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Found 471248 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:113576 (history)  Vaccinated:1998-08-18
Age:1.0  Onset:1998-08-20, Days after vaccination: 2
Gender:Female  Submitted:1998-08-21, Days after onset: 1
Location:Texas  Entered:1998-08-24, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
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
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4502952IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0003H2IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1229E0SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0786H2PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt woke up thursday 8AM w/rt leg swollen, reddened, & warm to touch;swelling noted from top of leg to below knee, including knee;motrin given q 6hr for pain & swelling;

VAERS ID:113589 (history)  Vaccinated:1998-08-18
Age:12.1  Onset:1998-08-18, Days after vaccination: 0
Gender:Female  Submitted:1998-08-18, Days after onset: 0
Location:Texas  Entered:1998-08-24, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD by connaught lot# 248311 given 18AUG98;
Current Illness: BP 100/70
Preexisting Conditions: mom was told pt had enlarge heart as a baby;no other problems;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2719A2 IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESTD91842 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Condition aggravated, Myasthenic syndrome, Paraesthesia, Syncope, Vasodilatation
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: approx 1 1/2min p/v pt appear to loose consciousness about 10 seconds;VS remained stable;los of consciousness;BP 120/70, 96% 02 sat;c/o paresthesia lt arm immed regained feeling in arm;c/o numbness;weakness;

VAERS ID:113697 (history)  Vaccinated:1998-08-18
Age:49.8  Onset:1998-08-19, Days after vaccination: 1
Gender:Female  Submitted:1998-08-26, Days after onset: 7
Location:Iowa  Entered:1998-08-28, Days after submission: 2
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':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7J91913 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: site hard itchy-day later circle red closer to elbow than shoulder no pain - scratchy;

VAERS ID:113698 (history)  Vaccinated:1998-08-18
Age:64.3  Onset:1998-08-20, Days after vaccination: 2
Gender:Female  Submitted:1998-08-26, Days after onset: 6
Location:Iowa  Entered:1998-08-28, 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: Prem co
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': IA98021
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6J81325 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Oedema, Oedema peripheral, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: swollen, redness, swollen by elbow now went down-it was hot but it''s not like it was before;took OTC generic antihistamine;

VAERS ID:113699 (history)  Vaccinated:1998-08-18
Age:1.7  Onset:1998-08-22, Days after vaccination: 4
Gender:Male  Submitted:1998-08-24, Days after onset: 2
Location:Minnesota  Entered:1998-08-28, 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: NONE
Diagnostic Lab Data:
CDC 'Split Type': IA98022
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09161203IMLA
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES09150503IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0504H0SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4546822PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Infection, Otitis media
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: pt mom reports p/vax pt given APAP just in case;no fever;child felt fine;21AUG98 went to local fair ate, took bath when got home;mom reports water blister on chest, back, & few on arms;most nickel size;dx ear infect;?virus?vaccine;

VAERS ID:113705 (history)  Vaccinated:1998-08-18
Age:64.2  Onset:1998-08-19, Days after vaccination: 1
Gender:Unknown  Submitted:0000-00-00
Location:Iowa  Entered:1998-08-28
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
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6J81325 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypokinesia, Vasodilatation
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: c/o hot & swollen arm;couldn''t lift up arm;placed on ATB doesn''t know name of ATB;

VAERS ID:113880 (history)  Vaccinated:1998-08-18
Age:72.0  Onset:1998-08-18, Days after vaccination: 0
Gender:Female  Submitted:1998-08-20, Days after onset: 2
Location:Unknown  Entered:1998-09-04, Days after submission: 15
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: no allergies;hypertens pt had 2 severe nosebleeds that caused anemia & syncope 16AUG-18AUG;
Diagnostic Lab Data: 19AUG98 CBC w/elevated WBC 12.6;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES448169 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site oedema, Pyrexia, Vasodilatation
SMQs:, 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: pt noticed redness & swelling of lt arm @ site of inj that spread up arm +warmth, + fever & chills;pt required hosp for tx of cellulitis w/IV ATB;

VAERS ID:113955 (history)  Vaccinated:1998-08-18
Age:5.9  Onset:1998-08-19, Days after vaccination: 1
Gender:Male  Submitted:1998-08-20, Days after onset: 1
Location:Nevada  Entered:1998-09-08, Days after submission: 19
Life Threatening? No
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: unk
CDC 'Split Type': NV98015
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09258804IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0789F3PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site oedema, Oedema peripheral, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: MOC presented w/child @ clinic; lt arm swolen & red;the swelling & rednes was down the arm 1/2 wasy & almost to the shoulder;20AUG mom states pt arm is worse & reddness & swelling is to the shoulder & elbow;

VAERS ID:113972 (history)  Vaccinated:1998-08-18
Age:5.6  Onset:1998-08-18, Days after vaccination: 0
Gender:Female  Submitted:1998-08-18, Days after onset: 0
Location:Georga  Entered:1998-09-08, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rxn 22MAR93 @ 2mo w/DTP dose 1;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to pertussis vaccine dx @ age 2mo
Diagnostic Lab Data: NONE
CDC 'Split Type': GA98067
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4528393 LL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2425A22 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0029H1 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0789A3PO 
Administered by: Public     Purchased by: Public
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax yesterday & began to devel n/v last PM which has persisted today;

VAERS ID:114038 (history)  Vaccinated:1998-08-18
Age:4.2  Onset:1998-08-19, Days after vaccination: 1
Gender:Female  Submitted:1998-08-21, Days after onset: 2
Location:South Carolina  Entered:1998-09-09, Days after submission: 19
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: cleft palate
Diagnostic Lab Data: NONE
CDC 'Split Type': SC98050
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164904 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1315E1 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4508443PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 18AUG98 & began having swelling & redness in rt deltoid were DTAP given;mom brought child to hlth dept 20AUG98 for nurse to see arm;rt deltoid extremely swollen, hot & red;

VAERS ID:114042 (history)  Vaccinated:1998-08-18
Age:27.8  Onset:1998-08-30, Days after vaccination: 12
Gender:Female  Submitted:1998-09-04, Days after onset: 5
Location:California  Entered:1998-09-09, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Truphasil
Current Illness: acute gastroenteritis
Preexisting Conditions: NKAM/NONE
Diagnostic Lab Data: labs pending
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2599A42IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema nodosum, Pain, Skin nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: erythema nodosum, painful, indurated, nodules bilat lower extremities;

VAERS ID:114044 (history)  Vaccinated:1998-08-18
Age:61.3  Onset:1998-08-22, Days after vaccination: 4
Gender:Female  Submitted:1998-09-01, Days after onset: 10
Location:Michigan  Entered:1998-09-09, Days after submission: 8
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: has hx of allergies to many meds & other things;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7K91938  LA
Administered by: Public     Purchased by: Unknown
Symptoms: Cellulitis, Pruritus, Rash maculo-papular, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 5 days p/vax pt devel a red raised rash localized to the deltoid area;stated that on arms was fine until 5 days post vax;stated that it became very itchy & scratched it;went to MD who stated had a cellulitis;

VAERS ID:114082 (history)  Vaccinated:1998-08-18
Age:5.5  Onset:1998-08-25, Days after vaccination: 7
Gender:Male  Submitted:1998-08-26, Days after onset: 1
Location:Nebraska  Entered:1998-09-11, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE KNOWN
CDC 'Split Type': NE987
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4558391IMRA
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1221E1IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR I)MERCK & CO. INC.790H0SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES786C1PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Oedema peripheral, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 8/18/98; on 8/25/98 pt exp RA swelling the size of a quarter, was hard, hot&itchy. Pt tx=Neosporrin& bandaids.Pt left upper arm warm to touch,tender, swollen w/ red erythemous ring around upper arm.

