER   RA
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49780851IMLA
Administered by: Private     Purchased by: Other
Symptoms: Abscess, Injection site hypersensitivity, Injection site oedema, Injection site pain, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 7/16/98; on 7/17/98 pt exp nausea, vomiting, pain/ red/ swollen vax site (2 wk); dx=sterile abscess

VAERS ID:123749 (history)  Vaccinated:1998-07-16
Age:1.0  Onset:1998-07-30, Days after vaccination: 14
Gender:Female  Submitted:1999-05-14, Days after onset: 288
Location:Massachusetts  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: none
Current Illness:
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type': WAES98071905
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0663H0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: p/ pt recv vax 14 days later exp 4 papules described as early vesicles.

VAERS ID:124065 (history)  Vaccinated:1998-07-16
Age:1.3  Onset:1998-10-07, Days after vaccination: 83
Gender:Male  Submitted:1999-05-14, Days after onset: 219
Location:California  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness: atopic dermatitis
Preexisting Conditions: ventricular septal defect
Diagnostic Lab Data:
CDC 'Split Type': WAES98100919
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Other
Symptoms: Herpes zoster, Infection
SMQs:
Write-up: p/vax pt exp shingles which were localized to the lt anterior thigh;pt sought unspecified medical attention;

VAERS ID:124500 (history)  Vaccinated:1998-07-16
Age:8.7  Onset:1999-02-03, Days after vaccination: 202
Gender:Male  Submitted:1999-05-14, Days after onset: 99
Location:Virginia  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt sibling devel skin lesion 9yr p/varivax dose 1;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES99020315
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt was seen by MD & dx w/post vax varicella w/over 200 vesicles;

VAERS ID:122523 (history)  Vaccinated:1998-07-16
Age:  Onset:1998-07-23, Days after vaccination: 7
Gender:Unknown  Submitted:1999-05-21, Days after onset: 302
Location:Colorado  Entered:1999-05-24, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: nonspecific allergy;PCN allergy
Diagnostic Lab Data:
CDC 'Split Type': WAES98080023
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypersensitivity, Injection site hypersensitivity, Injection site mass, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & exp erythema & induration @ the inj site;pt also devel a facial, cervical, thoracic & lt brachial rash (diffuse);pt sought unspecified med attention;exp reported as allerg rxn;

VAERS ID:126450 (history)  Vaccinated:1998-07-16
Age:  Onset:1998-07-17, Days after vaccination: 1
Gender:Female  Submitted:1999-07-20, Days after onset: 368
Location:New Hampshire  Entered:1999-07-29, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: nk
CDC 'Split Type': NH9913
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM911A20IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM979A21IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS450253A0IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P00400SCRL
Administered by: Private     Purchased by: Public
Symptoms: Convulsion, Pyrexia, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: p/recv vax pt seizure described by mom. not observed by the care providers. taken to ER no reported up temp

VAERS ID:150513 (history)  Vaccinated:1998-07-16
Age:  Onset:2000-03-09, Days after vaccination: 602
Gender:Male  Submitted:2000-03-09, Days after onset: 0
Location:Georga  Entered:2000-03-28, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Remission Lymphoblastic Lymphoma
Preexisting Conditions: Lymphoblastic Lymphoma
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0672H0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Developed chicken pox -03/09/00 after receiving vaccine 07/98

VAERS ID:150828 (history)  Vaccinated:1998-07-16
Age:4.0  Onset:1999-10-19, Days after vaccination: 460
Gender:Female  Submitted:2000-02-23, Days after onset: 127
Location:Texas  Entered:2000-04-06, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': 00TX017
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0058H0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Chickenpox infection with <50 lesions, no fever.

VAERS ID:182638 (history)  Vaccinated:1998-07-16
Age:4.5  Onset:1998-08-22, Days after vaccination: 37
Gender:Male  Submitted:2002-03-02, Days after onset: 1288
Location:Minnesota  Entered:2002-03-19, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE LABORATORIESM010RN3IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0219H0SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1572E0SC 
Administered by: Private     Purchased by: Private
Symptoms: Autism, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Developed high fever (103F) one month after MMR. MMR given 7/16/98. Developed fever and seen in urgent care without fever and ??. 8/22/98 - dx''d with autism several months later

VAERS ID:185991 (history)  Vaccinated:1998-07-16
Age:  Onset:0000-00-00
Gender:Male  Submitted:2002-06-03
Location:Minnesota  Entered:2002-06-04, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0369630A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS2633A22  
Administered by: Other     Purchased by: Other
Symptoms: Autism, Medication error
SMQs:
Write-up: Report A0369630A describes autism spectrum disorder in a male vaccinee of unspecified age who received hepatitis B vaccine recombinant. This report was received as part of litigation proceedings and has not been verified by a physician or other healthcare professional. Medical history, concurrent conditions were not provided. The vaccinee received vaccine on 26 SEP 1997, 14 NOV 1997, and 16 JUL 1997. The second injection of Engerix B was administered at a shorter than recommended interval from the first injection, and the third injection was administered at a longer than recommended interval from the second injection. The vaccinee''s attorney alleged that as a result of the exposure to thimerosal from the above vaccines, vaccinee sustained neurological injuries and a result of those injuries has been diagnosed with autism spectrum disorder. Time to onset from immunization, treatment, and outcome of the autism spectrum disorder were not specified. This report of autism spectrum disorder is considered medically serious.

VAERS ID:193377 (history)  Vaccinated:1998-07-16
Age:  Onset:0000-00-00
Gender:Male  Submitted:2002-11-14
Location:Unknown  Entered:2002-11-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ5222412NOV2002
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE LABORATORIESM010RN3  
Administered by: Other     Purchased by: Other
Symptoms: Autism, Drug toxicity, Nervous system disorder
SMQs:, Anticholinergic syndrome (broad), Drug abuse and dependence (broad)
Write-up: A legal complaint was received from an attorney alleging that a male child received series of Hib-Titer and Acel-Imune vaccines from 9/9/97 through 10/2/98. It is alleged that the child sustained neurological injuries upon using the company''s vaccine products containing Thimerosal. According to the complaint, as a result of these injuries, the child has been diagnosed with autism spectrum disorder. These events were considered medically important.

VAERS ID:193538 (history)  Vaccinated:1998-07-16
Age:0.2  Onset:2000-05-16, Days after vaccination: 670
Gender:Male  Submitted:2002-09-09, Days after onset: 846
Location:North Carolina  Entered:2002-11-19, Days after submission: 71
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Private     Purchased by: Private
Symptoms: Apraxia, Autism, Cognitive disorder, Neurodevelopmental disorder, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Developmental speech apraxia with sensory integration/fine motor control issues. Occupational therapy until 2/26/02. Speech therapy ongoing. Mild autism.

