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Found 588667 cases in entire database

Case Details (Sorted by Vaccination Date)

This is page 1346 out of 5887

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VAERS ID:85451 (history)  Vaccinated:1996-04-15
Age:1.0  Onset:1996-04-20, Days after vaccination: 5
Gender:Male  Submitted:1996-04-24, Days after onset: 4
Location:Illinois  Entered:1996-05-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: clarerythromycin
Current Illness: chronic otitis med
Preexisting Conditions: chronic recurrent otitis med, ant. tibial torsion
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1170B0SC 
Administered by: Private     Purchased by: Public
Symptoms: Conjunctivitis, Drug ineffective, Infection, Pyrexia, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax;devel high fever,morbilliform rash,conjunctivitis&koplick spots 1 wk p/ MMR;

VAERS ID:85467 (history)  Vaccinated:1996-04-15
Age:0.3  Onset:1996-04-15, Days after vaccination: 0
Gender:Female  Submitted:1996-04-25, Days after onset: 10
Location:Wisconsin  Entered:1996-05-01, 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: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4333641IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0728S1PO 
Administered by: Public     Purchased by: Other
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), Hypoglycaemia (broad)
Write-up: pt recv vax;unconsolable crying for 2 hrs beginning several hrs p/ vax;cry was different character than usual;

VAERS ID:85640 (history)  Vaccinated:1996-04-15
Age:0.3  Onset:1996-04-15, Days after vaccination: 0
Gender:Female  Submitted:1996-04-30, Days after onset: 15
Location:New Hampshire  Entered:1996-05-07, 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: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4278411IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0725A1PO 
Administered by: Private     Purchased by: Public
Symptoms: Convulsion, Gaze palsy, Salivary hypersecretion, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: mom states while in car, noticed pt body shaking, eyes rolled back & drooling;no color change;10AM probable sz approx 7 hr later-no fever

VAERS ID:85887 (history)  Vaccinated:1996-04-15
Age:40.3  Onset:1996-04-15, Days after vaccination: 0
Gender:Female  Submitted:1996-04-17, Days after onset: 2
Location:Georgia  Entered:1996-05-10, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Premrin;PPD by Parke Davis lot# 01475P
Current Illness: NONE
Preexisting Conditions: diabetes, sickle cell trait
Diagnostic Lab Data:
CDC Split Type: GA96045
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0883B SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L71095  LA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dizziness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: dizziness began around 12noon on date vax recv began having nausea & vomiting @ 8PM which cont off & on throughout noc;cont to have nausea, no vomiting on 16APR96;also weakness & dizziness;was seen @ ER 16APR96

VAERS ID:85985 (history)  Vaccinated:1996-04-15
Age:1.3  Onset:1996-04-16, Days after vaccination: 1
Gender:Male  Submitted:1996-04-19, Days after onset: 3
Location:North Carolina  Entered:1996-05-13, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: erthromycin
Diagnostic Lab Data:
CDC Split Type: NC96035
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4319673IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1164B0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: mom called 16APR96 states pt lt leg swollen,red&cried,t102;mom stopped by clinic area redness hard 2cm x 1cm;advised to keep cold on are try ATB ointment&stop by MD office;17APR96 temp up to 103.8

VAERS ID:86260 (history)  Vaccinated:1996-04-15
Age:21.5  Onset:1996-04-15, Days after vaccination: 0
Gender:Female  Submitted:1996-05-16, Days after onset: 31
Location:California  Entered:1996-05-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: orthosept;oral contraceptive
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: neg varicella titer 29SEP93
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0749B1SC 
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Influenza, Pharyngitis, Pyrexia, Rhinitis
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: temp to 100, 2-3 hrs post vax followed by fatigue;felt warm x 2-3 days;then mild cold like sx-nasal stiffness & flu like feeling;

VAERS ID:86633 (history)  Vaccinated:1996-04-15
Age:  Onset:1996-04-15, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1996-06-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none
Other Medications: proventil & intal;
Current Illness: none
Preexisting Conditions: asthma
Diagnostic Lab Data: none
CDC Split Type: MD96009
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4319124IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1065A0IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1164B1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0734C3PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Face oedema, Injection site pain, Oedema, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax; eyes were swollen & lt side swollen; T 102.8; to MD; lt leg was extremely sore to touch;

VAERS ID:86639 (history)  Vaccinated:1996-04-15
Age:53.4  Onset:1996-04-16, Days after vaccination: 1
Gender:Female  Submitted:1996-04-19, Days after onset: 3
Location:Maryland  Entered:1996-06-06, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: in pt, exp minor rxn w/ dose 1;
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type: MD96008
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.K05261 LA
Administered by: Public     Purchased by: Private
Symptoms: Chest pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax; hives on trunk; also chest pressure; taking DPH;

VAERS ID:86527 (history)  Vaccinated:1996-04-15
Age:1.4  Onset:1996-04-15, Days after vaccination: 0
Gender:Female  Submitted:1996-04-16, Days after onset: 1
Location:Oklahoma  Entered:1996-06-10, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: tempra for discomfort
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: OK9615
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5J610513IMRA
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5J610513IMRA
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Injection site oedema, Injection site pain, Screaming, Vasodilatation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)
Write-up: 15APR96 recv DTP/HIB in rt arm IM route according to parent-pt fussed & cried all noc & arm swelled & became hot to touch & tender to touch-tempra given q 4hr

VAERS ID:86965 (history)  Vaccinated:1996-04-15
Age:34.0  Onset:1996-04-16, Days after vaccination: 1
Gender:Female  Submitted:1996-04-26, Days after onset: 10
Location:South Carolina  Entered:1996-06-14, Days after submission: 49
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: SC96037
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.117B SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5C7115 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Lymphadenopathy, Muscle twitching, Nausea, Pain, Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: day p/vax pt exp nausea, fever (didn''t check), sore arm & dizziness x a week off & on;3 days later noticed twitching in arm where shots given & leg twitching;4th day rash started on back of neck-itched & burned;knots behind ears

VAERS ID:90424 (history)  Vaccinated:1996-04-15
Age:54.0  Onset:1996-04-15, Days after vaccination: 0
Gender:Female  Submitted:1996-05-02, Days after onset: 17
Location:California  Entered:1996-09-11, Days after submission: 132
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: bronchiectasis
Diagnostic Lab Data:
CDC Split Type: 896143024L
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4263540IM 
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax arm swelled to 3x its size & was painful;also exp facial swelling;pt has recovered;this is one to two pt from this site;

VAERS ID:97720 (history)  Vaccinated:1996-04-15
Age:1.0  Onset:1997-02-08, Days after vaccination: 299
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:1997-04-18
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: cellulitis
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97020813
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1429B0SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 15APR96 & 8FEB97 pt devel 6 varicella lesions & a low grade fever;it was reported that cellulitis of the eye may have contributed to fever;

VAERS ID:101397 (history)  Vaccinated:1996-04-15
Age:42.8  Onset:1996-04-17, Days after vaccination: 2
Gender:Male  Submitted:1997-04-11, Days after onset: 359
Location:Utah  Entered:1997-07-22, Days after submission: 102
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Relafen, Keflex
Current Illness: Laceration
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO6581
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H71005 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Hypertonia, Injection site hypersensitivity, Injection site pain, Myalgia, Pain, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: big bright, feverish, red spot about the size of an orange @ inj site;whole body ached x 2 to 3 days;very painful & stiff up around shoulder, down arm, down into armpit & chest area;