VAERS ID:114142 (history)  Vaccinated:1998-08-18
Age:0.4  Onset:0000-00-00
Gender:Male  Submitted:1998-08-21
Location:Missouri  Entered:1998-09-14, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': MO98045
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4538431IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0724H1IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIESN02921SCRL
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Crying
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)
Write-up: high pitched cry-did not last for hr;no fever;had 2 days p/vax;

VAERS ID:114210 (history)  Vaccinated:1998-08-18
Age:6.7  Onset:1998-08-18, Days after vaccination: 0
Gender:Female  Submitted:1998-08-19, Days after onset: 1
Location:California  Entered:1998-09-18, Days after submission: 30
Life Threatening? No
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: UNK
CDC 'Split Type': CA980093
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2596A22IMLL
Administered by: Public     Purchased by: Public
Symptoms: Nausea, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 8/18/98; one hour later pt exp nausea; a body rash in 3 hrs; urticaria in 1 hr.

VAERS ID:114318 (history)  Vaccinated:1998-08-18
Age:21.0  Onset:1998-08-31, Days after vaccination: 13
Gender:Male  Submitted:1998-09-14, Days after onset: 14
Location:Hawaii  Entered:1998-09-23, Days after submission: 9
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: diagnosed clinically;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0459H  LA
Administered by: Private     Purchased by: Private
Symptoms: Infection
SMQs:
Write-up: had chickenpox 2wk p/1st vaccination;

VAERS ID:114409 (history)  Vaccinated:1998-08-18
Age:12.2  Onset:1998-08-27, Days after vaccination: 9
Gender:Female  Submitted:1998-09-03, Days after onset: 7
Location:Arkansas  Entered:1998-09-28, Days after submission: 25
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: executive profila MRI of brain negative;
CDC 'Split Type': AR9853
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0125H0IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0233H1SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7F916940IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: pt noted 27AUG98 PM that lt side of mouth didn''t move w/rt side;AM of 28AUG it was noted that lt eye didn''t blink w/rt;sx were basically the same when seen by MD in office 31AUG;

VAERS ID:114462 (history)  Vaccinated:1998-08-18
Age:10.9  Onset:1998-09-01, Days after vaccination: 14
Gender:Female  Submitted:1998-09-24, Days after onset: 23
Location:California  Entered:1998-09-30, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: overweight
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1497E0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Facial palsy, Myasthenic syndrome
SMQs:, Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: pt recv vax 18AUG98 & approx 1SEP98 pt seen @ office w/MR w/dx of Bell''s palsy;

VAERS ID:114828 (history)  Vaccinated:1998-08-18
Age:27.6  Onset:1998-08-18, Days after vaccination: 0
Gender:Female  Submitted:1998-10-02, Days after onset: 45
Location:Indiana  Entered:1998-10-09, 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: NONE
Diagnostic Lab Data: hosp aspirated blister
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0231H1SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0944780 IMLA
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous, Malaise, Mouth ulceration
SMQs:, Severe cutaneous adverse reactions (narrow), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: fever blisters on mouth 25AUG98-26AUG98 noticed blisters on hands w/in 2 days blisters on both days; blah,tired, cold, coughing;sent home for work secondary inc blisters;dx as adverse rxn to MMR;

VAERS ID:115126 (history)  Vaccinated:1998-08-18
Age:1.6  Onset:1998-08-18, Days after vaccination: 0
Gender:Female  Submitted:1998-08-20, Days after onset: 2
Location:New Mexico  Entered:1998-10-20, Days after submission: 61
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: URI, teething
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC 'Split Type': NM98015
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES7K917653IMLA
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES7M817073IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Pyrexia, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: temp to 106 R;erythema, warmth 10x10cm @ site of inj;

VAERS ID:116039 (history)  Vaccinated:1998-08-18
Age:36.0  Onset:1998-08-18, Days after vaccination: 0
Gender:Unknown  Submitted:1998-10-26, Days after onset: 69
Location:Tennessee  Entered:1998-11-02, 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: allergic to sulfa drugs, hepatitis A
Diagnostic Lab Data:
CDC 'Split Type': 19980215971
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Gastrointestinal disorder
SMQs:
Write-up: pt recv vax 18AUG98 & exp a bloated feeling in the lower rt side;pt was not treated for the event;

VAERS ID:115937 (history)  Vaccinated:1998-08-18
Age:4.2  Onset:1998-09-20, Days after vaccination: 33
Gender:Female  Submitted:1998-10-06, Days after onset: 16
Location:Arkansas  Entered:1998-11-06, Days after submission: 31
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': AR9865
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4838464IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0233H1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0789E3PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0666H0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Herpes zoster, Infection
SMQs:
Write-up: child recv vax & grandparent devel shingles;child''s cousin devel shingles 6-7wk post the child vax;

VAERS ID:116347 (history)  Vaccinated:1998-08-18
Age:13.6  Onset:1998-08-18, Days after vaccination: 0
Gender:Male  Submitted:1998-11-12, Days after onset: 86
Location:California  Entered:1998-11-13, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: s/p splenectomy
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Injection site reaction, Leukocytosis, Myalgia, Pyrexia, Sepsis, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad)
Write-up: devel inc fever & lethargy (acute onset) myalgia, h/a, local rxn, T38.6, leukocytosis (WBC 30);required to hosp;started on ATB, in case of actual sepsis;

VAERS ID:116651 (history)  Vaccinated:1998-08-18
Age:62.3  Onset:1998-08-18, Days after vaccination: 0
Gender:Female  Submitted:1998-08-19, Days after onset: 1
Location:Ohio  Entered:1998-11-23, Days after submission: 96
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Theo-dur
Current Illness: NONE
Preexisting Conditions: emphysema-questionable lupus
Diagnostic Lab Data: NONE
CDC 'Split Type': OH98094
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1389E IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09507401IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 19AUG98 rt arm swollen & sore to touch;swollen from elbow to shoulder pt stated;20AUG98 seen by MD;pt states MD stated pt had pneumonia vax less than a yr ago-pt unsure of prev vax;

VAERS ID:117108 (history)  Vaccinated:1998-08-18
Age:5.1  Onset:1998-08-19, Days after vaccination: 1
Gender:Male  Submitted:1998-08-20, Days after onset: 1
Location:Georga  Entered:1998-12-07, Days after submission: 109
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: denies
Other Medications: NA
Current Illness: NA
Preexisting Conditions: cyst removed 93 occipitus
Diagnostic Lab Data: NA
CDC 'Split Type': GA98105
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM847A21IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N03482IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0029H1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Lymphadenopathy, Pain
SMQs:
Write-up: mom stated approx 3" x 1/2" tender area under rt armpit;grandma noticed today;child says was there yesterday;denies fever or any other sx;advised mom to bring to clinic for check;arm hurting;cyst removed;lymphadenitis;

VAERS ID:119158 (history)  Vaccinated:1998-08-18
Age:34.0  Onset:0000-00-00
Gender:Female  Submitted:1998-09-03
Location:Tennessee  Entered:1999-02-18, Days after submission: 168
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 898252026A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)PFIZER/WYETH4978105   
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & devel an inj site rxn characterized by redness, warmth, swelling, itching & induration;pt was seen by MD & treated w/applications of ice;