VAERS ID:209035 (history)  Vaccinated:1998-07-16
Age:2.1  Onset:2003-09-04, Days after vaccination: 1876
Gender:Male  Submitted:2003-09-04, Days after onset: 0
Location:Georga  Entered:2003-09-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0672H0 LA
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: (not given)

VAERS ID:232401 (history)  Vaccinated:1998-07-16
Age:1.0  Onset:2005-01-03, Days after vaccination: 2363
Gender:Unknown  Submitted:0000-00-00
Location:Georga  Entered:2005-01-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: ADD
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBPV: HIB POLYSACCHARIDE (HIBIMUNE)LEDERLE LABORATORIESM2401RL3IM 
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.02310SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.06480SCRA
Administered by: Private     Purchased by: Private
Symptoms: Blister, Skin ulcer
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: Multiple healing small crusts all over. A few drying vesicles at hairline a large on at the occipital area. Probably <50 lesions.

VAERS ID:239754 (history)  Vaccinated:1998-07-16
Age:1.1  Onset:2003-06-05, Days after vaccination: 1785
Gender:Female  Submitted:2005-06-06, Days after onset: 732
Location:West Virginia  Entered:2005-06-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0738H  RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.453844  LL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1574E   
Administered by: Private     Purchased by: Private
Symptoms: Rash papular
SMQs:
Write-up: Papular rash face, arms. Treated with Benadryl by mouth as needed.

VAERS ID:114025 (history)  Vaccinated:1998-07-16
Age:0.4  Onset:1998-07-16, Days after vaccination: 0
Gender:Male  Submitted:1998-09-08, Days after onset: 54
Location:Foreign  Entered:1998-09-10, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: JUL98 C-reactive protein .1;ESR -1 HR JUL98 3;ESR -2 HR 10;hematocrit 36.8;Hemoglobin 13.5;platelets 543000;WBC count 14.8;blood gas analysis w/o pathological findings;electrocardiography w/o pathological findings;electroencephalography
CDC 'Split Type': 19980220711
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Convulsion, Heart disease congenital, Infection, Laboratory test abnormal, Nausea, Pallor, Thrombocythaemia
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Congenital, familial and genetic disorders (narrow), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt recv vax 16JUL98 & some minutes later devel nausea & paleness & was therefore hosp for monitoring & to exclude convuls;pt showed no flush, no dyspnea, no tachycardia but middle to high frequent systolic murmur;

VAERS ID:112818 (history)  Vaccinated:1998-07-17
Age:34.2  Onset:1998-07-18, Days after vaccination: 1
Gender:Female  Submitted:1998-07-20, Days after onset: 2
Location:Maryland  Entered:1998-07-22, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0650H1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Rash, Skin nodule, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 7-8cm of erythema w/induration;warm to touch;tx amoxicillin;

VAERS ID:112917 (history)  Vaccinated:1998-07-17
Age:  Onset:1998-07-17, Days after vaccination: 0
Gender:Female  Submitted:1998-07-23, Days after onset: 6
Location:California  Entered:1998-07-24, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: small rash on trunk
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM0840A23 LL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2507A2  RL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES7D918813 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1597E0 RL
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Pyrexia, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: pt recv vax 17JUL98 in the afternoon;by that noc had fever 104 & irritability & fussines;no other sx;had nl exam x/flushed cheeks;sx resolved p/2 days;

VAERS ID:112873 (history)  Vaccinated:1998-07-17
Age:3.0  Onset:1998-07-19, Days after vaccination: 2
Gender:Male  Submitted:1998-07-20, Days after onset: 1
Location:Alabama  Entered:1998-07-27, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NA
Diagnostic Lab Data: CBC/diff-WBC 15.0 k/uh;M10-1.9;RR2;12.7%M-gran 9.2;R3 61.4%G
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1321E0SCRL
Administered by: Private     Purchased by: Public
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: urticarial rash;

VAERS ID:112910 (history)  Vaccinated:1998-07-17
Age:8.1  Onset:1998-07-17, Days after vaccination: 0
Gender:Male  Submitted:1998-07-21, Days after onset: 4
Location:Florida  Entered:1998-07-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dyspnoea, Oedema, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: exposure to hep B vax-pt mom holding child who was moving a lot & the needle & syringe separated & some vaccine went into mom''s eye;mom was ok when left clinic p/being checked by MD;that noc 9PM mom to ER w/diff breathing & rash & swelling;

VAERS ID:112952 (history)  Vaccinated:1998-07-17
Age:5.0  Onset:1998-07-17, Days after vaccination: 0
Gender:Male  Submitted:1998-07-23, Days after onset: 6
Location:Hawaii  Entered:1998-07-30, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9807
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164704IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0104E1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0789F3PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & MD noticed lt arm DTAP site red, swollen (about 2 1/2 x 2 1/2") soft, no pain, no fever & child appeared well;mom reported that sweling started noc of vax;APAP given;

VAERS ID:112953 (history)  Vaccinated:1998-07-17
Age:4.9  Onset:1998-07-18, Days after vaccination: 1
Gender:Female  Submitted:1998-07-22, Days after onset: 4
Location:Hawaii  Entered:1998-07-30, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': HI9806
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164704IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0104E1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0786F3PO 
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: mom reported 18JUL98 lt arm swollen (from shoulder down to 1/2 of upper arm), red, painful hot & hard to touch & child unable to lift arm;allergy med given twice & swelling stopped & subsided;

VAERS ID:113014 (history)  Vaccinated:1998-07-17
Age:18.7  Onset:1998-07-17, Days after vaccination: 0
Gender:Female  Submitted:1998-07-17, Days after onset: 0
Location:North Carolina  Entered:1998-08-03, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra;APAP sinus
Current Illness: sinus infect
Preexisting Conditions: DPH
Diagnostic Lab Data:
CDC 'Split Type': NC98028
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2425A21IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Dyspepsia, Vasodilatation
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Vestibular disorders (broad)
Write-up: immed p/vax pt c/o getting hot, light-headed, sick on stomach;pt assisted to side lying position feet elevated;BP 120/70, P90;

VAERS ID:113216 (history)  Vaccinated:1998-07-17
Age:45.6  Onset:1998-07-20, Days after vaccination: 3
Gender:Female  Submitted:1998-07-31, Days after onset: 11
Location:Virginia  Entered:1998-08-04, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Melatonin;Begen
Current Illness: NA
Preexisting Conditions: plastic surgery 2 1/2mo before;
Diagnostic Lab Data: blood & urine reported nl to ER;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES0925900 SC 
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: 20JUL98 h/a, knees ached;21JUL98 h/a, aching all over;went to ER early 22JUL;22JUL98 some relief from percodan;23JUL98 improved still some aches;28JUL98 much improved;

