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Case Details (Sorted by Vaccination Date)

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VAERS ID:114132 (history)  Vaccinated:1998-09-08
Age:11.0  Onset:1998-09-08, Days after vaccination: 0
Gender:Male  Submitted:1998-09-08, Days after onset: 0
Location:New York  Entered:1998-09-14, 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:
Current Illness: did not eat breakfast
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0433H1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Hypertension, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad)
Write-up: 1153AM pt became lightheaded & dizzy, nauseous p/vax;11:55 pt lying on exam table BP 110/78 given OJ & sucker

VAERS ID:114153 (history)  Vaccinated:1998-09-08
Age:1.0  Onset:1998-09-08, Days after vaccination: 0
Gender:Female  Submitted:1998-09-08, Days after onset: 0
Location:Florida  Entered:1998-09-15, 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: PPD by Connaught lot# 245511 given 8SEP98
Current Illness: NONE
Preexisting Conditions: eye crosses
Diagnostic Lab Data: NONE
CDC 'Split Type': FL98044
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0067H0SC 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0775D0PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0665H0SC 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 10-15 p/vax local rxn to both;varicella had one hive @ site w/reddened area (size of silver $);mom called 430PM to say awoke & has T103;arms red;

VAERS ID:114154 (history)  Vaccinated:1998-09-08
Age:1.0  Onset:1998-09-08, Days after vaccination: 0
Gender:Female  Submitted:1998-09-08, Days after onset: 0
Location:Florida  Entered:1998-09-15, 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: PPD by Connaught lot# 245511 given 8SEP98
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': FL98043
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0067H0SC 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0775D0PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0665H0SC 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: 10-15min p/vax local rxn to both;varicella site red one hive & reddened area (size of a silver $) given DPH;

VAERS ID:114180 (history)  Vaccinated:1998-09-08
Age:0.1  Onset:1998-09-08, Days after vaccination: 0
Gender:Female  Submitted:1998-09-09, Days after onset: 1
Location:Illinois  Entered:1998-09-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2705A21IM 
Administered by: Private     Purchased by: Private
Symptoms: Malaise, Pallor, Somnolence, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: lethargic, difficult to arouse, pallor;taken to Er-no abn findings;re evaluated 9SEP98 improved but still not self;

VAERS ID:114192 (history)  Vaccinated:1998-09-08
Age:5.4  Onset:1998-09-08, Days after vaccination: 0
Gender:Female  Submitted:1998-09-09, Days after onset: 1
Location:Florida  Entered:1998-09-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: blood drawn for testing (?type) @ hosp 8SEP98;
CDC 'Split Type': FL98042
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2628A21IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0232H1SCRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0789L4PO 
Administered by: Public     Purchased by: Public
Symptoms: Face oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: approx 3PM (4hr p/vax) pt face rt side from chin/jaw area to above rt eyelid & to midline of face swelled-eye is shut, lip bottom & top rt side swollen-no other c/o by child;ER visit approx 8PM given ATB;

VAERS ID:114278 (history)  Vaccinated:1998-09-08
Age:5.4  Onset:1998-09-14, Days after vaccination: 6
Gender:Female  Submitted:1998-09-15, Days after onset: 1
Location:Washington  Entered:1998-09-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7B918214IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0604E1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0775D3PO 
Administered by: Private     Purchased by: Private
Symptoms: Abscess, Injection site hypersensitivity, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 5.5cm x 4.5cm rt deltoid region (area of DTAP) erythema, indurated, tender, non fluc warm lesion;1st noticed by mom p/vax; dx cellulitis vs early abscess (sterile vs bact);tx med;

VAERS ID:114402 (history)  Vaccinated:1998-09-08
Age:29.9  Onset:1998-09-15, Days after vaccination: 7
Gender:Female  Submitted:1998-09-22, Days after onset: 7
Location:Virginia  Entered:1998-09-28, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: DepoProvera
Current Illness: Cat bite
Preexisting Conditions: Obesity
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LTD.09295905IMRL
Administered by: Private     Purchased by: Private
Symptoms: Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt recv vax on 9/8/98; on 9/15/98 pt exp tingling then numbness in thumb, index &middle fingers of right hand; right upper extremity pain.

VAERS ID:114432 (history)  Vaccinated:1998-09-08
Age:8.8  Onset:1998-09-09, Days after vaccination: 1
Gender:Male  Submitted:1998-09-21, Days after onset: 12
Location:Michigan  Entered:1998-09-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: DTP#1&2;5.5 &7.5 mos;swelling&discoloration injection site crying,fever
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Pt had 1 episode of asthma ''97-not ongoing problem
Diagnostic Lab Data: N/A
CDC 'Split Type': MI98098B
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2356A20IMRA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES7K91938 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Myalgia, Oedema peripheral, Rash, Rash maculo-papular, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 9/8/98; on 9/9/98 pt exp soreness LA;later in day-edema red patch 3-4" diameter LA, hot,very sore below injection site;tx=Tylenol,Benadryl,ice.On 9/11 pt imp.On 9/18 pt completely recovered.

VAERS ID:114434 (history)  Vaccinated:1998-09-08
Age:  Onset:1998-09-21, Days after vaccination: 13
Gender:Male  Submitted:1998-09-24, Days after onset: 3
Location:Utah  Entered:1998-09-29, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: PPD test-9/8/98-250011
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR I)MERCK & CO. INC.0956H0 LL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0667H0 RL
Administered by: Private     Purchased by: Private
Symptoms: Infection
SMQs:
Write-up: Pt recv vax on 9/8/98; on 9/21/98 pt exp chicken pox rash

VAERS ID:114665 (history)  Vaccinated:1998-09-08
Age:2.6  Onset:1998-09-08, Days after vaccination: 0
Gender:Female  Submitted:1998-09-11, Days after onset: 3
Location:Missouri  Entered:1998-10-02, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: 11SEP98 mom verbal report of possible seasonal allergies;
Preexisting Conditions: NONE
Diagnostic Lab Data: no tests-visual observation only;
CDC 'Split Type': MO98053
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4538433IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0469H3IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1236E0SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0665H0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous, Infection, Lymphadenopathy, Pyrexia, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 8SEP98 9AM-2PM call from mom w/report of breaking out lt arm pit;by that eve T102 w/stages papules, vesicles, pustules filled & ruptured-confined to lt axillary region from axilla to waist;dx chickenpox;lesions still present;

VAERS ID:114667 (history)  Vaccinated:1998-09-08
Age:1.8  Onset:1998-09-09, Days after vaccination: 1
Gender:Female  Submitted:1998-09-15, Days after onset: 6
Location:Missouri  Entered:1998-10-02, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthatic bronchitis
Diagnostic Lab Data: blood chemistry, CBC, CXR negative, throat cult negative;nasal cult;
CDC 'Split Type': MO98051
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0645H0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: rash, high temp;temp started @ 12:00AM on 9SEP98;rash started 14SEP98;

VAERS ID:114681 (history)  Vaccinated:1998-09-08
Age:0.5  Onset:1998-09-10, Days after vaccination: 2
Gender:Male  Submitted:1998-09-11, Days after onset: 1
Location:Texas  Entered:1998-10-02, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': TX98146
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4558412 RL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1166E2 LL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0724H2 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES787E22PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: small lump on area vaccine was administered to rt thigh;

VAERS ID:114726 (history)  Vaccinated:1998-09-08
Age:39.2  Onset:1998-09-23, Days after vaccination: 15
Gender:Female  Submitted:1998-09-28, Days after onset: 5
Location:New York  Entered:1998-10-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: healthy
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': NYS98024
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1304E0SC 
Administered by: Public     Purchased by: Public
Symptoms: Hyperhidrosis, Pharyngitis, Pyrexia, Rash maculo-papular, Rhinitis
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: fever-hot/cold sweats-fine red rash (generalized UR discomforts;

VAERS ID:114886 (history)  Vaccinated:1998-09-08
Age:38.1  Onset:1998-09-09, Days after vaccination: 1
Gender:Male  Submitted:1998-09-09, Days after onset: 0
Location:Georga  Entered:1998-10-13, Days after submission: 34
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': GA98073
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7K919381IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Headache, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: c/o of lt arm swollen about 1/4" & hurts, fever 102, h/a

VAERS ID:115175 (history)  Vaccinated:1998-09-08
Age:67.6  Onset:1998-09-09, Days after vaccination: 1
Gender:Female  Submitted:1998-10-16, Days after onset: 37
Location:Oregon  Entered:1998-10-22, 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: Fosomax,ambien, calcium, vit D
Current Illness: lt foot puncture wound
Preexisting Conditions: breast CA rt lumpectomy, hysterectomy, osteoporosis, diverticulitis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0944780 IMA
Administered by: Private     Purchased by: Private
Symptoms: Myalgia, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 8SEP98 & on 9SPE98 had 102 fever, chills;2 days later 11SEP98 had a rash from shoulder to elbow w/soreness in arm was given;