VAERS ID:119449 (history)  Vaccinated:1998-08-18
Age:90.1  Onset:1998-09-15, Days after vaccination: 28
Gender:Female  Submitted:1999-02-25, Days after onset: 163
Location:Louisiana  Entered:1999-03-01, Days after submission: 4
Life Threatening? Yes
Died? Yes
   Date died: 1998-09-16
   Days after onset: 1
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 0 eosinophilia;CXR acute pulmary edema;pt died 16SEP98-no c/o CHF prev;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1402H   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Bronchitis, Cough, Dyspnoea, Hepatic cirrhosis, Pneumonia, Pulmonary oedema, Right ventricular failure
SMQs:, Cardiac failure (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: pt recv vax & was adm to hosp on 15SEP98 for inc SOB, cough;cough began right p/vax; ?allergy;no rash, no pharyngeal edema;

VAERS ID:120007 (history)  Vaccinated:1998-08-18
Age:31.4  Onset:1998-08-19, Days after vaccination: 1
Gender:Male  Submitted:1999-03-01, Days after onset: 194
Location:Illinois  Entered:1999-03-03, 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: Claritin-D;
Current Illness:
Preexisting Conditions: allergy;hayfever;hypoglycemia;iodine allergy
Diagnostic Lab Data:
CDC 'Split Type': WAES98091558
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1395E0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Influenza, Myalgia, Nausea, Pain, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: pt recv vax & 19AUG98 pt exp strong flu-like sx including nausea, severe h/a, dizziness, body aches, pains, bowel problems, flush feeling & general fatigue & discomfort;21AUG98 exp profuse sweating & heat flashes;

VAERS ID:123841 (history)  Vaccinated:1998-08-18
Age:1.0  Onset:1998-08-21, Days after vaccination: 3
Gender:Female  Submitted:1999-05-14, Days after onset: 266
Location:Florida  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': WAES98081637
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: approx 3 days p/ vax pt devel papular rash & then 4 days p/ onset pt had approx 200 lesions

VAERS ID:123958 (history)  Vaccinated:1998-08-18
Age:14.7  Onset:1998-09-05, Days after vaccination: 18
Gender:Female  Submitted:1999-05-14, Days after onset: 251
Location:Wisconsin  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': WAES98090688
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Public     Purchased by: Unknown
Symptoms: Dermatitis bullous, Pruritus, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: p/vax pt exp a gen erythematous papular rash w/pruritus & 9/10/98 pt was seen by MD who described lesions as vesicular at onset;

VAERS ID:123994 (history)  Vaccinated:1998-08-18
Age:1.0  Onset:1998-09-18, Days after vaccination: 31
Gender:Male  Submitted:1999-05-14, Days after onset: 238
Location:Pennsylvania  Entered:1999-05-21, Days after submission: 7
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': WAES98091368
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: approx 1mo p/ vax pt devel 10 lesions

VAERS ID:122551 (history)  Vaccinated:1998-08-18
Age:15.5  Onset:1998-08-20, Days after vaccination: 2
Gender:Female  Submitted:1999-05-21, Days after onset: 274
Location:Arizona  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:
Current Illness:
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC 'Split Type': WAES98090023
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER    
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: pt recv vax on 8/18/98 1 dose of mmr& 1 dose of hepb & 1 dose dtp, on 8/20/98 pt exp swelling ``in front of her right ear'''', swelling extended down pt jaw. pt sought unspecified medical atten.

VAERS ID:153223 (history)  Vaccinated:1998-08-18
Age:3.0  Onset:2000-04-24, Days after vaccination: 615
Gender:Male  Submitted:2000-04-26, Days after onset: 2
Location:Florida  Entered:2000-06-08, Days after submission: 43
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: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Mild case, <3 varicella lesions.

VAERS ID:113577 (history)  Vaccinated:1998-08-19
Age:3.8  Onset:1998-08-20, Days after vaccination: 1
Gender:Female  Submitted:1998-08-21, Days after onset: 1
Location:Georga  Entered:1998-08-24, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp local rxn @ age 3 w/DTAP/HIB dose 2;
Other Medications:
Current Illness: low grade temp 99
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7M817072IMRA
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES7K917682IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0792A122PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Pyrexia
SMQs:, 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: pt devel T102 & local erythema & swelling @ inj site;alternated motrin & APAP x 24hr & applied ice to the area;improvement noted in 24hr;

VAERS ID:113635 (history)  Vaccinated:1998-08-19
Age:6.0  Onset:1998-08-20, Days after vaccination: 1
Gender:Female  Submitted:1998-08-20, Days after onset: 0
Location:Indiana  Entered:1998-08-25, 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: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4484514IMRA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2368A22IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES780A23PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 6" x 4" edema, erythema, hyperemia, tenderness, typical of urticaria rxn around inj site;

VAERS ID:113671 (history)  Vaccinated:1998-08-19
Age:4.0  Onset:1998-08-19, Days after vaccination: 0
Gender:Male  Submitted:1998-08-26, Days after onset: 7
Location:Florida  Entered:1998-08-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC 'Split Type': FL98064
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES713918244IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.L11940IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0232H1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Face oedema, Haemorrhage
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow)
Write-up: swelling of face & eyes w/extravasation of blood around eyes;epi & DPH given;

VAERS ID:113711 (history)  Vaccinated:1998-08-19
Age:36.4  Onset:0000-00-00
Gender:Female  Submitted:1998-08-25
Location:Wisconsin  Entered:1998-08-28, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: came in for EGD
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
HEPA: HEP A (VAQTA)MERCK & CO. INC. 0 RA
Administered by: Public     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: nurse gave 1/2 of unual dose for hep b & checked w/pharm to see if drugs were compatible pharmcist said they were;Hep B & hep B mixed together & given same time;

VAERS ID:113750 (history)  Vaccinated:1998-08-19
Age:5.2  Onset:1998-08-25, Days after vaccination: 6
Gender:Male  Submitted:1998-08-27, Days after onset: 2
Location:Florida  Entered:1998-08-31, Days after submission: 4
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: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1575E0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Infection, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: devel gen varicella rash involving trunk, face, extremities (25-50 pox) & fever;

VAERS ID:113751 (history)  Vaccinated:1998-08-19
Age:10.6  Onset:1998-08-19, Days after vaccination: 0
Gender:Female  Submitted:1998-08-21, Days after onset: 2
Location:California  Entered:1998-08-31, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: PPD by Connuaght lot# 248311 given 19AUG98
Current Illness: NONE
Preexisting Conditions: took ? med in Mexico-6 pills (parent unk of kind)
Diagnostic Lab Data: sed rate;
CDC 'Split Type': CA980084
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1038E  LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0031H1 LA
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Gaze palsy, Hypertension, Hypertonia, Urinary incontinence
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow)
Write-up: 20AUg98 was OK when getting vax;hypertonic sz;pt stated was sl dizzy;eyes rolled back, arms curled up;incontinence;Bp 120/80;

VAERS ID:113816 (history)  Vaccinated:1998-08-19
Age:0.1  Onset:1998-08-19, Days after vaccination: 0
Gender:Female  Submitted:1998-08-26, Days after onset: 7
Location:Pennsylvania  Entered:1998-09-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: ferrous sulfate
Current Illness: NONE
Preexisting Conditions: apnea of prematurity, prematurity-born @ 33 weeks
Diagnostic Lab Data: EEG sharp wave discharges;CF scan of head nl;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4538450 LL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS4477980 RL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N04960 RL
Administered by: Other     Purchased by: Private
Symptoms: Convulsion, Electroencephalogram abnormal, Hypertonia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: sz lasting 10-15min;no fever;generalized shaking w/stiffening;on apnea monitor @ the time-no alarms;

