National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

Found 607223 cases in entire database

Case Details (Sorted by Vaccination Date)

This is page 1346 out of 6073

Result pages: prev   1247 1248 1249 1250 1251 1252 1253 1254 1255 1256 1257 1258 1259 1260 1261 1262 1263 1264 1265 1266 1267 1268 1269 1270 1271 1272 1273 1274 1275 1276 1277 1278 1279 1280 1281 1282 1283 1284 1285 1286 1287 1288 1289 1290 1291 1292 1293 1294 1295 1296 1297 1298 1299 1300 1301 1302 1303 1304 1305 1306 1307 1308 1309 1310 1311 1312 1313 1314 1315 1316 1317 1318 1319 1320 1321 1322 1323 1324 1325 1326 1327 1328 1329 1330 1331 1332 1333 1334 1335 1336 1337 1338 1339 1340 1341 1342 1343 1344 1345 1346 1347 1348 1349 1350 1351 1352 1353 1354 1355 1356 1357 1358 1359 1360 1361 1362 1363 1364 1365 1366 1367 1368 1369 1370 1371 1372 1373 1374 1375 1376 1377 1378 1379 1380 1381 1382 1383 1384 1385 1386 1387 1388 1389 1390 1391 1392 1393 1394 1395 1396 1397 1398 1399 1400 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 1427 1428 1429 1430 1431 1432 1433 1434 1435 1436 1437 1438 1439 1440 1441 1442 1443 1444 1445   next


VAERS ID: 78948 (history)  
Age: 0.5  
Gender: Female  
Location: California  
Vaccinated:1995-11-03
Onset:1995-11-04
   Days after vaccination:1
Submitted: 1995-11-07
   Days after onset:3
Entered: 1995-11-14
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 428040 / 2 RL / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1664A2 / 2 RA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 728F / 2 - / PO

Administered by: Private       Purchased by: Public
Symptoms: Convulsion, Cough, Pyrexia, Rash maculo-papular, Rhinitis, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recvd vax 3NOV95 & 4NOV95 high fever & gen sz;pink rash on face started 4NOV95;no fever 5NOV95;cough & runny nose started 5NOV95 w/vomiting;PE on 7NOV95 pt alert, pink mac pap


VAERS ID: 79092 (history)  
Age: 62.0  
Gender: Female  
Location: Maryland  
Vaccinated:1995-11-03
Onset:1995-11-05
   Days after vaccination:2
Submitted: 1995-11-09
   Days after onset:4
Entered: 1995-11-15
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Public       Purchased by: Unknown
Symptoms: Malaise, Pyrexia, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem, Prempro
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MD95048

Write-up: starting vomiting @ 3PM during noc had fever 100 next day broke out in hives all over fever 102 starting Sunday sick until Wednesday feeling OK Thursday p/4days;


VAERS ID: 79907 (history)  
Age: 3.0  
Gender: Female  
Location: Washington  
Vaccinated:1995-11-03
Onset:1995-11-03
   Days after vaccination:0
Submitted: 1995-11-03
   Days after onset:0
Entered: 1995-12-07
   Days after submission:34
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958139 / - LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Cough, Rash, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WA951183

Write-up: 3NOV95 about 1 1/2hrs p/vax mom of pt called & reported some rash on the pt''s behing legs;some coughing episdoe;MD''s office contacted;rash/hives appeared per mom;


VAERS ID: 79884 (history)  
Age: 54.0  
Gender: Female  
Location: Tennessee  
Vaccinated:1995-11-03
Onset:1995-11-04
   Days after vaccination:1
Submitted: 1995-11-14
   Days after onset:10
Entered: 1995-12-08
   Days after submission:24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61126 / 1 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Hypersensitivity, Lung disorder, Migraine, Pharyngitis, Rhinitis
SMQs:, Agranulocytosis (broad), Angioedema (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Inderal, Estratab
Current Illness: history of migraines
Preexisting Conditions: migraines
Diagnostic Lab Data:
CDC Split Type: TN95125

Write-up: the next morning awoke w/severe sore throat which lasted 2 days & progressed to head & chest congestion;6 days p/inj devel a migraine which eventually led to hospitalization for treatment w/Demerol;MD said was allergic to the flu shot


VAERS ID: 83073 (history)  
Age: 27.0  
Gender: Female  
Location: North Carolina  
Vaccinated:1995-11-03
Onset:1995-12-15
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 1996-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0406B / 1 - / -

Administered by: Other       Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: varicella antibody neg;
CDC Split Type: WAES95101163

Write-up: pt recv vax;6-7 wk later lab eval revealed 11 neg titers;


VAERS ID: 83156 (history)  
Age: 5.0  
Gender: Female  
Location: New Jersey  
Vaccinated:1995-11-03
Onset:1995-11-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1996-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0746B / 0 - / -

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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95110561

Write-up: pt recvd 3NOV95 & 5NOV95 pt devel a chicken pox like rash on face, chest, scalp, & legs; MD reported that there were around 30-50 total lesions;pt subsequently recovered;


VAERS ID: 93033 (history)  
Age: 54.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:1995-11-03
Onset:1995-11-03
   Days after vaccination:0
Submitted: 1995-11-08
   Days after onset:5
Entered: 1996-10-30
   Days after submission:357
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1725A4 / 1 RA / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 950118291

Write-up: pt recv vax & exp an excessive sting while the pt was injected w/pain @ site;


VAERS ID: 93034 (history)  
Age: 19.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:1995-11-03
Onset:1995-11-03
   Days after vaccination:0
Submitted: 1995-11-08
   Days after onset:5
Entered: 1996-10-30
   Days after submission:357
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1725A4 / 1 RA / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 950118301

Write-up: pt recv vax & immed exp excessive sting while vaccine was injected w/pain @ site;no tx given;


VAERS ID: 94675 (history)  
Age: 12.0  
Gender: Male  
Location: Texas  
Vaccinated:1995-11-03
Onset:1995-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1997-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 0191A / 2 - / SC

Administered by: Private       Purchased by: Private
Symptoms: Chest pain, Epistaxis, Insomnia, Lung disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: allergy PCN;allergy insect bites
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95110711

Write-up: pt recv vax 11JUL95 & 3NOV95 MD gave vax again by mistake & pt exp chest pain, felt that there was liquid in lungs, has trouble sleeping & devel nose bleeds;f/u MD revealed that the pt was vaccinated w/measles vax 3NOV95;


VAERS ID: 97468 (history)  
Age: 9.0  
Gender: Male  
Location: Florida  
Vaccinated:1995-11-03
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 0 - / -

Administered by: Private       Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: allergy, dust;allergy, mildew;allergy, grass;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97010385

Write-up: pt recv vax 3NOV95 & pt devel chicken pox consisting of approx 1000 lesions;pt also exp fever the first day a/the full breakout;dx of varicella was confirmed by MD during an office visit;


VAERS ID: 98307 (history)  
Age: 49.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:1995-11-03
Onset:1995-11-03
   Days after vaccination:0
Submitted: 1997-02-06
   Days after onset:461
Entered: 1997-04-18
   Days after submission:70
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61165 / - - / IM A
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 5B71099 / 0 - / SC A

Administered by: Other       Purchased by: Other
Symptoms: Headache, Migraine, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6371

Write-up: h/a w/fever, then h/a progressively worse turning into migraine w/nausea;pt recovered;


VAERS ID: 110282 (history)  
Age: 2.0  
Gender: Female  
Location: Unknown  
Vaccinated:1995-11-03
Onset:1998-02-21
   Days after vaccination:841
Submitted: 1998-04-15
   Days after onset:52
Entered: 1998-04-17
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - - / -

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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data~ ()~~~In patient
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Varicella exposure
Diagnostic Lab Data:
CDC Split Type: WAES98022026

Write-up: 03Nov95 pt recv 1 dose vax. Pt exposed to varicella virus 10Feb98. 21Feb98 pt devel "approx 100 chickenpox lesions all over her body. There was no fever".