VAERS ID:115358 (history)  Vaccinated:1998-09-08
Age:7.6  Onset:1998-09-08, Days after vaccination: 0
Gender:Female  Submitted:1998-09-08, Days after onset: 0
Location:Pennsylvania  Entered:1998-10-26, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp puffy eye & runny nose w/MMR given 6AUG98 dose 1
Other Medications: pt recv Td by connaught lot# 7H91829 given 10SEP98;also recv hep b vax by SKB lot# 2607A2 given 10SEP98
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': PA9848
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0662E1SC 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4490872PO 
Administered by: Public     Purchased by: Public
Symptoms: Adverse drug reaction, Asthma, Face oedema, Palpitations, Rhinitis, Similar reaction on previous exposure to drug
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: 8SEP98 10min p/vax devel runny nose, expiratory wheeze, c/o pounding heart, puffy eyes;

VAERS ID:115699 (history)  Vaccinated:1998-09-08
Age:39.7  Onset:1998-09-09, Days after vaccination: 1
Gender:Female  Submitted:1998-10-22, Days after onset: 43
Location:Oregon  Entered:1998-11-04, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: 10SEP rt ear infect;17SEP98 rt hearing loss, severe;20SEP MRI;
CDC 'Split Type': OR9829
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0944780  RA
Administered by: Public     Purchased by: Public
Symptoms: Deafness transitory, Ear disorder, Tinnitus, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (narrow)
Write-up: loss of hearing in rt ear, vertigo, tinnitus, nausea, emesis;

VAERS ID:116165 (history)  Vaccinated:1998-09-08
Age:49.2  Onset:1998-09-10, Days after vaccination: 2
Gender:Female  Submitted:1998-09-15, Days after onset: 5
Location:Washington  Entered:1998-11-10, Days after submission: 56
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: NKDA
Diagnostic Lab Data: NONE
CDC 'Split Type': WA981492
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4478270IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt w/redness, painful @ site lt deltoid;tx med;

VAERS ID:116418 (history)  Vaccinated:1998-09-08
Age:0.2  Onset:1998-09-09, Days after vaccination: 1
Gender:Female  Submitted:1998-09-14, Days after onset: 5
Location:North Carolina  Entered:1998-11-16, Days after submission: 63
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pt brother exp same rx age 2 mon DTAP vax #3 dose
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': NC98039
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164800IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0496H0IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.NO2920IMLL
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Anorexia, Crying, Insomnia
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)
Write-up: Pt recv vax on 9/8/98; on 9/9/98 pt exp irritation, unconsolable high pitched cry, difficulty feeding, not sleeping well

VAERS ID:116670 (history)  Vaccinated:1998-09-08
Age:15.5  Onset:1998-09-15, Days after vaccination: 7
Gender:Female  Submitted:1998-09-28, Days after onset: 13
Location:Maine  Entered:1998-11-23, Days after submission: 56
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Urine, CBC, Sedrate, OP 12, Titer, Platelet count
CDC 'Split Type': ME025
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2626A20 RA
Administered by: Private     Purchased by: Public
Symptoms: Hypersensitivity, Vasculitis
SMQs:, Angioedema (broad), Vasculitis (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 9/8/98; on 9/15/98 pt exp diffuse vasculitis & hypersensitivity rx

VAERS ID:116813 (history)  Vaccinated:1998-09-08
Age:25.9  Onset:1998-09-08, Days after vaccination: 0
Gender:Female  Submitted:1998-10-16, Days after onset: 38
Location:New York  Entered:1998-11-25, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: pt recv Td vax AUG98
Current Illness:
Preexisting Conditions: asthma? allergy to ragweed;
Diagnostic Lab Data:
CDC 'Split Type': NYS98026
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0430H1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Laryngospasm, Pruritus, Rash
SMQs:, Anaphylactic reaction (narrow), Dystonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax went to work 2PM & felt as though throat was swelling this sensation lasted 45min 5PM devel a fine rash from elbow to hands some on thighs & chest;itching;

VAERS ID:119990 (history)  Vaccinated:1998-09-08
Age:3.8  Onset:1998-09-08, Days after vaccination: 0
Gender:Female  Submitted:1999-03-01, Days after onset: 174
Location:Illinois  Entered:1999-03-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data;
Other Medications: Tuberculin, old, tine test by Connaught
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': WAES98090463
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES 3IM 
HEP: HEP B (FOREIGN)MERCK & CO. INC. 3SC 
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC. 0IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0600E0IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv vax 8SEP98 & pt devel sl redness @ the vax site;

VAERS ID:120338 (history)  Vaccinated:1998-09-08
Age:5.5  Onset:1998-09-08, Days after vaccination: 0
Gender:Female  Submitted:1998-09-08, Days after onset: 0
Location:Michigan  Entered:1999-03-15, Days after submission: 188
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: mom states pt breaks out w/rashes couse unk
Diagnostic Lab Data: NONE
CDC 'Split Type': MI99028
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM858A20IM 
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2617A21IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1679E1IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0792F3PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Condition aggravated, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt returned to clinic shortly p/vax 8SEP98 rxn to immun;rash around mouth & on forehead;no distress rash resolved a/leaving clinic;no medication given;

VAERS ID:120424 (history)  Vaccinated:1998-09-08
Age:57.2  Onset:1998-09-09, Days after vaccination: 1
Gender:Female  Submitted:1998-09-22, Days after onset: 13
Location:Washington  Entered:1999-03-18, Days after submission: 177
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pt recv HepB #1 or #2, 43 yr age, exp "sick"
Other Medications: PPD, 9/8/98, Connaught, 246911, ID-LA; Premarin, Tetracycline, Ginseng, Kava Kava
Current Illness: NONE
Preexisting Conditions: Allergic to Septoa, Gall bladder removal 5/98, Gastric revision 1975
Diagnostic Lab Data: 8/31/98 Antibody to HBsAg -neg
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2717A22IMLA
Administered by: Public     Purchased by: Private
Symptoms: Abdominal pain, Influenza, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: Pt recv vax on 9/8/98; on 9/9/98 pt exp flu-like sx of aches, fever, abdominal pain

VAERS ID:128766 (history)  Vaccinated:1998-09-08
Age:0.1  Onset:1998-09-08, Days after vaccination: 0
Gender:Female  Submitted:1999-09-20, Days after onset: 377
Location:Florida  Entered:1999-09-30, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt & sibling; HepB; vomiting & struggling to breathe
Other Medications: propulsid
Current Illness: reflux
Preexisting Conditions: allergies to food/milk; lactose intolerlent
Diagnostic Lab Data: hair anaylsis show toxic heavy metals
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0924E1 RL
Administered by: Private     Purchased by: Private
Symptoms: Adverse drug reaction, Agitation, Condition aggravated, Dysphagia, Gastrointestinal disorder, Laboratory test abnormal, Mental retardation severity unspecified, Pain, Rash, Respiratory disorder
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: jerky; vomiting worse than average reflux; mucous too which choked pt;aspirated on some vomit;colic all day/night; red rash on body;severe crying nights/days;fever; now has lead; mercury;arsenic;alum poisoning;developmental delays

VAERS ID:151757 (history)  Vaccinated:1998-09-08
Age:1.1  Onset:1998-09-08, Days after vaccination: 0
Gender:Female  Submitted:2000-04-01, Days after onset: 571
Location:Michigan  Entered:2000-05-09, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: High fever;DTP + Hib (Mfr not classified);1;.00;In Patient
Other Medications: phenobarbital
Current Illness:
Preexisting Conditions: Seizure disorder.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0IM 
Administered by: Private     Purchased by: Other
Symptoms: Antisocial behaviour, Aphasia, Cognitive disorder, Depersonalisation, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Post vax, she developed a fever and extreme soreness at the vax site. Beginning on the day she received the MMR vax, she lost cognitive skills. She was speaking about 7 words; they were all lost. She stopped trying to interact with people. She now displays many autistic symptoms. Treated with gluten and dairy free diet and as of one month ago. It will not cause her to recover, only to improve.

VAERS ID:156168 (history)  Vaccinated:1998-09-08
Age:3.1  Onset:1999-09-19, Days after vaccination: 376
Gender:Female  Submitted:2000-05-16, Days after onset: 240
Location:Massachusetts  Entered:2000-07-10, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Amoxicillin allergy
Diagnostic Lab Data:
CDC 'Split Type': WAES99091394
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0701J0SC 
Administered by: Private     Purchased by: Public
Symptoms: Injection site vesicles, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Approximately 10 days post vax, pt experienced 2 positive lesions described as vesicles at the injection site, mild erythema and itching at the injection site.