VAERS ID:101398 (history)  Vaccinated:1996-04-15
Age:32.4  Onset:1996-04-17, Days after vaccination: 2
Gender:Female  Submitted:1997-04-11, Days after onset: 359
Location:Utah  Entered:1997-07-22, Days after submission: 102
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Relafen, Keflex
Current Illness: Laceration
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO6582
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H71005 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Hypertonia, Injection site hypersensitivity, Injection site pain, Myalgia, Pain, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: big bright, feverish, red spot about the size of an orange @ inj site;whole body ached x 2 to 3 days;very painful & stiff up around shoulder, down arm, down into armpit & chest area;

VAERS ID:100617 (history)  Vaccinated:1996-04-15
Age:21.4  Onset:1997-03-31, Days after vaccination: 350
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:1997-07-23
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: No relevant data;
CDC Split Type: WAES97040527
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 15APR96 & 31MAR97 pt devel approx 200 typical vesicular lesions on head & trunk;several were open;

VAERS ID:187121 (history)  Vaccinated:1996-04-15
Age:1.1  Onset:2002-06-18, Days after vaccination: 2255
Gender:Female  Submitted:2002-06-21, Days after onset: 3
Location:Texas  Entered:2002-07-02, Days after submission: 11
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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0389B   
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt had major typical case of varicella iwth hundreds of lesions all over her body in typica, pre-vaccine fashion.

VAERS ID:231512 (history)  Vaccinated:1996-04-15
Age:  Onset:2004-12-18, Days after vaccination: 3169
Gender:Female  Submitted:2004-12-21, Days after onset: 3
Location:Pennsylvania  Entered:2004-12-27, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0 RA
Administered by: Private     Purchased by: Unknown
Symptoms: Viral infection
SMQs:
Write-up: Symptoms c/w chicken pox

VAERS ID:237410 (history)  Vaccinated:1996-04-15
Age:1.1  Onset:2005-05-11, Days after vaccination: 3313
Gender:Female  Submitted:2005-05-12, Days after onset: 1
Location:Virginia  Entered:2005-05-16, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1414B SCLA
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: No Adverse Event Reported. Information from missing data report states: Person not at this address.

VAERS ID:85084 (history)  Vaccinated:1996-04-16
Age:0.5  Onset:1996-04-17, Days after vaccination: 1
Gender:Female  Submitted:1996-04-17, Days after onset: 0
Location:Utah  Entered:1996-04-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt''s sibling exp gastrointestinal @ 6mo w/DTP/polio dose 3
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: feb had fluid behind ears-given ATB seen again in March
Diagnostic Lab Data:
CDC Split Type: UT962308
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4299682 LL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1223B2 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0728H2PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Face oedema, Oedema peripheral, Pyrexia, Rhinitis
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: swollen face & body;rt leg more swollen, fever 102 next morning;evening a/seemed to be higher but not taken;nasal congestion;more crying hr p/inj than usual

VAERS ID:85091 (history)  Vaccinated:1996-04-16
Age:0.3  Onset:1996-04-16, Days after vaccination: 0
Gender:Female  Submitted:1996-04-17, Days after onset: 1
Location:Georgia  Entered:1996-04-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Amoxil Nystation oral solution
Current Illness: rt otitis media, thrush
Preexisting Conditions: NONE aware of/new pt to office APR96
Diagnostic Lab Data: CXR nl; CBC WNL;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4335671 RL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1408A1 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0737H1PO 
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Conjunctivitis, Infection, Insomnia, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: mom states started 3PM day of inj crying;cried off & on all PM only sleeping 30 to 60 mins @ a time;cried up to 1hr straight @ a time;highest time 014 R:inj site w/o problem;seen 17APR96 office dx immun rxn vs rt OM;hosp dx pink eye & virus

VAERS ID:85093 (history)  Vaccinated:1996-04-16
Age:30.8  Onset:1996-04-16, Days after vaccination: 0
Gender:Male  Submitted:1996-04-19, Days after onset: 3
Location:New York  Entered:1996-04-23, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA465A60IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES725EZ4PO 
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES5L610930SCRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Injection site hypersensitivity, Injection site oedema, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: large localized rxn-entire rt upper arm swollen, erythematous & pruritic-pt reports fever & chills x 24hrs (less than 101); recovered on APAP & seldane;

VAERS ID:85304 (history)  Vaccinated:1996-04-16
Age:18.3  Onset:1996-04-16, Days after vaccination: 0
Gender:Female  Submitted:1996-04-18, Days after onset: 2
Location:Washington  Entered:1996-04-25, 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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1404B2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 1hr p/vax pt noted swelling & redness of lips & face;no other rash, no SOB, no diff breathing;no vomiting,no nausea;tx w/DPH

VAERS ID:85305 (history)  Vaccinated:1996-04-16
Age:5.4  Onset:1996-04-17, Days after vaccination: 1
Gender:Female  Submitted:1996-04-17, Days after onset: 0
Location:California  Entered:1996-04-25, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES4E611154 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0736C4PO 
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: 3inch diameter warm, red edema in lt deltoid area;

VAERS ID:85391 (history)  Vaccinated:1996-04-16
Age:0.6  Onset:1996-04-16, Days after vaccination: 0
Gender:Male  Submitted:1996-04-19, Days after onset: 3
Location:North Carolina  Entered:1996-04-29, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NC96027
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4335672IMRL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1992A22IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0736K2PO 
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: t104.5 R several hrs p/vax;phone call from mom;

VAERS ID:85401 (history)  Vaccinated:1996-04-16
Age:0.2  Onset:1996-04-16, Days after vaccination: 0
Gender:Female  Submitted:1996-04-18, Days after onset: 2
Location:Louisiana  Entered:1996-04-29, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none
Other Medications: apap
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type: LA960407
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5H610470IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1359A1IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES4G10500IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0732C0PO 
Administered by: Public     Purchased by: Public
Symptoms: Crying, Diarrhoea, Injection site hypersensitivity, Pyrexia, Screaming
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax;noticed rash about 20min p/ injection at site;fever of about 101;high pitched crying for about 18 hrs;diarrhea for 4 days;

VAERS ID:85440 (history)  Vaccinated:1996-04-16
Age:1.3  Onset:1996-04-26, Days after vaccination: 10
Gender:Male  Submitted:0000-00-00
Location:New Jersey  Entered:1996-04-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM005LP3IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1422B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: t103;rash treated w/APAP

VAERS ID:85445 (history)  Vaccinated:1996-04-16
Age:2.0  Onset:1996-04-18, Days after vaccination: 2
Gender:Female  Submitted:1996-04-19, Days after onset: 1
Location:Colorado  Entered:1996-04-30, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: healthy
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5K611640IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1126B0SCRL
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity, Injection site hypersensitivity, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 16APR96&mom noticed marked swelling of leg&erythema @ inj site;seen @ hosp by MD who dx allerg rxn