VAERS ID: 176839 (history)  
Age: 0.6  
Gender: Male  
Location: Virginia  
Vaccinated:1995-11-03
Onset:1995-12-01
   Days after vaccination:28
Submitted: 2001-10-18
   Days after onset:2147
Entered: 2001-10-30
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 386908 / 0 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Autism, Diarrhoea, Emotional disorder, Eye disorder, Psychomotor hyperactivity, Sensory disturbance, Speech disorder
SMQs:, Peripheral neuropathy (narrow), Dementia (broad), Pseudomembranous colitis (broad), Akathisia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Corneal disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: The pt experienced diarrhea, sensitive to sound, hyperactivity, speech stopped, lost eye contact, became withdrawn, and autism. The 60 day follow up states diagnosis of autism unchanged.


VAERS ID: 200771 (history)  
Age: 1.75  
Gender: Male  
Location: California  
Vaccinated:1995-11-03
Onset:2003-03-18
   Days after vaccination:2692
Submitted: 2003-03-27
   Days after onset:9
Entered: 2003-04-02
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR 5G6100 / - - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PFIZER/WYETH 0720H / - - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0439B / 0 - / -

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)

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:

Write-up: Pt broke out with approximately 32 pox over a 3 day period.


VAERS ID: 238742 (history)  
Age: 1.02  
Gender: Female  
Location: Nebraska  
Vaccinated:1995-11-03
Onset:2004-10-31
   Days after vaccination:3285
Submitted: 2005-05-16
   Days after onset:197
Entered: 2005-06-01
   Days after submission:16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 608657/0419B / - - / SC

Administered by: Private       Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Constipation
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WAES0411USA00784

Write-up: Information has been received from a registered nurse concerning a 10 year old white female student with no pre-existing allergies or medical conditions who on 11/03/1995 was vaccinated subcutaneously in the right thigh with the first dose of varicella virus vaccine live. At the time of vaccination the patient had constipation. On approximately 10/15/2004, the patient was exposed to a neighbor boy with chickenpox. It was reported that the patient''s mother noticed the appearance of bit bites about two weeks later, on Sunday, 10/31/2004 and the patient''s mother reported that she developed a chickenpox rash on 11/01/2004. Unspecified medical attention was sought. No laboratory or diagnostic studies were performed. The patient recovered. No product quality complaint was involved. Additional information has been requested.


VAERS ID: 78921 (history)  
Age: 71.0  
Gender: Male  
Location: Arkansas  
Vaccinated:1995-11-04
Onset:1995-11-04
   Days after vaccination:0
Submitted: 1995-11-07
   Days after onset:3
Entered: 1995-11-13
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61006 / - RA / -

Administered by: Private       Purchased by: Private
Symptoms: Anaemia, Chills, Insomnia, Malaise, Myalgia, Purpura, Thrombocytopenia
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: myalgia 2hrs, chills-rigors 2hr, malaise 24-48hr, insomnia


VAERS ID: 79589 (history)  
Age: 46.0  
Gender: Male  
Location: Indiana  
Vaccinated:1995-11-04
Onset:1995-11-07
   Days after vaccination:3
Submitted: 1995-11-17
   Days after onset:10
Entered: 1995-11-20
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Other       Purchased by: Other
Symptoms: Chills, Cough, Malaise, Myalgia, Photophobia, Sinusitis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp rxn @ 44yrs w/flu vax~ ()~~~In patient
Other Medications: Vasotec
Current Illness: NONE
Preexisting Conditions: HTN, (birth defect)
Diagnostic Lab Data: Blood test (WBC)
CDC Split Type:

Write-up: pt started feeling bad 6NOV, 7NOV, 8NOV acute sinusitis 11NOV went to MD rx Vantin; 14NOV started feeling bad, chills, cough, phlegm, body ache, light sensitive


VAERS ID: 79481 (history)  
Age: 19.0  
Gender: Male  
Location: California  
Vaccinated:1995-11-04
Onset:1995-11-04
   Days after vaccination:0
Submitted: 1995-11-09
   Days after onset:5
Entered: 1995-11-21
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4948192 / - LA / IM

Administered by: Military       Purchased by: Military
Symptoms: Bradycardia, Headache, Hypotension, Stupor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: headache
Preexisting Conditions: erythromicin
Diagnostic Lab Data:
CDC Split Type:

Write-up: LOC-dec BP, dec HR, h/a


VAERS ID: 79713 (history)  
Age: 12.0  
Gender: Male  
Location: Oregon  
Vaccinated:1995-11-04
Onset:1995-11-04
   Days after vaccination:0
Submitted: 1995-11-07
   Days after onset:3
Entered: 1995-11-27
   Days after submission:20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1722A2 / 0 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1381A / 1 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 5C71114 / 5 - / IM

Administered by: Public       Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: OR9562

Write-up: 5NOV95 130AM t105 oral temp;6NOV95 101-102 oral temp;7NOV95 102;8NOV95 100;


VAERS ID: 79906 (history)  
Age: 6.0  
Gender: Female  
Location: California  
Vaccinated:1995-11-04
Onset:1995-11-04
   Days after vaccination:0
Submitted: 1995-11-14
   Days after onset:10
Entered: 1995-12-07
   Days after submission:23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E2805HC / - LA / IM

Administered by: Other       Purchased by: Private
Symptoms: Hyperhidrosis, Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1:40 pt fel faint lowered self to floor;1:45 BP 92/62, P72, R20 skin cool clammy alert awake; 1:55 BP 118/62, P84, R16 juice given @ pts request walk to chair; 2:10 BP 118/62, P72;2:25 BP 100/78 walked around mall;2:40 BP 118/80;2:45 feelse


VAERS ID: 79945 (history)  
Age: 59.0  
Gender: Female  
Location: Iowa  
Vaccinated:1995-11-04
Onset:1995-11-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958067 / 0 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Chills, Leukopenia, Myalgia, Pyrexia, Thrombocytopenia
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: WBC 2200, platelet 82,000;
CDC Split Type:

Write-up: myalgias, fever, chills, leukopenia & thrombocytopenia;


VAERS ID: 79995 (history)  
Age: 43.0  
Gender: Female  
Location: Alaska  
Vaccinated:1995-11-04
Onset:1995-11-05
   Days after vaccination:1
Submitted: 1995-11-13
   Days after onset:8
Entered: 1995-12-13
   Days after submission:30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958207 / - - / -
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4948189 / - - / -