VAERS ID:113320 (history)  Vaccinated:1998-07-17
Age:40.8  Onset:1998-07-18, Days after vaccination: 1
Gender:Female  Submitted:1998-07-22, Days after onset: 4
Location:Georga  Entered:1998-08-10, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: started to having some congestion the day of vax
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': GA98058
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2602C60IMRA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 17JUL98 & had general malaise 18JUL98 1 day post vax;fever 19JUL98, 20JUL98 & 21JUL98 highest T102.5 off & on relieved some w/APAP & Ibuprofen;22JUL98 MD noted pink blotchy rash on tops & inside of both arms & inside thigh;

VAERS ID:113323 (history)  Vaccinated:1998-07-17
Age:16.4  Onset:1998-07-18, Days after vaccination: 1
Gender:Male  Submitted:1998-07-20, Days after onset: 2
Location:Georga  Entered:1998-08-10, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': GA98054
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4528410IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site mass, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: lt deltoid sl swollen w/hard area about size of a egg;no redness to area;no warmth to arm;

VAERS ID:113324 (history)  Vaccinated:1998-07-17
Age:16.9  Onset:1998-07-18, Days after vaccination: 1
Gender:Male  Submitted:1998-07-20, Days after onset: 2
Location:Georga  Entered:1998-08-10, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: EEG allergy
Diagnostic Lab Data:
CDC 'Split Type': GA98055
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2425A20IMLA
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Headache, Influenza, Myalgia, Pain, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: approx 24hr post vax pt c/o h/a, body aches (feet hurt), 30-36hr p/vax p/n/v & diarrhea;chills & fever cont today 20JUL98 w/body aches & diarrhea;flu like sx;

VAERS ID:113327 (history)  Vaccinated:1998-07-17
Age:5.3  Onset:1998-07-17, Days after vaccination: 0
Gender:Female  Submitted:1998-07-17, Days after onset: 0
Location:Arkansas  Entered:1998-08-10, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: PCN
Diagnostic Lab Data:
CDC 'Split Type': AR9844
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4538464 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0025H2 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0772B123PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1565E1 RA
Administered by: Public     Purchased by: Public
Symptoms: Hyperhidrosis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt became diaphoretic-nauseated then vomited;applied cold rag;laid on exam table;

VAERS ID:113420 (history)  Vaccinated:1998-07-17
Age:17.0  Onset:1998-07-18, Days after vaccination: 1
Gender:Female  Submitted:1998-07-24, Days after onset: 6
Location:Washington  Entered:1998-08-13, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WA981480
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0878E0IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM525A21IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: nausea x5 days-vomiting x1 on 4th day of nausea sx-no other symptoms;

VAERS ID:113545 (history)  Vaccinated:1998-07-17
Age:1.1  Onset:1998-07-27, Days after vaccination: 10
Gender:Male  Submitted:1998-08-17, Days after onset: 21
Location:Tennessee  Entered:1998-08-21, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0309H0IMLL
Administered by: Private     Purchased by: Public
Symptoms: Infection, Rash, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt devel a rash over chest & back which was raised & red 10 days p/vax;rash spread over the next 2 days when saw;had greater than 100 papulovesicular lesions over trunk, face & extremities;dx varicella made;

VAERS ID:113928 (history)  Vaccinated:1998-07-17
Age:16.2  Onset:1998-07-17, Days after vaccination: 0
Gender:Female  Submitted:1998-07-17, Days after onset: 0
Location:Texas  Entered:1998-09-08, Days after submission: 53
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt family states pt is afraid of shots & gets lightheaded;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': TX98126
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1554E0IMLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7F91700 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 5min post vax pt was standing by doorway while cousin was being immunized;a thump was heard & pt was seen lying on back;ammonia inhalent strips were used & pt responded quickly to verbal stimuli & aware of surrounding;referred to ER;

VAERS ID:113976 (history)  Vaccinated:1998-07-17
Age:43.9  Onset:1998-07-18, Days after vaccination: 1
Gender:Female  Submitted:1998-08-19, Days after onset: 32
Location:Nevada  Entered:1998-09-08, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': NV98014
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER6K81366 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: noc of vax pt exp shooting pain in arm x 2-3 days;painful movement of arm x 1wk;18JUl-19JUL pt had fever 102 et h/a et nausea;

VAERS ID:114871 (history)  Vaccinated:1998-07-17
Age:8.8  Onset:1998-07-31, Days after vaccination: 14
Gender:Male  Submitted:1998-09-30, Days after onset: 61
Location:Arkansas  Entered:1998-10-13, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE-father has lupus;takes multiple meds including pred;
Diagnostic Lab Data: NA
CDC 'Split Type': AR9855A
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0648H0 RA
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: 2wk p/vax broke out in approx 5 lesions;

VAERS ID:115411 (history)  Vaccinated:1998-07-17
Age:67.6  Onset:1998-07-23, Days after vaccination: 6
Gender:Female  Submitted:1998-10-15, Days after onset: 84
Location:Texas  Entered:1998-10-28, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NOEn
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0906E IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7K91938 IMLA
Administered by: Other     Purchased by: Public
Symptoms: Oedema peripheral, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax 17JUL98 & thursday 23JUL98 lt arm swollen & red;pt was given a steroid inj on 24ht for rxn to tetanus by MD;improvement noted by end of day;

VAERS ID:116016 (history)  Vaccinated:1998-07-17
Age:0.9  Onset:1998-07-18, Days after vaccination: 1
Gender:Male  Submitted:1998-10-26, Days after onset: 100
Location:Georga  Entered:1998-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 19980201941
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2633A22IMRL
Administered by: Private     Purchased by: Private
Symptoms: Asthma, Lung disorder, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 17JUL98 & 18JUL98 pt devel hives, wheezing & congestion of the rt lung;seen in ER;parents were instructed to give DPH @ home;

VAERS ID:120698 (history)  Vaccinated:1998-07-17
Age:30.2  Onset:1998-07-18, Days after vaccination: 1
Gender:Male  Submitted:1998-09-01, Days after onset: 45
Location:Wisconsin  Entered:1999-03-29, Days after submission: 209
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type': U199800428
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0929590 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hyperhidrosis, Nuchal rigidity, Photophobia, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: pt recv vax 17JUL98 & 18JUL98 pt exp vigor (shaking) for 4-5hr, fever (unspecified),profuse sweating, neck stiffness & photophobia;18JUL98 3:00 pt devel uncontrollable shaking/rigors lasting 4-5hr, fever, profuse sweating, v, photophobia;

VAERS ID:123697 (history)  Vaccinated:1998-07-17
Age:1.0  Onset:1998-07-27, Days after vaccination: 10
Gender:Female  Submitted:1999-05-14, Days after onset: 291
Location:Maryland  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: none
Current Illness:
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type': WAES98071691
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0609H0SCLL
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Diarrhoea, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: p/ pt recv vax approx 10 days later pt exp diarrhea, fever & a general rash w/a chickenpox appearance.