VAERS ID:85448 (history)  Vaccinated:1996-04-16
Age:5.2  Onset:1996-04-18, Days after vaccination: 2
Gender:Female  Submitted:1996-04-23, Days after onset: 5
Location:Michigan  Entered:1996-04-30, Days after submission: 7
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: NA
CDC Split Type: MI96059
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1198B2 RA
Administered by: Public     Purchased by: Other
Symptoms: Cellulitis, Injection site hypersensitivity, Pruritus, Pyrexia, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: rt arm w/circular pale-raised area (4cm)-non-tender w/pin size red dot directly in center (deltoid muscle) surrounding tissue to rt elbow red, warm to touch c/o itching, t99 in AM to MD 19APR96 w/dx of cellulitis;started on Amoxicillin

VAERS ID:85466 (history)  Vaccinated:1996-04-16
Age:0.3  Onset:1996-04-23, Days after vaccination: 7
Gender:Female  Submitted:1996-04-23, Days after onset: 0
Location:Hawaii  Entered:1996-05-01, 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: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4280380 LL
Administered by: Other     Purchased by: Public
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax; induration of thigh at site of inject, noticed by PAR 7 days p/ immunization;

VAERS ID:85472 (history)  Vaccinated:1996-04-16
Age:16.4  Onset:1996-04-16, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Connecticut  Entered:1996-05-02
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 applicable
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H710053IMLA
Administered by: Private     Purchased by: Public
Symptoms: Myalgia, Oedema peripheral
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax;devel localized tenderness&mild swelling on lt deltoid area;no redness noted;pt instructed to apply ice pack compress as needed and to take apap per MD;

VAERS ID:85575 (history)  Vaccinated:1996-04-16
Age:0.4  Onset:1996-04-18, Days after vaccination: 2
Gender:Female  Submitted:1996-04-18, Days after onset: 0
Location:Mississippi  Entered:1996-05-06, Days after submission: 18
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: NONE
CDC Split Type: MS96014
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4319671IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1965A1IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0730B1PO 
Administered by: Public     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: mom called & stated pt has fine rash under neck & on rt side of face, cheeks & corner of eyes & on upper chest above nipple line;not raised;denies pt crying or inc temp;no problems @ inj site;

VAERS ID:85579 (history)  Vaccinated:1996-04-16
Age:0.2  Onset:1996-04-16, Days after vaccination: 0
Gender:Female  Submitted:1996-04-16, Days after onset: 0
Location:Louisiana  Entered:1996-05-06, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: 2wks ago Naldecom for sinus drainage
Current Illness: poss teething-temp 99.5
Preexisting Conditions: NONE
Diagnostic Lab Data: unk
CDC Split Type: LA960408
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5H610470IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1197B1IMRL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5H611180IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES735F30PO 
Administered by: Public     Purchased by: Public
Symptoms: Crying, Pyrexia, Screaming
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 16APR96 between 930-11AM & MD office states pt exp poss rxn to DTP-non stop crying $g3hr w/t99.6 desires Td only in future;mom states very high pitched screaming type crying for long periods-MD gave APAP & DPH

VAERS ID:85584 (history)  Vaccinated:1996-04-16
Age:1.3  Onset:1996-04-23, Days after vaccination: 7
Gender:Male  Submitted:1996-04-25, Days after onset: 2
Location:Indiana  Entered:1996-05-06, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil;Bactroban
Current Illness: impetigo
Preexisting Conditions: febrile sz
Diagnostic Lab Data:
CDC Split Type: IN96007
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5H610503 LL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5H610503 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0887B0 LA
Administered by: Private     Purchased by: Public
Symptoms: Febrile convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: onset fever 23APR96 t max 103.8 24APR;febrile sz 25APR AM; seen by MD 25APR96 w/nl exam

VAERS ID:85597 (history)  Vaccinated:1996-04-16
Age:1.3  Onset:1996-04-16, Days after vaccination: 0
Gender:Male  Submitted:1996-04-19, Days after onset: 3
Location:Ohio  Entered:1996-05-06, 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:
Current Illness: NONE
Preexisting Conditions: allergy to biaxin, suprex
Diagnostic Lab Data:
CDC Split Type: OH96055
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5K610153IMLL
Administered by: Public     Purchased by: Public
Symptoms: Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: bright red cheeks (circular rash),rash on chest&stomach;no fever;MD office recommended giving DPH;rash subsided p/ 2 days;no further DTAP to be given

VAERS ID:85598 (history)  Vaccinated:1996-04-16
Age:44.8  Onset:1996-04-18, Days after vaccination: 2
Gender:Female  Submitted:1996-04-18, Days after onset: 0
Location:Ohio  Entered:1996-05-06, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: hx of allergy to bug bites, bee stings (localized);no resp involvement
Diagnostic Lab Data: NA
CDC Split Type: OH96056
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1955A62IMLA
Administered by: Other     Purchased by: Public
Symptoms: Hypersensitivity, Injection site hypersensitivity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 16APR96;denies rxn to 1st or 2nd vax;devel welt hot hive-like spot @ inj site;seen by MD felt had rxn;took APAP sinus that evening;no evidence of allerg rxn the next day

VAERS ID:85620 (history)  Vaccinated:1996-04-16
Age:42.9  Onset:1996-04-18, Days after vaccination: 2
Gender:Female  Submitted:1996-05-02, Days after onset: 14
Location:Oregon  Entered:1996-05-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: denies
Other Medications: Synthyroid
Current Illness: denies
Preexisting Conditions: NKA, has ETXS since 1989
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA434A40IMRA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 2 1/2 days p/vax pt devel hives on face, scalp, lt breast, abd & back;itching of feet & legs;took DPH & hives resolved by 0600 20APR96

VAERS ID:85665 (history)  Vaccinated:1996-04-16
Age:5.0  Onset:1996-04-16, Days after vaccination: 0
Gender:Female  Submitted:1996-05-03, Days after onset: 17
Location:California  Entered:1996-05-08, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5K611641IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0738B4PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt arm checked 2 days p/vax & pt arm had erythema, redness & swelling which was hard to touch;the swelling measured 2.5in by 1.75in;pt mom advised to use cold compress

VAERS ID:85905 (history)  Vaccinated:1996-04-16
Age:4.5  Onset:1996-04-18, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:1996-05-10
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: WA961225
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES4310192IMLA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1410A1 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0728A2PO 
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site oedema, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: red, swollen outer lt (upper) 15 x 13cm palpable axillary, lymph nodes;tx w/ATB for poss cellulitis-allerg component ? dad reports pt recovered 24APR96

VAERS ID:85913 (history)  Vaccinated:1996-04-16
Age:5.2  Onset:1996-04-26, Days after vaccination: 10
Gender:Female  Submitted:1996-05-01, Days after onset: 5
Location:Missouri  Entered:1996-05-10, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MO96032
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5G610014 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0346B1 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES6734M4PO 
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 10 days p/vax pt broke out w/rash;no temp lasted for 2 days;

VAERS ID:85987 (history)  Vaccinated:1996-04-16
Age:32.7  Onset:1996-04-16, Days after vaccination: 0
Gender:Female  Submitted:1996-04-18, Days after onset: 2
Location:North Carolina  Entered:1996-05-13, Days after submission: 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: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NC96033
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5C71152IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: rt arm is sore, red & very painful;