Administered by: Military       Purchased by: Military
Symptoms: Asthenia, Convulsion, Headache, Hypertonia, Nausea, Stupor, Urinary incontinence, Vasodilatation
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NL CBC, NL chem 24, sl low magnesium
CDC Split Type:

Write-up: 4NOV95 1030 recvd vax & 5NOV95 0200 nausea, flushed, weak & h/a;0330 leg cramping, worse h/a,nausea/weakness;0335 gen tonic rxn, clenched teeth, posturing, x 72sec w/o incontinence;positive postictal;h/a, nausea, weakness lasted 1wk


VAERS ID: 80051 (history)  
Age: 0.4  
Gender: Female  
Location: Florida  
Vaccinated:1995-11-04
Onset:1995-11-04
   Days after vaccination:0
Submitted: 1995-11-28
   Days after onset:24
Entered: 1995-12-13
   Days after submission:15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429964 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 398928 / 1 - / PO

Administered by: Private       Purchased by: Private
Symptoms: Agitation, Crying, Nervousness, Screaming
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: started screaming about 5hrs p/vax; screaming spells lasted 4-5hrs over 48hrs period w/some very irritability & restless sleep between screaming episodes


VAERS ID: 80102 (history)  
Age: 22.0  
Gender: Female  
Location: Washington  
Vaccinated:1995-11-04
Onset:1995-11-04
   Days after vaccination:0
Submitted: 1995-12-11
   Days after onset:37
Entered: 1995-12-15
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958120 / 0 RA / -

Administered by: Private       Purchased by: Private
Symptoms: Injection site hypersensitivity, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: seasonal allergies, Doxycycline, Codeine, Amox
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5mins p/shot onset of hives, arm worse where shot given, across chest-itchy;no swelling, SOB; tx DPH


VAERS ID: 80693 (history)  
Age: 26.0  
Gender: Male  
Location: Unknown  
Vaccinated:1995-11-04
Onset:1995-11-04
   Days after vaccination:0
Submitted: 1995-12-18
   Days after onset:44
Entered: 1996-01-03
   Days after submission:16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5J61010 / 0 - / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA436A6 / 0 - / IM

Administered by: Military       Purchased by: Military
Symptoms: Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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: lichen planus-pulse dose pred
Diagnostic Lab Data: finished pulse dose pred 1 day prior for lichen planus
CDC Split Type:

Write-up: emesis x 1 10 mins p/vax start of h/a mins later;h/a described as rt sided sinus h/a not sharp or dull, constant w/some throbbing; neg assoc photophobia;started to resolve p/30 mins


VAERS ID: 81095 (history)  
Age: 6.0  
Gender: Female  
Location: Tennessee  
Vaccinated:1995-11-04
Onset:1995-11-06
   Days after vaccination:2
Submitted: 1995-11-14
   Days after onset:8
Entered: 1996-01-23
   Days after submission:70
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 1 - / -

Administered by: Public       Purchased by: Public
Symptoms: Injection site hypersensitivity, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aerosal PRN for asthma
Current Illness: NONE
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC Split Type: TN96012

Write-up: mom says pt devel fine rash (feels like cornmeal) couple of days p/vax;rash began @ inj site & spread to back, chest & neck;c/o itching;denies other sxs;


VAERS ID: 81096 (history)  
Age: 9.0  
Gender: Female  
Location: Tennessee  
Vaccinated:1995-11-04
Onset:1995-11-06
   Days after vaccination:2
Submitted: 1995-11-14
   Days after onset:8
Entered: 1996-01-23
   Days after submission:70
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 1 - / -

Administered by: Public       Purchased by: Public
Symptoms: Injection site hypersensitivity, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: TN96011

Write-up: mom states pt devel fines rash (feels like cornmeal) couple of days p/vax;rash began @ inj site & spread to back, chest, & neck;c/o itching;denies other sxs;


VAERS ID: 84158 (history)  
Age: 39.0  
Gender: Female  
Location: Minnesota  
Vaccinated:1995-11-04
Onset:1995-11-05
   Days after vaccination:1
Submitted: 1995-11-06
   Days after onset:1
Entered: 1996-02-26
   Days after submission:112
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site mass, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 895336005L

Write-up: pt recv vax 4NOV95 & 5NOV95 pt devel a baseball-sized welt @ the inj site which persisted as of 77NOV95;6NOV95 pt devel hand swelling on the rt hand which has lessened somewhat but does persist;no further details known as of the date rpt


VAERS ID: 84270 (history)  
Age: 76.0  
Gender: Female  
Location: Minnesota  
Vaccinated:1995-11-04
Onset:1995-11-05
   Days after vaccination:1
Submitted: 1995-11-06
   Days after onset:1
Entered: 1996-02-26
   Days after submission:112
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896010012L

Write-up: pt recv vax 4NOV95 & devel urticaria @ inj site w/itching;pt has not recovered as of the reporting date;


VAERS ID: 86135 (history)  
Age:   
Gender: Female  
Location: California  
Vaccinated:1995-11-04
Onset:1995-11-04
   Days after vaccination:0
Submitted: 1995-12-01
   Days after onset:27
Entered: 1996-05-13
   Days after submission:163
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00885P / - - / IM A

Administered by: Private       Purchased by: Other
Symptoms: Headache, Injection site hypersensitivity, Injection site oedema, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: history was not reported
Diagnostic Lab Data: not reported
CDC Split Type: 0010150950266

Write-up: pt recv vax 4NOV95 & exp a large local rxn of redness & swelling @ inj site, body aches, & a h/a;pt has recovered;


VAERS ID: 87815 (history)  
Age: 62.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:1995-11-04
Onset:1995-11-05
   Days after vaccination:1
Submitted: 1995-11-09
   Days after onset:4
Entered: 1996-06-18
   Days after submission:221
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 384906 / - LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: routine PE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: 895331011L

Write-up: pt recv vax 4NOV95 & 5NOV95 pt devel swollen glands in ax area in addition to an inj site rxn characterized by redness, tenderness & swelling;pt had not yet recovered as of the reporting date;


VAERS ID: 87822 (history)  
Age: 30.0  
Gender: Male  
Location: Pennsylvania  
Vaccinated:1995-11-04
Onset:1995-11-04
   Days after vaccination:0
Submitted: 1995-11-09
   Days after onset:5
Entered: 1996-06-18
   Days after submission:221
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 384906 / - RA / IM

Administered by: Private       Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: scalp laceration
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896040016L

Write-up: pt recv vax 4NOV95 & 5NOV95 pt devel swollen glands in the ax area in addtl to an inj site rxn characterized by redness, tenderness & swelling;9NOV95 pt was improved;


VAERS ID: 98293 (history)  
Age: 70.0  
Gender: Unknown  
Location: West Virginia  
Vaccinated:1995-11-04
Onset:0000-00-00
Submitted: 1997-02-06
Entered: 1997-04-18
   Days after submission:70
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61126 / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6344

Write-up: massive edema of entire arm & hand;vaccine given in arm of side where modified radical mastectomy preformed 18yr prior;


VAERS ID: 98624 (history)  
Age: 3.0  
Gender: Male  
Location: California  
Vaccinated:1995-11-04
Onset:1997-05-03
   Days after vaccination:546
Submitted: 1997-05-28
   Days after onset:25
Entered: 1997-06-03
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0440B / 0 LA / -