VAERS ID:123751 (history)  Vaccinated:1998-07-17
Age:1.0  Onset:1998-07-27, Days after vaccination: 10
Gender:Female  Submitted:1999-05-14, Days after onset: 291
Location:Massachusetts  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98071916
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Public
Symptoms: Dermatitis bullous, Injection site hypersensitivity
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: p/ pt recv vax approx 10 days later pt exp 2 lesions @ inject site, on 7/28 the area became vesicular

VAERS ID:123753 (history)  Vaccinated:1998-07-17
Age:15.3  Onset:1998-07-17, Days after vaccination: 0
Gender:Female  Submitted:1999-05-14, Days after onset: 301
Location:Maine  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant pain
Other Medications: none
Current Illness:
Preexisting Conditions: abd pain
Diagnostic Lab Data:
CDC 'Split Type': WAES98080083
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1108E1SCRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Similar reaction on previous exposure to drug
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 6/4/98 pt recv 1st dose vax exp red, hot swollen area i@ inject site 2days. p/ 2nd dose approx 10min following pt exp stinging & swelling which p/ 1 day spread to a circle approx 3-4'''' in size on upper arm. treated w/ice, motrin, benadryl.

VAERS ID:124402 (history)  Vaccinated:1998-07-17
Age:5.2  Onset:1998-12-08, Days after vaccination: 144
Gender:Male  Submitted:1999-05-14, Days after onset: 156
Location:Texas  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES99010082
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1329E0SCRA
Administered by: Private     Purchased by: Public
Symptoms: Drug ineffective, Infection, Pyrexia, Rash maculo-papular
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: p/vax pt broke out w/chickenpox w/mult papules on trunk, face & limbs a low grade fever;pt sought unspecified medical attention;

VAERS ID:123903 (history)  Vaccinated:1998-07-17
Age:1.0  Onset:1999-06-09, Days after vaccination: 327
Gender:Male  Submitted:1999-06-09, Days after onset: 0
Location:Georga  Entered:1999-06-10, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: na
Preexisting Conditions: na
Diagnostic Lab Data: na
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0425H3IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1339E0SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0309H0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Infection, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 7/17/98, exposed to cousin who had varicella, presented in m.d. ofc w/rash under arms & spreading, dx: probable varicella

VAERS ID:125834 (history)  Vaccinated:1998-07-17
Age:77.0  Onset:1998-07-18, Days after vaccination: 1
Gender:Male  Submitted:1999-07-12, Days after onset: 359
Location:California  Entered:1999-07-14, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: hx of glaucoma, obesity, pancytopenia
Diagnostic Lab Data:
CDC 'Split Type': WAES98071705
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1278E1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Ecchymosis, Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: the day following pneumococcal vax pt devel inj site pain w/redness, warmth, & swelling of the arm from shoulder to elbow; MD attention sought; still had bruise arm at time of rpt; used ice pack; recovered approx 2weeks following onset;

VAERS ID:172264 (history)  Vaccinated:1998-07-17
Age:3.0  Onset:0000-00-00
Gender:Unknown  Submitted:2001-05-15
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Serum varicella zoster-4 fold rise in antibody titer
CDC 'Split Type': WAES01034333
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Infection, Laboratory test abnormal, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Information has been received from the CDC concerning a 3 year old child who on 7/17/98 was vaccinated with varicella virus vaccine live. Subsequently the patient experienced 50-250 lesions of chickenpox and a fever that lasted approximately 4 days. Unspecified medical attention was sought and it was noted that the child had four fold rise in the antibody titer. Additional patients (WAES01034332,01034334-0103435) also developed chickenpox following exposure to varicella virus vaccine live.

VAERS ID:217883 (history)  Vaccinated:1998-07-17
Age:6.0  Onset:2004-03-11, Days after vaccination: 2064
Gender:Female  Submitted:2004-03-12, Days after onset: 1
Location:Texas  Entered:2004-03-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.1683E0 LL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0314H0 RL
Administered by: Private     Purchased by: Private
Symptoms: Headache, Malaise, Pruritus, Rash papular, Rash pustular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Papules, pustules, malaise, headache, pruritis- started 3/11/04- papules appeared 3/12/04 treated with antihistamines

VAERS ID:238007 (history)  Vaccinated:1998-07-17
Age:1.0  Onset:2005-01-26, Days after vaccination: 2385
Gender:Female  Submitted:2005-05-19, Days after onset: 112
Location:California  Entered:2005-05-24, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Granulocytopenia; Asthma
Diagnostic Lab Data: hyperbaric oxygenation 02/05: incision and drainage of the right leg; 02/01/05, 02/02/05, 02/03/05, 02/07/05: incision and drainage of the right leg. 01/31/05 Body temp 104.
CDC 'Split Type': WAES0505USA01432
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Drug ineffective, Fasciitis, Hypoxia, Infection, Laboratory test abnormal, Necrosis, Pain in extremity, Pruritus, Pyrexia, Skin discolouration, Viral infection
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: Information has been received from a physician concerning a 7 year old female with a history of chronic benign Granulocytopenia at childhood and asthma, who on 17Jul1998 was vaccinated once with a 0.5ml SC dose of varicella virus vaccine live. There was no concomitant medication. It was indicated that the chronic benign granulocytopenia causes a low WBC count, and that the pt''s WBC count was still low. In Feb 2005 (also reported as 26Jan05), the pt developed a severe case of chickenpox. The pt was hospitalized for 2 weeks and had 4 surgeries. The pt had developed necrotizing fascitis and had a problem with her foot. It was reported that the pt recovered. Unspecified medical attention was sought. No product quality complaint was involved. Follow up information from a physician indicated that on 26Jan05 the pt developed chickenpox lesions. She presented to the physician''s office on 27Jan05 and was diagnosed with breakthrough. On 31Jan05, she presented to the hospital, febrile with chickenpox, and was not looking toxic. She was then noted to have a 104 degree fever, increased soreness in her right leg, foot pain, foot itching, and 2 gray spots on her toe. She was then transferred to another hospital on 01Feb05 for immediate incision and drainage of her right leg. She had an incision and drainage again on 02Feb05, 03Feb05 and 07Feb05. It was noted to be a deep tissue infection for the fascia with no necrosis. She was also noted to receive hyperbaric treatment during hospitalization. She was treated with antibiotics. The discharge diagnosis on 14Feb05 included: cellulitis with deep tissue necrosis, chickenpox, and chronic benign granulocytopenia at childhood. At the time of the call, the pt was noted to be recovered. Her sites were well healed and she was active. No product quality complaint was involved. Chickenpox and cellulitis with deep tissue necrosis were considered to be immediately life threatening and other important medical events. Additional information has been requested.

