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Found 593491 cases in entire database

Case Details (Sorted by Vaccination Date)

This is page 1346 out of 5935

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VAERS ID:87568 (history)  Vaccinated:1996-03-06
Age:18.0  Onset:0000-00-00
Gender:Male  Submitted:1996-07-01
Location:Foreign  Entered:1996-07-05, Days after submission: 4
Life Threatening? No
Died? Yes
   Date died: 1996-06-09
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 23MAY96 Basophils .01;eosinophils .08;ESR-1; HR 1;hemoglobin 15.4; 24MAY96 hepatitis A IGM antibodies neg;infective mononeucleosis neg;23MAY96 lymphocytes 1.95;mean corp hemoglobin 29.8;mean corp hemoglobin conc 34.3;mean corp volume 44.8;
CDC Split Type: 960088261
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMB1875A4 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hepatic failure, Hepatitis, Hepatocellular damage, Infection, Laboratory test abnormal, Leukopenia, Pyrexia, Thrombocytopenia
SMQs:, Hepatitis, non-infectious (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: pt recv vax 6MAR96 & died of acute fulminant hepatic failure secondary to glandular fever on 9JUN96;pt hosp;MD felt probably unrelated to vax & that glandular fever may be implicated;poss viral infect (non hepatitis A/B) poss EBV;

VAERS ID:100362 (history)  Vaccinated:1996-03-06
Age:1.3  Onset:1996-03-28, Days after vaccination: 22
Gender:Male  Submitted:1997-07-18, Days after onset: 476
Location:Foreign  Entered:1997-07-22, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: PCN
Current Illness:
Preexisting Conditions: cystic fibrosis
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97070298
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Coordination abnormal, Ear disorder, Gait disturbance, Hypokinesia, Insomnia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax 6MAR96 & 28MAR96 pt exp fever, insomnia, & flux from one ear;during the following days pt walked less than usual & fell frequently;1wk later pt had a sl insecure gait;pt hosp

VAERS ID:101916 (history)  Vaccinated:1996-03-06
Age:0.3  Onset:1996-04-06, Days after vaccination: 31
Gender:Female  Submitted:1997-08-13, Days after onset: 493
Location:Foreign  Entered:1997-08-26, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: family hx of epilepsy;child''s maternal uncle devel epilepsy p/pertussis vax & had tx during childhood;girl cousin on mom side had also tx w/antiepileptic drugs for 2 to 11 yr of age;
Diagnostic Lab Data: 19APR96 EEG nl;
CDC Split Type: 970191931
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM    
Administered by: Unknown     Purchased by: Unknown
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), Hypoglycaemia (broad)
Write-up: pt recv vax 6MAR96 & 6APR96 31 days p/vax pt was hosp d/t absence attacks;during hosp pt had convuls of epilepsy type;19APR96 EEG was found to be nl;d/t on phenobarb;4JUN97 pt was still on antiepileptic drugs but in dec doses;

VAERS ID:125426 (history)  Vaccinated:1996-03-06
Age:13.0  Onset:1996-04-15, Days after vaccination: 40
Gender:Male  Submitted:1999-07-01, Days after onset: 1172
Location:Foreign  Entered:1999-07-08, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recv HEP #3 8/13/96-text does not describe further sx
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: ANA neg; complement neg; Borrelia serology neg
CDC Split Type: 19990149521
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Scleroderma
SMQs:
Write-up: p/vax pt devel disabling lt facial scleroderma in upper lt maxillary area;w/o lingual hemiatrophy or maxillary asymmetry; no sign of systemic scleroderma noted; tx w/ corticoids & Plaquenil w/o effect;tx w/ ultraviolet; pt not recovered

VAERS ID:83542 (history)  Vaccinated:1996-03-07
Age:1.3  Onset:1996-03-07, Days after vaccination: 0
Gender:Female  Submitted:1996-03-08, Days after onset: 1
Location:Georgia  Entered:1996-03-08
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: sz on 5JAN96, unk cause
Diagnostic Lab Data: glucose 127;pulse ox 95-99%
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM315LE3IMRL
Administered by: Private     Purchased by: Public
Symptoms: Convulsion, Hyperglycaemia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: w/in 10seconds of HIB vax, pt had sz lasted approx 1min;pt was given 02;pt transported by EMS to hosp

VAERS ID:83697 (history)  Vaccinated:1996-03-07
Age:0.6  Onset:1996-03-11, Days after vaccination: 4
Gender:Female  Submitted:1996-03-12, Days after onset: 1
Location:Missouri  Entered:1996-03-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OPV
Current Illness: Nasal congestion
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC & blood cultures were drawn on12MAR96;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4299661IMRL
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: pt recvd vax 7MAR96 called office on 11MAR96 asking about red area where shot was given;mom called again on 12MAR96 appt given;MD gave augmentin;

VAERS ID:83744 (history)  Vaccinated:1996-03-07
Age:0.1  Onset:1996-03-09, Days after vaccination: 2
Gender:Male  Submitted:1996-03-12, Days after onset: 3
Location:Illinois  Entered:1996-03-19, Days after submission: 7
Life Threatening? No
Died? Yes
   Date died: 1996-03-09
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: cocaine baby; ward of state at birth;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0524B1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Infection, Pulmonary oedema
SMQs:, Cardiac failure (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax;well baby in for routine checkup,vitals ok,noted nasal stuffiness;

VAERS ID:83746 (history)  Vaccinated:1996-03-07
Age:0.2  Onset:1996-03-07, Days after vaccination: 0
Gender:Male  Submitted:1996-03-07, Days after onset: 0
Location:South Carolina  Entered:1996-03-19, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: SC96012
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4278400 RL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0519B1 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4271170PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Hyperhidrosis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: tc recvd from mom stating since shot given pt has cont to cry, sleeps a few minutes & wakes up-gave APAP x 1hr p/shot given-sweating now, felt hot;advised to go to ER;

VAERS ID:83767 (history)  Vaccinated:1996-03-07
Age:  Onset:1996-03-08, Days after vaccination: 1
Gender:Male  Submitted:1996-03-08, Days after onset: 0
Location:New Mexico  Entered:1996-03-19, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4299663IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0469B0SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0735E2PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recvd vax; fever, erythema,edema, induration at inject site; onset several hrs p/ vax;

VAERS ID:83789 (history)  Vaccinated:1996-03-07
Age:1.2  Onset:1996-03-07, Days after vaccination: 0
Gender:Male  Submitted:1996-03-11, Days after onset: 4
Location:North Carolina  Entered:1996-03-20, 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: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: NC96021
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4293213IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1169B0SC 
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Otitis media, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: possible sz;t103 prescribed med for ear infect

VAERS ID:83844 (history)  Vaccinated:1996-03-07
Age:1.22  Onset:1996-03-10, Days after vaccination: 3
Gender:Female  Submitted:1996-03-18, Days after onset: 8
Location:North Carolina  Entered:1996-03-25, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: soft signs of CP
Diagnostic Lab Data:
CDC Split Type: NC96022
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4319673IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4293363PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Coordination abnormal, Encephalopathy, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: None reported.