VAERS ID:113832 (history)  Vaccinated:1998-08-19
Age:28.5  Onset:1998-08-20, Days after vaccination: 1
Gender:Female  Submitted:1998-08-27, Days after onset: 7
Location:New Jersey  Entered:1998-09-02, Days after submission: 6
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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4533001IMA
Administered by: Other     Purchased by: Other
Symptoms: Abscess, Headache, Malaise, Oedema peripheral, Pain, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: T102, inc pain swelling, redness to lt arm;sterile abscess, gen malaise, h/a;

VAERS ID:113846 (history)  Vaccinated:1998-08-19
Age:6.2  Onset:1998-08-19, Days after vaccination: 0
Gender:Male  Submitted:1998-08-20, Days after onset: 1
Location:Wyoming  Entered:1998-09-02, 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: nothing reported
Diagnostic Lab Data: NONE
CDC 'Split Type': WY9820
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4558414IM 
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0400E1IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0772B3PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0649H0SC 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Dyspnoea, Hypertonia, Stupor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad)
Write-up: pt recv vax & became very stiff, shoulder rolled forward, mom stood child up eyes were open, no change in skincolor, child cont to breath;p/15sec child unresponsive, eye still open began to gasp air & began to cry;

VAERS ID:113902 (history)  Vaccinated:1998-08-19
Age:4.5  Onset:1998-08-20, Days after vaccination: 1
Gender:Male  Submitted:1998-08-21, Days after onset: 1
Location:Louisiana  Entered:1998-09-04, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp crying long periods & to MD found no problems w/DTAP dose 4;
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergic to amoxil-augmentum-cefzil-PCN;mom reports allergic to mosquitos & bees;
Diagnostic Lab Data:
CDC 'Split Type': LA980808
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4538434 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0029H1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES789L33PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site reaction, Insomnia, Pain, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: mom reported to hlth unit 21AUG98 states went to ER;reports p/vax c/o arm hurting gave APAP;c/o arm pain next day & last noc pt came in mom room c/o itching & arm hurting;mom turned on light found whelps starting from DTAP site;local rxn;

VAERS ID:113935 (history)  Vaccinated:1998-08-19
Age:21.0  Onset:1998-08-19, Days after vaccination: 0
Gender:Female  Submitted:1998-08-20, Days after onset: 1
Location:Arizona  Entered:1998-09-08, 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: PPD by Connaught lot# 248611 given 19AUG98
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4978071 IMLA
Administered by: Other     Purchased by: Public
Symptoms: Headache, Hyperhidrosis, Nausea, Nuchal rigidity, Pyelonephritis
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 15 to 30min p/vax pt devel h/a, nausea, ?sweaty & tight feeling in lt lateral neck;pt did return on 21AUG98 w/similar vague sx & was dx w/pyelonephritis;

VAERS ID:113982 (history)  Vaccinated:1998-08-19
Age:5.5  Onset:1998-08-23, Days after vaccination: 4
Gender:Male  Submitted:1998-09-02, Days after onset: 10
Location:New Hampshire  Entered:1998-09-08, Days after submission: 6
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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09397904IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0772K3PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1101E0SCRA
Administered by: Private     Purchased by: Public
Symptoms: Dermatitis bullous, Injection site hypersensitivity, Pruritus, Rash maculo-papular, Skin discolouration
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: pt came in today as an acute for macular papular eruption;pt recv vax 14AUG98 & devel erythema & a rash around site of inj;intermittent papules, occasionally pustules that burst;cough;not feeling wonderfully;itchy;erythematous dry papules;

VAERS ID:114009 (history)  Vaccinated:1998-08-19
Age:12.8  Onset:1998-08-19, Days after vaccination: 0
Gender:Male  Submitted:1998-08-20, Days after onset: 1
Location:Colorado  Entered:1998-09-08, 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: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': CO98039
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2626A20IMRA
Administered by: Public     Purchased by: Public
Symptoms: Gaze palsy, Hypertonia, Mydriasis, Opisthotonus, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: 60sec p/vax pt was still seated, pt legs became spastic & then body arched backwards in chair, head hyper extended & eyes rolled sl backwards;body was in tonic, spastic state for 5-10sec;pt regained consciousness;pt pale pupils dilated;

VAERS ID:114059 (history)  Vaccinated:1998-08-19
Age:0.2  Onset:1998-08-19, Days after vaccination: 0
Gender:Male  Submitted:1998-08-21, Days after onset: 2
Location:Florida  Entered:1998-09-09, 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:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09258800IM 
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1314E1IM 
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0499H0IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N03480SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cyanosis
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: post vax w/in seconds pt turned blue periorally & in extreme lasting 1min then recovered w/no further problems

VAERS ID:114083 (history)  Vaccinated:1998-08-19
Age:5.7  Onset:1998-08-26, Days after vaccination: 7
Gender:Female  Submitted:1998-08-27, Days after onset: 1
Location:Virginia  Entered:1998-09-11, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: N/A
CDC 'Split Type': VA98055
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES0925880   
MMR: MEASLES + MUMPS + RUBELLA (MMR I)MERCK & CO. INC.0034H  LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES449525 PO 
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 8/19/98; on 8/26/98 pt exp rash on both thighs.

VAERS ID:114152 (history)  Vaccinated:1998-08-19
Age:14.3  Onset:1998-09-01, Days after vaccination: 13
Gender:Female  Submitted:1998-09-03, Days after onset: 2
Location:Michigan  Entered:1998-09-13, Days after submission: 10
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': MI98095
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09394400 RA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0669H0 LA
Administered by: Public     Purchased by: Public
Symptoms: Drug ineffective, Infection, Injection site hypersensitivity, Injection site mass, Injection site pain, Vasodilatation
SMQs:, Lack of efficacy/effect (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 5cm indurated area @ inj site;tender, warm & red 2wk p/vax;also <20modified varicella lesions on trunk;

VAERS ID:114129 (history)  Vaccinated:1998-08-19
Age:4.6  Onset:1998-08-19, Days after vaccination: 0
Gender:Male  Submitted:1998-08-24, Days after onset: 5
Location:Idaho  Entered:1998-09-14, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp mild fever w/all vax;pt sibling exp mild fever w/all vax;
Other Medications: NONE
Current Illness: runny nose & cough
Preexisting Conditions: allergic to bee sting, spider bites & mosquito
Diagnostic Lab Data: NA
CDC 'Split Type': ID98037
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4514954IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0024H SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0787M2PO 
Administered by: Public     Purchased by: Public
Symptoms: Cough, Pyrexia, Somnolence, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: vomited @ 11:30PM on 19AUG98, coughed all noc while sleeping 20AUG98 drowsy & sleepy all day;7PM temp was 102 gave med for fever p/pt vomited again;21AUG98 parent reported pt was totally fine;

VAERS ID:114175 (history)  Vaccinated:1998-08-19
Age:52.4  Onset:1998-08-28, Days after vaccination: 9
Gender:Female  Submitted:1998-09-09, Days after onset: 12
Location:Texas  Entered:1998-09-16, 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: Serzone, Synthroid, Estace, Provera, Vit
Current Illness: NONE
Preexisting Conditions: diabetic talwin, codeine, darvocet, toadel;valteric;
Diagnostic Lab Data: NA
CDC 'Split Type': SA98007
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM557860IMRA
Administered by: Public     Purchased by: Private
Symptoms: Pruritus, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 19AUG98 & noted bumps w/itching 28AUG98;spots were red w/scratching;from chin down lasting thru sept saw MD;hives w/itching;