VAERS ID:238450 (history)  Vaccinated:1998-07-17
Age:8.0  Onset:2004-07-08, Days after vaccination: 2183
Gender:Female  Submitted:2005-05-16, Days after onset: 312
Location:Ohio  Entered:2005-05-27, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0408USA00470
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Rash, Viral infection
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 8 year old female who on 7/17/98 was vaccinated SC with a 0.5ml dose of varicella virus vaccine live. It was reported to the physician''s office on 7/8/04, that the patient developed breakthrough varicella. Unspecified medical attention was sought. It was noted that therapy with varicella virus vaccine live was discontinued. A product quality complaint was not involved. No further information was available. The nurse also reported that the patient''s female sibling had a similar experience after therapy with varicella virus vaccine live (WAES0407USA00746).

VAERS ID:263702 (history)  Vaccinated:1998-07-17
Age:0.0  Onset:1999-06-05, Days after vaccination: 323
Gender:Male  Submitted:2006-09-25, Days after onset: 2669
Location:Maryland  Entered:2006-09-29, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Hearing test responses were inconsistent and a mild loss was suspected.
CDC 'Split Type': WAES0609USA03204
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Autism, Bronchitis, Conjunctivitis, Cough, Gastroenteritis, Hypoacusis, Lymphocytosis, Mental retardation severity unspecified, Nasopharyngitis, Otitis media, Pharyngitis, Pyrexia, Rash, Rash papular, Rhinitis, Rhinitis allergic, Sinusitis, Somnolence, Tonsillitis, Upper respiratory tract infection
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (broad)
Write-up: Information has been received from medical records regarding a case in litigation concerning an 11-month-old male whose mother did not have prenatal care and who have depression. He was born at 40 weeks gestation without complications and has no known allergies. On 17-JUL-1998 he was vaccinated intramuscularly with a first 0.5 ml dose of hepatitis B virus vaccine rHBsAg (yeast) (manufacturer unknown). The second, third and fourth doses of hepatitis B virus vaccine rHBsAg (yeast) (manufacturer unknown). The second, third and fourth doses of hepatitis B vaccine rHBsAg (yeast) (manufacturer unknown) were given on 16-JUL-1999, 17-DEC-1999 and 21-JUL-2001. Secondary suspect vaccinations included the first, second and third doses of Hib conj vaccine (manufacturer unknown) given on 18-MAR-1999, 16-JUL-1999 and 17-DEC-1999. At 16 months of age he was seen by a physician at a well examination and a developmental evaluation revealed some slight developmental delay. Following the examination the patient received services to increase his developmental skills, services included occupational, physical and speech therapy. An audiological evaluation was attempted on 06-JUN-2000, the responses were inconsistent and a mild loss was suspected. On 26-JUL-2001, at 3 years of age, the patient was diagnosed with autism. Subsequently, vaccination with diphtheria toxoid (+) pertussis vaccine (unspecified) (+) tetanus toxoid dose number 4 was omitted due to suspicion of problems from the vaccine. On 06-SEP-2002, at 4 years of age he was diagnosed with pervasive developmental disorder (PDD). Following this diagnosis, vaccination with diphtheria toxoid (+) pertussis vaccine (unspecified) (+) tetanus toxoid and measles virus vaccine live (unspecified) were deferred. Following the diagnosis, he "was put on trial of NYSTATIN". It was reported that the patient was on "TMG. SuperNuthera (1/3 teaspoon 3 times a day), Taurine, NYSTATIN, cod liver oil, vitamin B12 injections" and was off of milk and wheat. It was also reported that the patient was on folic acid, 0.8 mg, 2 times a day. As of 30-NOV-2002, the patient underwent a third round of chelation, and as of 30-OCT-2003, the patient was on folic acid, 0.8 mg, 2 times a day. As of 30-NOV-2002, the patient without improvement. Additional treatment included methylcobamide, risperidone (RISPERDAL), donepezil hydrochloride (ARICEPT) and aripiprazole (ABILIFY). The patient''s vaccination history included: poliovirus vaccine inactivated (unspecified) given on 18-MAR-1999, 16-JUL-1999, and 18-JUL-2000; diphtheria toxoid (+) pertussis vaccine (unspecified) (tetanus toxoid given on 11-MAR-1999, 16-JUL-1999 and 17-DEC-1999; measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (manufacturer unknown) given on 17-DEC-1999; varicella virus vaccine live given on 27-MAR-2000; and pneumococcal 4 6B 9V 14 18C 19F 23F conj vaccine (CRM197) (PREVNAR) given on 26-JUL-2001. Information received on 12-SEP-2006 contained the following adverse experiences: otitis media (05-JUN-1999), fever (23-SEP-1999), papular rash (07-JAN-2000), a little adverse reaction to NYSTATIN (2000), nasophyringitis (September 1999), sinusitis (23-OCT-2000), viral upper respiratory infection (29-NOV-2000), conjunctivitis (05-MAY-2001), cough (05-MAY-2001), pharyngitis (02-OCT-2001), bronchitis (02-OCT-2001), rash (03-JAN-2002), gastroenteritis (04-MAR-2002), rhinitis (19-DEC-2002) rhinitis allergic (11-DEC-2003) and sleeping excessively with risperidone (RISPERDAL) (05?-MAR-2004). Upon internal review autism and pervasive developmental disorder were determined to be other important medical events. No further information is available. All medical records will be provided upon request. (OMIC)