VAERS ID:171366 (history)  Vaccinated:1998-09-08
Age:2.0  Onset:2000-05-04, Days after vaccination: 604
Gender:Male  Submitted:2001-05-15, Days after onset: 376
Location:Pennsylvania  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: test: diagnostic laboratory, date 05/09/00, value unit neg, normal range -, comment vzv culture
CDC 'Split Type': WAES00052987
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1657H0SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Rash, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: Varicella - Information has been received concerning a 33 month old Caucasian male who on 08 Sep 1998 was vaccinated with one dose of varicella virus vaccine live. Concomitant therapy included vitamins. On 04 May 2000 the patient experienced chickenpox with at least 300 lesions. He also experienced pustules. The rash worsened. The diagnosis was made by a physician on 08 May 2000. On 09 May 2000 a VZV culture revealed no viurs, however, the physician felt it was chickenpox. Three emergency room physician visits were required. The patient was administered cetiritine dihydrochloride (Zyrtec). The patient recovered on 12 May 2000.

VAERS ID:171861 (history)  Vaccinated:1998-09-08
Age:3.0  Onset:2000-10-31, Days after vaccination: 784
Gender:Female  Submitted:2001-05-15, Days after onset: 195
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES00110360
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: 0     Purchased by: 0
Symptoms: Drug ineffective, Rash, Viral infection
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: On 10/31/2000, the patient experienced clinical varicella with multiple lesions. Unspecified medical attention was sought. Follow up information from the registered nurse indicated that the varicella was not related to the varicella virus vaccine live. No further information is available.

VAERS ID:195899 (history)  Vaccinated:1998-09-08
Age:42.0  Onset:1999-07-07, Days after vaccination: 302
Gender:Male  Submitted:2002-12-29, Days after onset: 1271
Location:Florida  Entered:2003-01-08, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergic to Renecillian
Diagnostic Lab Data: Arthritus Blood Panel x 3: Negative results
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Oedema, Osteoarthritis, Pelvic pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad)
Write-up: Severe, chronic joint pain and swelling. (Enteric Aspirin) The follow up received on 2/19/03 states joint pain left/right pelvis/hip, left hip, both knees, left wrist; swelling of both hands.

VAERS ID:223504 (history)  Vaccinated:1998-09-08
Age:33.0  Onset:1998-09-08, Days after vaccination: 0
Gender:Male  Submitted:2004-06-29, Days after onset: 2121
Location:New Hampshire  Entered:2004-06-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: see above section 7;Rabies (unknown mfr);1;403;In Patient
Other Medications: None
Current Illness: prophalaxis for rabies
Preexisting Conditions: Depression/Anxiety, was not treated at that time. Allergic to mold and grass. Allergic to Percocet and Cat Scan Dye. High blood pressure, was not treated at that time.
Diagnostic Lab Data: Too numerous and unknown to me. Please contact the following two doctors who have treated me.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN0IMLL
Administered by: Private     Purchased by: Private
Symptoms: Aphthous stomatitis, Arthralgia, Diarrhoea, Fatigue, Headache, Influenza like illness, Joint stiffness, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: 4 to 5 hours after first injection of a rabies vaccine 09/1998 had a fever of 102.7 for three days. Severe pain in all muscles and joints along with stiffness. Severe Flu like symptoms, stomach problems and overall feeling of ill health. Routine severe diarrehia. Severe Headache for approximately two years everyday at base of skull/top of neck which would not go away with any over the counter pain medication. Four months after vaccine for the first time in my life suffered a severe cold sore on my upper lip. Have had routine canker sores inside my mouth ever since which correspond to severe pain in joints and muscles and stiffness. For two years following vaccine (until 2000) was extremely fatigued many times sleeping for as much as 16 hours per day along with constant joint and muscle pain and stiffness. From 2000 (until 2003 when treatment was sought) suffered periodically from severe fatigue. Suffered daily from severe muscle and joint pain and stiffness. Also routine severe headaches at base of skull/top of neck. An overall feeling of sickness including stomach problems and diarrehia. Was put on numerous anti inflamatory drugs which didn''t help i.e. Bextra, Mobic. Was put on 20 miligrams of Prednisone for one week and stiffness and joint muscle pain decreased by 80 percent upon return visit. Stayed on Prednisone for one year while doctor tried numerous drugs to relieve symptoms so I could get off Prednisone. Currently off Prednisone for three months and now taking Salsalate, Lexapro, Plaquenil, Folic Acid, Ultracet as needed for pain which are all working very well. Still suffer from slight pain, stiffness and swelling and sometimes redness everyday. Once or twice a month pain and stiffness will spike and become severe and need to take ultracet for pain for 2 or three days. Again canker sores, stomach problems, headache at base of skull and all over feeling of poor health correspond with increased joint and muscle pain and stiffness. Stiffness continues to spread to

VAERS ID:314195 (history)  Vaccinated:1998-09-08
Age:2.0  Onset:1998-09-08, Days after vaccination: 0
Gender:Male  Submitted:2008-05-16, Days after onset: 3538
Location:New York  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0710USA06110
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Varicella
SMQs:
Write-up: Information has been received from a physician concerning a 32 month old male with no medical history or allergies who on 08-SEP-1998 was vaccinated SC with a 0.5 mL dose of varicella virus vaccine live (Oka/Merck). There was no concomitant medication. In September 1998, within days of vaccination the patient developed a severe case of chickenpox. It was reported that the patient was vaccinated by another physician. No diagnostic laboratory tests were undertaken. Unspecified medical attention was sought. At the time of report the patient had recovered. A product quality complaint was not involved. Additional information has been requested.

VAERS ID:115143 (history)  Vaccinated:1998-09-08
Age:1.6  Onset:1998-09-11, Days after vaccination: 3
Gender:Male  Submitted:1998-10-16, Days after onset: 35
Location:Foreign  Entered:1998-10-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 19980248581
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM200013VH IM 
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER    
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Agitation, Coordination abnormal, Crying, Encephalitis, Gait disturbance, Gastroenteritis, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (broad)
Write-up: pt recv vax & approx 2 to 3 days later devel a cerebellar ataxia & screaming attacks which persisted about 2 days & disappeared then w/o sequelae;

VAERS ID:150889 (history)  Vaccinated:1998-09-08
Age:42.0  Onset:1998-09-08, Days after vaccination: 0
Gender:Female  Submitted:2000-04-04, Days after onset: 574
Location:Foreign  Entered:2000-04-11, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Co-Proxamol, ibuprofen, Microgynon
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES00032733
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.P1273 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Hypoaesthesia, Injection site hypersensitivity, Lacrimation increased, Muscle spasms, Nausea
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Lacrimal disorders (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: The same day of vax, the pt developed a numbness and cramp in leg and foot, localized redness in left arm, diarrhea, nausea, and runny eyes. The pt''s symptoms were considered to be other medical events. The pt went to the ER and on 9/9/00 was prescribed Piriton.

VAERS ID:156525 (history)  Vaccinated:1998-09-08
Age:17.0  Onset:1998-11-19, Days after vaccination: 72
Gender:Female  Submitted:2000-07-07, Days after onset: 595
Location:Foreign  Entered:2000-07-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: EEG - discrete theta-dysrhythmia without focus or potentials typical for epilepsia, MRI - Some cerebral lesions bilateral and trabecular but no cortical lesions, Neurological exam - nml, Cerebrospinal fluid cx - abn.
CDC 'Split Type': WAES00064414
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.5570112IM 
Administered by: 0     Purchased by: 0
Symptoms: CSF test abnormal, Electroencephalogram abnormal, Encephalitis, Grand mal convulsion, Laboratory test abnormal, Loss of consciousness, Movement disorder, Multiple sclerosis, Muscle twitching, Nuclear magnetic resonance imaging brain abnormal, Paresis
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Information has been received from a healthcare professional concerning a 17 year old female. On 11/19/98, the pt developed the first disturbance of consciousness accompanied with repeated twitching of arms and legs lasting for 1-5 minutes. The frequency of twitching increased and led finally to a loss of consciousness. No biting of the tongue, wetting, etc. had been observed. The symptoms were seen as further ictal disturbance of movement. On 11/19/98, the pt experienced a grand mal convulsion and a paresis was noted. A multiple sclerosis was dx''d later. A juvenile myoclonic epilepsia was assumed and had been treated with valproic acid. The pt was hospitalized for clarification of the cerebral lesions. On 7/15/99, the pt was examined by a neurologist. The pt reported that during the last hospitalization, the CSF revealed pathological results but at the time of reporting, the results were not available. The CSF had been performed for clarification of the MRI results. One week before the exam, on 7/15/99, the pt had developed, for 3 days, a feeling of numbness of the left thigh and left arm from which she recovered. The EEG detected general changes without signs for convulsion. No further information is available. 15-day follow-up states a diagnosis of encephalomyelitis was confirmed and then the diagnosis of idiopathic epilepsy was made. Symptoms started in the summer of 1999. The pt experiences were considered to be an "other medical event". F/U this is an amended report, the onset date of the ictal syncope was changed to 12/18/98. The date of the EEG was changed to 7/15/99.This is a corrected report as amended.