VAERS ID:114195 (history)  Vaccinated:1998-08-19
Age:5.5  Onset:1998-08-20, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1998-09-17
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: developmentally delayed
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0746E2IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: swelling @ inj site noted by parent @ home on 20AUG98;@ appt 21AUG98 swelling brought to attention of MD rx for DPH given;

VAERS ID:114217 (history)  Vaccinated:1998-08-19
Age:19.9  Onset:1998-08-19, Days after vaccination: 0
Gender:Male  Submitted:1998-08-25, Days after onset: 6
Location:Pennsylvania  Entered:1998-09-18, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: Allergy to Ceclor &Ampicillin
Diagnostic Lab Data: UNK
CDC 'Split Type': PA9845
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.09386400SCLA
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Asthenia, Headache, Infection, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad)
Write-up: Pt recv vax on 8/19/98; on the same day pt exp headache, fever (100-102.5) for 2 dys; decreased appetite &weak. Pt to M.D. on 8/22; dx=viral illness. On 8/25 pt headache continued; no other sxs; pt return to M.D. if headache continues.

VAERS ID:114284 (history)  Vaccinated:1998-08-19
Age:6.0  Onset:1998-08-21, Days after vaccination: 2
Gender:Male  Submitted:1998-09-15, Days after onset: 25
Location:Ohio  Entered:1998-09-22, Days after submission: 7
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: migraine;
Diagnostic Lab Data: SEP98 magnetic resonance imaging occipital low lesions, post inflammatory, maybe infarct;spinal tap nl;
CDC 'Split Type': WAES98090530
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Cerebral infarction, Hallucination, Laboratory test abnormal, Neuropathy, Pyrexia, Visual disturbance
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic cerebrovascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad)
Write-up: pt recv vax 19AUG98 & 21AUG98 pt exp migraine h/a;8SEP98 pt exp fever, migraine, & visual hallucinations in rt eye;MRI indicated occipital lobe lesions post inflammatory, maybe infarct;pt hosp;LP nl;

VAERS ID:114341 (history)  Vaccinated:1998-08-19
Age:13.0  Onset:1998-08-19, Days after vaccination: 0
Gender:Male  Submitted:1998-09-16, Days after onset: 28
Location:Virginia  Entered:1998-09-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vancenase, nasal spray oral;clariten;
Current Illness: NONE
Preexisting Conditions: allergy to dairy products-bronchitis
Diagnostic Lab Data: NONE
CDC 'Split Type': VA98057
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM530A90 LA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES09465000 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Anxiety, Hallucination, Hyperacusis, Malaise, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow)
Write-up: afternoon day of vax c/o mild abd cramping;that evening was out running & had serious abd cramping;went to bed 830PM not feeling well;T99.4 po;woke @ 0100;father stated having auditory hallucination;T100.2;anxious & fearful x2hr;

VAERS ID:114380 (history)  Vaccinated:1998-08-19
Age:7.5  Onset:1998-08-19, Days after vaccination: 0
Gender:Female  Submitted:1998-08-21, Days after onset: 2
Location:California  Entered:1998-09-25, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: PPD by Connaught lot# 249011 given 19AUG98;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': CA980096
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2626A20IMLA
Administered by: Private     Purchased by: Public
Symptoms: Abdominal pain, Gaze palsy, Pallor, Rash, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: 1-2min p/vax pt fainted & was out for 20second;eyes rolled upwards briefly, had blotchy rash w/circumoral pallor & abd pain;given med;

VAERS ID:114457 (history)  Vaccinated:1998-08-19
Age:1.0  Onset:1998-08-31, Days after vaccination: 12
Gender:Male  Submitted:1998-09-23, Days after onset: 23
Location:Montana  Entered:1998-09-30, 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:
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: CBC, chem 7, blood cult, ESR
CDC 'Split Type': MT98023
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0229H0SCLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4521072PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0653H0SCRL
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Anorexia, Dermatitis bullous, Influenza, Insomnia, Malaise, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: rash on trunk, face, legs to clinic 31AUG98;gen varicella like rash secondary to varicella vax;pt fussy, not sleeping well 2SEP98;dx viral synd probably secondary to post vax; inc fussiness, dec appetite, acting more ill;T102;

VAERS ID:114914 (history)  Vaccinated:1998-08-19
Age:4.2  Onset:1998-08-20, Days after vaccination: 1
Gender:Male  Submitted:1998-09-24, Days after onset: 35
Location:Michigan  Entered:1998-10-13, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Intal;Provental;Hydor-cortisone cream
Current Illness: NONE
Preexisting Conditions: asthma, eczema
Diagnostic Lab Data: NONE
CDC 'Split Type': MI98099
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4480713IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0229H1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4521143PO 
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: approx 17hr p/vax pt devel hives on abd, neck & lower arms;advised to contact child MD for treatment for hives;

VAERS ID:114953 (history)  Vaccinated:1998-08-19
Age:5.9  Onset:1998-08-21, Days after vaccination: 2
Gender:Male  Submitted:1998-08-24, Days after onset: 3
Location:Ohio  Entered:1998-10-14, Days after submission: 51
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': OH98068
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4514983IMLA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0747E0IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1679E1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0792H3PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Oedema peripheral, Pyrexia
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: swollen arm 2x shoulder to elbow;rash around arm, T102.5;

VAERS ID:115243 (history)  Vaccinated:1998-08-19
Age:1.3  Onset:1998-08-21, Days after vaccination: 2
Gender:Female  Submitted:1998-08-25, Days after onset: 4
Location:Georga  Entered:1998-10-21, Days after submission: 57
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: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': 898238037A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4558383IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM010RN3IMRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 8/19/98; on 8/20/98 pt exp injection site rx.

VAERS ID:115245 (history)  Vaccinated:1998-08-19
Age:1.4  Onset:1998-08-21, Days after vaccination: 2
Gender:Female  Submitted:1998-08-25, Days after onset: 4
Location:Georga  Entered:1998-10-21, Days after submission: 57
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: UNK
CDC 'Split Type': 898238039A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4558383IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM010RN3IMRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 8/19/98; on 8/21/98 pt exp injection site rx.

VAERS ID:115326 (history)  Vaccinated:1998-08-19
Age:11.0  Onset:1998-08-20, Days after vaccination: 1
Gender:Female  Submitted:1998-10-05, Days after onset: 46
Location:South Carolina  Entered:1998-10-26, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt sibling exp febrile sz as infant w/DTP unk dose;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy-Amoxicillin, Tegretol
Diagnostic Lab Data: NOEn
CDC 'Split Type': SC98056
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2567A90 RA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: immun given on Wednesday & by Thursday had rash that could see & feel, small, fine, bumps over entire body that itches;mom concerned because pt had stevens johnson synd around age 7;rash lasted for about 5 days;

VAERS ID:115334 (history)  Vaccinated:1998-08-19
Age:41.1  Onset:1998-08-20, Days after vaccination: 1
Gender:Female  Submitted:1998-10-19, Days after onset: 60
Location:Florida  Entered:1998-10-26, 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: Agumentin
Current Illness: puncture wound rt 4th finger
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES49780490IM 
Administered by: Private     Purchased by: Private
Symptoms: Myasthenic syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad)
Write-up: numbness & weakness in the lt upper extremity which happened p/having a Td in the lt arm because a puncture wound;