VAERS ID:263902 (history)  Vaccinated:1998-07-17
Age:0.0  Onset:0000-00-00
Gender:Male  Submitted:2006-10-03
Location:Unknown  Entered:2006-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Questionable history of maternal depression. Uneventful pregnancy. The subject was born at 40 weeks gestation to an 18 year old mother and weighed 7 pounds 13 ounces at birth. In 6/99, the subject was treated for otitis media with amoxicillin, Suprax, Irelphin, and Motrin. Adverse reaction to Nystatin. Chronic middle ear infections since 5 months of age. At 13 months of age, experi
Diagnostic Lab Data: On 12/2/04 aluminum 103.6 (high); arsenic normal; chromium 0.69 (high); copper 7.49 (low); hair mercury 0.62 (high); iron 119.1 (high); lead 1.09 normal; manganese 1.41 (high); Selenium .94 (low); Zinc 143.9 normal. 12/30/99; Amino acids no
CDC 'Split Type': A0621540A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 0  
Administered by: Private     Purchased by: Other
Symptoms: Autism, Balance disorder, Hypertonia, Hypoacusis, Hypokinesia, Laboratory test abnormal, Mental retardation severity unspecified, Speech disorder, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 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 (Engerix B) 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 neurological damage which was attributed to cumulative mercury toxicity. The following information was received via medical records, The subject was vaccinated with hep B vaccine (Engerix B) on 7/17/98. The subject was vaccinated with hepatitis B vaccine (manufacturer unspecified) on 7/16/1999m 12/17/1999, and 7/21/2000. The subject was vaccinated with DTap on 12/17/99. The subject was also vaccinated with Polio vaccine, MMR, Hib and varicella for prophylaxis. On 12/30/1999, the subject was evaluated for concerns of saying only da da and not walking, It was noted that he had been saying more at 12 months of age. On 10/26/1999 a gross functional assessment showed increased muscle tone and rigidity, increased tremor of the upper extremities, inability to perform thumb opposition, and reduced proximal stability, postural control and balance. Upon evaluation on 11/2/99, the subject had expressive communication skills at the 7 months range, and receptive and expressive language skills at the 6 to 9 month range. By April 200 he had been diagnosed with developmental delay. Physical exam was grossly unremarkable, and impression included pervasive developmental disorder. Behavior included hand flapping, and treatment included occupational therapy. Audiology exam on 6/6/00 were suggestive of mild hearing loss, however, findings were considered to be inconclusive. ON 10/19/00, the subject was evaluated for suspected autism, and achieved an age equivalent score of 11 months, indicating a 25 percent delay in development. Clinical impressions included moderate to severe receptive and expressive language del

VAERS ID:209858 (history)  Vaccinated:1998-07-17
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2003-09-29
Location:Foreign  Entered:2003-10-01, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data: Visual acuity reduced from 0.8 to 0.3 (right eye) and from 0.5 to 0.2 (left eye).
CDC 'Split Type': D0041953A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Other     Purchased by: Other
Symptoms: Uveitis, Visual acuity reduced
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Ocular infections (broad)
Write-up: A physician reported the occurrence of uveitis in a 42 year old female who was vaccinated with hepatitis A-B vaccine for prophylaxis. The subject had received two previous vaccinations with hepatitis A-B vaccine (12/16/97 and 1/16/98) which were well tolerated. On 7/17/98 the subject received the third dose of hepatitis A-B vaccine. Approximately six weeks post vaccination the subject developed uveitis. An unknown time later her visual acuity diminished on both sides. At the time of reporting it was decreased from 0.8 to 0.3 on the right side and from 0.5 to 0.2 on the left side.

VAERS ID:118702 (history)  Vaccinated:1998-07-18
Age:6.8  Onset:1998-12-30, Days after vaccination: 165
Gender:Female  Submitted:1999-01-05, Days after onset: 6
Location:New York  Entered:1999-02-09, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 18JUL98 & papular vesicular eruption note 30DEC98;

VAERS ID:157211 (history)  Vaccinated:1998-07-18
Age:2.0  Onset:1999-06-02, Days after vaccination: 319
Gender:Female  Submitted:2000-05-16, Days after onset: 349
Location:Ohio  Entered:2000-07-18, Days after submission: 63
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES99061274
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0284E0SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0558E0SC 
Administered by: Private     Purchased by: Private
Symptoms: Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Subsequent to receiving one dose of varicella virus vaccine live and one dose of MMR the pt broke out in a rash with small, raised lesions on her arms, legs and a few on her chest and buttocks. Pt was seen by her physician.

VAERS ID:206801 (history)  Vaccinated:1998-07-18
Age:  Onset:1998-07-18, Days after vaccination: 0
Gender:Male  Submitted:2003-07-29, Days after onset: 1837
Location:Foreign  Entered:2003-07-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valproate sodium; Buprenorphine; Morphine sulphate; Diazepam; Ergocalciferol; Fluoride salt; Zidovudine
Current Illness: UNK
Preexisting Conditions: Cytomegalovirus; Epilepsy; Hepatitis C Virus; HIV infection; Toxicomania; Toxoplasmosis
Diagnostic Lab Data: At birth: brithweight 2500g, height 49cm, head circumference 34cm, Apgar score 5-6. Grade III anemia and increased mean cell volume from birth to one month. At one month, increased lactates (1.8N). At 27 months: ASAT=1.5 times normal and li
CDC 'Split Type': B0068900B
Vaccination
Manufacturer
Lot
Dose
Route
Site
BCG: BCG (NO BRAND NAME)UNKNOWN MANUFACTURER    
DTPIHI: DT+IPV+HIB+HEPB (NO BRAND NAME)UNKNOWN MANUFACTURER    
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Anaemia macrocytic, Arthralgia, Aspartate aminotransferase increased, Blood lactic acid increased, Dyspnoea, Fracture, Neurodevelopmental disorder, Oedema, Pain, Strabismus, Thermal burn
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Haematopoietic erythropenia (narrow), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Osteoporosis/osteopenia (broad), Ocular motility disorders (narrow), Arthritis (broad)
Write-up: A regulatory authority reported that a male neonate was exposed to antiretroviral treatment in utero during pregnancy when the mother received zidovudine for the treatment of HIV infection. The mother was hospitalized at 7 months gestation due to ill health and received treatment with sodium valporate, byprenorphine, morphine sulphate and diazepam. The neonate was delivered by caesarean section at 38 weeks gestation, weighing 2500g with an Apgar score of 5-6. The neonate received treatment with zidovudine 5mg four times daily and was found to be HIV negative. Concurrent medication included ergocalciferol and fluoride (dates unspecified). Vaccination against pentacoq, Bacille Calmette Guerin (BCG) and hepatitis B was also received. At birth, the neonate was admitted to the intensive care unit due to difficulty breathing and moderate weaning syndrome. A grade III macrocytic anemia and increased mean red cell volume were also noted at birth and had improved by one month. At this time, the infant developed an increased lactate level. At two months old, the infant was hospitalized due to burns on the hands and buttocks. At six months old, the infant developed pain in the knees and thighs. At seven months old, the infant developed left calf oedema, opisthotonus tendency and a suspected fracture but was able to walk alone by the age of 24 months. At approximately 27 months the child developed an increased ASAT (1.5 times normal) and an increased lipase (1.13 times normal). It was also reported that psychomotor function was subnormal for his age and behavior-developmental age was estimated at 2 years and 10 months, but actual age was three years nine months. At age four years the child has strabimus that requires glasses. At the time of reporting the outcome was unknown. This case refers to the neonate and case B0069054 refers to the mother. In the last follow up information received on 7/9/03, it was reported that the events were resolved without sequelae when the child was followed up at five years of age. This case wa