VAERS ID:487810 (history)  Vaccinated:1998-09-08
Age:34.0  Onset:1999-12-01, Days after vaccination: 449
Gender:Male  Submitted:2013-03-26, Days after onset: 4863
Location:Foreign  Entered:2013-03-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0175SYRRA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Dizziness, Rash
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Skin Rashes. Dizziness. Sore Joints.

VAERS ID:114240 (history)  Vaccinated:1998-09-09
Age:1.5  Onset:1998-09-09, Days after vaccination: 0
Gender:Male  Submitted:1998-09-16, Days after onset: 7
Location:Michigan  Entered:1998-09-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC 'Split Type': MI98105
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES4543423IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS  IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR I)MERCK & CO. INC.0902H0SCLL
Administered by: Public     Purchased by: Public
Symptoms: Face oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 9/9/98; 3 hrs later pt exp hives & swollen lips. Family directed to call E.R. for tx.

VAERS ID:114259 (history)  Vaccinated:1998-09-09
Age:74.8  Onset:1998-09-09, Days after vaccination: 0
Gender:Male  Submitted:1998-09-14, Days after onset: 5
Location:New York  Entered:1998-09-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Tenormin, Norvasc
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': FLU85060998
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER02988P0IM 
Administered by: Private     Purchased by: Private
Symptoms: Cerebral ischaemia, Chills, Dizziness, Hyperhidrosis, Speech disorder, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic cerebrovascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)
Write-up: cold sweats;slurred speech;tremors;lightheadedness;near syncope TIA like sx;

VAERS ID:114275 (history)  Vaccinated:1998-09-09
Age:55.1  Onset:1998-09-10, Days after vaccination: 1
Gender:Female  Submitted:1998-09-11, Days after onset: 1
Location:California  Entered:1998-09-21, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: foot pain & edema;
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0950730  RA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Pain, Skin nodule, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: large red indurated 80x115mm w/some c/o discomfort vx poss cellulitis;sent to ER to be seen;

VAERS ID:114295 (history)  Vaccinated:1998-09-09
Age:4.2  Onset:1998-09-10, Days after vaccination: 1
Gender:Female  Submitted:1998-09-15, Days after onset: 5
Location:Delaware  Entered:1998-09-23, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': DE9805
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09258804IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous, Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Severe cutaneous adverse reactions (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 9SEP98 & 11SEP98 lt deltoid area from shoulder & elbow swollen 7 warm;blisters (small patch) seen about 2" under inj site;pt referred to MD:

VAERS ID:114310 (history)  Vaccinated:1998-09-09
Age:5.7  Onset:0000-00-00
Gender:Female  Submitted:1998-09-17
Location:New York  Entered:1998-09-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: hives all over body;

VAERS ID:114416 (history)  Vaccinated:1998-09-09
Age:5.9  Onset:1998-09-10, Days after vaccination: 1
Gender:Male  Submitted:1998-09-18, Days after onset: 8
Location:Pennsylvania  Entered:1998-09-28, 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: asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09447704IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: pruritic, maculopapular rash devel @ the site of DTAP w/in 24hr of inj;rash spread over several dasy across back, neck & eventually face;partially responded to med;

VAERS ID:114446 (history)  Vaccinated:1998-09-09
Age:11.1  Onset:1998-09-09, Days after vaccination: 0
Gender:Female  Submitted:1998-09-09, Days after onset: 0
Location:New York  Entered:1998-09-29, Days after submission: 20
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: CBC, diff done;HCT 39% on site
CDC 'Split Type': BA5
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2418A2 IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0027H SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0776A PO 
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0934600 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Hyperventilation, Hypotension, Hypothermia, Hypotonia, Pallor, Stupor
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: p/vax pt appeared weak, limp, pale, no response; used ammonia inhalant w/good response;BP 80/55, P72, R24, T97.8;position on exam table w/feet up,head down;OJ given to drink;called MD into the room;

VAERS ID:114468 (history)  Vaccinated:1998-09-09
Age:71.2  Onset:1998-09-09, Days after vaccination: 0
Gender:Female  Submitted:1998-09-10, Days after onset: 1
Location:Ohio  Entered:1998-09-30, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1425E  RA
Administered by: Private     Purchased by: Private
Symptoms: Hypokinesia, Injection site hypersensitivity, Injection site oedema, Myalgia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: 2hr p/vax c/o face hot, muscle aches all noc, redness @ site, edema from deltoid to elbow, unable to move arm;tx ice to area x 2APAP;

VAERS ID:114654 (history)  Vaccinated:1998-09-09
Age:1.1  Onset:1998-09-09, Days after vaccination: 0
Gender:Male  Submitted:1998-09-09, Days after onset: 0
Location:Texas  Entered:1998-10-02, Days after submission: 23
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': TX98147
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1233E0SCLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0786H2PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Agitation, Cyanosis, Stupor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax & became unresponsive, skin color dusky, unresponsive to stimulus;called 911;crying;pt taken to hosp by parents for further observation;

VAERS ID:114736 (history)  Vaccinated:1998-09-09
Age:69.0  Onset:1998-09-10, Days after vaccination: 1
Gender:Male  Submitted:1998-09-30, Days after onset: 20
Location:North Carolina  Entered:1998-10-05, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pred;ASA;Viagra-antivert & vitamins;
Current Illness:
Preexisting Conditions: low Hgb 12-12.5, elevated sed rate (been to 32);possible polymyalgia rheumatic;s/p arthroscopic lt shoulder surgery AUG94;? TA w/h/a & scalp tingling;
Diagnostic Lab Data: CO2 total 32;urea nitrogen 29;uric acid 3.0;Iron, total serum 21;hemoglobin 12.0;HCT 38.1;MCHC 31.5;RDW 15.1;polys 73;lymph 17;EOS 1;BP 102/70;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR09758600IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cardiovascular disorder, Coordination abnormal, Dysuria, Guillain-Barre syndrome, Influenza, Laryngitis, Neuropathy, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Demyelination (narrow)
Write-up: c/o vertigo, coordination problem, laryngitis & URI;18SEP98 strange sensation in arms;numbness of arms, legs & face;unable to r/o GBS @ this time;poss sensory neuropathy;flu;problems starting urine;arterial insufficiency;

VAERS ID:114749 (history)  Vaccinated:1998-09-09
Age:1.3  Onset:1998-09-26, Days after vaccination: 17
Gender:Male  Submitted:1998-09-29, Days after onset: 3
Location:South Carolina  Entered:1998-10-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: well
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER847A23IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1424E0SCRA
Administered by: Other     Purchased by: Public
Symptoms: Dermatitis bullous, Infection, Lymphadenopathy, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 36hr p/vax scattered vesicular lesions w/erythematous base;15 lesions on scalp, trunk, lower extremities;lt pos auricular lymphadenopathy;pt dx w/chickenpox;

VAERS ID:114766 (history)  Vaccinated:1998-09-09
Age:56.1  Onset:1998-09-19, Days after vaccination: 10
Gender:Female  Submitted:1998-09-30, Days after onset: 11
Location:Florida  Entered:1998-10-06, 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: sinusitis
Preexisting Conditions: diverticulitis, depression
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES456053  RA
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Headache, Neck pain, Osteoarthritis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Arthritis (broad)
Write-up: temp to 103, h/a, neck pain & back pain, knee & ankle swelling 22SEP98;

VAERS ID:114836 (history)  Vaccinated:1998-09-09
Age:13.2  Onset:1998-09-27, Days after vaccination: 18
Gender:Male  Submitted:1998-10-05, Days after onset: 8
Location:Colorado  Entered:1998-10-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp grand mal sz w/dose 1 hep b vax;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EEG-MRI
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0878E1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Condition aggravated, Convulsion, Grand mal convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt recv vax & pt exp grand mal sz;approx 3wk later pt is being followed by neurologist for r/o seizure disorder;

VAERS ID:115028 (history)  Vaccinated:1998-09-09
Age:0.2  Onset:0000-00-00
Gender:Male  Submitted:1998-10-06
Location:Texas  Entered:1998-10-16, 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:
Diagnostic Lab Data: EHCO +enlarged WBC 9.9;ESR 104, coronaries, pl 516;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09397900 RL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0112H1 RL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS09634200 RL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N06520 RL
Administered by: Private     Purchased by: Private
Symptoms: Coronary artery disease, Myocarditis, Pyrexia, Red blood cell sedimentation rate increased, Thrombocythaemia, Vasculitis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Vasculitis (narrow)
Write-up: pt presented w/fever w/in hr of vax;hosp 48hr p/onset;eval revealed probable Kawasaki''s disease w/coronary artery enlargement, inc ESR, persistent T, myocarditis resolved w/IVIG/ASA;

VAERS ID:115348 (history)  Vaccinated:1998-09-09
Age:32.1  Onset:1998-09-09, Days after vaccination: 0
Gender:Female  Submitted:1998-09-10, Days after onset: 1
Location:Washington  Entered:1998-10-26, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pt exp similar sxs after 1st Hep vax (8/13/98).
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Acyclovir for herpes
Diagnostic Lab Data: NONE
CDC 'Split Type': WA981487
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2702A41IMLA
Administered by: Other     Purchased by: Private
Symptoms: Adverse drug reaction, Asthenia, Chills, Dizziness, Myalgia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: Pt recv vax on 9/9/98; on same day pt exp nausea, dry heaves, lightheaded, achiness, dizzy, chills&weakness for 2 day.