VAERS ID:86089 (history)  Vaccinated:1996-04-16
Age:0.3  Onset:1996-04-17, Days after vaccination: 1
Gender:Male  Submitted:1996-05-06, Days after onset: 19
Location:New York  Entered:1996-05-15, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: sl runny nose
Preexisting Conditions: NONE
Diagnostic Lab Data: EEG, CAT SCAN, bloodwork, MRI all result nl;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES 1 L
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Gait disturbance, Somnolence, Speech disorder
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: afeb sz 17,18,19APR;to ER-EEG-adm&observed sz on 20APR-Phenobarb;CAT scan,MRI nl;

VAERS ID:86345 (history)  Vaccinated:1996-04-16
Age:0.6  Onset:1996-04-17, Days after vaccination: 1
Gender:Female  Submitted:1996-04-18, Days after onset: 1
Location:Michigan  Entered:1996-05-24, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MI96046
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4326572IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1198B2IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0734B2PO 
Administered by: Public     Purchased by: Other
Symptoms: Otitis media, Pharyngitis, Pyrexia, Somnolence, Tremor
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: saw MD 17APR96 AM;pt has throat & ear infect was running fever of 102, lethargic & upper body jerking 3x every 5min beginning 17APR96 4AM until seeing MD;MD felt pt rxn was d/t throat infect & being injected w/vax

VAERS ID:86348 (history)  Vaccinated:1996-04-16
Age:1.4  Onset:1996-04-28, Days after vaccination: 12
Gender:Male  Submitted:1996-04-29, Days after onset: 1
Location:Michigan  Entered:1996-05-24, Days after submission: 25
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: MI96049
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4319663IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1311B0SCRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0736H2PO 
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: TC from mom 28APR pt devel fever & a red bumpy rash on back & abd;29APR rash subsiding looks like pinpoint-t100.4;noticed a spot on shoulder;has appointment @ clinic Wednesday PM;

VAERS ID:86380 (history)  Vaccinated:1996-04-16
Age:1.2  Onset:1996-04-16, Days after vaccination: 0
Gender:Male  Submitted:1996-04-25, Days after onset: 9
Location:Georgia  Entered:1996-05-28, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Amoxicillin
Current Illness: NONE
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type: GA96052
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS305LF3IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1169B0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Otitis media, Pharyngitis, Pyrexia, Rash, Rhinitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: mom states fever began (101) same day vax;took pt to MD 21APR96 where dx w/ear inject & a cold & placed on amoxicillin;rash present when awoke this AM on stomach & between legs;advised contact PMD;

VAERS ID:86505 (history)  Vaccinated:1996-04-16
Age:12.0  Onset:1996-04-16, Days after vaccination: 0
Gender:Female  Submitted:1996-04-16, Days after onset: 0
Location:Texas  Entered:1996-06-03, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type: TX96066
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1180B  RA
Administered by: Public     Purchased by: Public
Symptoms: Hypotension, Nausea, Pallor, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: pt recv vax; felt n; passed out while taking bath; became pale & v; ice cold towel to forehead; BP 88/68 p/ 10 min;

VAERS ID:86510 (history)  Vaccinated:1996-04-16
Age:14.7  Onset:1996-04-17, Days after vaccination: 1
Gender:Female  Submitted:1996-04-17, Days after onset: 0
Location:Texas  Entered:1996-06-03, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: well child
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type: TX96072
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5C711154IM 
Administered by: Public     Purchased by: Other
Symptoms: Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax; had nausea & v; fever; seen by MD;

VAERS ID:87077 (history)  Vaccinated:1996-04-16
Age:31.9  Onset:1996-04-16, Days after vaccination: 0
Gender:Female  Submitted:1996-04-19, Days after onset: 3
Location:Montana  Entered:1996-06-17, Days after submission: 59
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: currently on Inderal for migraines
Current Illness: NONE
Preexisting Conditions: migraine h/a
Diagnostic Lab Data:
CDC Split Type: MT96009
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1170B0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Hypertension, Lymphadenopathy, Oedema, Paraesthesia, Personality disorder, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 16APR96 1/2hr p/vax pt c/o tingling lips & itchy neck;phone call to clinic was told to to to MD immed;MD visit same day-no tx;17APR96 c/o feeling funny & swollen neck;to ER dx inc BP & swollen glands-hosp overnoc;MD stated probably not vax;

VAERS ID:87150 (history)  Vaccinated:1996-04-16
Age:24.7  Onset:1996-04-18, Days after vaccination: 2
Gender:Male  Submitted:1996-06-04, Days after onset: 47
Location:Unknown  Entered:1996-06-18, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Injection site oedema, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: 2 days p/vax & to ER w/nausea/vomiting, body aches, dizziness, lt shoulder was edematous

VAERS ID:87128 (history)  Vaccinated:1996-04-16
Age:43.0  Onset:1996-04-21, Days after vaccination: 5
Gender:Female  Submitted:1996-05-07, Days after onset: 16
Location:New York  Entered:1996-06-19, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896137018L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4968019 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Face oedema, Hypersensitivity, Lymphadenopathy, Pain, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 16APR96 & devel ax lymphadenopathy & pain in lt arm, which resolved on 19APR96;21APR96 devel hives, erythema, swelling of lower eyelids & itchiness;pt seen by MD who was uncertain of etiology of sx;was allerg rxn to Td

VAERS ID:87211 (history)  Vaccinated:1996-04-16
Age:0.2  Onset:1996-04-16, Days after vaccination: 0
Gender:Male  Submitted:1996-04-16, Days after onset: 0
Location:New York  Entered:1996-06-21, Days after submission: 66
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5M610780IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM230NA0IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES735K30PO 
Administered by: Private     Purchased by: Private
Symptoms: Screaming
SMQs:, Hostility/aggression (broad)
Write-up: pt cried for 6hr;mom holding pt entire time & still unable to console;no fever or lethargy recalled;no vomiting;APAP given;

VAERS ID:87543 (history)  Vaccinated:1996-04-16
Age:62.0  Onset:1996-04-17, Days after vaccination: 1
Gender:Female  Submitted:1996-06-25, Days after onset: 69
Location:Oregon  Entered:1996-07-02, 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: Prolosec, Premarin
Current Illness: breast pain lt breast
Preexisting Conditions: household dust, bee stings (?)
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4958010 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Injection site hypersensitivity, Injection site oedema, Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: elevated temp 10-12hr;shoulder soreness;swelling, rash @ inj site 12hr, malaise, dizzy, light-headed, overall achiness (shoulder, neck lt side of back)

VAERS ID:87592 (history)  Vaccinated:1996-04-16
Age:14.7  Onset:1996-04-21, Days after vaccination: 5
Gender:Female  Submitted:1996-04-24, Days after onset: 3
Location:Washington  Entered:1996-07-08, Days after submission: 75
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: asthma
Diagnostic Lab Data:
CDC Split Type: WA961240
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES429310 IMRA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0741B IMLA
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site oedema, Injection site pain, Myalgia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: arm hurt p/shot;small red area day p/shot;on day 6 devel a large reaction ( 3 1/2 x 2 1/2) w/tender, swollen area;exam: 3 1/2 x 2 1/2 swollen, erythematous, warm area on rt upper arm, tender to touch;IMP: vax rxn vs cellulitis