VAERS ID:83852 (history)  Vaccinated:1996-03-07
Age:1.0  Onset:1996-03-15, Days after vaccination: 8
Gender:Female  Submitted:1996-03-19, Days after onset: 4
Location:Florida  Entered:1996-03-25, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: mild case of measles dx
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 3  
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 3  
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER 3  
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER 3PO 
Administered by: Public     Purchased by: Other
Symptoms: Cough, Drug ineffective, Infection, Pyrexia, Rash, Stupor
SMQs:, Anaphylactic reaction (narrow), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: high temp 103.8; mild rash-that turned into rash that covered entire body, coughing-glassy eyed look

VAERS ID:83864 (history)  Vaccinated:1996-03-07
Age:  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:North Carolina  Entered:1996-03-25
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: NC96023
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4293191IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0732B1PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Abscess, Infection, Injection site hypersensitivity, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 7MAR96 & pt into clinic 13MAR w/3cm erythema w/pustule centrally located rt mid lateral thigh w/local abscess;pt placed on ATB biaxin

VAERS ID:84063 (history)  Vaccinated:1996-03-07
Age:1.5  Onset:1996-03-08, Days after vaccination: 1
Gender:Female  Submitted:1996-03-12, Days after onset: 4
Location:Tennessee  Entered:1996-03-28, Days after submission: 16
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: TN96032
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5M610782IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0523B1IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM010LL2IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0732D2PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Crying, Hypokinesia, Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: pt recvd vax & 8MAR95 8AM pt''s rt thigh was red, swollen & warm to touch @ site of inj;pt was crying & screamed when picked up;high pitched & cont crying until 10AM;pt taken to MD who stated rxn to DTP-to have DTAP next time;would not walk

VAERS ID:84470 (history)  Vaccinated:1996-03-07
Age:1.3  Onset:1996-03-07, Days after vaccination: 0
Gender:Male  Submitted:1996-03-25, Days after onset: 18
Location:Idaho  Entered:1996-04-04, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pt on APAP w/codeine
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: ID96023
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5E610083IMRA
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5E610083IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0465B0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Pharyngitis, Pyrexia, Vasodilatation, Vomiting
SMQs:, Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: temp 102 ax;body flushed;throat red, vomiting;DPH, pedialyte, clear liquids, no throat culture done;dx rxn to immun r/o strep throat

VAERS ID:84643 (history)  Vaccinated:1996-03-07
Age:52.0  Onset:1996-03-10, Days after vaccination: 3
Gender:Male  Submitted:1996-04-04, Days after onset: 25
Location:Missouri  Entered:1996-04-08, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allerg to PCN
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.L07020SCRA
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESEJN120B0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Malaise, Paraesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt called MD office 15MAR96;reports rash & numbness from forehead to lips on the lt side of face,malaise,chills;instructed to take DPH;

VAERS ID:84732 (history)  Vaccinated:1996-03-07
Age:46.0  Onset:1996-03-08, Days after vaccination: 1
Gender:Female  Submitted:1996-03-11, Days after onset: 3
Location:Minnesota  Entered:1996-04-09, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: MN96011
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1810A40IMLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Myalgia, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: woke up on friday AM w/some hives;cont to devel hives all day;were pretty much gone by Saturday afternoon;on Saturday Am woke up w/shoulder & joint ache, going up lt side of neck;achiness about the same now;took advil all weekend;

VAERS ID:84693 (history)  Vaccinated:1996-03-07
Age:38.0  Onset:1996-03-19, Days after vaccination: 12
Gender:Female  Submitted:1996-04-05, Days after onset: 17
Location:Washington  Entered:1996-04-12, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none
Other Medications: none
Current Illness: none
Preexisting Conditions: no allergies; patello femoral tracking dis;
Diagnostic Lab Data: ESR 16; ANA neg; CBC nl;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0610B0SCLA
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Oedema peripheral, Osteoarthritis, Red blood cell sedimentation rate decreased
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow)
Write-up: pt recv vax;onset of migrating joint effusions and arthralgias (knees,elbows,wrist,ankles,toes);no fever;started on pred;

VAERS ID:84698 (history)  Vaccinated:1996-03-07
Age:33.0  Onset:1996-03-09, Days after vaccination: 2
Gender:Female  Submitted:1996-03-09, Days after onset: 0
Location:Unknown  Entered:1996-04-12, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP, estrogen
Current Illness:
Preexisting Conditions: smoker
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Injection site mass, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax;noted warmth induration and erythema over deltoid region of lt shoulder approx 10-12cm;

VAERS ID:85220 (history)  Vaccinated:1996-03-07
Age:2.0  Onset:1996-03-07, Days after vaccination: 0
Gender:Female  Submitted:1996-03-08, Days after onset: 1
Location:Arkansas  Entered:1996-04-24, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: ear infect in ER
Preexisting Conditions: ear infect diagnosed in ER 7MAR96 when fever inc
Diagnostic Lab Data: CXR-neg
CDC Split Type: AR9619
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4299653IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0887B0SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0730H2PO 
Administered by: Public     Purchased by: Public
Symptoms: Chills, Cyanosis, Gaze palsy, Otitis media, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Noninfectious encephalopathy/delirium (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 7MAR approx 1hr p/vax devel fever,chills on route to ER;had an spell eyes rolled back & shook all over;had called hlth office @ 420PM regarding pt described ass lips blue & shaking-sent to ER;in ER tx w/apap,ATB for ear infect

VAERS ID:85413 (history)  Vaccinated:1996-03-07
Age:2.0  Onset:1996-04-07, Days after vaccination: 31
Gender:Female  Submitted:1996-04-24, Days after onset: 16
Location:Florida  Entered:1996-04-30, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: FL96027
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1072B1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Guillain-Barre syndrome, Hypokinesia
SMQs:, Peripheral neuropathy (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: mom described child sx 2wk p/vax pt had problems walking then was unable to sit on toilet;took pt to ER then to MD who hosp for 10 days;mom states pt dx w/GBS

VAERS ID:85548 (history)  Vaccinated:1996-03-07
Age:0.6  Onset:1996-03-11, Days after vaccination: 4
Gender:Female  Submitted:1996-03-20, Days after onset: 9
Location:New York  Entered:1996-05-06, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: asyclor
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: culture of spinal fluids blood, stool and urine;
CDC Split Type: BA96K007
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4333630 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES212020PO 
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Encephalitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax; fever 104; had couple of sz on 11mar96;still presently hosp for encephalitis;

VAERS ID:85607 (history)  Vaccinated:1996-03-07
Age:1.0  Onset:1996-03-16, Days after vaccination: 9
Gender:Male  Submitted:1996-03-19, Days after onset: 3
Location:Florida  Entered:1996-05-06, Days after submission: 47
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:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: FL96026
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4299651 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1165B0 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0729H3PO 
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 7MAR96 pt recv vax;19MAR96 mom called pt had rash over body, temp of 102, vomited x 1, some diarrhea on 16MAR & 17MAR

VAERS ID:86291 (history)  Vaccinated:1996-03-07
Age:1.1  Onset:1996-03-11, Days after vaccination: 4
Gender:Male  Submitted:1996-05-16, Days after onset: 65
Location:Massachusetts  Entered:1996-05-23, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM265253IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1425B0SC 
Administered by: Public     Purchased by: Public
Symptoms: Osteoarthritis, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 4 days p/vax severe urticaria w/swollen joints & fever to 101; rxn took 3 days to resolve

VAERS ID:87726 (history)  Vaccinated:1996-03-07
Age:0.1  Onset:1996-03-07, Days after vaccination: 0
Gender:Female  Submitted:1996-03-25, Days after onset: 18
Location:Iowa  Entered:1996-06-11, Days after submission: 77
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type: 896087002L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4326550IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1195B1IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0736E080PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax 7MAR96 & 3-4hr later devel an inj site rxn affecting the entire thigh;the rxn resolved on its own;

VAERS ID:88153 (history)  Vaccinated:1996-03-07
Age:1.3  Onset:1996-03-17, Days after vaccination: 10
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES96031729
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 7MAR96 & 17MAR96 pt broke out in a chicken pox rash all over body;no further details were provided;

VAERS ID:88265 (history)  Vaccinated:1996-03-07
Age:1.7  Onset:1996-03-27, Days after vaccination: 20
Gender:Female  Submitted:0000-00-00
Location:Connecticut  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: otitis med, bilat
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES96032516
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1122B0SC 
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 7MAR96 & 27MAR96 pt devel two raised erythematous lesions on back & one @ the inj site;pt recovered;no further details were provided;

VAERS ID:90824 (history)  Vaccinated:1996-03-07
Age:28.0  Onset:1996-03-12, Days after vaccination: 5
Gender:Female  Submitted:1996-09-25, Days after onset: 196
Location:Michigan  Entered:1996-10-21, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rt side of body heavy numb feeling w/gen weakness w/dose 1 of Hep B vax;
Other Medications: Synthroid
Current Illness: NONE
Preexisting Conditions: PCN allergy
Diagnostic Lab Data: CAT scan, MRI, EEG, Blood work--pt states all WNL
CDC Split Type: MI96132
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1613A11 LA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Paraesthesia, Similar reaction on previous exposure to drug
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: pt recv vax & exp rt side of body heavy numb feeling w/gen weakness;lasted 1mo;