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: pt contacted full blown varicella infect p/being immunized;


VAERS ID: 98625 (history)  
Age: 3.0  
Gender: Female  
Location: California  
Vaccinated:1995-11-04
Onset:1997-05-10
   Days after vaccination:553
Submitted: 1997-05-28
   Days after onset:18
Entered: 1997-06-03
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0440B / 0 LA / -

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: pt contacted full blown varicella infect p/being immunized;


VAERS ID: 101066 (history)  
Age: 3.0  
Gender: Female  
Location: Illinois  
Vaccinated:1995-11-04
Onset:1997-06-02
   Days after vaccination:576
Submitted: 0000-00-00
Entered: 1997-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0436B / 0 - / SC

Administered by: Private       Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy, pediazole
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97060240

Write-up: pt recv vax 4NOV95 & 2JUN97 pt devel about 50-75 vesicles which were gen pruritic;pt seen by MD dx w/chickenpox;


VAERS ID: 109763 (history)  
Age: 0.5  
Gender: Female  
Location: Pennsylvania  
Vaccinated:1995-11-04
Onset:1996-01-03
   Days after vaccination:60
Submitted: 1998-04-14
   Days after onset:831
Entered: 1998-04-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 4861018 / 2 - / L
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 4861018 / 2 - / L

Administered by: Private       Purchased by: Other
Symptoms: Agitation, Convulsion, Mental retardation severity unspecified, Pyrexia, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations: pt exp fever, fussiness @ mo & 4mo w/DTP dose 1& 2;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EEG numerous spinal taps;blood work, EKG, MRI (brain)
CDC Split Type:

Write-up: pt exp temp & fussiness-starting 3JAN96 pt started having sz in form of infantile spasms;speech & devel language delays by 6 to 8mo;


VAERS ID: 78910 (history)  
Age: 31.0  
Gender: Male  
Location: Tennessee  
Vaccinated:1995-11-05
Onset:1995-11-06
   Days after vaccination:1
Submitted: 1995-11-08
   Days after onset:2
Entered: 1995-11-13
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Military       Purchased by: Other
Symptoms: Influenza, Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: local redness & swelling @ inj site flu-like sxs;


VAERS ID: 101435 (history)  
Age: 7.0  
Gender: Male  
Location: Missouri  
Vaccinated:1995-11-05
Onset:1995-11-05
   Days after vaccination:0
Submitted: 1997-03-31
   Days after onset:512
Entered: 1997-07-22
   Days after submission:112
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (IMOVAX) / PASTEUR MERIEUX INST. K0531 / 1 - / IM A

Administered by: Private       Purchased by: Other
Symptoms: Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp 1st dose w/o incident;~ ()~~~In patient
Other Medications: IMOGAM RIG by Merieux given 2NOV95;Augmentin
Current Illness:
Preexisting Conditions: no allergy
Diagnostic Lab Data:
CDC Split Type: CO6298

Write-up: giant hive & fever 102 p/2nd dose in post exposure series;sent to Er & treated w/Decadron;seen again by MD w/persistent giant hive;inj site is fine;tx w/atarax;child bitten by baby raccoon that was not captured;


VAERS ID: 107548 (history)  
Age: 49.0  
Gender: Female  
Location: New Jersey  
Vaccinated:1995-11-05
Onset:1995-11-05
   Days after vaccination:0
Submitted: 1997-11-29
   Days after onset:755
Entered: 1998-01-15
   Days after submission:47
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71355 / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6980

Write-up: pt devel muscles aches, malaise & a fever of 101, duration almost a wk;nurse feels as though vaccine related;


VAERS ID: 274137 (history)  
Age: 1.9  
Gender: Unknown  
Location: Pennsylvania  
Vaccinated:1995-11-05
Onset:0000-00-00
Submitted: 2007-03-16
Entered: 2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Drug ineffective, Varicella
SMQs:, Lack of efficacy/effect (narrow)

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: spina bifida, scoliosis, neuroblastoma, chronic lung disease, pulmonary aspergillosis, GER
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed atypical varicella at the age of 13.


VAERS ID: 315377 (history)  
Age: 9.0  
Gender: Male  
Location: Illinois  
Vaccinated:1995-11-05
Onset:1995-11-29
   Days after vaccination:24
Submitted: 2008-05-16
   Days after onset:4551
Entered: 2008-05-23
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0441B / 0 - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Varicella
SMQs:

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0706USA00872

Write-up: Information has been received from a registered nurse concerning a 9 year old male who on 05-NOV-1995 was vaccinated subcutaneously with the first dose of varicella virus vaccine live (Oka/Merck) (Lot # 609296/0441B). There was no concomitant medication. On 29-NOV-1995 the patient experienced a mild case of chickenpox. The patient sought unspecified medical attention. Subsequently, the patient recovered from chickenpox. The office is considering a booster dose. Additional information has been requested.


VAERS ID: 78947 (history)  
Age: 46.0  
Gender: Female  
Location: California  
Vaccinated:1995-11-06
Onset:1995-11-07
   Days after vaccination:1
Submitted: 1995-11-07
   Days after onset:0
Entered: 1995-11-14
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4958009 / - RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Chills, Convulsion, Injection site pain, Myalgia, Pain, Pyrexia, Rash, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Keflex;Estroderm patches;Xanax
Current Illness: paronychia infect rt great toe
Preexisting Conditions: allergic to sulfa, PCN, Ceclor; mitral valve prolapse; IBS; panic attacks;migraines
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever of 101 oral, local tenderness, erythema & body aches;pt states had convuls the noc recvd inj;tx is APAP q 4 hrs for fever & body aches;Vicodin for pain;heating pad to rt arm & f/u visit in 3 days or sooner if sxs worsen


VAERS ID: 78957 (history)  
Age: 46.0  
Gender: Female  
Location: North Carolina  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 1995-11-08
   Days after onset:2
Entered: 1995-11-14
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958228 / 3 LL / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site reaction, Skin nodule, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Verapmil
Current Illness: NONE
Preexisting Conditions: NKDA, HTN
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 6NOV95 flu vax given immed rxn @ site finger size welt @ site which inc to nickle size;pt took DPH;7NOV95 area warm, red & swollen, seize of quarter;18NOV area red, swollen, warm & dark red area to center 2 1/2inches x 4 inches in diameter


VAERS ID: 79085 (history)  
Age: 51.0  
Gender: Female  
Location: Texas  
Vaccinated:1995-11-06
Onset:1995-11-11
   Days after vaccination:5
Submitted: 1995-11-14
   Days after onset:3
Entered: 1995-11-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Other       Purchased by: Other
Symptoms: Hypokinesia, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Vasotex, Lpiex
Current Illness: NONE
Preexisting Conditions: PCN, arteria by-pass (legs)
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: arm from shoulder to hand, aching severely-could not use or raise arm


VAERS ID: 79000 (history)  
Age: 4.0  
Gender: Male  
Location: Kansas  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 1995-11-07
   Days after onset:1
Entered: 1995-11-16
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 386988 / - - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1055 / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0723R / 3 - / PO