VAERS ID:87600 (history)  Vaccinated:1996-04-16
Age:56.7  Onset:1996-04-28, Days after vaccination: 12
Gender:Female  Submitted:1996-06-17, Days after onset: 50
Location:Florida  Entered:1996-07-08, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Demadex, Premarin, Lotensin
Current Illness: NONE
Preexisting Conditions: HTN
Diagnostic Lab Data:
CDC Split Type: FL96042
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1311B0SC 
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: all over body rash, pink raised, pinpoint & diffused;rash from 28APR to 30APR96;discomfort & aching both wrists from 1MAY96 3AM to 2MAY96 1PM;wrists ached constantly

VAERS ID:88492 (history)  Vaccinated:1996-04-16
Age:1.1  Onset:1996-04-26, Days after vaccination: 10
Gender:Female  Submitted:0000-00-00
Location:Maryland  Entered:1996-07-18
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: allergy, drug
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES96050024
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 16APR96 & 26APR96 pt exp vesicular lesions some of which were fluid filled & fever;No further details were provided

VAERS ID:88549 (history)  Vaccinated:1996-04-16
Age:14.5  Onset:1996-05-06, Days after vaccination: 20
Gender:Male  Submitted:0000-00-00
Location:New Jersey  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depakote; Sebulex shampoo; Gold bond medicated powder;
Current Illness: none
Preexisting Conditions: Down''s syndrome; sz disorder; osteoporosis;Scoliosis,thoracolumbar;
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES96050864
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0389B0SC 
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax;06may96 devel rash on back & groin area; pt was isolated & recv no tx;by 15may96 rash had resolved;

VAERS ID:89033 (history)  Vaccinated:1996-04-16
Age:1.7  Onset:1996-04-16, Days after vaccination: 0
Gender:Male  Submitted:1996-04-23, Days after onset: 7
Location:Virginia  Entered:1996-08-05, Days after submission: 104
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: 896116002L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4326563IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0417B0IMRL
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 16APR96 & devel an inj site rxn, characterized by a knot & redness, measuring 10cm x 8cm;pt was treated symptomatically, & recovered in 9 days;

VAERS ID:93319 (history)  Vaccinated:1996-04-16
Age:41.0  Onset:1996-04-16, Days after vaccination: 0
Gender:Female  Submitted:1996-05-28, Days after onset: 42
Location:Illinois  Entered:1996-10-30, Days after submission: 155
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: 960050531
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1814A42 LA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: pt recv vax 16APR96 & & w/in 1hr p/vax pt exp lightheadedness;pt recv vax 10:45 & had not eaten lunch;pt had some juice, sat for a while & started to feel better;sx totally resolved by 15:30 the day of the vax;

VAERS ID:93327 (history)  Vaccinated:1996-04-16
Age:25.0  Onset:1996-04-16, Days after vaccination: 0
Gender:Female  Submitted:1996-06-06, Days after onset: 51
Location:Colorado  Entered:1996-10-30, Days after submission: 146
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergic to some beer;NKDA;
Diagnostic Lab Data:
CDC Split Type: 960053801
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1410A62  
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Dizziness, Injection site pain, Rash, Somnolence, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax & same day 220PM exp arthritic pain in joints, dizziness, flushing, drowsiness, upper torso rash, arm discomfort (inj site);ER or MD visit was required;all sx dissipated w/in 1hr while waiting in MD office x/sluggish feeling;

VAERS ID:93712 (history)  Vaccinated:1996-04-16
Age:27.2  Onset:1996-04-22, Days after vaccination: 6
Gender:Female  Submitted:1996-04-23, Days after onset: 1
Location:Oregon  Entered:1997-01-10, Days after submission: 262
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: OR9617
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L71095 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Serum sickness
SMQs:, Hypersensitivity (narrow)
Write-up: arthus reaction began 22APR96;

VAERS ID:101399 (history)  Vaccinated:1996-04-16
Age:21.1  Onset:1996-04-18, Days after vaccination: 2
Gender:Female  Submitted:1997-04-11, Days after onset: 358
Location:Utah  Entered:1997-07-22, Days after submission: 102
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO6583
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0B79B1IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H71005 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Hypertonia, Injection site hypersensitivity, Injection site pain, Myalgia, Pain, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: big bright, feverish, red spot about the size of an orange @ inj site;whole body ached x 2 to 3 days;very painful & stiff up around shoulder, down arm, down into armpit & chest area;

VAERS ID:121272 (history)  Vaccinated:1996-04-16
Age:5.6  Onset:1999-04-09, Days after vaccination: 1088
Gender:Male  Submitted:1999-04-13, Days after onset: 4
Location:Pennsylvania  Entered:1999-04-16, Days after submission: 3
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:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES    
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Public     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: had chickenpox dx;

VAERS ID:122814 (history)  Vaccinated:1996-04-16
Age:4.4  Onset:1998-03-30, Days after vaccination: 713
Gender:Female  Submitted:1999-05-14, Days after onset: 409
Location:Michigan  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:
Other Medications: unknown
Current Illness:
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC Split Type: WAES98032496
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: after pt recv vax on 4/16/96 w/1 dose of varicella virus vax live on 3/30/98 pt devel 10 fluid filled pox on various area of body.

VAERS ID:122994 (history)  Vaccinated:1996-04-16
Age:5.0  Onset:1998-04-20, Days after vaccination: 734
Gender:Male  Submitted:1999-05-14, Days after onset: 389
Location:Illinois  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: NONE
Diagnostic Lab Data:
CDC Split Type: WAES98041995
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0442B0SC 
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Headache, Infection, Pruritus, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax & devel a h/a & T103 which lasted for 3 days & breakthrough varicella w/80-100 itchy lesions;on approx 4/30/98 pt recovered;

VAERS ID:123524 (history)  Vaccinated:1996-04-16
Age:3.0  Onset:1996-05-05, Days after vaccination: 19
Gender:Male  Submitted:1999-05-14, Days after onset: 1104
Location:New Jersey  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: allergy;amoxicillin allergy
Diagnostic Lab Data:
CDC Split Type: WAES98061352
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1124B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Infection
SMQs:
Write-up: p/vax pt devel chickenpox pt was seen by MD;

VAERS ID:123408 (history)  Vaccinated:1996-04-16
Age:2.6  Onset:1998-05-18, Days after vaccination: 762
Gender:Female  Submitted:1999-05-14, Days after onset: 361
Location:Florida  Entered:1999-05-24, Days after submission: 10
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: WAES98051720
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0403B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: p/ pt recv vax devel an active case of chickenpox

VAERS ID:156427 (history)  Vaccinated:1996-04-16
Age:3.0  Onset:1999-11-06, Days after vaccination: 1299
Gender:Female  Submitted:2000-05-16, Days after onset: 191
Location:Pennsylvania  Entered:2000-07-13, Days after submission: 58
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol
Current Illness:
Preexisting Conditions: allergic rhinitis; asthma
Diagnostic Lab Data: NONE
CDC Split Type: WAES99110911
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0388B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Pyrexia
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt experienced a fever of 101F. Two days later the pt was seen in the physicians office and diagnosed with varicella. Pt had pox with vesicles on her trunk, face, arms and neck. Pt was treated with Zyrtec for pruritus. It was reported that the varicella was due to vaccine failure.