VAERS ID:116042 (history)  Vaccinated:1998-08-19
Age:7.0  Onset:1998-08-19, Days after vaccination: 0
Gender:Male  Submitted:1998-10-26, Days after onset: 68
Location:California  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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 19980218451
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2704A20IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Somnolence, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 19AUG98 & later in the evening pt exp somnolence, itching, severe gen urticaria, vomiting;pt did not have a fever;sx were treated w/DPH;

VAERS ID:116829 (history)  Vaccinated:1998-08-19
Age:  Onset:1998-08-21, Days after vaccination: 2
Gender:Unknown  Submitted:0000-00-00
Location:New York  Entered:1998-11-25
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:
Diagnostic Lab Data:
CDC 'Split Type': NYS98022
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM852A23 LA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2587A22 RA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0053H0 RA
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous, Infection, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 19AUG98 & 21AUG98 pt came down w/full blown case of chicken pox w/low grade temp;pox & low grade temp still presents as of 3SEP98

VAERS ID:117202 (history)  Vaccinated:1998-08-19
Age:1.3  Onset:1998-08-20, Days after vaccination: 1
Gender:Male  Submitted:1998-12-07, Days after onset: 109
Location:Kentucky  Entered:1998-12-08, Days after submission: 1
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': KY980050
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4515001IMRA
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0595H3IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0230H0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Abscess, Oedema peripheral, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: mom states leg was red & swollen about 1-2 days p/vax given;got worse about 1mo later & was told leg needed to be drained;

VAERS ID:117978 (history)  Vaccinated:1998-08-19
Age:0.2  Onset:1998-08-20, Days after vaccination: 1
Gender:Female  Submitted:1998-10-19, Days after onset: 60
Location:Arkansas  Entered:1999-01-11, Days after submission: 84
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': AR9878
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4538460IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2596A21IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS0499H0IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURERN003210SCLL
Administered by: Public     Purchased by: Public
Symptoms: Apnoea, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: mom noted pt groggy the day p/shots was taking a nap day p/shots, grandma noted child quit breathing & in a deep sleep;responded to stimulus;came out of it;Md wanted hosp observation only;no other sx was fine after that;

VAERS ID:119985 (history)  Vaccinated:1998-08-19
Age:32.7  Onset:1998-08-21, Days after vaccination: 2
Gender:Female  Submitted:1999-03-01, Days after onset: 192
Location:California  Entered:1999-03-03, Days after submission: 2
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: 24AUG98 full blood chem panel WNL;lab test hep C antibody test negative;
CDC 'Split Type': WAES98081837
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypersensitivity, Malaise, Myalgia, Nausea, Oedema
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 19AUG98 & on 21AUG98 pt devel nausea, gen body swelling, body aches, malaise;sx persisted & was seen in urgent care facility on 22AUg98;dx has having allerg reaction to hep b vax;

VAERS ID:120829 (history)  Vaccinated:1998-08-19
Age:18.2  Onset:1998-08-19, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1999-03-31
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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Myalgia, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt recv vax on 8/19/98; 3 min post vax pt exp feverish, dizzy, blacked out, weak (x 2hr), sore arm (1-2 days); tx=ammonia

VAERS ID:123836 (history)  Vaccinated:1998-08-19
Age:14.6  Onset:1998-08-21, Days after vaccination: 2
Gender:Male  Submitted:1999-05-14, Days after onset: 266
Location:New York  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: unk
Current Illness:
Preexisting Conditions: allergy
Diagnostic Lab Data: 1998, neg varicella antibody titer
CDC 'Split Type': WAES98081603
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1101E0 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Drug ineffective, Face oedema, Skin discolouration, Skin striae
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Lack of efficacy/effect (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: it was rpt pt vax & on 8/21/98 pt exp right eyelid swelling, red w/dark coloration & red streak on cheek. treated w/atarax. sx resolved p/ 1wk. approx 3wks p/ initial vax pt exp vesicular rash, less than 20 lesions. f/u pt titer 0.44

VAERS ID:123846 (history)  Vaccinated:1998-08-19
Age:  Onset:1998-08-22, Days after vaccination: 3
Gender:Unknown  Submitted:1999-05-14, Days after onset: 265
Location:New York  Entered:1999-05-21, Days after submission: 7
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': WAES98081828
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
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: approx 3 days p/ vax pt exp raised, red swelling described as bumps @ inject site lesions spread to 12-5 days p/vax

VAERS ID:123945 (history)  Vaccinated:1998-08-19
Age:1.0  Onset:1998-08-29, Days after vaccination: 10
Gender:Male  Submitted:1999-05-14, Days after onset: 258
Location:New York  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:
Current Illness:
Preexisting Conditions: lt hydronephrosis & surgery
Diagnostic Lab Data: blood cx-neg; PCR analysis samples inadequate (1skin & 1 tracheal sample mixed together);tracheal aspirate neg;VZV antibody pos;platelet-high, gluc-63, K+-5.3, RDW-high, alkaline phosphatase-high
CDC 'Split Type': WAES98090422
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Anorexia, Blood alkaline phosphatase increased, Cough, Dermatitis bullous, Hyperkalaemia, Hypoglycaemia, Hypokinesia, Laboratory test abnormal, Otitis media, Pneumonia, Productive cough, Pyrexia, Thrombocythaemia
SMQs:, Liver related investigations, signs and symptoms (broad), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Tumour lysis syndrome (broad)
Write-up: pt exp a rash w/about 50 scattered lesions;pt devel lesions on lt side of neck, then face/trunk/limbs;dx OM;mo noted productive cough, fever 102.0, dec activity & dec PO intake;to ER, dx: pneumonia & hosp;MD noted possible varicella pneumon

VAERS ID:123962 (history)  Vaccinated:1998-08-19
Age:2.0  Onset:1998-09-10, Days after vaccination: 22
Gender:Female  Submitted:1999-05-14, Days after onset: 246
Location:Connecticut  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: PPD Tine Test
Current Illness:
Preexisting Conditions: varicella exposure
Diagnostic Lab Data:
CDC 'Split Type': WAES98090756
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1552D0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Infection, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: p/vax pt exp varicella w/4-5 confirmed lesions & some itchiness;pt sought unspecified medical attention & was given DPH for rash;

VAERS ID:123997 (history)  Vaccinated:1998-08-19
Age:18.7  Onset:1998-09-06, Days after vaccination: 18
Gender:Male  Submitted:1999-05-14, Days after onset: 250
Location:Missouri  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: claritin
Current Illness:
Preexisting Conditions: down''s syndrome
Diagnostic Lab Data:
CDC 'Split Type': WAES98091458
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0548E0SCRA
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous, Pruritus, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: approx 17 days p/ vax pt devel a typical chickenpox rash w/about 20-30 lesions w/fever & itching over entire body

VAERS ID:153222 (history)  Vaccinated:1998-08-19
Age:5.0  Onset:2000-04-24, Days after vaccination: 614
Gender:Male  Submitted:2000-04-26, Days after onset: 2
Location:Florida  Entered:2000-06-08, Days after submission: 43
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: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Mild case, <20 varicella lesions.

VAERS ID:153845 (history)  Vaccinated:1998-08-19
Age:2.2  Onset:2000-05-27, Days after vaccination: 647
Gender:Female  Submitted:2000-06-05, Days after onset: 9
Location:Massachusetts  Entered:2000-06-09, 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:
Current Illness: NONE
Preexisting Conditions: Mild asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0669H0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Cough, Drug ineffective, Ear pain, Eye irritation, Infection, Pharyngolaryngeal pain
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Corneal disorders (broad)
Write-up: On May 13, doctor vistit for cough, sore throat, ear pain, itchy red eyes. Diagnosed with OM. Treated with amoxicillin. On May 27, presented to health center with rash and diagnosed with chicken pox. Resolved on June 2.