Administered by: Military       Purchased by: Military
Symptoms: Pruritus, Rash, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 1hr p/vax pt devel erythema of trunk & neck, pruritis, then devel pruritic papules


VAERS ID: 79001 (history)  
Age: 45.0  
Gender: Female  
Location: Texas  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 1995-11-13
   Days after onset:7
Entered: 1995-11-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61014 / 2 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Angioneurotic oedema, Asthma, Laryngospasm, Pruritus, Rhinitis
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Dystonia (broad), Oropharyngeal allergic conditions (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ventolin inhaler, Tilade
Current Illness: NONE
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC Split Type:

Write-up: 7hrs p/vax acute onset of sneezing, wheezing, angioedema & itching of face & throat, hoarseness;responded slowly to ventolin inhaler & DPH


VAERS ID: 79578 (history)  
Age: 64.0  
Gender: Female  
Location: Florida  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 1995-11-06
   Days after onset:0
Entered: 1995-11-20
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61095 / 1 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Amblyopia, Dyspnoea, Hypertension, Laryngospasm, Myalgia, Nausea, Paraesthesia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Mevacor
Current Illness: No current illness
Preexisting Conditions: allergic to demerol-Morphine;high cholesterol
Diagnostic Lab Data: NONE
CDC Split Type: FL95080

Write-up: w/in 5-10mins pt began to feel like could not pass air;also felt throat was swollen-later described as numb (like w/novacaine);described blurry vision; was visibly tremulous; BP sl elevated 150/85, P72 & reg;resolved in 15mins


VAERS ID: 79593 (history)  
Age: 69.0  
Gender: Female  
Location: Florida  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1995-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 426354 / 1 RA / -

Administered by: Public       Purchased by: Public
Symptoms: Oedema peripheral, Pruritus, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Lodine
Current Illness: NONE
Preexisting Conditions: arthritis
Diagnostic Lab Data: NONE
CDC Split Type: FL95086

Write-up: began to have intense itching aprox 15mins p/vax then arm began to swell & became erythematous from shoulder to elbow w/in approx 4 hrs; did not go to PMD for tx


VAERS ID: 79598 (history)  
Age: 0.2  
Gender: Female  
Location: South Carolina  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 1995-11-08
   Days after onset:2
Entered: 1995-11-20
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1161A / 1 RL / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES 4B61142 / 0 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 396923 / 0 - / PO

Administered by: Public       Purchased by: Unknown
Symptoms: Agitation, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: SC95081

Write-up: pt recvd vax & 6NOV95 PM t100 ax, fussiness, & vomiting;attempt made to contact mom via phone but operator reports phone disconnected;


VAERS ID: 79674 (history)  
Age: 0.2  
Gender: Female  
Location: Pennsylvania  
Vaccinated:1995-11-06
Onset:1995-11-07
   Days after vaccination:1
Submitted: 1995-11-21
   Days after onset:14
Entered: 1995-11-27
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429970 / 1 LL / -

Administered by: Private       Purchased by: Other
Symptoms: Personality disorder, Tremor, Urinary incontinence
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: very small VSD
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: day p/vax pt had a shaking episode but never lost consciousness became incontinent of urine;not self x 48hrs


VAERS ID: 79717 (history)  
Age: 8.0  
Gender: Male  
Location: New York  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 1995-11-08
   Days after onset:2
Entered: 1995-11-27
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 5D71014 / 5 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: BA9543

Write-up: pt recvd vax 6NOV, 8NOV RTC c/o pain & swelling @ site, erythema, induration, & tenderness lt triceps area; pt advised to apply warm compresses;


VAERS ID: 79721 (history)  
Age: 0.4  
Gender: Male  
Location: New Jersey  
Vaccinated:1995-11-06
Onset:1995-11-07
   Days after vaccination:1
Submitted: 1995-11-20
   Days after onset:13
Entered: 1995-11-27
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429037 / 1 RA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 729E6 / 1 - / PO

Administered by: Private       Purchased by: Unknown
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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: excessive high pitchted crying $g3hrs, t104


VAERS ID: 79737 (history)  
Age: 0.2  
Gender: Male  
Location: Oklahoma  
Vaccinated:1995-11-06
Onset:0000-00-00
Submitted: 1995-11-06
Entered: 1995-11-27
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 428035 / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0656B / 0 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0722D / 0 - / PO

Administered by: Public       Purchased by: Unknown
Symptoms: Agitation, Injection site hypersensitivity, Vasodilatation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: OK9541

Write-up: 4:00 parent called & stated pt was crying & only stopped when mom held;that rt leg was red around inj site & very warm to touch;called MD who recommended APAP & cont cold compress to leg


VAERS ID: 79632 (history)  
Age: 41.0  
Gender: Female  
Location: Ohio  
Vaccinated:1995-11-06
Onset:1995-11-07
   Days after vaccination:1
Submitted: 1995-11-20
   Days after onset:13
Entered: 1995-11-28
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01285P / 1 RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NA
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type: OH95162

Write-up: pt recvd vax 6NOV95 815AM;hives appeared 7NOV95 own MD contacted 7NOV95 MD instructed pt to take DPH;9NOV95 pt contacted stating hives were not any better & DPH inc; see MD


VAERS ID: 79634 (history)  
Age: 1.0  
Gender: Male  
Location: Virginia  
Vaccinated:1995-11-06
Onset:1995-11-07
   Days after vaccination:1
Submitted: 1995-11-14
   Days after onset:7
Entered: 1995-11-28
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 - / -

Administered by: Public       Purchased by: Other
Symptoms: Muscle twitching, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: VA95084

Write-up: pt recvd vax & temp as high as 104 would occasionally jerk, run temp for 1wk temp did drop several days later shot was recvd;


VAERS ID: 79770 (history)  
Age: 11.0  
Gender: Female  
Location: North Carolina  
Vaccinated:1995-11-06
Onset:1995-11-17
   Days after vaccination:11
Submitted: 1995-11-17
   Days after onset:0
Entered: 1995-11-30
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1658B2 / 0 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0876B / 2 LA / SC

Administered by: Public       Purchased by: Public
Symptoms: Face oedema, Pain
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NC95125

Write-up: as described by MD swelling of the angle of the jaw on the rt side w/tenderness but no heat;physical exam revealed no significant findings


VAERS ID: 79821 (history)  
Age: 12.0  
Gender: Male  
Location: North Dakota  
Vaccinated:1995-11-06
Onset:1995-11-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 1995-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1645A2 / 1 RA / -

Administered by: Public       Purchased by: Public
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Delirium, Malaise, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: tested for Hep A-B-C neg;ultrasound done neg; viral illness neg; AST 7000 & ALT 4000;chem profile nl; toxicity level 20;
CDC Split Type: ND95025

Write-up: pt recvd vax 7NOV95 & c/o of aching & nausea;lasted about 3 days;able to return to school;14NOV95 c/o aching, T98.1-pt given APAP;c/o not feeling well;delirious;taken to ER;toxicity level 20;emesis;AST 7000 & ALT 4000 were elevated;