VAERS ID:173124 (history)  Vaccinated:1996-04-16
Age:1.1  Onset:1996-04-23, Days after vaccination: 7
Gender:Male  Submitted:2001-07-10, Days after onset: 1904
Location:Foreign  Entered:2001-07-11, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Common cold; cough; diarrhea; otic infection; visual disturbance; vomiting
Diagnostic Lab Data: Hearing test 7/97-nml; MRI 7/97-pending; colonoscopy 7/12/98-ileal nodular hyperplasia; X-ray 9/98-significant loading; Labs in 7/97; blood Abu, chromosomal analysis, urine cultue and deoxyribonuclear acid analysis for fragile X-all pending
CDC Split Type: WAES99031594
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1449A SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Antisocial behaviour, Aphasia, Autism, Diarrhoea, Gait disturbance, Gastrointestinal disorder, Hyperplasia, Lymphadenopathy, Neurodevelopmental disorder, Psychomotor hyperactivity, Sleep disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Akathisia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a foreign legal firm concerning a 13 month old male who on 4/16/96 was vaccinated with MMRII. Immediately following the injection, the child''s parents noted regression in his development and he stopped saying words that he had been able to say prior to the injection. Seven days, post vax on 4/23/96, he experienced vomiting and diarrhea that lasted for 10 days. Within 1 month, he started to hand flap and walk on his tip toes. He had vomiting and diarrhea that lasted for several days. The vomiting and diarrhea was cyclical in nature and never resolved. Two to three months, post vax, approx. 6/96, his behavior deteriorated and he became withdrawn and frustrated at his inability to communicate. A communication problem was noted in approx. 11/96. In 4/97, he was hyperactive and developed erratic sleeping patterns. He had no receptive understanding of language. In 9/97, he was dx''d as autistic with moderate learning difficulties. In 3/98, he was dx''d with ileocecal changes consisting of marked lymphoid follicles and lymphoid nodular hyperplasia. The pt''s autism and lymphoid nodular hyperplasia had not resolved and were considered "Other Medical Events". Additional information has been requested. This is an amended report. The batch number has been added. The lot number for the MMRII given on 4/16/96 is 613747/1449A. F/U states conflicting follow-up information has been received from a foreign legal firm reporting that the pt suffers from inflammatory bowel disease as well as autism. It was noted that his first reaction was on 4/23/99 and his initial symptoms were diarrhea, vomiting and fever. Upon internal review Autism, inflammatory bowel disease and ileal lymphoid nodular hyperplasia were considered "Other Medical Evetns". F/U states conflicting follow-up information has been received from a foreign legal firm who stated that his 1st reaction was on 4/23/99 and his initial symptoms were diarrhea, vomiting and fever. Generalized skin rash, cough and colds were considered to be incide

VAERS ID:85038 (history)  Vaccinated:1996-04-17
Age:0.2  Onset:1996-04-17, Days after vaccination: 0
Gender:Female  Submitted:1996-04-18, Days after onset: 1
Location:Illinois  Entered:1996-04-22, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type: IL960047
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5F610590IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0892B0IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5F610590IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0732D0PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Apnoea, Crying, Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Respiratory failure (narrow), Hypoglycaemia (broad)
Write-up: rt leg swollen et bright red from groin to knee, hot to touch;used cold compresses;improved next high pitched cry for 45mins, episode of not breathing;grandma flicked pt on feet;

VAERS ID:85319 (history)  Vaccinated:1996-04-17
Age:0.1  Onset:1996-04-17, Days after vaccination: 0
Gender:Male  Submitted:1996-04-17, Days after onset: 0
Location:Oregon  Entered:1996-04-26, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4261210IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1290A1IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4319880PO 
Administered by: Military     Purchased by: Military
Symptoms: Agitation, Injection site hypersensitivity
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: mom states pt became irritable p/vax;would quiet down when held, ate normally via bottle & napped about 1/2-1hr @ a time when held;mom states when trying to lay pt down pt cried & has been irritable since this AM;mom noted lt leg red @ inj

VAERS ID:85419 (history)  Vaccinated:1996-04-17
Age:5.0  Onset:1996-04-19, Days after vaccination: 2
Gender:Male  Submitted:1996-04-19, Days after onset: 0
Location:Michigan  Entered:1996-04-30, Days after submission: 11
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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)MICHIGAN DEPT PUB HLTHDT41750IMRA
Administered by: Private     Purchased by: Private
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: swelling & erythema around inj site; total length of 15cm-rt upper arm;

VAERS ID:85449 (history)  Vaccinated:1996-04-17
Age:3.5  Onset:1996-04-19, Days after vaccination: 2
Gender:Female  Submitted:1996-04-19, Days after onset: 0
Location:Hawaii  Entered:1996-04-30, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4333622IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES736E3   
Administered by: Military     Purchased by: Military
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: significant local rxn to vax;warmth, edema, erythema, tenderness in 48hr

VAERS ID:85450 (history)  Vaccinated:1996-04-17
Age:0.1  Onset:1996-04-19, Days after vaccination: 2
Gender:Male  Submitted:1996-04-30, Days after onset: 11
Location:California  Entered:1996-04-30
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: EEG 2MAY96
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4326550IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1404B1IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES738B0PO 
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Hypertonia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)
Write-up: hands & feet go out & pt stiffens up-lasting about 2 seconds, then screams & cries out very loudly & hard;easily comforted afterwards;this has happened 3x in the past 10 days;1st time 2-3 days p/vax; last time 2 days ago;

VAERS ID:85453 (history)  Vaccinated:1996-04-17
Age:29.0  Onset:1996-04-18, Days after vaccination: 1
Gender:Male  Submitted:1996-04-19, Days after onset: 1
Location:North Carolina  Entered:1996-05-01, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: in pt, rxn to TD booster at 21 yrs in 1988
Other Medications: none
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: NC96029
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1164B  RA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L71072  LA
Administered by: Public     Purchased by: Public
Symptoms: Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax;elev T 104;aching all over,n;to er;

VAERS ID:85464 (history)  Vaccinated:1996-04-17
Age:0.5  Onset:1996-04-18, Days after vaccination: 1
Gender:Male  Submitted:1996-04-24, Days after onset: 6
Location:Colorado  Entered:1996-05-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: in pt, sz at 6mo w/ dtp/hib #3;
Other Medications: apap
Current Illness: none
Preexisting Conditions: lt occipital flattening (positional molding);
Diagnostic Lab Data: EEG nl;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5J610732IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5J610732IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES737D62PO 
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Hypertonia, Muscle twitching, Pyrexia, Stupor
SMQs:, Neuroleptic malignant syndrome (narrow), Anticholinergic syndrome (narrow), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax;fever approx 100; then staring; arms & legs jerking for few seconds;irritable p/ 45 min;had trunk stiffening & arms/legs jerking for few sec;30 min later,pt appearing nl;

VAERS ID:85543 (history)  Vaccinated:1996-04-17
Age:1.1  Onset:1996-04-17, Days after vaccination: 0
Gender:Male  Submitted:1996-04-18, Days after onset: 1
Location:Virginia  Entered:1996-05-03, Days after submission: 15
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: denied any allergies w/immun;pre interview
Diagnostic Lab Data:
CDC Split Type: VA96026
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4326543IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0880B0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt''s mom contacted PHN informing provider that pt was evaluated @ ER last evening for leg swelling;was told had cellulitis & was rx cephalexin;has f/u appt tomorrow w/MD