VAERS ID:115440 (history)  Vaccinated:1998-09-09
Age:33.1  Onset:0000-00-00
Gender:Female  Submitted:1998-10-26
Location:Ohio  Entered:1998-10-29, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: pregnancy
Diagnostic Lab Data: 23SEP98 ultrasound confirmed pregnancy;total serum human chorio positive;
CDC 'Split Type': WAES98091240
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Abortion
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: pt recv vax 9SEP98 & learned that she was pregnant (LMP 5AUG98);23SEP98 pregnancy was confirmed by n ultrasound & pregnancy test (hCG);f/u info indicated that pt pregnancy ended in a spontaneous abortion 5-6wk from LMP;

VAERS ID:115458 (history)  Vaccinated:1998-09-09
Age:33.3  Onset:0000-00-00
Gender:Female  Submitted:1998-10-22
Location:Connecticut  Entered:1998-10-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: blood drawn 1mo p/last inj;did not sero-convert p/2nd vax;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0495H1SCLA
Administered by: Public     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: vaccine failure;

VAERS ID:115459 (history)  Vaccinated:1998-09-09
Age:32.5  Onset:0000-00-00
Gender:Female  Submitted:1998-10-22
Location:Connecticut  Entered:1998-10-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: blood drawn 1mo p/last inj;pt did not seroconvert p/2nd vax
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0495H1SCLA
Administered by: Public     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: vaccine failure;

VAERS ID:115460 (history)  Vaccinated:1998-09-09
Age:  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:Connecticut  Entered:1998-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: blood drawn 1mo p/last inj;pt did not serovconvert p/2nd vax;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0495H1SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: vaccine failure

VAERS ID:117274 (history)  Vaccinated:1998-09-09
Age:32.8  Onset:1998-09-09, Days after vaccination: 0
Gender:Female  Submitted:1998-11-12, Days after onset: 64
Location:Massachusetts  Entered:1998-11-19, 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: Birth control pills
Current Illness:
Preexisting Conditions: prev recv 3 prev inj of another MFR rabies vaccine;no hx of allergies to eggs or ATB;
Diagnostic Lab Data: A titer on JUn97 was 1:50, a titer on 5SEP98 was reported to be $g.09;
CDC 'Split Type': 3622
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION2080110IM 
Administered by: Private     Purchased by: Other
Symptoms: Back pain, Chills, Diarrhoea, Headache, Injection site pain, Pain, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax & devel pain radiating down back & forearm 18hr p/vax;6hr later pt exp severe pain @ the inj site;12hr post vax exp lethargy, chills, h/a, diarrhea & felt feverish;18hr post vax had severe pain radiating down back & forearm;

VAERS ID:117038 (history)  Vaccinated:1998-09-09
Age:0.3  Onset:1998-09-09, Days after vaccination: 0
Gender:Male  Submitted:1998-11-10, Days after onset: 62
Location:South Carolina  Entered:1998-12-03, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt sibling exp rxn @ age 2mo
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: born 1mo premature-on apnea monitor
Diagnostic Lab Data: potassium 5.6;carbon dioxide 19;BUN 6;creatinine 0.4;RBC 4.21;MCV 86.4;PLT 576;MPV 7.3;lymph 71.6;neut 13.2;baso 6.3;urine color straw
CDC 'Split Type': SC98072
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164900 LL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.060141 RL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS361503A0 LL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N02910 RL
Administered by: Public     Purchased by: Public
Symptoms: Anaemia, Condition aggravated, Hyperkalaemia, Laboratory test abnormal, Pallor, Respiratory alkalosis, Thrombocythaemia, Urine analysis abnormal
SMQs:, Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad)
Write-up: pt recv vax 9SEP98 & child had periods of apnea & was then taken to ER & adm for observation;pt was born 1mo premature & was sent home on apnea monitor;pt exp pallor;

VAERS ID:117303 (history)  Vaccinated:1998-09-09
Age:0.0  Onset:1998-09-09, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Colorado  Entered:1998-12-11
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: NA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0112H0IMRL
Administered by: Private     Purchased by: Private
Symptoms: Agitation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: parents of pt notified office that 9SEP98 pt cried on & off all day & noc & evening of 10SEP98;APAP improved pt disposition;

VAERS ID:117506 (history)  Vaccinated:1998-09-09
Age:1.0  Onset:1998-12-16, Days after vaccination: 98
Gender:Female  Submitted:1998-12-16, Days after onset: 0
Location:Pennsylvania  Entered:1998-12-18, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR I)MERCK & CO. INC.7207060  
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES7231142  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1573E0  
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster, Infection
SMQs:
Write-up: Pt recv vax on 9/9/98; on 12/16/98 pt exp zoster

VAERS ID:117536 (history)  Vaccinated:1998-09-09
Age:1.5  Onset:1998-09-16, Days after vaccination: 7
Gender:Female  Submitted:1998-10-15, Days after onset: 29
Location:Idaho  Entered:1998-12-21, Days after submission: 67
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: runny nose
Preexisting Conditions: NONE gets spots when katsup touches skin;no ketsup recently
Diagnostic Lab Data: NONE
CDC 'Split Type': ID98047
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4514983IMLA
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM240RL3IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1311E0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash, Rash maculo-papular, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: rash little tiny spots all over body, blotchy on face only;fever for 4 days;mom had no thermometer, but was pretty hot;fever lasted consistently for 2 days then intermittently for 2 days;mom was cutting jalapeno peppers, handled child w/pep

VAERS ID:117541 (history)  Vaccinated:1998-09-09
Age:15.3  Onset:1998-09-12, Days after vaccination: 3
Gender:Female  Submitted:1998-09-28, Days after onset: 16
Location:Idaho  Entered:1998-12-21, Days after submission: 84
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': ID98054
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1311E1SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7F917000IMRA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: pt had fever/chills 3 days p/vax;pt devel severe h/a 5 days p/vax lasting about 48hr;pt seen by chiropractor x 2 w/resolution of h/a;

VAERS ID:118301 (history)  Vaccinated:1998-09-09
Age:  Onset:1998-09-20, Days after vaccination: 11
Gender:Female  Submitted:1999-01-07, Days after onset: 109
Location:Pennsylvania  Entered:1999-01-25, Days after submission: 18
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 899011003A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)PFIZER/WYETH    
Administered by: Other     Purchased by: Other
Symptoms: Anaphylactoid reaction, Syncope, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & devel anaphylactic shock on 21SEP98;pt devel hives on 1OCT98;pt seen by MD treated w/DPH;

VAERS ID:123956 (history)  Vaccinated:1998-09-09
Age:1.1  Onset:1998-09-09, Days after vaccination: 0
Gender:Female  Submitted:1999-05-14, Days after onset: 247
Location:Massachusetts  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98090660
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: p/vax pt exp a fever of 102.0;pt was treated w/APAP & Ibuprofen symptomatically;

VAERS ID:123982 (history)  Vaccinated:1998-09-09
Age:30.0  Onset:1998-09-11, Days after vaccination: 2
Gender:Female  Submitted:1999-05-14, Days after onset: 245
Location:California  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: obesity
Diagnostic Lab Data:
CDC 'Split Type': WAES98091118
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site pain, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: approx 2 days p/ vax pt exp erythematous & tenderness around the inject site, malaise & fever of 99.5. pt treated w/benadryl & tylenol. addl info requested

VAERS ID:123991 (history)  Vaccinated:1998-09-09
Age:26.0  Onset:1998-09-13, Days after vaccination: 4
Gender:Female  Submitted:1999-05-14, Days after onset: 243
Location:New York  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98091258
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Headache, Nausea, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: 4 days p/ vax pt devel rash of about 20 pox located on her extremities & behind the ears, exp headache, nausea, mild fever of 100 degrees.