VAERS ID:171421 (history)  Vaccinated:1998-08-19
Age:4.0  Onset:2000-05-07, Days after vaccination: 627
Gender:Male  Submitted:2001-05-15, Days after onset: 373
Location:Indiana  Entered:2001-06-01, 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: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': WAES00060253
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Skin ulcer
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Skin Lesion - Information has been received from a registered nurse concerning a 4 year old caucasian male patient with no allergies or medical history who on 19 Aug 1998 was vaccinated with a first dose of varicella virus vaccine live in the left arm. On 07 May 2000 the patient developed round, fluid filled skin lesions erupting successively over a 3 day period from 07 May 2000 to 11 May 2000. Most lesions had healed or disappeared by 14 May 2000. The patient was treated with calamine (+) pramoxine (+) nine acetate (Caladryl) and one or two doors of diphendydramine HCL (Benadryl) was given for itching. on 14 may 2000, the patient recovered.

VAERS ID:113623 (history)  Vaccinated:1998-08-20
Age:25.9  Onset:1998-08-20, Days after vaccination: 0
Gender:Female  Submitted:1998-08-23, Days after onset: 3
Location:Florida  Entered:1998-08-25, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vlatrex
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER01907460  
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Hallucination, Hyperhidrosis, Insomnia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: pt has had hallucinatory dreams, noc sweats, very tired/trouble sleeping d/t dreams & noc sweats;

VAERS ID:113677 (history)  Vaccinated:1998-08-20
Age:5.5  Onset:1998-08-20, Days after vaccination: 0
Gender:Male  Submitted:1998-08-21, Days after onset: 1
Location:North Carolina  Entered:1998-08-27, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': NC98035
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164804IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1593E1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0788A3PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: gen hives, 2hr p/vax;recv DPH & steroids @ ER;

VAERS ID:113901 (history)  Vaccinated:1998-08-20
Age:51.3  Onset:1998-08-20, Days after vaccination: 0
Gender:Female  Submitted:1998-08-25, Days after onset: 5
Location:Montana  Entered:1998-09-04, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lotensin;Amitirpixillie;Premarin
Current Illness: pre-op physical exam
Preexisting Conditions: chloranphenicol
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0963390  LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: erythema, induration, discomfort @ inj site over area approx 8cm x 4cm;

VAERS ID:114004 (history)  Vaccinated:1998-08-20
Age:2.5  Onset:1998-08-23, Days after vaccination: 3
Gender:Female  Submitted:1998-09-01, Days after onset: 9
Location:South Dakota  Entered:1998-09-08, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Private     Purchased by: Public
Symptoms: Hypertonia, Infection, Leukocytosis, Pharyngitis, Pyrexia, Rash, Red blood cell sedimentation rate increased, Synovitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (narrow), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: devel fever 3 days post shot, lasted until 8 days post shot;also had rash, sore throat;main concern was inability to walk devel 6 days post vax; fever to 105;had nl x-rays but inc WBC & sed rate to 85;morning stiffness;viral toxic synovitis

VAERS ID:114010 (history)  Vaccinated:1998-08-20
Age:0.8  Onset:1998-08-21, Days after vaccination: 1
Gender:Male  Submitted:1998-08-31, Days after onset: 10
Location:New York  Entered:1998-09-08, Days after submission: 8
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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES094472IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1372E2IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM240RK2IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: thigh feels warm to touch, red, swollen 11:05 21AUG98 per mom;

VAERS ID:114037 (history)  Vaccinated:1998-08-20
Age:14.3  Onset:1998-08-20, Days after vaccination: 0
Gender:Female  Submitted:1998-08-25, Days after onset: 5
Location:South Carolina  Entered:1998-09-09, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NA
CDC 'Split Type': SC98049
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2567A92IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1010E1SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09605805IMRA
Administered by: Public     Purchased by: Public
Symptoms: Back pain, Injection site mass, Injection site oedema, Injection site pain, Oedema, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: c/o pain & swelling to rt upper arm extending to scapula area w/low grade fever lasting approx 3 days;indurated area rt upper arm w/pain extending back to rt scapula;good ROM of shoulder;no redness or heat @ present;rxn to Td;

VAERS ID:114159 (history)  Vaccinated:1998-08-20
Age:5.1  Onset:1998-08-20, Days after vaccination: 0
Gender:Male  Submitted:1998-08-21, Days after onset: 1
Location:Louisiana  Entered:1998-09-15, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rxn @ 1yr w/dose 1;
Other Medications:
Current Illness: NONE
Preexisting Conditions: multiple allergies per mom history
Diagnostic Lab Data:
CDC 'Split Type': LA980902
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES9164802IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0509H1SC 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0789L2PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Asthma, Cough, Dyspnoea, Hypersensitivity, Insomnia, Rash
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: rash p/vax mom states devel a fine allerg type rash over face & back of arms 2hr p/vax;mom called PMD;mom stated had a bad noc w/a wheezy type cough & breathing problems;mom never took to PMD;

VAERS ID:114270 (history)  Vaccinated:1998-08-20
Age:1.0  Onset:1998-08-20, Days after vaccination: 0
Gender:Male  Submitted:1998-09-17, Days after onset: 28
Location:Illinois  Entered:1998-09-21, Days after submission: 4
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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0515H0 LA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0315H0 RA
Administered by: Private     Purchased by: Unknown
Symptoms: Coordination abnormal, Hypokinesia, Mydriasis, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax & in 5min period eyes seemed to dilate;that evening & the next day seemed off balance & wasn''t sure of self & not eager to walk;one diarrhea stool evening p/vax;eye dilated, seemed unware of surroundings for moment;

VAERS ID:114289 (history)  Vaccinated:1998-08-20
Age:5.2  Onset:1998-08-22, Days after vaccination: 2
Gender:Female  Submitted:1998-08-31, Days after onset: 9
Location:Georga  Entered:1998-09-22, Days after submission: 22
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: NONE
CDC 'Split Type': GA98071
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0056H0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Face oedema, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 8/20/98; on 8/22/98 pt exp swelling of face &both ears w/ rash. Pt seen by M.D.; tx=Cyproheptadine liquid.

VAERS ID:114455 (history)  Vaccinated:1998-08-20
Age:20.1  Onset:1998-09-20, Days after vaccination: 31
Gender:Male  Submitted:1998-09-22, Days after onset: 2
Location:New York  Entered:1998-09-30, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Deneid
Other Medications: Denied
Current Illness: Denied
Preexisting Conditions: Denied
Diagnostic Lab Data:
CDC 'Split Type': NY98033
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1304E1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Dysphagia, Pallor, Pharyngitis, Rash
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: sore throat, pale, rash over entire body, chest pain, diff swallowing;MD dx scarlet fever;

VAERS ID:114771 (history)  Vaccinated:1998-08-20
Age:4.1  Onset:1998-08-21, Days after vaccination: 1
Gender:Female  Submitted:1998-09-25, Days after onset: 35
Location:New York  Entered:1998-10-07, Days after submission: 12
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: NA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164803IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0287E1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0785K3PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: rt deltoid w/redness, tenderness, & swelling around inj site, redness is about 3 centimeters @ visit 2 days p/pt recv vax;