VAERS ID:85546 (history)  Vaccinated:1996-04-17
Age:0.5  Onset:1996-04-18, Days after vaccination: 1
Gender:Male  Submitted:1996-04-25, Days after onset: 7
Location:Tennessee  Entered:1996-05-06, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations: na
Other Medications: none
Current Illness: none
Preexisting Conditions: prematurity 33-34 wks;
Diagnostic Lab Data: nl Head CT scan; cl electrolytes, calcium, magnesium;
CDC Split Type: TN96043
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4299691IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0732D1PO 
Administered by: Public     Purchased by: Public
Symptoms: Apnoea, Convulsion, Muscle twitching
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow), Hypoglycaemia (broad)
Write-up: pt recv vax;began having focal sz;rt hand twitching;lasted 5 min&occurred on 3 episodes;mild apnea w/ last sz;given dilantin&sz stopped;

VAERS ID:85561 (history)  Vaccinated:1996-04-17
Age:1.8  Onset:1996-04-18, Days after vaccination: 1
Gender:Male  Submitted:1996-04-18, Days after onset: 0
Location:Illinois  Entered:1996-05-06, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TB Monovac by Connaught lot# K0230
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: IL960050
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES426113IMLL
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5PM temp reached 102 ax despite APAP 9AM;hives began on arms then legs then abd;seen by MD 12:50;hives were gone but reoccurred again in late afternoon;advised father it was pertussis rxn

VAERS ID:85651 (history)  Vaccinated:1996-04-17
Age:1.0  Onset:1996-04-29, Days after vaccination: 12
Gender:Male  Submitted:1996-04-29, Days after onset: 0
Location:California  Entered:1996-05-07, 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:
Current Illness: impetigo
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1427B  RL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1504B  LL
Administered by: Private     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: c/o red spots x 1 day

VAERS ID:85676 (history)  Vaccinated:1996-04-17
Age:3.3  Onset:1996-04-19, Days after vaccination: 2
Gender:Male  Submitted:1996-05-06, Days after onset: 17
Location:North Carolina  Entered:1996-05-09, 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: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax 17APR96&came into office 6MAY96 w/mild&modified case d/t vax;no treatment given recently: close watch&f/u w/office on progress

VAERS ID:85893 (history)  Vaccinated:1996-04-17
Age:58.1  Onset:1996-04-22, Days after vaccination: 5
Gender:Female  Submitted:1996-04-29, Days after onset: 7
Location:Georgia  Entered:1996-05-10, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: GA96050
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H71005 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 22APR96 pt states swelling @ site $gfifty cents piece, itching, redness, hot to touch

VAERS ID:86352 (history)  Vaccinated:1996-04-17
Age:0.4  Onset:1996-04-17, Days after vaccination: 0
Gender:Male  Submitted:1996-04-19, Days after onset: 2
Location:Michigan  Entered:1996-05-24, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: UA
CDC Split Type: MI96052
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5K610571 LL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1189B1 RL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5K610571 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4319911PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Diarrhoea, Hypersensitivity, Injection site hypersensitivity, Oedema, Pyrexia, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 1hr p/shot t104 ax,ear 102;crying & fussy, vomiting each time p/eating;lt thigh red, scrotum swollen to ER 18APR;mom states UA done MD felt allergic rxn to shots;following vax mom gave bath & APAP;sl diarrhea;pt fussy & irritable x 5 days;

VAERS ID:86356 (history)  Vaccinated:1996-04-17
Age:4.1  Onset:1996-04-17, Days after vaccination: 0
Gender:Male  Submitted:1996-04-19, Days after onset: 2
Location:Michigan  Entered:1996-05-24, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TB by Connaught lot# 241411 given 17APR96;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MI96056
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5K610150 RL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0898B2 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1325B1 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4326683PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site mass, Oedema peripheral, Skin discolouration, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: 19APR96 mom brought pt in rt leg was swollen, reddened, hot & had area of discoloration @ center of circumferential area;area 3" by $g3inches w/tan coloration;rim of swollen area was bright red, 7/8 of hot, firm area was tan discoloration;

VAERS ID:86491 (history)  Vaccinated:1996-04-17
Age:0.3  Onset:1996-04-19, Days after vaccination: 2
Gender:Female  Submitted:1996-04-26, Days after onset: 7
Location:Texas  Entered:1996-06-03, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations: none
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type: TX96076
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES3949561 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0730E1PO 
Administered by: Private     Purchased by: Private
Symptoms: Febrile convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax; febrile sz, high fever 104;

VAERS ID:86849 (history)  Vaccinated:1996-04-17
Age:3.6  Onset:1996-04-17, Days after vaccination: 0
Gender:Female  Submitted:1996-04-17, Days after onset: 0
Location:Pennsylvania  Entered:1996-06-10, Days after submission: 54
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: PA9624
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MICHIGAN DEPT PUB HLTHTR1226ASB2IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4320022PO 
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 15-20min p/arrived home from vax-started vomiting 7x''s & diarrhea 5-6x''s;reported to clinic 2PM;advised to call family MD;330PM t101.5 po;vomitus 4x''s w/in 1 1/2hr as well as 2-3 diarrhea stools;pt given APAP & anti-diarrhea med by mom;

VAERS ID:87143 (history)  Vaccinated:1996-04-17
Age:4.9  Onset:1996-04-18, Days after vaccination: 1
Gender:Male  Submitted:1996-06-01, Days after onset: 44
Location:California  Entered:1996-06-18, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD by Connaught lot#240111
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES430957 IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4301741PO 
Administered by: Private     Purchased by: Other
Symptoms: Hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: local allergic reaction to DTAP & swollen & tender

VAERS ID:87374 (history)  Vaccinated:1996-04-17
Age:0.2  Onset:1996-04-17, Days after vaccination: 0
Gender:Female  Submitted:1996-04-26, Days after onset: 9
Location:Colorado  Entered:1996-06-27, Days after submission: 62
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: CO96029
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4293210IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1593B0IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0733M0PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Injection site hypersensitivity, Injection site oedema, Pyrexia, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: rt leg became red, swollen, hot in area of lateral thigh where DTP/HIB inj was given;pt cried for 1hr, t101;parent gave APAP, ice packs to leg;seen by MD who advised no more pertussis vax be given to pt;pt recovered completely

VAERS ID:87517 (history)  Vaccinated:1996-04-17
Age:1.1  Onset:1996-04-22, Days after vaccination: 5
Gender:Female  Submitted:1996-05-07, Days after onset: 15
Location:Texas  Entered:1996-07-02, Days after submission: 56
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: IGM high reported 6MAY96
CDC Split Type: TX96093
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM010LL3IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1176B0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Conjunctivitis, Drug ineffective, Infection, Lymphadenopathy, Oral candidiasis, Otitis media, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: pt recv vax 17APR96 & 22APR96 devel t104 to ER dx OM;med given;29APR96 rash onset to ER 30APR96 rash gen;blood drawn for IGm to TDH;cough, coryza, conjunctivitis, lymphadenopathy, koplik spot per MD;dx thrush