VAERS ID:124005 (history)  Vaccinated:1998-09-09
Age:1.0  Onset:1998-09-20, Days after vaccination: 11
Gender:Female  Submitted:1999-05-14, Days after onset: 236
Location:Ohio  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: none
Diagnostic Lab Data: none
CDC 'Split Type': WAES98091663
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0IM 
Administered by: Private     Purchased by: Unknown
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: 11 days p/ vax pt exp mild fluid-filled rash w/approx 25-30 pox over parts of body

VAERS ID:124006 (history)  Vaccinated:1998-09-09
Age:21.2  Onset:0000-00-00
Gender:Female  Submitted:1999-05-14
Location:Utah  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: 9/9 & 9/21 beta-human chorionic
CDC 'Split Type': WAES98091668
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Vasodilatation
SMQs:
Write-up: it was rpt pt was expecting period 6sept. on 9sept & on 21sept pregnancy tests performed & pt believes it may have affected her norm cycle pt also exp hot flashes.

VAERS ID:125844 (history)  Vaccinated:1998-09-09
Age:70.2  Onset:1998-09-09, Days after vaccination: 0
Gender:Male  Submitted:1999-07-12, Days after onset: 306
Location:Michigan  Entered:1999-07-14, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: gastroesophagel reflux disease; hypertension
Diagnostic Lab Data: 9/9/98 chest x-ray; pulmonary perfusion scan; arterial blood gas; serum electrolytes test; CB cell;
CDC 'Split Type': WAES98090879
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0305H IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dyspnoea, Hyperhidrosis, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad)
Write-up: p/recv vax almost immed the pt exp a total body tremor & difficulty breathing as well as sweating; pt admitted to ER & treated w/IV saline, benadryl, & motrin;

VAERS ID:165452 (history)  Vaccinated:1998-09-09
Age:1.3  Onset:1998-09-16, Days after vaccination: 7
Gender:Male  Submitted:2001-01-20, Days after onset: 857
Location:New Jersey  Entered:2001-01-31, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ;Hep B (Mfr not specified);1;.08;In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: brother has autism
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER09642703IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0958HA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Aphasia, Autism, Social avoidant behaviour, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Post vax, the pt developed loss of eye contact, no socialization, no language, not responding to his name, and withdrawn. Dx with autism.

VAERS ID:168297 (history)  Vaccinated:1998-09-09
Age:38.0  Onset:1999-02-01, Days after vaccination: 145
Gender:Male  Submitted:2001-03-27, Days after onset: 785
Location:Idaho  Entered:2001-04-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: Normal electrolytes, CBC and TSH. Brain MRI on 11/17/98-small basilar artery system
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0170SCLA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Dizziness, Hot flush, Nervous system disorder, Vertigo
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow)
Write-up: Dizziness, vertigo, falling over from standing if eyes closed, hot flashes and early AM weakness. Onset a few weeks after initial Anthrax vaccination. Dizziness slowly resolved. Continued early morning weakness and hot flashes. Normal electrolytes, CBC, thyroid. Neurology consult on 11/17/98; Brain MRI. Follow up: Patient has not recovered from adverse event. Patient experiences hot flashes, body temperature has low tolerance to heat. Patient''s current work duty status is full duty. Patient has been evaluated by a physician or health care provider. Patient did receive further shots since reported event, however no effects were taken place." The follow up received on 4/24/01 states hot flashes, body temperature has low tolerance to heat.

VAERS ID:173137 (history)  Vaccinated:1998-09-09
Age:1.3  Onset:1998-09-16, Days after vaccination: 7
Gender:Unknown  Submitted:2001-07-02, Days after onset: 1020
Location:Washington  Entered:2001-07-11, Days after submission: 9
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: irregular breathing, seizure
Diagnostic Lab Data:
CDC 'Split Type': WAES01062223
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.  IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SC 
Administered by: Private     Purchased by: Other
Symptoms: Breath holding, Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: On 9/16/98, pt experienced a breath holding spell followed by a 30 to 60 minute convulsion. An ER or MD visit was required. Pt was given diazepam (Valium) but no outpt therapy. Subsequently, pt recovered. The reporting investigator felt that the breath holding spell and convulsion were possibly related to study vax. Upon internal review, these were considered to be other important medical events. No further info is available.

VAERS ID:189566 (history)  Vaccinated:1998-09-09
Age:1.0  Onset:2002-06-30, Days after vaccination: 1390
Gender:Male  Submitted:2002-08-29, Days after onset: 60
Location:Florida  Entered:2002-08-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Herpes zoster, Infection, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Adverse event actually happened nearly 5 years later. Near the end of June 2002, my son developed a painful rash on both sides of his neck. After realizing this was no ordinary rash (about a week after its appearance), I took him to the doctor. They took a culture, and called me several days later to tell me it was positive for shingles. This, they said, was most likely from the vaccine. We are no longer with the practice where the vaccine was administered. If you need the address of the practice where herpes was diagosed, email me, or contact me at the above address or phone number.

VAERS ID:271346 (history)  Vaccinated:1998-09-09
Age:38.0  Onset:2000-06-15, Days after vaccination: 645
Gender:Male  Submitted:2007-01-27, Days after onset: 2417
Location:Florida  Entered:2007-01-27
Life Threatening? No
Died? Yes
   Date died: 2006-03-16
   Days after onset: 2100
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: sinus problems, mild anxiety issues
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0173IMLA
Administered by: Military     Purchased by: Military
Symptoms: Amyotrophic lateral sclerosis, Eye pain, Fatigue, Headache, Irritable bowel syndrome, Malaise, Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad), Glaucoma (broad), Noninfectious diarrhoea (broad)
Write-up: After receiving the anthrax vaccine, my husband''s health begin to decline. He had symptons such as fatigue, headaches, eye-aches, IBS, and muscle twitching. He was finally diagnosed with ALS in 2005. He died March 2006. He was vaccinated with Lot # FAV017. There is no history of ALS in his family.

VAERS ID:483244 (history)  Vaccinated:1998-09-09
Age:24.0  Onset:1998-09-09, Days after vaccination: 0
Gender:Male  Submitted:2013-02-03, Days after onset: 5261
Location:Unknown  Entered:2013-02-03
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fever, cramps, itching at site, fatigue, soreness, mental problems(memory loss, short term, paranoia.) Excessive dry skin, unexplained itching, bathing in hotter water to sooth skin.
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0170SYRAR
Administered by: Military     Purchased by: Military
Symptoms: Amnesia, Dry skin, Fatigue, Injection site pruritus, Mental disorder, Muscle spasms, Pain, Paranoia, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Hypersensitivity (broad)
Write-up: NO TREATMENT-

VAERS ID:114488 (history)  Vaccinated:1998-09-09
Age:1.3  Onset:1998-09-09, Days after vaccination: 0
Gender:Female  Submitted:1998-09-24, Days after onset: 15
Location:Foreign  Entered:1998-09-29, Days after submission: 5
Life Threatening? Yes
Died? Yes
   Date died: 1998-09-12
   Days after onset: 3
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Diagnostic Lab Data: autopsy-hypoxic encephalopathy following out of hosp cardiac arrest;
CDC 'Split Type': WAES98091172
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1000E SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Acidosis, Agitation, Hypoxia, Pyrexia, Stupor, Sudden infant death syndrome, Syncope, Tachycardia, Unevaluable event
SMQs:, Torsade de pointes/QT prolongation (broad), Asthma/bronchospasm (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Tumour lysis syndrome (broad)
Write-up: pt recv vax 9SEP98 & 6hr post vax pt parents found pt collapsed & unresponsive;pt adm to ICU & was ventilated for 3 days;12SEP98 pt died;pt COD sudden infant synd;

VAERS ID:120409 (history)  Vaccinated:1998-09-09
Age:51.0  Onset:0000-00-00
Gender:Female  Submitted:1999-03-11
Location:Foreign  Entered:1999-03-18, 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: Cholecystectomy 25 years ago
Diagnostic Lab Data: AST 413, ALAT 1352, alk phos 180;Gamma GT 300;viral serologies & other aetiological search were negative;
CDC 'Split Type': U199900144
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURERB00601  A
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM    
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESB0421  A
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Asthenia, Blood alkaline phosphatase increased, Gamma-glutamyltransferase increased, Hepatic function abnormal, Hepatitis, Nausea
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax 9SEP98 & a few days later pt exp nausea & asthenia;biological check-up performed later showed cytolysis: ASAT 413UI/L, ALAT 1352 UI/L, alk phos 180 UI/L, gamma GT 300 UI/L;dx auto immune hepatitis

VAERS ID:114072 (history)  Vaccinated:1998-09-10
Age:5.6  Onset:1998-09-10, Days after vaccination: 0
Gender:Male  Submitted:1998-09-11, Days after onset: 1
Location:New York  Entered:1998-09-11
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: N/A
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: History of asthma
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Anaphylactoid reaction, Dyspnoea, Pharyngitis, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Agranulocytosis (broad), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 9/10/98; 10 mins later pt exp anaphylactic reaction w/ urticaria, sore throat, difficulty breathing, and puritis.