VAERS ID: 79877 (history)  
Age: 61.0  
Gender: Female  
Location: Michigan  
Vaccinated:1995-11-06
Onset:1995-11-07
   Days after vaccination:1
Submitted: 1995-11-09
   Days after onset:2
Entered: 1995-12-08
   Days after submission:29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958138 / - RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Myalgia, Pruritus, Rash, Rash maculo-papular
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MI95138

Write-up: 7NOV95 devel red blotches & rash over body, hands were extremely itchy-no temp BP 155/65 some achiness; called MD who advised cortisone cream;denies allergies prev known;had flu shots prev yrs & no rxn;


VAERS ID: 79878 (history)  
Age: 1.3  
Gender: Male  
Location: Michigan  
Vaccinated:1995-11-06
Onset:1995-11-07
   Days after vaccination:1
Submitted: 1995-11-09
   Days after onset:2
Entered: 1995-12-08
   Days after submission:29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH DT4175 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M305LF / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0468B / 0 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0726K / 1 - / PO

Administered by: Public       Purchased by: Unknown
Symptoms: Agitation, Convulsion, Cyanosis, Eye disorder, Hypertonia, Muscle twitching, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Corneal disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: In brother, exp rxn on Nov 88 @ 2 mo w/DTP dose 1~ ()~~~In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC Split Type: MI95139

Write-up: woke from sleep cried had sz like jerking, eyes became very wide w/blinking, fists clenched, turned blue sz like jerking;mom noted hives on face, checked back which also had hives, episode of wide eyes w/blink & sz lik jerking & blue


VAERS ID: 79968 (history)  
Age: 74.0  
Gender: Female  
Location: Washington  
Vaccinated:1995-11-06
Onset:1995-11-07
   Days after vaccination:1
Submitted: 1995-12-06
   Days after onset:29
Entered: 1995-12-11
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 0 LA / -

Administered by: Private       Purchased by: Private
Symptoms: Bone pain, Diarrhoea, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Diabeta, Prilosec
Current Illness: diabetic type II
Preexisting Conditions: diabetic type ii, inflamation of eosphagus & stomach, moderate BP
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 6NOV95 given flu vax @ MD''s office;7NOV95 sever aching of every bone of body, muscular soreness of lt deltoid area;9NOV95 mod diarrhea;


VAERS ID: 79980 (history)  
Age: 12.0  
Gender: Female  
Location: Unknown  
Vaccinated:1995-11-06
Onset:1995-11-07
   Days after vaccination:1
Submitted: 1995-11-30
   Days after onset:23
Entered: 1995-12-13
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1645A2 / 1 - / IM A

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Delirium, Hepatic failure, Injection site pain, Malaise, Nausea, Pharyngitis, Pyrexia
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: in pt, unk rxn w/dtp vax;~ ()~~~In patient
Other Medications: apap;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 950131951

Write-up: pt recvd vax;noted a burning sensation at inject site;next day,flu-like sxs,fever,n;these sxs cont 3-4 days & started to resolve''1 wk p/ 2nd dose,sudden tiredness,sore throat,malaise,low fever;delirious;seen by MD;to hosp;liver failure


VAERS ID: 80081 (history)  
Age: 54.0  
Gender: Male  
Location: California  
Vaccinated:1995-11-06
Onset:1995-11-16
   Days after vaccination:10
Submitted: 1995-12-11
   Days after onset:25
Entered: 1995-12-15
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0337B / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Antinuclear antibody, Paraesthesia, Red blood cell sedimentation rate increased
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: zocor
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES95111302

Write-up: pt recvd vax;16nov95,pt exp transient numbness of lt arm & hand;hosp for 3 days;lab eval showed inc ANA & inc sedimentation rate;


VAERS ID: 80887 (history)  
Age: 4.0  
Gender: Male  
Location: New York  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 1995-11-20
   Days after onset:14
Entered: 1996-01-16
   Days after submission:57
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0431B / 0 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Dyspnoea, Injection site hypersensitivity, Injection site mass, Injection site oedema, Oedema, Tongue oedema, Vasodilatation, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: 28wk preemie (15mos in hosp);chronic resp;BPD;G tube: RAD; ETOH w/pregnancy & nursing;strabismus
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recvd vax 12noon; 1215PM pt w/blush coloring, swelling to tongue & neck;diff in breathing;had vomiting/dry heaves;inject site: red, golf ball size w/in 20mins;treated w/Epi SC, inhaled albuterol & 02


VAERS ID: 81279 (history)  
Age: 47.0  
Gender: Female  
Location: Oklahoma  
Vaccinated:1995-11-06
Onset:1995-11-07
   Days after vaccination:1
Submitted: 1995-12-27
   Days after onset:50
Entered: 1996-01-24
   Days after submission:28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Other       Purchased by: Public
Symptoms: Pharyngitis, Rhinitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: w/in 48hrs pt started a scratchy sore throat w/in 3 days it was a bad cold that lasted 10 more days;worked x/1 afternoon


VAERS ID: 81460 (history)  
Age: 68.0  
Gender: Female  
Location: New Jersey  
Vaccinated:1995-11-06
Onset:1995-11-11
   Days after vaccination:5
Submitted: 1996-01-25
   Days after onset:75
Entered: 1996-01-30
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00785P / 0 - / IM A

Administered by: Private       Purchased by: Other
Symptoms: Atrial fibrillation, Cough, Infection, Pericarditis, Pneumonia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: hx of hypercholesterolemia
Diagnostic Lab Data: abn EKG noted
CDC Split Type: 0010150950295

Write-up: pt recvd vax 6NOV95 & 11NOV95 exp fever, cough & dx w/pneumonia 21NOV95;dx w/pericarditis 22NOV95 & hospitalized 2DEC95 w/carditis, pneumonitis & atrial fibrillation


VAERS ID: 81711 (history)  
Age: 40.0  
Gender: Female  
Location: Nebraska  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 1995-11-28
   Days after onset:22
Entered: 1996-02-01
   Days after submission:65
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958118 / - - / IM A

Administered by: Public       Purchased by: Private
Symptoms: Injection site hypersensitivity, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Zoloft;Cardura
Current Illness: NONE
Preexisting Conditions: allergy to Anaprox
Diagnostic Lab Data:
CDC Split Type:

Write-up: approx 4 to 5hrs p/vax itching noted-on exam hives noted-legs, feet, arms, lower abd (initially itching @ site of inj which passed p/1 1/2 to 2hrs);rash cont x 5 days;reported to family MD 10NOV95;Pred for relief then recovered;


VAERS ID: 82314 (history)  
Age: 0.3  
Gender: Female  
Location: Kansas  
Vaccinated:1995-11-06
Onset:1995-11-07
   Days after vaccination:1
Submitted: 1996-01-05
   Days after onset:59
Entered: 1996-02-12
   Days after submission:38
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 427841 / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0728D / 1 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Apnoea, Convulsion
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow), Hypoglycaemia (broad)

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: pt exp rxn following 1st series @ 2mo~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: 7NOV95 EEG-CT of head during hospitalization dx sz disorder
CDC Split Type: KS95069

Write-up: pt recvd vax 6NOV95 early AM hrs of 7NOV95;pt crying for approx 5 seconds, then began sz activity, stopped breathing;EMS responded, resuscitated;pt hospitalized