VAERS ID:87599 (history)  Vaccinated:1996-04-17
Age:0.6  Onset:1996-04-17, Days after vaccination: 0
Gender:Female  Submitted:1996-06-25, Days after onset: 69
Location:Florida  Entered:1996-07-08, 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: minimal upper resp inf
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: FL96043
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4319662IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1197B2IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0734A2PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site oedema, Injection site pain, Skin discolouration, Skin disorder, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: 13JUN96 mom c/o following 17APR96 vax given in lt leg hot, swollen immed following shot & soon p/became discolored;states it was approx 1mo a/swelling went down & cont to be tender to touch;dimpled depression now @ site mom states;

VAERS ID:87654 (history)  Vaccinated:1996-04-17
Age:0.3  Onset:1996-04-17, Days after vaccination: 0
Gender:Male  Submitted:1996-06-28, Days after onset: 72
Location:Idaho  Entered:1996-07-09, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4333642IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0732E1PO 
Administered by: Private     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), Hypoglycaemia (broad)
Write-up: pt recv vax; screaming for 2 1/2 hrs day vax given; no fever p/ resolution;

VAERS ID:88383 (history)  Vaccinated:1996-04-17
Age:1.0  Onset:1996-04-21, Days after vaccination: 4
Gender:Male  Submitted:0000-00-00
Location:Missouri  Entered:1996-07-18
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: exposure, varicella
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES96042413
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1500B0IM 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 17APR96 & 21APR96 pt devel 2-3 lesions & presented to MD;23APR96 pt had 20 lesions w/extensions;24APR96 pt had devel full-blown chicken pox w/numerous lesions all over body;

VAERS ID:88515 (history)  Vaccinated:1996-04-17
Age:41.2  Onset:1996-05-01, Days after vaccination: 14
Gender:Male  Submitted:0000-00-00
Location:Florida  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Catapress;Maxizide, Cardura
Current Illness:
Preexisting Conditions: smoker, high blood pressure;allergy, pollen;hayfever;
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES96050267
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0414B0SC 
Administered by: Public     Purchased by: Other
Symptoms: Lymphadenopathy, Myalgia, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: pt recv vax 17APR96 & 1MAY96 t100, tender, swollen rt axillary lymph node;8MAY96 pt had completely recovered;reporter felt that the swollen auxiliary lymph node was not r/t vax;attributed swollen lymph node to pt smoking;

VAERS ID:88010 (history)  Vaccinated:1996-04-17
Age:26.8  Onset:0000-00-00
Gender:Female  Submitted:1996-07-15
Location:Virginia  Entered:1996-07-22, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: pregnancy tests-pregnancy confirmed;25JUN96 ultrasound no cardiac activity;25JUN96 ultrasound fetal death;
CDC Split Type: WAES96052296
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Myalgia, Oedema peripheral, Stillbirth, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Termination of pregnancy and risk of abortion (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax & exp swollen, red, sore hand x 1wk;pt LMP 12APR96-pregnancy test confirmed pregnancy;ultrasound & vaginal probe confirmed fetal death @ 7 1/2 wk gestation;

VAERS ID:89038 (history)  Vaccinated:1996-04-17
Age:1.7  Onset:0000-00-00
Gender:Female  Submitted:1996-05-07
Location:Ohio  Entered:1996-08-05, Days after submission: 90
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:
Diagnostic Lab Data:
CDC Split Type: 896145001L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4333633IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1424B3IMRA
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax in rt arm & devel fever of 103, grumpiness, & sore arms that evening;pt recovered;

VAERS ID:89705 (history)  Vaccinated:1996-04-17
Age:4.9  Onset:1996-04-30, Days after vaccination: 13
Gender:Female  Submitted:1996-04-30, Days after onset: 0
Location:Illinois  Entered:1996-09-09, Days after submission: 132
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: IL960082
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5M610854 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0873B1 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0732D4PO 
Administered by: Public     Purchased by: Public
Symptoms: Oedema, Pain, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: rt arm swollen egg size & reddened;c/o pain when bump arm is using it;only noticed today 30APR96;

VAERS ID:90208 (history)  Vaccinated:1996-04-17
Age:4.9  Onset:1996-04-18, Days after vaccination: 1
Gender:Female  Submitted:1996-04-23, Days after onset: 5
Location:Washington  Entered:1996-09-25, Days after submission: 155
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: No relevant data;
CDC Split Type: WAES96081505
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1196B0 RL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1502B0 LL
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Pain, Pruritus, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 17APR96 & 18APR96 exp numerous severe blisters on labia, perineum & rectum accompanied by itching & pain, which progressed to blisters on body, head, hair & extremities by 72hr post onset;t99;required MD visit;

VAERS ID:91112 (history)  Vaccinated:1996-04-17
Age:22.9  Onset:1996-06-28, Days after vaccination: 72
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:1996-10-18
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: 28JUN96 IGG <0.7;
CDC Split Type: WAES96072523
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 2 doses of vax 17FEB96 & 17APR96 & 28JUN96 lab eval revealed IgG less than 0.7 & the pt exp a lack of seroconversion;

VAERS ID:97645 (history)  Vaccinated:1996-04-17
Age:5.0  Onset:1996-12-18, Days after vaccination: 245
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1997-04-18
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: hematuria
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96121548
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2007A22IM 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1503B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax & 18DEC96 pt had many papular lesions w/small vesicles;pt was treated w/DPH & recovered by JAN97;

VAERS ID:97850 (history)  Vaccinated:1996-04-17
Age:2.4  Onset:1997-03-06, Days after vaccination: 323
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:1997-04-18
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: No relevant data;
CDC Split Type: WAES97030613
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0389B0SC 
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dermatitis bullous, Drug ineffective, Infection, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 17APR96 & on 5MAR97 pt devel pox lesions on face & head;6MAR97 pt presented to a MD;@ time pt had approx 10 pox lesions;

VAERS ID:101395 (history)  Vaccinated:1996-04-17
Age:75.6  Onset:1996-04-18, Days after vaccination: 1
Gender:Female  Submitted:1997-04-11, Days after onset: 358
Location:Maine  Entered:1997-07-22, Days after submission: 102
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin, Lasxi atenolol;ferrous gluconate, magnesium, mevacor, calan SR;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6569
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L71095 IMRA
Administered by: Private     Purchased by: Public
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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: orange-sized redness & swelling w/area hot to touch & itchy;tx w/prophylactic ATb;28MAy96 f/u rxn 2 days p/shot given;5cm erythema, center blister, swollen, hot & somewhat hard;pt recovered;

VAERS ID:101400 (history)  Vaccinated:1996-04-17
Age:23.9  Onset:1996-04-18, Days after vaccination: 1
Gender:Female  Submitted:1997-04-11, Days after onset: 358
Location:Utah  Entered:1997-07-22, Days after submission: 102
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO6584
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM14443A60IMLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H71005 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Hypertonia, Injection site hypersensitivity, Injection site pain, Myalgia, Pain, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Big bright, feverish, red spot about the size of an orange @ inj site;whole body ached x 2 to 3 days;very painful & stiff up around shoulder, down into armpit & chest area;

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