VAERS ID:114150 (history)  Vaccinated:1998-09-10
Age:0.2  Onset:1998-09-10, Days after vaccination: 0
Gender:Female  Submitted:1998-09-10, Days after onset: 0
Location:Utah  Entered:1998-09-15, 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 LABORATORIES09258800IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1555D1IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0722H0IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N01470SCRL
Administered by: Public     Purchased by: Unknown
Symptoms: Agitation, Hypertension, Hypoxia, Respiratory disorder, Somnolence
SMQs:, Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypertension (narrow), Eosinophilic pneumonia (broad)
Write-up: pt cried & held breath & became sleepy;mom attempted to comfort child;pt fell asleep on way from exam room to exit;mom stated that this was nl behavior-to fall asleep p/crying hard;on exam T36.9, HR 131, BP 119/77, good color;02 sat 87-97%

VAERS ID:114171 (history)  Vaccinated:1998-09-10
Age:4.5  Onset:1998-09-10, Days after vaccination: 0
Gender:Male  Submitted:1998-09-14, Days after onset: 4
Location:California  Entered:1998-09-16, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD by Connaught lot# 248211 given 10SEP98
Current Illness: NONE
Preexisting Conditions: premature, speech delayed
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM858A24IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0901E1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES792C53PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0808E0SCRA
Administered by: Private     Purchased by: Public
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: convuls on the same day p/vax w/DTAP, OPV, MMR, varicella dec admitted to hosp;

VAERS ID:114230 (history)  Vaccinated:1998-09-10
Age:0.4  Onset:1998-09-10, Days after vaccination: 0
Gender:Female  Submitted:1998-09-11, Days after onset: 1
Location:Arkansas  Entered:1998-09-21, Days after submission: 10
Life Threatening? No
Died? Yes
   Date died: 1998-09-10
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Lactalose;Cardac Dm
Current Illness: nasal congestion
Preexisting Conditions: constipation
Diagnostic Lab Data:
CDC 'Split Type': AR9852
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES4538461IMLL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES09425501IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N003211SCRL
Administered by: Private     Purchased by: Public
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)
Write-up: pt was seen in the office on 10SEP98 for 4mo check up;recv vax died early evening on 10SEP98;15SEP98 MD reports poss SIDS:vaccine related pending;

VAERS ID:114231 (history)  Vaccinated:1998-09-10
Age:79.9  Onset:1998-09-10, Days after vaccination: 0
Gender:Male  Submitted:1998-09-14, Days after onset: 4
Location:New York  Entered:1998-09-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Uniphyl, Pred, Lasix, K-dur, atrovent
Current Illness: NONE
Preexisting Conditions: No known drug allergies
Diagnostic Lab Data: blood glucose=42 in Er
CDC 'Split Type': FLU85020998
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02988P0IM 
Administered by: Other     Purchased by: Private
Symptoms: Chills, Dizziness, Hyperhidrosis, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)
Write-up: cold sweats;tremors;light headedness;near syncope;

VAERS ID:114304 (history)  Vaccinated:1998-09-10
Age:3.4  Onset:1998-09-11, Days after vaccination: 1
Gender:Male  Submitted:1998-09-17, Days after onset: 6
Location:Michigan  Entered:1998-09-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1573E0 RL
Administered by: Private     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: hives all over body;

VAERS ID:114744 (history)  Vaccinated:1998-09-10
Age:1.0  Onset:1998-09-12, Days after vaccination: 2
Gender:Female  Submitted:1998-09-15, Days after onset: 3
Location:Illinois  Entered:1998-10-06, Days after submission: 21
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
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09397902 LL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES09545302 RL
Administered by: Private     Purchased by: Unknown
Symptoms: Hypokinesia
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt does not use lt leg when crawling moves rt leg et drags lt;pt stand on both legs et does not cry when mom feel leg;

VAERS ID:114757 (history)  Vaccinated:1998-09-10
Age:1.2  Onset:1998-09-10, Days after vaccination: 0
Gender:Male  Submitted:1998-09-18, Days after onset: 8
Location:California  Entered:1998-10-06, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: unk
Other Medications: APAP
Current Illness: mild motor delay, hypotonia
Preexisting Conditions: motor delay, hypotonia, maenophaly
Diagnostic Lab Data: LP, CT
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES09189803 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0509H0SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0841H0SCRL
Administered by: Other     Purchased by: Public
Symptoms: Convulsion, Otitis media
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: sz 6hr p/vax & 13hr p/vax seen in ER also had LP, CT;ear infect diagnosed;

VAERS ID:114795 (history)  Vaccinated:1998-09-10
Age:8.0  Onset:1998-09-11, Days after vaccination: 1
Gender:Male  Submitted:1998-09-15, Days after onset: 4
Location:Maryland  Entered:1998-10-08, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': MD98013
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0624E1 LA
Administered by: Public     Purchased by: Unknown
Symptoms: Pharyngitis, Pruritus, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: pt began 101 fever 24hr p/vax;48hr later began w/hives, sore throat, itching, fever cont;seen by MD 14SEP98 @ clinic;given DPH & APAP s/s improved-99 temp 15SEP98;

VAERS ID:115356 (history)  Vaccinated:1998-09-10
Age:4.6  Onset:1998-09-16, Days after vaccination: 6
Gender:Female  Submitted:1998-09-17, Days after onset: 1
Location:Pennsylvania  Entered:1998-10-26, Days after submission: 39
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': PA9851
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09073804IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0990E1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4500323PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0053H0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: devel 6 erythematous papules on rt lower leg 6 days;also exp localized itching;

VAERS ID:115383 (history)  Vaccinated:1998-09-10
Age:37.6  Onset:1998-10-23, Days after vaccination: 43
Gender:Female  Submitted:1998-10-23, Days after onset: 0
Location:Washington  Entered:1998-10-27, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: non apparent
Preexisting Conditions: no known
Diagnostic Lab Data: rubeola titer negative
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1232E0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Influenza, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: flu like s/s w/itching;DPH;

VAERS ID:122256 (history)  Vaccinated:1998-09-10
Age:26.3  Onset:1998-09-21, Days after vaccination: 11
Gender:Female  Submitted:1999-03-30, Days after onset: 190
Location:Washington  Entered:1999-05-20, Days after submission: 50
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Tetracycline 250mg bid x 1year
Current Illness: NONE
Preexisting Conditions: heart murmer @ birth
Diagnostic Lab Data: ECG, CXR both WNL;friction rub on physical
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2565A40IMA
Administered by: Unknown     Purchased by: Public
Symptoms: Chest pain, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad)
Write-up: 21SEP98 fullness/pain on inspiration;seen in clinic found to have friction rub dx w/pericarditis;

VAERS ID:123993 (history)  Vaccinated:1998-09-10
Age:5.3  Onset:1998-09-19, Days after vaccination: 9
Gender:Female  Submitted:1999-05-14, Days after onset: 237
Location:Pennsylvania  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: varicella exposure
Diagnostic Lab Data:
CDC 'Split Type': WAES98091367
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: 9 days p/ vax pt devel papular vesicular rash w/more than 50 lesions. MD stated pt may have been exposed to natural chickenpox prior to vax

VAERS ID:165626 (history)  Vaccinated:1998-09-10
Age:4.0  Onset:2001-01-09, Days after vaccination: 852
Gender:Male  Submitted:2001-01-29, Days after onset: 20
Location:Illinois  Entered:2001-02-06, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09296903IM 
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0726H3IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4525993PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0960E0IM 
Administered by: Private     Purchased by: Public
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: On 1/9/01, the pt developed 20 or so lesions typical of chicken pox. These were not infected.

VAERS ID:175754 (history)  Vaccinated:1998-09-10
Age:4.0  Onset:2000-12-18, Days after vaccination: 830
Gender:Male  Submitted:2001-04-10, Days after onset: 112
Location:Maryland  Entered:2001-09-26, Days after submission: 169
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Private     Purchased by: Unknown
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt started with pox of scalp, then to back, arms and legs about 7-10 a day.