VAERS ID:114890 (history)  Vaccinated:1998-08-20
Age:2.6  Onset:1998-08-21, Days after vaccination: 1
Gender:Female  Submitted:1998-08-21, Days after onset: 0
Location:Arkansas  Entered:1998-10-13, Days after submission: 53
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: dallergy;Nasacort;Tenafed;ALbuterol;Intal
Current Illness: NONE
Preexisting Conditions: asthma, environmental (dust mites)
Diagnostic Lab Data: NA
CDC 'Split Type': AR9859
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1372E3IMRA
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0499H2IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0666H0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: mom called & reported that pt devel whelp-like red rash on torso, under rt arm & 6 areas on face;pt c/o itching;afeb but whelp area warm to touch;mom notified peds who is treating w/DPH;rash devel 21hr p/vax;

VAERS ID:121294 (history)  Vaccinated:1998-08-20
Age:50.9  Onset:1998-09-25, Days after vaccination: 36
Gender:Female  Submitted:1999-03-31, Days after onset: 187
Location:Massachusetts  Entered:1999-04-15, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: dx MS at age 44;
Diagnostic Lab Data:
CDC 'Split Type': WAES99041504
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0876E2SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Adverse drug reaction, Condition aggravated, Deafness, Diplopia, Multiple sclerosis, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Demyelination (narrow), Hearing impairment (narrow), Ocular motility disorders (broad)
Write-up: entire lt side went numb, exp double vision & deafness in lt ear;needed 5 days IV steroids to ease sensory sx;lt hand & lt side of head remain numb may be permanent;pt felt vax exacerbated the worse sensory attack ever; Annual follow-up received on 11/27/00 provided no additional data.

VAERS ID:124066 (history)  Vaccinated:1998-08-20
Age:6.0  Onset:1998-08-24, Days after vaccination: 4
Gender:Male  Submitted:1999-05-14, Days after onset: 263
Location:New York  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: unk
Current Illness:
Preexisting Conditions: cardiac murmur
Diagnostic Lab Data:
CDC 'Split Type': WAES98100991
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0654H0SC 
Administered by: Private     Purchased by: Other
Symptoms: Infection
SMQs:
Write-up: p/vax pt devel a mild case of chickenpox;

VAERS ID:128690 (history)  Vaccinated:1998-08-20
Age:20.0  Onset:1999-02-01, Days after vaccination: 165
Gender:Male  Submitted:1999-09-20, Days after onset: 230
Location:Virginia  Entered:1999-09-28, 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: minor hayfever;
Diagnostic Lab Data: pulmonary function test-asthma;RASTs + to all allergens;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER 2  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthma
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: pt devel severe asthma which has been resistant to tx;pt is an allergic person;

VAERS ID:154635 (history)  Vaccinated:1998-08-20
Age:40.0  Onset:1998-08-22, Days after vaccination: 2
Gender:Male  Submitted:1998-08-27, Days after onset: 5
Location:North Carolina  Entered:2000-06-19, Days after submission: 662
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:
CDC 'Split Type': U1998005100
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.M10533IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chest pain, Dyspnoea, Pruritus, Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Next day post vax, the pt broke out in red splotches on sides. On 8/22/98, the pt developed hives, rash, intense itching, shortness of breath, wheezing, and chest pain. Treated with prednisone dose pack and Atarax.

VAERS ID:169130 (history)  Vaccinated:1998-08-20
Age:3.0  Onset:2001-04-18, Days after vaccination: 972
Gender:Male  Submitted:2001-04-18, Days after onset: 0
Location:Texas  Entered:2001-04-25, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0667H0SCLL
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: The pt developed varicella disease with 100-200 lesions.

VAERS ID:170940 (history)  Vaccinated:1998-08-20
Age:1.3  Onset:1998-08-29, Days after vaccination: 9
Gender:Male  Submitted:2002-05-30, Days after onset: 1370
Location:New York  Entered:2001-06-01, Days after submission: 363
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: NONE
Diagnostic Lab Data: Body Temperature - 08/29/98 -105 F
CDC 'Split Type': WAES01031021
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0505H0SC 
Administered by: Private     Purchased by: Private
Symptoms: Infection, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: On 08/30/98, the patient developed a fever of 103 degrees F and a slight rash on his legs. The event required a doctor visit. the patient recovered. Additional information has been requested.

VAERS ID:171594 (history)  Vaccinated:1998-08-20
Age:4.0  Onset:2000-04-03, Days after vaccination: 592
Gender:Male  Submitted:2001-05-15, Days after onset: 407
Location:Georga  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:
CDC 'Split Type': WAES00071472
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Viral infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: On 04/03/2000 the patient experienced chickenpox with 10 lesions. Subsequently, the patient recovered from chickenpox. Medical attention was sought. No further information is available.

VAERS ID:172246 (history)  Vaccinated:1998-08-20
Age:0.9  Onset:2001-03-09, Days after vaccination: 932
Gender:Male  Submitted:2001-05-15, Days after onset: 66
Location:Massachusetts  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: amoxicillin allergy
Diagnostic Lab Data:
CDC 'Split Type': WAES01031283
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1574E0SCLL
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: On 03/09/2001 the patient developed chicken pox. The patient sought medical attention. Additional information has been requested. Per F/U 6/18/02: Info has been received from an RN concerning a 42 month old Asian male with an amoxicillin allergy who on 8/20/98 was vaccinated with the 1st dose of varicella vaccine (lot 625047/1574E) in the PM, SC in the left thigh. On 3/9/01, the pt developed chicken pox. The pt had "many vesicles with fluid on torso, face and arms". It was also reported that there were "some scabs noted". It was noted to be an apparent breakthrough of varicella. The pt sought unspecified medical attention. Additional info has been requested.

VAERS ID:221308 (history)  Vaccinated:1998-08-20
Age:6.0  Onset:2003-11-09, Days after vaccination: 1907
Gender:Female  Submitted:2004-05-14, Days after onset: 186
Location:Ohio  Entered:2004-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0311USAS01046
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.62668806500SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a RN concerning a 6 year old white female with no pertinent medical history or allergies who on 20Aug98 was vaccinated SC in the left thigh with a first dose of varicella virus vaccine live. There was no concomitant medication. There was no illness at the time of vaccination. There were no adverse events following prior vaccinations. On 10Nov2003 the pt presented to the office with a mild case of chickenpox that was also described as a varicella rash. The onset date was reported as 09Nov03. The pt was treated with diphenhydramine (Benadryl) and colloidal oatmeal (Aveeno) bath. No prescription drug treatment was required. No diagnostic lab tests were performed. Subsequently, the pt recovered with no further problems. No product quality complaint was involved. No further information is expected.

VAERS ID:253649 (history)  Vaccinated:1998-08-20
Age:1.0  Onset:2006-03-29, Days after vaccination: 2778
Gender:Female  Submitted:2006-03-30, Days after onset: 1
Location:Ohio  Entered:2006-04-04, 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:
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.1002H0SCLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0668H0SCRL
Administered by: Private     Purchased by: Public
Symptoms: Viral infection
SMQs:
Write-up: Pt developed chickenpox on 3/29/06.

VAERS ID:274501 (history)  Vaccinated:1998-08-20
Age:1.0  Onset:2006-11-03, Days after vaccination: 2997
Gender:Male  Submitted:2007-03-08, Days after onset: 125
Location:Georga  Entered:2007-03-21, Days after submission: 12
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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEUR788012IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0793H0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0850S0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Rash papular, Skin lesion
SMQs:
Write-up: Rash papular lesions on body, scalp, behind ears and and palate. To use Aveeno and Dytan Q 12 hours.

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