VAERS ID: 82405 (history)  
Age: 70.0  
Gender: Female  
Location: Colorado  
Vaccinated:1995-11-06
Onset:1995-12-04
   Days after vaccination:28
Submitted: 1996-02-05
   Days after onset:63
Entered: 1996-02-13
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958116 / 2 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: KCL, micronase, Trimillerene, alleporinal
Current Illness: diabetes, HTN
Preexisting Conditions: diabetes, HTN
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recvd vax & had sore & tender feet on 4DEC95 by 15JAN96 devel numbness thought to be diabetic neuropathy however presented 19JAN,22JAN & 29JAN w/progressive numbness in lower extremities;adm to hosp 29JAN then to nursing home for rehab


VAERS ID: 82761 (history)  
Age: 73.0  
Gender: Female  
Location: Washington  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 1995-12-12
   Days after onset:36
Entered: 1996-02-20
   Days after submission:70
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 0 LA / -

Administered by: Public       Purchased by: Private
Symptoms: Diarrhoea, Dizziness, Headache, Malaise, Pain, Pruritus, Vaginal infection
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: in son, same sxs p/ flu vax;~ ()~~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: sensitive to meds, bee; bee stings;
Diagnostic Lab Data:
CDC Split Type: WA951197

Write-up: pt recvd vax; exp dizziness, cramping, d; 2 days later malaise, yeast infect, itching vaginal severe; HA;


VAERS ID: 84260 (history)  
Age:   
Gender: Female  
Location: California  
Vaccinated:1995-11-06
Onset:0000-00-00
Submitted: 1995-11-09
Entered: 1996-02-26
   Days after submission:109
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 495811 / - LA / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 895355006L

Write-up: pt recv vax 6NOV95 & devel swelling the size of an orange,@ inj site;no other details were available as of the reporting date;


VAERS ID: 84842 (history)  
Age: 54.0  
Gender: Male  
Location: Kansas  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1996-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1013B / 0 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Paraesthesia oral, Vasodilatation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95110565

Write-up: pt recv vax 6NOV95 & w/in 30min of vax pt devel a flushed face, hot cheeks & numbness of the lips;did not exp tightness in throat & recovered;


VAERS ID: 84844 (history)  
Age: 51.0  
Gender: Female  
Location: Kansas  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1996-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1013B / 0 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Asthenia, Myalgia, Nausea, Pain, Vasodilatation, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95110567

Write-up: pt recv vax & devel a flushed,red face,felt hot & vomited;f/u reported that pt felt achy,flushed,nauseated & rt arm began to hurt a few min p/vax;waves of pain throughout day;rt arm hurt;felt tired


VAERS ID: 84880 (history)  
Age: 40.0  
Gender: Male  
Location: Kansas  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1996-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / 0 - / IM

Administered by: Public       Purchased by: Public
Symptoms: Headache
SMQs:

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: sore throat
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95121578

Write-up: pt recv vax 6NOV95 & exp h/a 4hr post vax;h/a was successfully treated w/APAP & the pt was able to remain @ work the rest of the day


VAERS ID: 84265 (history)  
Age: 38.0  
Gender: Female  
Location: Texas  
Vaccinated:1995-11-06
Onset:1995-11-07
   Days after vaccination:1
Submitted: 1995-11-20
   Days after onset:13
Entered: 1996-02-28
   Days after submission:100
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958133 / 0 RA / IM

Administered by: Private       Purchased by: Other
Symptoms: Oedema peripheral, Pain, Paraesthesia, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896003009L

Write-up: pt recv vax 6NOV95 & the next day devel a large,painful,edematous area covering upper rt arm & axilla;also devel an itchy throat;pt was treated w/Epi,DPH & cortisone;p/sx pt exp numbness & tingling of entire rt arm;


VAERS ID: 83304 (history)  
Age: 37.0  
Gender: Female  
Location: California  
Vaccinated:1995-11-06
Onset:1995-11-16
   Days after vaccination:10
Submitted: 1995-11-20
   Days after onset:4
Entered: 1996-02-29
   Days after submission:101
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1201A / - RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4F61058 / - LA / -

Administered by: Other       Purchased by: Public
Symptoms: Lymphadenopathy, Pharyngitis, Pyrexia
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CA960009

Write-up: pt recvd vax; exp sore throat; fever of 101; swollen glands; no rash;


VAERS ID: 83712 (history)  
Age: 27.0  
Gender: Female  
Location: New York  
Vaccinated:1995-11-06
Onset:1995-11-26
   Days after vaccination:20
Submitted: 1996-03-13
   Days after onset:108
Entered: 1996-03-18
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 5H71142 / - - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Myelitis, Neuropathy, Paralysis
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6511

Write-up: severe neurological complications ultimately rendering paralyzed from the chest down to toes,including both arms;started approx 10 days p/vax;hospitalized & tremens in hosp w/a dx condition of acute transverse myelitis


VAERS ID: 84060 (history)  
Age: 0.2  
Gender: Female  
Location: California  
Vaccinated:1995-11-06
Onset:1995-12-08
   Days after vaccination:32
Submitted: 1996-03-05
   Days after onset:88
Entered: 1996-03-28
   Days after submission:23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH - / 0 RL / IM
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / 0 - / PO

Administered by: Private       Purchased by: Private
Symptoms: CSF test abnormal, Cellulitis, Drug ineffective, Dyspnoea, Pyrexia, Salivary hypersecretion, Tongue oedema, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: study vaccine by Lederle labs given 6NOV95
Current Illness: unk
Preexisting Conditions: pt was a twin, born @ 39wks gestation by c-section;had a hx of bronchiolitis in late November
Diagnostic Lab Data: WBC 16.9; poly 75%;bands 4%;LP 8DEC96 24WBC, 35% poly, 15% mono, 43% lymphs 63 RBC, glucose 63, protein 18 gram stain-no organisms seen;LP 11DEC95 3930 RBC, 0 WBC, glucose 6, protein 93, gram stain neg;BC positive-H. influenzae type b
CDC Split Type: 896066008L

Write-up: pt recvd vax 6NOV95 & presented to the hosp on 8DEC95 w/recent hx of fever to 103 R;pt noted to have redness & edema on the floor of the mouth w/tongue pushed up against hard palate;drooling resulting in airway obstruction;dx cellulitis


VAERS ID: 85558 (history)  
Age: 16.0  
Gender: Female  
Location: Tennessee  
Vaccinated:1995-11-06
Onset:1995-11-20
   Days after vaccination:14
Submitted: 1996-05-02
   Days after onset:163
Entered: 1996-05-06
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0053B / 2 - / IM

Administered by: Other       Purchased by: Public
Symptoms: Asthenia, Malaise, Paraesthesia, Syncope, Tachycardia, Thinking abnormal
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: allergy, environmental
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES96022042

Write-up: pt recv vax 6NOV95&exp chronic fatigue,orthostatic syncope,progressive&gen malaise/weakness,multi-focal paresthesia w/cognitive side effects&tachycardia;MD stated that pt''s malaise was so severe,was brought to ofc in wheel chair


VAERS ID: 86671 (history)  
Age:   
Gender: Female  
Location: Ohio  
Vaccinated:1995-11-06
Onset:0000-00-00
Submitted: 1996-02-19
Entered: 1996-06-03
   Days after submission:104
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - LA / IM