VAERS ID:122524 (history)  Vaccinated:1998-07-19
Age:1.3  Onset:1998-07-29, Days after vaccination: 10
Gender:Female  Submitted:1999-05-21, Days after onset: 296
Location:New Jersey  Entered:1999-05-24, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98080058
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug ineffective, Infection, Pyrexia
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: pt recv vax & pt devel a fever;8/1/98 devel measles;

VAERS ID:112855 (history)  Vaccinated:1998-07-20
Age:1.0  Onset:1998-07-20, Days after vaccination: 0
Gender:Female  Submitted:1998-07-21, Days after onset: 1
Location:California  Entered:1998-07-27, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0510H0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & w/in 1/2hr pt got rash all over;brought to office & in less than 45min had hives all over w/o face swelling w/o resp problems;pt given DPH & Epi & in 15min rash resolved;

VAERS ID:112905 (history)  Vaccinated:1998-07-20
Age:1.1  Onset:1998-07-20, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Oklahoma  Entered:1998-07-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURERN003213IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0638E0IMLL
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Rash
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: SOB, rash on face & elbow;

VAERS ID:112906 (history)  Vaccinated:1998-07-20
Age:11.1  Onset:1998-07-23, Days after vaccination: 3
Gender:Female  Submitted:1998-07-24, Days after onset: 1
Location:Georga  Entered:1998-07-28, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to septra, vantin
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4537210IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 3 days post vax 4-5" area of red ten cents to twenty five centss size spots;no blisters;no itch;no streaking;area warm to touch;rx prelone & atarax for sx;

VAERS ID:112921 (history)  Vaccinated:1998-07-20
Age:2.5  Onset:1998-07-20, Days after vaccination: 0
Gender:Unknown  Submitted:1998-07-22, Days after onset: 2
Location:Oklahoma  Entered:1998-07-28, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Public     Purchased by: Unknown
Symptoms: Pyrexia, Stomatitis
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: pt recv vax 20JUL98 & w/in hr has fever & ulcerations in mouth;dx herpangina;

VAERS ID:112946 (history)  Vaccinated:1998-07-20
Age:13.4  Onset:1998-07-20, Days after vaccination: 0
Gender:Male  Submitted:1998-07-23, Days after onset: 3
Location:South Carolina  Entered:1998-07-30, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2368A20IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0229H1IMLA
Administered by: Private     Purchased by: Public
Symptoms: Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad)
Write-up: pt recv vax & states would like to ly down then pt started uncontrolable jerking to inc & dec bilat extremity lasting 5sec;no loss of conscious noted;pt alert & oriented x 3;

VAERS ID:113011 (history)  Vaccinated:1998-07-20
Age:5.7  Onset:1998-07-22, Days after vaccination: 2
Gender:Female  Submitted:1998-07-29, Days after onset: 7
Location:Texas  Entered:1998-08-03, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recv TBST by Connaught lot# 248411 given lt foreamr dose 1 20JUL98;
Current Illness: rhinitis
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES7J816762IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0623E1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES787A42PO 
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv vax 20JUL98 pt returned to office on 22JUL98 w/large red sl warm area around site of inj;pt was advised to use DPH q 4hr & call if anymore problems;

VAERS ID:113208 (history)  Vaccinated:1998-07-20
Age:1.0  Onset:1998-07-21, Days after vaccination: 1
Gender:Female  Submitted:1998-07-29, Days after onset: 8
Location:Ohio  Entered:1998-08-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Motrin PRN
Current Illness: blocked lt tear duct
Preexisting Conditions: blocked lt tear duct since birth;
Diagnostic Lab Data: CBC
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0505H0SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0651H0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: day p/vax slept almost 24hr straight;no other sx;mom took child to Er noc p/vax d/t sleeping;negative findings-next day was fine;

VAERS ID:113334 (history)  Vaccinated:1998-07-20
Age:3.1  Onset:1998-07-24, Days after vaccination: 4
Gender:Male  Submitted:1998-07-28, Days after onset: 4
Location:Wisconsin  Entered:1998-08-10, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: nONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1424E0SCLL
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: fever of 103 axillary 24JUL98 w/vomiting, reduced appetite;APAP given & temp remained @ 102 orally for 24hr;

VAERS ID:113354 (history)  Vaccinated:1998-07-20
Age:12.6  Onset:1998-07-20, Days after vaccination: 0
Gender:Male  Submitted:1998-07-21, Days after onset: 1
Location:Minnesota  Entered:1998-08-11, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Attention Deficit Disorder-no medications
Diagnostic Lab Data: UNK
CDC 'Split Type': MN98013
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1679E1SCLA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES452842 IMRL
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Gaze palsy, Hypotonia, Muscle twitching
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Pt recv vax on 7/20/98; immed exp upper torso seizure activity.Pt head went back, eyes rolled back, and upper body, arms, head, and hands jerked.Ambulance came and pt had recovered.F/U w/ Dr advised seizure w/u if exp again.

VAERS ID:113359 (history)  Vaccinated:1998-07-20
Age:72.2  Onset:1998-07-20, Days after vaccination: 0
Gender:Female  Submitted:1998-07-30, Days after onset: 10
Location:Minnesota  Entered:1998-08-11, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: Hypertension, lupus erythematosis, osteoarthritis, hypothyroidism, hemorrhoids, healing skin abrasion
Diagnostic Lab Data: UNK
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4543790 LA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4546781 RA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: On 7/20/98 pt recv vax and exp local erythema at injection site for 3 weeks.

VAERS ID:113382 (history)  Vaccinated:1998-07-20
Age:3.7  Onset:1998-07-20, Days after vaccination: 0
Gender:Female  Submitted:1998-07-20, Days after onset: 0
Location:California  Entered:1998-08-12, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': CA980073
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0684E SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1580E13 SCLA
Administered by: Public     Purchased by: Public
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: On 7/20/98 pt recv vax and 2 hours later exp generalized seizure. Pt hosp one day.