VAERS ID:93177 (history)  Vaccinated:1996-03-07
Age:36.0  Onset:1996-03-08, Days after vaccination: 1
Gender:Female  Submitted:1996-03-13, Days after onset: 5
Location:Florida  Entered:1996-10-30, Days after submission: 231
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: 960032031
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Other     Purchased by: Other
Symptoms: Headache, Nausea, Vasodilatation
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax & w/in 24hr post vax pt exp h/a, nausea & a warm feeling;tx w/DPH;

VAERS ID:93181 (history)  Vaccinated:1996-03-07
Age:46.0  Onset:1996-03-09, Days after vaccination: 2
Gender:Female  Submitted:1996-03-14, Days after onset: 5
Location:Minnesota  Entered:1996-10-30, Days after submission: 230
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: 960032571
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1810A40IMLA
Administered by: Other     Purchased by: Other
Symptoms: Myalgia, Nuchal rigidity, Pain, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax & awoke w/hives;next day exp shoulder pain, neck stiffness & achiness;tx advil;hives resolved;shoulder pain, neck stiffness, & achiness cont;

VAERS ID:93461 (history)  Vaccinated:1996-03-07
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:1996-08-09
Location:Massachusetts  Entered:1996-10-30, Days after submission: 82
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: 960114601
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1822A40  
Administered by: Private     Purchased by: Other
Symptoms: Agitation, Chills, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax & exp fever, malaise, chills, & irritability;sx resolved w/o tx in 1-2 days;

VAERS ID:96605 (history)  Vaccinated:1996-03-07
Age:1.2  Onset:1996-03-07, Days after vaccination: 0
Gender:Male  Submitted:1997-03-05, Days after onset: 363
Location:Wisconsin  Entered:1997-03-31, Days after submission: 26
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: WI97009
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4319673IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1220B2IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0217B0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: had fever of 103 despite APAP q 4hr;just before next APAP dose due, father reported child shook for 10-15 seconds then lost consciousness for approx 15min;

VAERS ID:169090 (history)  Vaccinated:1996-03-07
Age:6.0  Onset:2001-04-14, Days after vaccination: 1864
Gender:Male  Submitted:2001-04-17, Days after onset: 3
Location:Pennsylvania  Entered:2001-04-26, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tine (Monovacc), Connaught, lot # K1132-2, sub Q left forearm.
Current Illness: Right otitis media 03/02/96.
Preexisting Conditions: History of otitis media.
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1129B0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This patient was exposed to his sibling with the chicken pox on 03/31/01, 30 - 40 lesions on his trunk, extremities and mouth. Afebrile.

VAERS ID:185407 (history)  Vaccinated:1996-03-07
Age:6.0  Onset:2001-08-28, Days after vaccination: 2000
Gender:Female  Submitted:2002-05-15, Days after onset: 260
Location:Minnesota  Entered:2002-05-24, 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: Seasonal allergy
Diagnostic Lab Data:
CDC Split Type: WAES01090661
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES 3  
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1325B0  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0441B0  
Administered by: Private     Purchased by: Public
Symptoms: Blister, Dermatomyositis, Herpes zoster, Pruritus, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician concerning a 6 year old female with seasonal allergies and no past medical history who on 03/07/1996 was vaccinated with a first dose of VARIVAX (0.5 ml) (site unknown). Concomitant vaccination the same day included a first dose of MMRII and the fourth dose of ACTHIB. There was no illness at the time of vaccination. On 08/28/2001, the pt developed an itchy rash on her left thorax, dermatome just below the nipple with linear distribution. The pt was seen by the physician on 08/30/2001 and diagnosed with herpes zoster with bacterial super infection also described as shingles of right T4 dermatome with secondary cellulitis. The pt was treated with amoxicillin (Augmentin) 400 mg BID, which started on 08/30/2001. There was no collection of a specimen, it was reported that the vesicles were "probably dried". It was noted that there was no rash at the site of of injection. The pt was afebrile, however other systemic symptoms reported were otorrhea and impertigo. The patient''s pain was reported to be 8 on a scale of 0-10. It was also noted that the pt did not have a history of chicken pox or recent exposure to chicken pox of herpes zoster. The pt did not any adverse reactions following previous vaccinations It was reported that the pt recovered on 10/05/2001.

VAERS ID:263844 (history)  Vaccinated:1996-03-07
Age:  Onset:0000-00-00
Gender:Male  Submitted:2006-10-02
Location:Unknown  Entered:2006-10-02
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: A0621524A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 2  
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Abnormal behaviour, Autism, Drug toxicity, Hypokinesia, Neurodevelopmental disorder, Neurological symptom, Speech disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Drug abuse and dependence (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: This case was reported by a lawyer and described the occurrence of nerve injury in a male subject of unspecified age who was vaccinated with hepatitis B vaccine, live attenuated oral poliomyelitis vaccine, hepatitis B vaccine, live attenuated MMR, strain not specified, and diphtheria and tetanus toxoids and acellular pertussis vaccine for prophylaxis. Previous and/or concurrent vaccination included diphtheria and tetanus toxoids and acellular pertussis vaccine (manufacturer unspecified, unknown) given on 6/6/89, 8/11/89, and 8/29/90; live MMR (strain not specified) (manufacturer unspecified, unknown) given on 5/16/90and 8/10/94; live attenuated oral poliomyelitis vaccine (unknown) given on 5/16/90 and 8/10/94. On an unspecified date the subject received unspecified dose of hepatitis B vaccine. According to the legal complaint, at an unspecified time after vaccination with hepatitis B vaccine, the subject experienced serious and permanent neurological injuries which were attributed to toxic mercury exposure. The following information was received via medical records: On 3/7/94, he was evaluated for speech and language because he doesn''t like to talk at all. At the time of this visit, the subject was five years old. At this time, he communicates primarily in single words described as babbling and mumbling. The speech-language pathologist considered that the subject had significantly delayed speech, language, social pragmatic skills. ON 5/8/96, he was evaluated by developmental pediatrician. At this visit, it was reported that he was crawling at 9 month, walking alone at 18 months, and cruising just before one year. After starting kindergarten, he was diagnosed with autism. Following this visit, he was diagnosed with moderate mental retardation and autism. On 3/30/00 the subject was evaluated by a physician for autism. It was noted that the principal concern was tantrums and other behavioral issues. It was reported that the 25 year old mother of the subject had an uncomplicated pregnancy that ended in a normal spont

VAERS ID:313362 (history)  Vaccinated:1996-03-07
Age:1.0  Onset:2002-11-07, Days after vaccination: 2436
Gender:Female  Submitted:2008-05-16, Days after onset: 2016
Location:Texas  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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA05210
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: Information has been received from a physician concerning an 7 year old female who on 07-MAR-1996, at 12 months of age, was vaccinated with a dose of VARIVAX. It was reported on 07-NOV-2002, the patient developed shingles. A dermatologist diagnosed the lesions as shingles and the patient was prescribed acyclovir as treatment. Subsequently, the patient fully recovered from shingles. PCR analysis was refused by the reporter. No product quality complaint was involved. Shingles was considered to be other important medical event by the reporter. Additional information has been requested.