VAERS ID:177938 (history)  Vaccinated:1998-09-10
Age:7.0  Onset:2001-11-07, Days after vaccination: 1154
Gender:Male  Submitted:2001-11-09, Days after onset: 2
Location:Pennsylvania  Entered:2001-11-19, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1009H1SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0846H0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: No description provided

VAERS ID:184741 (history)  Vaccinated:1998-09-10
Age:5.0  Onset:2000-06-23, Days after vaccination: 652
Gender:Female  Submitted:2002-05-15, Days after onset: 691
Location:Maine  Entered:2002-05-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES01041410
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Public     Purchased by: Private
Symptoms: Rash vesicular, Skin ulcer
SMQs:, Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 5 year old caucasian female patient who on 09/10/1998 was vaccinated with Varicella virus vaccine live SC. The registered nurse reported that the patient "got chicken pox twice". On 06/23/00, the pt presented with a "erythmatous papular rash. The registered nurse reported that on 04/06/01, the pt presented again with the same type of symptoms. The patient''s outcome was not reported. Unspecified medical attention was sought. In follow-up, the registered nurse reported that the pt experienced "no adverse effects. The registered nurse reported, "pt received vaccine 09/10/1998 then had chickenpox looking rash 06/23/00 and again 04/09/01. the registered nurse also reported on the pt''s sibling, WAES #01041029, who had an experience following vaccination with Varicella virus vaccine live and on an unspecified number of children who developed chicken pox following vaccination with Varicella virus vaccine live (WAES01041411). Additional information has been requested.

VAERS ID:191260 (history)  Vaccinated:1998-09-10
Age:1.3  Onset:1998-12-01, Days after vaccination: 82
Gender:Female  Submitted:2002-10-11, Days after onset: 1409
Location:New York  Entered:2002-10-14, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC 'Split Type': WAES0210USA00268
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1009H0SC 
Administered by: Private     Purchased by: Private
Symptoms: Autism, Nasopharyngitis
SMQs:
Write-up: Information has been received from a licensed visiting nurse concerning a 16 month old female with no significant past medical historyn and no known allergies who on 09/10/98 was vaccinated with a first dose of MMR II *in the left arm SC*. There was no concomitant medication. *The PT''s mother reported that her daughter progressed typically w/out any prob''s, "achieving all her milestones, sitting, crawling, walking, etc, early," The PT was breast fed until approx 13 mts of age, and was reportedly always of good health and weight. The mother described photos that "show her getting ready for her one yr b-day party, wearing a ballerina tutu w/lots of netting and rollers in her hair... in the photos she is smiling and twirling for us. She did not have sensory issues at all at that point." The info received on 12/9/02 reported that "of course now, she will not allow anything to be placed in her hair or anything but very soft cotton to touch her skin." The mother reported that she can not say when her daughter began to regress as it was a slow but steady process. From photos, the mother reportedly saw a "difference in eye contact and in her presence in Christmas Eve pic of 98." The PT had a very bad cold then and reportedly did not seem to be herself. She was described as "withdrawn and not playful or excited for X-mas." The PT''s mother assumed that it was due to her sickness. In pictures from Spring 99, the mother described her daughter covering her ears. The PT''s mother also noticed a mispronunciation of words. The PT''s mother also reported SXs of w/drawal and lack of eye contact, difficulty sleeping, and self injurious behaviors, "(head banging, throwing herself down in tantrums if her blocks would not balance, etc) grew from there".* It was reported that at the age of 32 months, the child''s speech has regressed, and the child was not doing well in social situations. In 09/2000, the patient was sent to a specialist and was diagnosed with autism. On 1/7/02, it was recorded that the child "is in school and is continuin

VAERS ID:193587 (history)  Vaccinated:1998-09-10
Age:1.5  Onset:0000-00-00
Gender:Male  Submitted:2002-11-19
Location:Unknown  Entered:2002-11-20, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unk
Preexisting Conditions:
Diagnostic Lab Data: Unk
CDC 'Split Type': A0386158A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEUR09425402IM 
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS2703A92IM 
HIBV: HIB (ACTHIB)AVENTIS PASTEUR09545302IM 
Administered by: Other     Purchased by: Other
Symptoms: Abnormal behaviour, Cognitive disorder, Drug toxicity, Drug withdrawal syndrome, Nervous system disorder, Neurodevelopmental disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Drug abuse and dependence (broad), Drug withdrawal (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad)
Write-up: This report describes the occurrence of mercury poisoning in an 18 month old male who was vaccinated with hep B vaccine recombinant (Engerix B) for prophylaxis. This report was received as part of litigation proceedings and has not been verified by a physician or other health care professional. The subject was allegedly "born a perfectly normal, healthy boy whose Apgar scores at birth were well within the normal range Developmentally, neurologically and socially, he achieved every developmental milestones anticipated of all normally developing children until the age of 18 months." The subject received injection of Engerix B on 2/18/98 (lot 2361B9) and 9/10/98 (lot 2703A9). He also received injections of hepatitis B vaccine (Recombivax-HB) 3/20/98; Tripedia 4/21/98, 6/3/98, and 9/10/98; and Act-HIB 4/21/98 and 9/10/98, 6/30/98. The subject''s attorney alleged that "The subject has suffered devastating injuries through mercury toxicity and associated complications and sequelae and the aggravation of other conditions directly through exposure, via an intramuscular injection of mercury." He further alleged that "At approximately 18 months of age, the subject was neurologically devastated by the accumulation of mercury in his body, haivng been exposed via IM vaccinations, and suddenly regressed developmentally, losing milestones of neurological development previously achieved, specifically including, but not limited to: a. Becoming withdraw, unable to speak, unresponsive to his/her environment, engagin in repetitive behavior, and b. The loss of languag skills, motor skills and affect." Treatment and outcomes of these events were not specified. The mercury poisoning and developmental regression in this report are considered medically serious (OMIC).

VAERS ID:213933 (history)  Vaccinated:1998-09-10
Age:6.0  Onset:2003-10-18, Days after vaccination: 1864
Gender:Male  Submitted:2003-10-19, Days after onset: 1
Location:Massachusetts  Entered:2003-12-12, Days after submission: 54
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)LEDERLE LABORATORIES0786F2  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0837H0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Vaccine failure.

VAERS ID:239234 (history)  Vaccinated:1998-09-10
Age:1.2  Onset:2005-02-18, Days after vaccination: 2353
Gender:Unknown  Submitted:2005-05-16, Days after onset: 86
Location:Unknown  Entered:2005-06-07, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0503USA02556
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.626961/0848H   
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection, Skin ulcer
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a health professional concerning a 7 year of patient who on 09/10/1998 was vaccinated with a dose of varicella virus vaccine live. On 02/18/2005 the patient presented with about 6 lesions attributed to breakthrough varicella. Unspecified medical attention was sought. No treatment was needed. There was no product quality complaint involved. Additional information has been requested.

VAERS ID:255709 (history)  Vaccinated:1998-09-10
Age:1.2  Onset:2005-02-19, Days after vaccination: 2354
Gender:Female  Submitted:2006-05-12, Days after onset: 446
Location:Massachusetts  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Body height 9/10/98-48 inches; body weight 9/10/98-46 lbs.
CDC 'Split Type': WAES0504USA01368
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)PFIZER/WYETHM240RL3  
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1019E0  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0848H0  
Administered by: Private     Purchased by: Public
Symptoms: Drug ineffective, Infection, Vaccine positive rechallenge
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Info has been received from a physician concerning a 7 year old white female who on 9/10/98 was vaccinated with the 1st dose of varicella virus vaccine live. Concomitant vaccinations on the same day, included the 1st dose of MMRII and the 4th dose of Hib-Titer. On 2/19/05, the pt developed 6 lesions after exposure to a child with active chickenpox, 2 weeks earlier. It was reported that the pt recovered. No product quality complaint was involved. Additional info has been requested.

VAERS ID:114354 (history)  Vaccinated:1998-09-10
Age:2.3  Onset:1998-09-10, Days after vaccination: 0
Gender:Male  Submitted:1998-09-17, Days after onset: 7
Location:Foreign  Entered:1998-09-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: fever
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': U199800541
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESM06971   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Convulsion, Dyspnoea, Electroencephalogram abnormal, Hypersensitivity, Hypertonia, Pharyngitis, Rash
SMQs:, Anaphylactic reaction (narrow), Agranulocytosis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (narrow), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 10SEP98 & 20min later exp gen rash w/breathing difficulties & hypertonic limbs;there was no fever;quick & full recovery was obtained w/corticorsteroids tx & 02;pt hosp from 10SEP98 to 15SEP98;

VAERS ID:116570 (history)  Vaccinated:1998-09-10
Age:10.0  Onset:1998-09-20, Days after vaccination: 10
Gender:Male  Submitted:1998-11-17, Days after onset: 58
Location:Foreign  Entered:1998-11-20, 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: Dridase
Current Illness:
Preexisting Conditions: bladder disorder;intestinal disorder;meingomyelocele
Diagnostic Lab Data: lab test pleocytosis;
CDC 'Split Type': WAES98110905
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Malaise, Meningitis, Nausea, Photophobia, Pleocytosis, Vomiting
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: pt recv vax 10SEP98 & 20SEP98 pt exp serous meningitis & pleocytosis (123/3 cells) & was hosp;the reporting MD felt that serous meningitis & pleocytosis were not r/t to therapy w/hep b vax;

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