VAERS ID:113518 (history)  Vaccinated:1998-07-20
Age:37.6  Onset:1998-07-20, Days after vaccination: 0
Gender:Female  Submitted:1998-07-22, Days after onset: 2
Location:Ohio  Entered:1998-08-19, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PTU for hyperthyroid, Topril, Covera has been on
Current Illness: NONE
Preexisting Conditions: hyperthyroid, HTN
Diagnostic Lab Data: NONE
CDC 'Split Type': OH98054
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1681E0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Hypoaesthesia, Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 2 days ago in AM & by evening inj site sl raised, reddened-50mm x 50mm, warm to touch;no c/o itching;states skin is very sensitive;advised to apply cool compressor, ice pack & call if ineffective & can take APAP;

VAERS ID:113608 (history)  Vaccinated:1998-07-20
Age:12.4  Onset:1998-07-20, Days after vaccination: 0
Gender:Female  Submitted:1998-07-20, Days after onset: 0
Location:Arkansas  Entered:1998-08-24, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': AR9847
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2596A20IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0025H1SCRA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4514635IMLA
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Hyperhidrosis, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt recv vax & became pale, skin clammy & then lost consciousness;pt appeared to have seizure x 10sec;pt regained consciousness w/o further difficulty;

VAERS ID:113871 (history)  Vaccinated:1998-07-20
Age:19.8  Onset:1998-07-28, Days after vaccination: 8
Gender:Female  Submitted:1998-08-07, Days after onset: 10
Location:Arkansas  Entered:1998-09-03, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: OCP;Zoloft
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC drawn 30JUL98; WBC 3.4L;
CDC 'Split Type': AR9848
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0769E1SCRA
Administered by: Other     Purchased by: Unknown
Symptoms: Epistaxis, Headache, Leukopenia, Neck pain, Pyrexia
SMQs:, Haematopoietic leukopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: T101 & h/a 28JUL98 x 2 days;took Ibuprofen;sore neck 29JUL98 x 2 days;took Ibuprofen;sl nose bleed 30JUL98;pt saw MD;CBC drawn-no tx recommended;

VAERS ID:113908 (history)  Vaccinated:1998-07-20
Age:5.7  Onset:1998-07-22, Days after vaccination: 2
Gender:Female  Submitted:1998-08-03, Days after onset: 12
Location:Maryland  Entered:1998-09-04, Days after submission: 32
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rash, w/white head, hard nodule, spider bite w/dose DTAP/OPV/MMR/HEP B va
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': MD98009
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1038E1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Acne, Dermatitis bullous, Infection, Rash, Similar reaction on previous exposure to drug, Skin nodule
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt rec vax 20JUL98 & 22JUL pt had red dots on back, legs & buttocks;devel white head, turned brown dark becamea blue raised nodule formed opened & dained clear;MD notified;tx w/ATB for spiders bites;

VAERS ID:114309 (history)  Vaccinated:1998-07-20
Age:5.3  Onset:0000-00-00
Gender:Male  Submitted:1998-09-18
Location:Indiana  Entered:1998-09-23, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp fever w/DTP
Other Medications: NONE
Current Illness:
Preexisting Conditions: lt club foot-allergy PCN
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES450497  L
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Oedema peripheral, Pyrexia, Skin disorder, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: leg @ site turned red, raised, hot, feverish (entire leg from groin to just ablve feet) w/scarring post event, temp, leg swelled, fever;

VAERS ID:114931 (history)  Vaccinated:1998-07-20
Age:0.5  Onset:1998-07-29, Days after vaccination: 9
Gender:Female  Submitted:1998-10-08, Days after onset: 71
Location:Ohio  Entered:1998-10-13, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications:
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98100016
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER 2  
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0076H0  
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER 2  
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia, Hypotonia, Laboratory test abnormal, Myasthenic syndrome, Myelitis, Otitis media, Pyrexia, Rash, Stupor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 2AUG98 & 4AUG98 exp transverse myelitis & was hosp for 6 days;pt recovered & was discharged;

VAERS ID:116037 (history)  Vaccinated:1998-07-20
Age:17.0  Onset:1998-07-20, Days after vaccination: 0
Gender:Female  Submitted:1998-10-26, Days after onset: 98
Location:New York  Entered:1998-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: advil
Current Illness:
Preexisting Conditions: migraine h/a, mitral valve prolapse
Diagnostic Lab Data:
CDC 'Split Type': 19980215811
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Hyperreflexia, Migraine
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: pt recv vax 20JUL98 & 8hr later 20JUL98 pt devel a migraine like h/a w/weakness & hyperreflexia in legs;

VAERS ID:116635 (history)  Vaccinated:1998-07-20
Age:1.3  Onset:1998-07-22, Days after vaccination: 2
Gender:Male  Submitted:1998-07-27, Days after onset: 5
Location:Kentucky  Entered:1998-11-23, Days after submission: 119
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': KY980027
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER0229H0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous, Injection site hypersensitivity
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: blister like rash from inj site on lt arm, upper arm,side of neck & onto face;

VAERS ID:119261 (history)  Vaccinated:1998-07-20
Age:40.5  Onset:1998-07-21, Days after vaccination: 1
Gender:Female  Submitted:1999-02-17, Days after onset: 211
Location:Indiana  Entered:1999-02-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recv hep b vax 1JUN98 by SKB lot# 2565A4;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE attending PT
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2565A41IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax20JUL98 had has soreness in lt arm;lt deltoid has a 1 1/2cm knot;ROM is full;denied any problems w/1st hep b inj given 1JUN98;

VAERS ID:120193 (history)  Vaccinated:1998-07-20
Age:29.0  Onset:1998-07-20, Days after vaccination: 0
Gender:Male  Submitted:1998-08-13, Days after onset: 24
Location:South Carolina  Entered:1999-03-03, Days after submission: 202
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Facial laceration
Preexisting Conditions: UIGH
Diagnostic Lab Data:
CDC 'Split Type': 898208119A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49782881  
Administered by: Other     Purchased by: Other
Symptoms: Chills, Dizziness, Dyspnoea, Hypersensitivity, Hypotension, Pallor, Pyrexia, Vasodilatation
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 7/20/98; 2 hr post vax pt exp shortness of breath, fever (101F), chills, pallor, dizzy, pink color of vax arm; dx=allergy to tetanus vax; tx=Benadryl, fluids, Tylenol, rest

VAERS ID:120340 (history)  Vaccinated:1998-07-20
Age:0.7  Onset:0000-00-00
Gender:Female  Submitted:1998-07-20
Location:Michigan  Entered:1999-03-15, Days after submission: 238
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': MI99031
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4504961IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0788A0PO 
Administered by: Public     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: no rxn reported by mom @ 5PM time of telephone call informing mom OPV needs to be repeated at age 12mo of age;report submitted because OPV administered too soon;

VAERS ID:123942 (history)  Vaccinated:1998-07-20
Age:6.9  Onset:1998-09-01, Days after vaccination: 43
Gender:Male  Submitted:1999-05-14, Days after onset: 255
Location:Ohio  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98090320
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0431B   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt exp chickenpox w/approx 10 lesions over entire body;pt had approx 60 lesions some fluid filled & all red & raised;pt seen by MD;

VAERS ID:156713 (history)  Vaccinated:1998-07-20
Age:1.0  Onset:1999-03-12, Days after vaccination: 235
Gender:Male  Submitted:2000-05-16, Days after onset: 430
Location:Arizona  Entered:2000-07-14, Days after submission: 59
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES99032538
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1575E0SC 
Administered by: Other     Purchased by: Other
Symptoms: Blister, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad)
Write-up: 7-8- months post vax the pt experienced blisters on his body and a fever. No further information is available.

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