VAERS ID:88870 (history)  Vaccinated:1996-03-07
Age:28.0  Onset:1996-04-01, Days after vaccination: 25
Gender:Female  Submitted:1996-08-07, Days after onset: 127
Location:Foreign  Entered:1996-08-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: lumbo-dorsal pain and macroamylasemia
Diagnostic Lab Data: no relevant data16Oct96-f/u-serum amylase -??April 96-2120 U/L
CDC Split Type: WAES96080144
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Blood amylase increased, Laboratory test abnormal, Nausea, Pancreatitis, Vomiting
SMQs:, Acute pancreatitis (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 7MAR96 & APR96 pt exp acute pancreatitis & was hosp;addtl info was requested;

VAERS ID:83692 (history)  Vaccinated:1996-03-08
Age:7.0  Onset:1996-03-08, Days after vaccination: 0
Gender:Female  Submitted:1996-03-08, Days after onset: 0
Location:Arizona  Entered:1996-03-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp anaphaxis p/DTP @3mps required ER visit
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: AZ9605
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0625B1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Cyanosis, Dizziness, Dyspnoea, Hyperhidrosis, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: pt recv vax & less than 10mins-c/o nausea,dizziness,diaphoretic,cyanotic,SOB;sent stat to hosp

VAERS ID:83731 (history)  Vaccinated:1996-03-08
Age:1.5  Onset:1996-03-08, Days after vaccination: 0
Gender:Male  Submitted:1996-03-09, Days after onset: 1
Location:Illinois  Entered:1996-03-18, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: sl diarrhea runny nose
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5K610153IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 430AM 9MAR96 t105.2 oral mode on thermoscan thermometer;no other sx;temp temp 101.2 po p/tempra;9MAR noon temp 101.3 ax;

VAERS ID:83765 (history)  Vaccinated:1996-03-08
Age:5.0  Onset:1996-03-09, Days after vaccination: 1
Gender:Female  Submitted:1996-03-11, Days after onset: 2
Location:Colorado  Entered:1996-03-19, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5F710802IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES735C53PO 
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recvd vax 8MAR96 w/in 24hrs redness, swelling w/tenderness (+itching) lt thigh inj site w/induration

VAERS ID:83773 (history)  Vaccinated:1996-03-08
Age:1.7  Onset:1996-03-08, Days after vaccination: 0
Gender:Female  Submitted:1996-03-11, Days after onset: 3
Location:California  Entered:1996-03-19, 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: PPD by Connaught lot# 240111 given 8MAR96
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM005LN0 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0889B0 LL
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: red swollen circle around inj site started few hrs p/vax

VAERS ID:83780 (history)  Vaccinated:1996-03-08
Age:5.0  Onset:1996-03-10, Days after vaccination: 2
Gender:Female  Submitted:1996-03-13, Days after onset: 3
Location:Ohio  Entered:1996-03-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma, allergies-severe in past
Diagnostic Lab Data:
CDC Split Type: OH96032
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5K610150IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: redness, swelling, warmth c/o itching 2 1/2 days p/inj-area of redness 6x8 cm-no induration;much improved by 13MAR96 sl redness remains

VAERS ID:83797 (history)  Vaccinated:1996-03-08
Age:29.0  Onset:1996-03-11, Days after vaccination: 3
Gender:Male  Submitted:1996-03-12, Days after onset: 1
Location:Illinois  Entered:1996-03-20, 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: URI symptoms
Preexisting Conditions:
Diagnostic Lab Data: WBC 6,400;64seg;27lymph;5EOS 12MAR96
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5E710251IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3 days p/vax while pt had concomitant URI sx,pt devel pinpoint,hot,red,pruritic lesions on elbow,knees,anterior thighs

VAERS ID:83843 (history)  Vaccinated:1996-03-08
Age:1.3  Onset:1996-03-14, Days after vaccination: 6
Gender:Female  Submitted:1996-03-18, Days after onset: 4
Location:Ohio  Entered:1996-03-25, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: not ill
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4333623 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0879B0 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4281583PO 
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Convulsion, Crying, Febrile convulsion, Muscle twitching, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: fever,scream,twitching,sz (multiple) starting 6 days p/vax (t104 in ER);complex febrile seizure;6 days p/vax t101-screaming lasted seconds but twitching & sz had started-to ER t41.5 C/106.7;

VAERS ID:83850 (history)  Vaccinated:1996-03-08
Age:43.0  Onset:1996-03-08, Days after vaccination: 0
Gender:Female  Submitted:1996-03-11, Days after onset: 3
Location:Ohio  Entered:1996-03-25, Days after submission: 14
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
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA427A60IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5G710251IMLA
Administered by: Other     Purchased by: Other
Symptoms: Anxiety, Hyperventilation, Tremor
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Hypoglycaemia (broad)
Write-up: pt exp anxiety feelings & surge of adrenalin beginning suddenly about 8mins p/inj;hyperventilated & felt shaky-no wheezing or SOB;VS q 15mins WNL;tx reassurance given/pt watched until 3PM;

VAERS ID:83882 (history)  Vaccinated:1996-03-08
Age:0.4  Onset:1996-03-10, Days after vaccination: 2
Gender:Female  Submitted:1996-03-18, Days after onset: 8
Location:Arizona  Entered:1996-03-25, 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: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5H610471 LL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5H610471 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4281561PO 
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Apnoea, Hypertonia, Hypotonia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (narrow), Hypoglycaemia (broad)
Write-up: few seconds of apnea w/tremor & rigidity in otherwise fussy pt w/in few seconds of hypotonia p/event w/o sequelae occurred 10MAR96 p/tetraimmun & OPV vax on 8MAR96;

VAERS ID:84036 (history)  Vaccinated:1996-03-08
Age:5.0  Onset:1996-03-08, Days after vaccination: 0
Gender:Male  Submitted:1996-03-15, Days after onset: 7
Location:Maine  Entered:1996-03-27, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type: ME96010
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5M610854IMLA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1163A0 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0683A1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0734D3PO 
Administered by: Private     Purchased by: Public
Symptoms: Ecchymosis, Hypokinesia, Injection site pain, Pain, Vasodilatation
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recvd vax; c/o of soreness in lt arm, bruising & redness from elbow to shoulder; painful to touch & move; resolved by apap & cold compress;

VAERS ID:84054 (history)  Vaccinated:1996-03-08
Age:3.0  Onset:1996-03-10, Days after vaccination: 2
Gender:Female  Submitted:1996-03-14, Days after onset: 4
Location:Virginia  Entered:1996-03-27, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1122B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: chicken pox started 10MAR; 150-200 lesion evident 14MAR; low fever;

VAERS ID:84240 (history)  Vaccinated:1996-03-08
Age:1.6  Onset:1996-03-24, Days after vaccination: 16
Gender:Male  Submitted:1996-03-25, Days after onset: 1
Location:North Carolina  Entered:1996-04-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0388B0  
Administered by: Private     Purchased by: Other
Symptoms: Febrile convulsion, Otitis media
SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: febrile sz on 24MAR96;duration 4mins;also found to have OM on exam 25MAR96;

VAERS ID:84657 (history)  Vaccinated:1996-03-08
Age:0.2  Onset:1996-03-08, Days after vaccination: 0
Gender:Male  Submitted:1996-03-12, Days after onset: 4
Location:Washington  Entered:1996-04-08, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WA961215
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES4310190IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0895B1IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM005LH0IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4284900PO 
Administered by: Private     Purchased by: Public
Symptoms: Screaming, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)
Write-up: shots given 1030AM pt slept 1030AM-1PM then cried relentlessly 1PM-6PM;temp not taken as mom stated pt doesn''t feel hot;630PM was sleeping;MD prescribed APAP & cool pack

VAERS ID:84706 (history)  Vaccinated:1996-03-08
Age:73.0  Onset:1996-03-08, Days after vaccination: 0
Gender:Female  Submitted:1996-03-11, Days after onset: 3
Location:Texas  Entered:1996-04-12, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hypertensive medication
Current Illness: none
Preexisting Conditions: hypertension
Diagnostic Lab Data: none
CDC Split Type: TX96047
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES430109  RA
Administered by: Other     Purchased by: Other
Symptoms: Oedema peripheral, Pruritus, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax;redness,edema,itching;sx began soon p/ inject;had been applying warm wet compresses;

VAERS ID:84929 (history)  Vaccinated:1996-03-08
Age:35.0  Onset:1996-03-11, Days after vaccination: 3
Gender:Male  Submitted:1996-03-12, Days after onset: 1
Location:Unknown  Entered:1996-04-15, Days after submission: 33
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: 12-mar-96 WBC 64000;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5E71025   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax;3 days later devel pinpoint red,pruritic lesions on elbow,knees and thighs;

VAERS ID:85023 (history)  Vaccinated:1996-03-08
Age:2.0  Onset:1996-03-09, Days after vaccination: 1
Gender:Male  Submitted:1996-04-09, Days after onset: 30
Location:Illinois  Entered:1996-04-22, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations: NA
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: portable CXR-WNL 10MAR96; culture & CSF culture;drawn 9MAR96 no growth;EEG 11MAR96 WNL; CT scan cerebral 10MAR96 no abnormalities
CDC Split Type: IL960042
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES4F610003IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0732D2PO 
Administered by: Public     Purchased by: Other
Symptoms: Muscle twitching, Pyrexia, Salivary hypersecretion
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt had been playing on the floor, then climbed upon the couch w/dad & began to twitch & drool;was immed taken to hosp, t101.7;had been taking APAP earlier in the day;pt recv ativan in ER & was intubated & transferred to another hosp;

VAERS ID:85799 (history)  Vaccinated:1996-03-08
Age:5.0  Onset:1996-03-08, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Wisconsin  Entered:1996-04-23
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: no relevant data
CDC Split Type: WAES96030919
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0421B0SC 
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax; devel a rash;

VAERS ID:85822 (history)  Vaccinated:1996-03-08
Age:3.0  Onset:1996-03-11, Days after vaccination: 3
Gender:Male  Submitted:0000-00-00
Location:Missouri  Entered:1996-04-23
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: No relevant data;
CDC Split Type: WAES96031271
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0388B0  
Administered by: Other     Purchased by: Other
Symptoms: Eye disorder, Face oedema, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 8MAR96 & 11MAR96 pt exp puffy eyes;no further details were provided;

VAERS ID:85527 (history)  Vaccinated:1996-03-08
Age:2.0  Onset:1996-04-02, Days after vaccination: 25
Gender:Female  Submitted:0000-00-00
Location:Virginia  Entered:1996-05-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Anamine syrup
Current Illness: ?URI-rhinorrhea
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1232B0 RL
Administered by: Private     Purchased by: Private
Symptoms: Erythema multiforme, Rhinitis
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 8MAR96 to a well child;approx 2 wk later devel rhinorrhea;approx 3 wk p/vax devel classic,diffuse erythema multiforme

VAERS ID:85625 (history)  Vaccinated:1996-03-08
Age:12.0  Onset:1996-03-30, Days after vaccination: 22
Gender:Female  Submitted:1996-04-19, Days after onset: 19
Location:California  Entered:1996-05-07, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC vitamins
Current Illness:
Preexisting Conditions: seasonal hayfever;no viral illness, no exposure to hepatitis, no parasite exposure
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 8MAR96&devel hives&a morbilliform rash on 30MAR96;

VAERS ID:86409 (history)  Vaccinated:1996-03-08
Age:0.5  Onset:1996-03-08, Days after vaccination: 0
Gender:Male  Submitted:1996-04-18, Days after onset: 40
Location:Ohio  Entered:1996-05-29, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: in brother, cried for many hrs w/ 1 DTP;
Other Medications:
Current Illness: little congestion from allergies
Preexisting Conditions: allergic rhinitis;
Diagnostic Lab Data:
CDC Split Type: OH96083
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3749001 RL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM010LL1 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0730C1PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Asthma, Bronchitis, Otitis media, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax; extremely fussy & woke up w/ T of 104 R;fever gone but wheezing; to MD;dx of bronchitis;tx w/ Albuterol & Rocephin;Otitis media;bronchitis again 22mar w/ ear infect;

VAERS ID:86421 (history)  Vaccinated:1996-03-08
Age:0.3  Onset:1996-03-08, Days after vaccination: 0
Gender:Male  Submitted:1996-05-17, Days after onset: 69
Location:North Carolina  Entered:1996-05-29, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: NC96046
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4319671IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1950A2 IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0737A PO 
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Screaming
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)
Write-up: prolonged irritability & crying x 2 days;

VAERS ID:86437 (history)  Vaccinated:1996-03-08
Age:0.2  Onset:1996-03-08, Days after vaccination: 0
Gender:Male  Submitted:1996-05-17, Days after onset: 69
Location:South Carolina  Entered:1996-05-29, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: SC96034
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5H610070 LL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0519B0 RL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5H610070 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4271770PO 
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Screaming, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: mom states had severe local rxn-gulf ball sized knot red & hot, unconsolable, constant crying over 4 hr same day, called MD;MD said allergic (did not see pt);pt recv DT/OPV/HB vax 10MAY96 w/no reported problems;

VAERS ID:86529 (history)  Vaccinated:1996-03-08
Age:36.0  Onset:1996-03-16, Days after vaccination: 8
Gender:Female  Submitted:1996-04-05, Days after onset: 20
Location:Oklahoma  Entered:1996-06-03, Days after submission: 58
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: OK9611
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0624B1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Back pain, Chest pain, Headache, Myalgia, Nausea, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: c/o back, neck, & h/a pain;chest pressure from aches; nausea;no vomiting;no fever;no rash;sx subsided on 3APR96;

VAERS ID:87251 (history)  Vaccinated:1996-03-08
Age:1.8  Onset:1996-03-15, Days after vaccination: 7
Gender:Male  Submitted:1996-04-05, Days after onset: 21
Location:New York  Entered:1996-06-24, Days after submission: 79
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp febrile sz, t102.6 w/DTP/HIB #1, OPV #1, MMR #1 on 12JAN96
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: NYS96023
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4261151IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0724E1PO 
Administered by: Public     Purchased by: Public
Symptoms: Febrile convulsion, Pyrexia, Similar reaction on previous exposure to drug
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: per MD pt had febrile sz 15MAR95;came to ER 613PM, t102.8

VAERS ID:87867 (history)  Vaccinated:1996-03-08
Age:1.3  Onset:1996-03-08, Days after vaccination: 0
Gender:Female  Submitted:1996-03-12, Days after onset: 4
Location:Georgia  Entered:1996-07-15, Days after submission: 124
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: unk
Diagnostic Lab Data: NONE
CDC Split Type: GA96081
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES4E611483IMLA
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM315LE3IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0785A0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Cough, Ear pain, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: run fever all weekend up to 104 even w/APAP, vomiting x1, coughing & pulling @ ears

VAERS ID:88305 (history)  Vaccinated:1996-03-08
Age:4.0  Onset:1996-03-19, Days after vaccination: 11
Gender:Female  Submitted:0000-00-00
Location:Illinois  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt sibling devel varicella-like illness 4APR96 w/varivax
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES96041100
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1501B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 8MAR96 & 19MAR96 pt devel 12 varicella lesions, & no fever was noted;cult of the lesions were taken;@time of the report result were pending;pt recovered;

VAERS ID:88006 (history)  Vaccinated:1996-03-08
Age:65.0  Onset:1996-03-09, Days after vaccination: 1
Gender:Male  Submitted:1996-07-15, Days after onset: 127
Location:Oklahoma  Entered:1996-07-19, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: ?IVP dye
Diagnostic Lab Data: CBC
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0SCA
Administered by: Private     Purchased by: Private
Symptoms: Lymphangitis
SMQs:
Write-up: lymphangitis @ site of pneumovax inj; med given;

VAERS ID:88981 (history)  Vaccinated:1996-03-08
Age:4.0  Onset:1996-03-08, Days after vaccination: 0
Gender:Female  Submitted:1996-07-08, Days after onset: 121
Location:Georgia  Entered:1996-08-14, Days after submission: 37
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: GA96088
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES4E611481IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1408A0IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1129A1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0729M3PO 
Administered by: Public     Purchased by: Public
Symptoms: Influenza, Skin discolouration
SMQs:, Hypotonic-hyporesponsive episode (broad)
Write-up: grandma stated pt was seen in ER 8MAR96 w/both legs black from hip to feet;pt had on long pants & discoloration noted when clothes were removed to put pt in bath tub;color got better p/putting in warm water but was taken to ER;21MAR96 flu;

VAERS ID:93180 (history)  Vaccinated:1996-03-08
Age:32.0  Onset:1996-03-08, Days after vaccination: 0
Gender:Female  Submitted:1996-03-14, Days after onset: 6
Location:New Jersey  Entered:1996-10-30, Days after submission: 230
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp funny taste in mouth, blurred vision w/Engerix-B dose 1 & 2;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC Split Type: 960032061
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1740A42IMLA
Administered by: Public     Purchased by: Other
Symptoms: Amblyopia, Injection site oedema, Rash maculo-papular, Similar reaction on previous exposure to drug
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Optic nerve disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax & 24-36 hr p/vax pt exp a swelling @ the lt deltoid inj site, & sl blurring of vision;pt was examined by a MD who observed a bumpy rash on face;tx DPH;

VAERS ID:93199 (history)  Vaccinated:1996-03-08
Age:43.0  Onset:1996-03-09, Days after vaccination: 1
Gender:Female  Submitted:1996-05-09, Days after onset: 60
Location:Unknown  Entered:1996-10-30, Days after submission: 174
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Anaprox
Current Illness:
Preexisting Conditions: multiple drug allergies, multiple food allergies;
Diagnostic Lab Data:
CDC Split Type: 960044531
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1613A11IMLA
Administered by: Other     Purchased by: Other
Symptoms: Amblyopia, Eye disorder, Neuropathy, Paraesthesia, Retinal artery occlusion, Visual field defect
SMQs:, Peripheral neuropathy (narrow), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Optic nerve disorders (broad), Corneal disorders (broad), Retinal disorders (narrow)
Write-up: pt recv vax 8MAR96 & 24 hr p/vax pt exp a pins & needles sensation in lt arm & hands; sensation has persisted;also exp numbness in hand;MD visit was required;tx Daypro & a course of therapy;

VAERS ID:94072 (history)  Vaccinated:1996-03-08
Age:21.0  Onset:1996-08-07, Days after vaccination: 152
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1997-01-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: varicella antibody negative 7AUG96;
CDC Split Type: WAES96091737
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax 8MAR96 & 7AUG96 & revealed a lack of seroconversion;

VAERS ID:95959 (history)  Vaccinated:1996-03-08
Age:36.0  Onset:1996-03-09, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96032352
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0764A2IM 
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Hypertonia, Malaise, Neck pain, Pain, Pharyngitis
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 8MAR96 & on 9MAR96 pt exp stiffness & pain down the arm & neck described as burning in muscle going down arm & up to shoulder, sore throat, gen malaise & fatigue;

VAERS ID:96268 (history)  Vaccinated:1996-03-08
Age:  Onset:1997-01-05, Days after vaccination: 303
Gender:Male  Submitted:1997-03-07, Days after onset: 61
Location:Texas  Entered:1997-03-14, 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: TB tine by Lederle lot# 429355 given 8MAR96
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1128B0SCLL
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: mom stated pt breaking out in chicken pox p/known exposure two wk prior;MD office protocol for chickenpox reviewed;

VAERS ID:97951 (history)  Vaccinated:1996-03-08
Age:8.0  Onset:1997-02-26, Days after vaccination: 355
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1997-04-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97031246
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1195B2IM 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1128D0SC 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Pruritus, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 8MAR96 & on 26FEB97 pt devel a chickenpox like rash consisting of bumps w/fluid;devel approx 10 lesions on back;fever & itchiness;pt was doing OK @ the time of the report;

VAERS ID:99723 (history)  Vaccinated:1996-03-08
Age:1.3  Onset:1996-03-15, Days after vaccination: 7
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:1997-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp hypersensitivity w/unk vax;
Other Medications:
Current Illness:
Preexisting Conditions: hypersensitivity
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96040361
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1310B0IM 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Dyspnoea, Infection, Malaise, Pallor, Pyrexia, Rash maculo-papular, Rhinitis
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 8MAR96 & 15MAR96 pt devel fever 105, looked pale, was very ill & had runny nose & breathing heavily;21MAR96 broke out into a characteristic measles-like rash;MD also saw koplik spots;pt recovered from severe case of measles;

VAERS ID:100711 (history)  Vaccinated:1996-03-08
Age:6.0  Onset:1997-04-19, Days after vaccination: 407
Gender:Male  Submitted:0000-00-00
Location:Illinois  Entered:1997-07-23
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: No relevant data;
CDC Split Type: WAES97041719
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0747B0SC 
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 8MAR96 & 19APR97 pt devel a chickenpox rash consisting of greater than fifty lesions disseminated on trunk & face;pt also exp a low grade fever of moderate severity;

VAERS ID:104161 (history)  Vaccinated:1996-03-08
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:1996-10-10
Location:Minnesota  Entered:1997-10-30, Days after submission: 385
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control med;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 960147611A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Private     Purchased by: Private
Symptoms: Malaise
SMQs:
Write-up: pt recv vax 8MAR96 & did not feel well;sx resolved w/o tx;

VAERS ID:124464 (history)  Vaccinated:1996-03-08
Age:  Onset:1999-01-01, Days after vaccination: 1029
Gender:Unknown  Submitted:1999-05-14, Days after onset: 132
Location:Illinois  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: WAES99011280
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0753B SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: approx 3yrs p/vax pt exp chickenpox. addl info requested

VAERS ID:126824 (history)  Vaccinated:1996-03-08
Age:1.0  Onset:1999-05-26, Days after vaccination: 1174
Gender:Female  Submitted:1999-07-08, Days after onset: 43
Location:Texas  Entered:1999-08-02, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: n/a
Other Medications: 10 day course of amocicillin
Current Illness: mild ear infect, (otitis media)
Preexisting Conditions: otitis media
Diagnostic Lab Data: none
CDC Split Type: TX99148
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0753B0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: rash lasted 3 days; approx 50 pos on whole body; no fever detected

VAERS ID:134348 (history)  Vaccinated:1996-03-08
Age:1.5  Onset:1996-05-15, Days after vaccination: 68
Gender:Female  Submitted:2000-02-22, Days after onset: 1378
Location:Massachusetts  Entered:2000-02-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Twin sister & brother, both 15 mos, reacted to MMR (1st) & Hib (2nd).
Other Medications: NONE
Current Illness: NONE KNOWN
Preexisting Conditions: Preemie 31 wks gestation
Diagnostic Lab Data: CBC = ANC 800 - wnl by 6/96, Blood culture-nml.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM010LP3IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1175B0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Leukopenia, Pyrexia
SMQs:, Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 9 wks post vax, devel fever. Treated with Ceftriaxone. Fever abated. Mild neutropenia abated by 6/96. No firm dx. Possible "benign neutropenia of childhood."

VAERS ID:134349 (history)  Vaccinated:1996-03-08
Age:1.2  Onset:1996-03-18, Days after vaccination: 10
Gender:Female  Submitted:2000-02-22, Days after onset: 1436
Location:Massachusetts  Entered:2000-02-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Twin sister & brother, 15 mos, MMR (1st) HIb (4th), ANC dec.
Other Medications: NONE
Current Illness: NONE KNOWN
Preexisting Conditions: Preemie 31 wk gestation.
Diagnostic Lab Data: CBC ANC 42 resolved over period of 1 yr.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM010LP3IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1175B0SCRA
Administered by: Private     Purchased by: Public
Symptoms: Leukopenia, Pyrexia
SMQs:, Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Onset 10 days post vax, fever 105. CHild never felt ill. Fever treated and abated with Tylenol or Motrin. No firm dx made. Possible benign neutropenia of childhood.

VAERS ID:153248 (history)  Vaccinated:1996-03-08
Age:7.0  Onset:2000-05-05, Days after vaccination: 1519
Gender:Female  Submitted:2000-05-10, Days after onset: 5
Location:Missouri  Entered:2000-06-08, Days after submission: 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
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0753B0SCLL
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Broke out with Chicken pox after varicella vaccine.

VAERS ID:155963 (history)  Vaccinated:1996-03-08
Age:9.0  Onset:1999-12-07, Days after vaccination: 1369
Gender:Male  Submitted:2000-05-16, Days after onset: 160
Location:New York  Entered:2000-07-03, Days after submission: 48
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: PCR-positive for wild type varicella
CDC Split Type: WAES99120661
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0446B0SC 
Administered by: Private     Purchased by: Other
Symptoms: Herpes zoster, Infection
SMQs:
Write-up: On 12/7/99, the pt presented with herpes zoster on the right side of his thorax. The lesions were described as being vesicular in nature. The child''s physician did not treat him with antiviral medications because he was handling the zoster well.

VAERS ID:171323 (history)  Vaccinated:1996-03-08
Age:8.0  Onset:2000-05-16, Days after vaccination: 1530
Gender:Unknown  Submitted:0000-00-00
Location:Unknown  Entered:2001-06-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ;Vaccine not specified;1;7.00;In Sibling
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES00051748
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0753B0SC 
Administered by: Private     Purchased by: Public
Symptoms: Infection
SMQs:
Write-up: Varicella- Information has been received from a physician concerning an 8 year old white male student with no past medical history who on 08 Mar 1996 was vaccinated with the first dose of vericella virus vaccine live SC in the left thigh (lot 612212/0753B). There was no concomitant medication. On 15 May 2000 the patient experienced breakthrough chickenpox with 20 or more pox and was alightly febrile. Medical attention was sought. On 25 May 2000, the patient recovered. The patient''s sister had a similar experienced following vaccination with varicella virus vaccine live (waes 00060311.

VAERS ID:93865 (history)  Vaccinated:1996-03-08
Age:46.0  Onset:1996-03-23, Days after vaccination: 15
Gender:Female  Submitted:1997-01-10, Days after onset: 293
Location:Foreign  Entered:1997-01-17, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pleuresia;Hysterectomy (Fibroma);
Diagnostic Lab Data: anticardiolipin antibodies neg;antinative DNA antibodies neg;antinuclear antibodies neg;skin biopsy hypodermis perivascular inflammatory infiltrate (lymphocytes only);skin biopsy small arteries hypersensitivity angeitis;tuberculin intraderm
CDC Split Type: 960199901
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Polyarteritis nodosa, Purpura, Skin discolouration, Skin nodule, Vasculitis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Interstitial lung disease (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Vasculitis (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 8MAR96 & 23MAR96 exp lt calf sensitive purplish nodules which spread over controlateral lower limb;skin lesions biopsies, periarteritis nodosa w/hypersensitivity angeitis dx;mildly speckled skin patches remained;

VAERS ID:96069 (history)  Vaccinated:1996-03-09
Age:35.0  Onset:1996-03-09, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1997-03-11
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: allergy, sulfa
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96072156
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Pain, Similar reaction on previous exposure to drug
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax 9MAR96 & exp pain @ inj site which extended the length of the arm & into the chest wall;the pain lasted 2 days;

VAERS ID:103582 (history)  Vaccinated:1996-03-09
Age:6.0  Onset:1997-06-30, Days after vaccination: 478
Gender:Male  Submitted:0000-00-00
Location:Ohio  Entered:1997-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: encopresis
Preexisting Conditions: exposure, varicella;stiffness, neck;pain, neck;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97070923
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1128B0  
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Injury, Neck pain, Nuchal rigidity, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt w/encopresis which began on 6MAR96 & who was exposed to varicella on 9MAR96 recv vax & on 30JUN97 pt devel chickenpox consisting of mult pustular lesion on the neck & face;also exp fever of 99.8;seen by MD;stiffness & pain in neck;

VAERS ID:169462 (history)  Vaccinated:1996-03-09
Age:7.0  Onset:2001-04-25, Days after vaccination: 1873
Gender:Male  Submitted:2001-04-26, Days after onset: 1
Location:New Jersey  Entered:2001-05-04, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Post nasal drip
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1128B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Child developed chickenpox. Child had varivax vaccine on 3/9/1996.

VAERS ID:186421 (history)  Vaccinated:1996-03-09
Age:7.0  Onset:2002-02-04, Days after vaccination: 2158
Gender:Male  Submitted:2002-05-15, Days after onset: 99
Location:Unknown  Entered:2002-06-12, Days after submission: 28
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: WAES0202USA00303
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a woman in a doctor''s office concerning a 7 year old male who on 03/09/1996 was vaccinated with a dose of varicella virus vaccine live. On 02/04/2002 it was reported that the pt "now" has chicken pox. The pt sought unspecified medical attention. Additional info has been requested.

VAERS ID:236236 (history)  Vaccinated:1996-03-09
Age:32.0  Onset:0000-00-00
Gender:Female  Submitted:2005-01-25
Location:Rhode Island  Entered:2005-04-18, Days after submission: 82
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: concurrent conditions were not reported
Preexisting Conditions: The patient''s medical history, and concurrent medications were not reported.
Diagnostic Lab Data: 09 March 1996: Western Blot results IgG and IgM negative. 26 September 1996: Western blot results IgG and IgM negative. 14 March 2000: Cervical Spine: No evidence of fracture or subluxation. Degenerative changes at the lower cervical spine with a cervical rib noted on the right. Dorsal Spine: No evidence of fracture. Lumbosacral Spine: No evidence of fracture. 18 August 2000: Western Blot IgM; Negative IgG: Indeterminate. August 2000: Lyme Disease by PCR: Negative, Babesia by PCR: Negative and Ehtichia by PCR: Negative; 08 December 2000: Chest PA & Lateral: Normal. Negative C6 Lyme Peptide Elisa Index: 0.120; 28 April 2001: Lyme Disease Western Blot IgG and IgM Equivocal. 26 June 2001: INJ 99M-IC Neurolite/Brain Spect.: Overall heterogenous
CDC Split Type: A0537304A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 2IMUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Amnesia, Arthritis, Back pain, Cognitive disorder, Computerised tomogram normal, Dyslexia, Fatigue, Gastrointestinal disorder, Immunology test, Malaise, Neck pain, Neuralgia, Neuropathy peripheral, Night sweats, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain abnormal, Pain, Paraesthesia, Sleep disorder
SMQs:, Peripheral neuropathy (narrow), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (narrow)
Write-up: This case was reported by a lawyer and describes the occurrence of peripheral neuropathy in a 41year old female patient who received Lyme disease vaccine recombinant OspA (LYMErix) injection for prophyalxis. A physician or other health care professional has not verified this report. On an unspecified date, the patient received LYMErix. At an unknown time after receiving LYMErix, the patient experienced " peripheral neuropathy, secondary to GI problems, memory loss, and severe back and neck pain". Time to onset, treatment and outcome were not reported. Follow up information was received on 02 March 2009 via information obtained form an interview between the subject and attorneys. The subject received the first dose of LYMERIX in March 1995, and the second dose and third doses of LYMERIX also in 1995, as part of a clinical study. In 1996, the subject developed joint inflammation and pain. In 1997 or 1998, she experienced night sweats which resolved in 2003 or 2004. In 1998 or 1999, she developed fatigue and malaise. In 1998 or 1999 she also developed a sleep disturbance that resolved in 2004 or 2005. In 1999 or 2000, she developed neuropathy in her feet, shooting pain, and nerve pain. In 2001 or 2002, she developed speech "issues", memory issues, and signs of dyslexia. She stated that a brain scan showed white matter lesions. She reported that she no longer had memory issues, that dyslexia issues were "rare", and that her speech issues resolved around 2004 to 2005. Treatment included chiropractice therapy, Trazodone, antidepressants, antibiotics, PLAQUENIL, NEURONTIN, BEXTRA, and anti-inflammatories including nonsteroidal anti-inflammatory medications (NSAIDS). This case was assessed by GSK to be medically significant based upon follow up information, with the exception of sleep disturbance, speech and memory issues, and night sweats, the events were unresolved at the time of this report. Follow up information was received on 18 March 2009 via study records. The subject was initially enrolled in protocol. The subject received LYMERIX vaccine administered on 09 February 1995, 28 March 1995, and 09 March 1996, on 28 February 1995, the subject developed moderate shoulder pain assessed to be possibly related to study vaccine that resolved with sequelae on 09 March 1995. On 28 February 1995, she developed headache assessed to be possibly related to study vaccine that resolved on 02 March 1995. On 30 July 1995, she developed left wrist tenderness assessed to be possibly related to study vaccine that resolved. On 11 March 1995, she developed intermittent shoulder pain assessed to be possibly related to study vaccine that resolved on 13 March 1995. On 04 April 1995 she developed intermittent shoulder pain assessed to be possibly related to study vaccine that resolved on 05 April 1995. Shoulder pain was treated with ADVIL. She was subsequently enrolled in studies. There were no adverse events found or reported upon postcard follow-up. Follow-up information was received on 25 March 2009 in the form of medical records. The subject was seen for a physical therapy evaluation for the treatment of a thoracic strain on 09 November 1998. The subject presented with findings of soft tissue density of the left thoracic paravertebral muscles, rotations of the midthoracic vertebrae, and decreased thoracic spine ROM. The subject was evaluated on 22 December 1998 following physical therapy treatments secondary to thoracic spine strain. The subject original complaints of a sharp pain in the left rib cage during inhalation and exhalation were no longer present. The subject did complain of a fatigued feeling of the thoracic muscles after a full day of working, however, the statement was made that this had improved and the subject felt it would continue to improve. It was reported that the subject had achieved her goals as originally stated in initial evaluation back on 09 November 1998. The subject was examined on 06 December 2000 for question of Lyme di

VAERS ID:85370 (history)  Vaccinated:1996-03-09
Age:21.0  Onset:1996-04-09, Days after vaccination: 31
Gender:Male  Submitted:1996-04-15, Days after onset: 6
Location:Foreign  Entered:1996-04-29, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 5APR96 abdominal echography nl
CDC Split Type: 960045851
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Haematuria, Nephritis, Nephropathy toxic, Nephrotic syndrome, Purpura, Pyrexia, Skin nodule
SMQs:, Acute renal failure (narrow), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Proteinuria (broad), Tubulointerstitial diseases (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax&1mo later a vasculitis (reporter''s dx) w/arthralgia,fever,purpura&cutaneous nodules;no endocarditis was found,& abd echography was nl;initially tx w/NSAID&amoxicillin&began to improve;

VAERS ID:168622 (history)  Vaccinated:1996-03-09
Age:58.0  Onset:1996-07-01, Days after vaccination: 114
Gender:Male  Submitted:2002-04-26, Days after onset: 2125
Location:Foreign  Entered:2001-04-12, Days after submission: 379
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zocor
Current Illness: UNK
Preexisting Conditions: Hypercholesterolemia
Diagnostic Lab Data: On 3/14/99, lab tests showed increased CPK at 102 mmol/l (N,&) and cholesterol at 3.15 gm/l (N,2.2). 12/99 muscular biopsy revealed macrophagic myofasciitis. 2/25/00, lab tests revealed an increase in CPK, cholesterol at 8.9 gm/l and alumin
CDC Split Type: 20010082761
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS  IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Blood cholesterol increased, Blood creatine phosphokinase increased, Fasciitis, Muscle disorder, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Eosinophilic pneumonia (broad), Lipodystrophy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: On 7/1/96, Zocor was stopped. From 7/96, approx. 4 months, post vax of the last injection, the pt developed periodic myalgia on thighs and calves. At the end of the summer of 1999, the pain spread on upper limbs and trunk and was like myalgia and arthralgia. In 2/00, the pt initiated ketoprofena (Bi-Profenid), duration was not specified. In 4/00, the pt was hospitalized in order to perform a check-up. He was then treated with prednisolone. Immunological check-up performed at an unspecified date was normal. A hypothesis of myositis was suspected but it was not confirmed by the muscular biopsy. This case was considered as incapacitating. The most recent information received on 4/2/01, reports the outcome of the pt as not yet recovered. Causality assessment was reported as dubious for unspecified Hep-B vaccine and not specified for Zocor. On September 1995, the pt received a first injection of Genhavac B vaccine. On 07/1996 the pt also developed knee arthralgia especially during the night. At an unspecified date, simvaotatine was stopped. The pain stopped three weeks and then restarted. At an unspecified date, radiographies showed osteoarthritis of left hip and slight calcification of left internal area and laboratory tests revealed slight increased creatine phosphokinse, blood cell count sedimentation rate were normal, electromyogram was normal, and thigh MRI showed a slight inflammatory signal. The most recent info received on 04/06/2002 reports the outcome of the pt as not yet recovered.

VAERS ID:83762 (history)  Vaccinated:1996-03-10
Age:4.0  Onset:1996-03-10, Days after vaccination: 0
Gender:Female  Submitted:1996-03-13, Days after onset: 3
Location:Oregon  Entered:1996-03-19, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES59610014IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0736F4PO 
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 6cm red slightly raised warm area;

VAERS ID:85592 (history)  Vaccinated:1996-03-10
Age:32.0  Onset:1996-03-21, Days after vaccination: 11
Gender:Male  Submitted:1996-04-02, Days after onset: 12
Location:New York  Entered:1996-05-06, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: BA96K009
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1420B  LA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: rash on hands,feet,elbows,knees lasting for 10 days&hands swollen&itchy

VAERS ID:95982 (history)  Vaccinated:1996-03-10
Age:39.0  Onset:1996-04-15, Days after vaccination: 36
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96041693
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Blood lactate dehydrogenase increased, Hepatic function abnormal, Hypertonia
SMQs:, Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax11MAR96 & 15APR96 pt exp spasms in rt upper quad;lab eval on 15APR96 revealed elevated liver function tests & LDH;tx w/two courses of Zithromax for poss pleurisy or pneumonia;gall stones, pleurisy & pneumonia were r/o;

VAERS ID:97717 (history)  Vaccinated:1996-03-10
Age:3.0  Onset:1996-12-01, Days after vaccination: 266
Gender:Male  Submitted:0000-00-00
Location:Texas  Entered:1997-04-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97020807
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax MAR96 & DEC96 pt exp gen chickenpox;It was noted that a sibling subsequently devel chickenpox;another pt was reported as well WAES97020805;

VAERS ID:83849 (history)  Vaccinated:1996-03-11
Age:0.7  Onset:1996-03-11, Days after vaccination: 0
Gender:Male  Submitted:1996-03-14, Days after onset: 3
Location:Ohio  Entered:1996-03-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: collapsed lung, pneumonia, hyaline membraine disease @ birth
Diagnostic Lab Data: NONE
CDC Split Type: OH96030
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4293212IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0725B2PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Anorexia, Injection site hypersensitivity, Injection site mass, Pyrexia, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: mom gave pt APAP 1030AM prior to vax;pt recvd vax 11AM by 2PM pt became irritable w/t101;inj site was red, hot to touch w/a knot under the surface;cont w/APAP which would bring fever down temp;pt not eating;used warm compress @ the site;

VAERS ID:83853 (history)  Vaccinated:1996-03-11
Age:42.0  Onset:1996-03-13, Days after vaccination: 2
Gender:Female  Submitted:1996-03-20, Days after onset: 7
Location:New Jersey  Entered:1996-03-25, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to tetanus
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: broke out in rash 2 days post vax legs,stomachache,arms,neck;very itchy

VAERS ID:83869 (history)  Vaccinated:1996-03-11
Age:0.7  Onset:1996-03-11, Days after vaccination: 0
Gender:Male  Submitted:1996-03-12, Days after onset: 1
Location:Illinois  Entered:1996-03-25, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: sl cold
Preexisting Conditions: surgery for ears on 7MAR96
Diagnostic Lab Data: NA
CDC Split Type: IL960027
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5H610502 LL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0118B2 RL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5H610502 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0732D2PO 
Administered by: Public     Purchased by: Public
Symptoms: Crying, Pyrexia, Screaming
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: t102.5 on APAP-2 droppers-a/ & after-switched to motrin 12MAR high pitched screaming x 12hrs;had surgery 7th for ears;pvt MD exam pt 12MAR pt starting to calmed own-to call back in 24hrs;

VAERS ID:83967 (history)  Vaccinated:1996-03-11
Age:0.4  Onset:1996-03-11, Days after vaccination: 0
Gender:Female  Submitted:1996-03-19, Days after onset: 8
Location:California  Entered:1996-03-26, 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: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5F610721 LL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0834B1 RL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5F610721 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES728L31PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: pt recvd vax; has red strawberry colored circle around inject site;

VAERS ID:85884 (history)  Vaccinated:1996-03-11
Age:15.0  Onset:1996-03-12, Days after vaccination: 1
Gender:Female  Submitted:1996-03-29, Days after onset: 17
Location:Georgia  Entered:1996-05-10, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: orthrocept something for indigestion
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: GA96042
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0883B1SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H710030IMLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: mom reports h/a, rash & pruritis beginning Tuesday PM (no fever), became worse Wednesday;went to ER was given a shot of Adrenaline & rx for seldane & elastic bandage for lt arm;pt was out of school thursday but back to school Friday 15MAR;

VAERS ID:95946 (history)  Vaccinated:1996-03-11
Age:23.0  Onset:1996-03-11, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96031039
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 11MAR96 & w/in 5 to 10min p/vax pt devel a rash;no further details were provided;

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