Administered by: Other       Purchased by: Other
Symptoms: Neck pain, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: pt has recv flu vax in the pas w/no problems
Diagnostic Lab Data: neurological tests r/o carpal tunnel, thoracic outlet synd & cervical abnormalities
CDC Split Type: 896053016L

Write-up: pt recv vax 6NOV95 & devel cervical neck pain, upper lt arm pain, numbness down into the lt hand;treated w/physical therapy & anti-inflammatory meds;sx have since dec in severity, but cont to persist


VAERS ID: 87010 (history)  
Age: 1.3  
Gender: Male  
Location: Texas  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1996-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M010LL / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 - / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0410B / 0 - / SC

Administered by: Private       Purchased by: Private
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES95110400

Write-up: pt recv vax 6NOV95 & 8 days later pt devel a morbilliform rash;pt recovered;no further details were provided;


VAERS ID: 87856 (history)  
Age: 1.3  
Gender: Male  
Location: Wisconsin  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 1996-07-02
   Days after onset:238
Entered: 1996-07-15
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 5K61164 / 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M005LN / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0217B / 0 RA / SC

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Crying, Hypotonia, Pallor, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recv vax 6NOV95 830-93AM & 10AM threw up;no fever;became very limp/pale, screaming & crying;


VAERS ID: 90382 (history)  
Age: 71.0  
Gender: Female  
Location: Colorado  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 1995-11-14
   Days after onset:8
Entered: 1996-09-11
   Days after submission:301
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E2745HD / - LA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH - / - RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Chills, Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp chills/fever ''years ago'' p 1st dose of influenza vax~ ()~~~In patient
Other Medications: Modeurtic
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 895333012L

Write-up: pt recv vax 6NOV95 & that day devel in inj site rxn characterized by swelling & redness;pt also c/o chills;


VAERS ID: 94981 (history)  
Age: 12.0  
Gender: Male  
Location: North Carolina  
Vaccinated:1995-11-06
Onset:1995-11-10
   Days after vaccination:4
Submitted: 1995-11-15
   Days after onset:5
Entered: 1997-02-12
   Days after submission:455
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1658B2 / 0 - / IM

Administered by: Public       Purchased by: Unknown
Symptoms: Pharyngitis, Rash, Rhinitis, Urticaria
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hx of asthma
Diagnostic Lab Data:
CDC Split Type: NC96143

Write-up: pt seen @ ER on 10NOV96 by MD for rash & hives;pt recv vax 6NOV95 & MD stated pt has hx of asthma & is on inhaler;pt given ATB for cold sx 8NOV95;grandma states pt had one dose only but does not believe the rxn was from ATB;


VAERS ID: 96719 (history)  
Age: 2.0  
Gender: Male  
Location: Unknown  
Vaccinated:1995-11-06
Onset:1997-02-11
   Days after vaccination:463
Submitted: 1997-03-22
   Days after onset:39
Entered: 1997-04-04
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0400B / - - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recv vax on 6NOV95 & devel acute chicken pox 11FEB97;


VAERS ID: 98756 (history)  
Age: 41.0  
Gender: Female  
Location: Texas  
Vaccinated:1995-11-06
Onset:1995-11-06
   Days after vaccination:0
Submitted: 1997-02-06
   Days after onset:458
Entered: 1997-04-18
   Days after submission:70
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61112 / 0 - / IM A

Administered by: Other       Purchased by: Other
Symptoms: Asthenia, Chills, Dysphagia, Laryngospasm, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to PCN;no hx of asthma;
Diagnostic Lab Data:
CDC Split Type: CO6304

Write-up: started as diff swollowing 3hr p/vax;then thraot swollen, stridor 45min later w/achyness & inc temp 3-4hr later;resolved p/taking Codinal;@ work next day & only feels tired;no other changes in habits;1st time for flu vax;


VAERS ID: 104991 (history)  
Age: 4.0  
Gender: Female  
Location: Florida  
Vaccinated:1995-11-06
Onset:1997-11-12
   Days after vaccination:737
Submitted: 1997-11-13
   Days after onset:1
Entered: 1997-11-19
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0440B / 0 RA / SC

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: broke out w/chickenpox, recovered;


VAERS ID: 116712 (history)  
Age: 1.0  
Gender: Male  
Location: Virginia  
Vaccinated:1995-11-06
Onset:1998-11-17
   Days after vaccination:1107
Submitted: 1998-11-17
   Days after onset:0
Entered: 1998-11-23
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0443B / 0 - / SC A

Administered by: Private       Purchased by: Private
Symptoms: Skin nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: approx 12 lesions on abd;


VAERS ID: 124371 (history)  
Age: 7.0  
Gender: Male  
Location: Pennsylvania  
Vaccinated:1995-11-06
Onset:1998-12-05
   Days after vaccination:1125
Submitted: 1999-05-14
   Days after onset:159
Entered: 1999-05-21
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0439B / 0 - / -

Administered by: Other       Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98121623

Write-up: approx 3yrs p/vax pt exp chickenpox w/approx 2 dozen lesions.


VAERS ID: 124391 (history)  
Age:   
Gender: Female  
Location: Pennsylvania  
Vaccinated:1995-11-06
Onset:1998-12-18
   Days after vaccination:1138
Submitted: 1999-05-14
   Days after onset:146
Entered: 1999-05-21
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0439B / 0 - / -

Administered by: Other       Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: brother, varicella, 10yrs, varivax, dose 1in series~ ()~~~In Sibling
Other Medications: iml
Current Illness:
Preexisting Conditions: sulfa allergy
Diagnostic Lab Data:
CDC Split Type: WAES98121957

Write-up: approx 3yrs p/vax pt exp chickenpox w/over 100 lesions.


VAERS ID: 124482 (history)  
Age: 1.1  
Gender: Unknown  
Location: Florida  
Vaccinated:1995-11-06
Onset:1999-01-18
   Days after vaccination:1169
Submitted: 1999-05-14
   Days after onset:115
Entered: 1999-05-21
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - LA / SC

Administered by: Other       Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES99011701

Write-up: pt vax in 1995 & in 1996 pt exp mild atypical chickenpox


VAERS ID: 128940 (history)  
Age: 1.5  
Gender: Male  
Location: Texas  
Vaccinated:1995-11-06
Onset:1999-06-15
   Days after vaccination:1317
Submitted: 1999-09-30
   Days after onset:107
Entered: 1999-10-05
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 4C61142 / 3 LL / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0437B / 0 RL / -

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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type: TX99188

Write-up: rash lasted 5 days, no fever, no antipyretics given;MD dx;no complications & no meds given by MD;less than 50


VAERS ID: 156653 (history)  
Age: 3.0  
Gender: Female  
Location: Texas  
Vaccinated:1995-11-06
Onset:1999-03-18
   Days after vaccination:1228
Submitted: 2000-05-16
   Days after onset:424
Entered: 2000-07-14
   Days after submission:59
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 0 - / SC

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective, Headache, Infection, Pruritus, Pyrexia, Restlessness
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99031375

Write-up: Subsequent to receiving one dose of varicella virus vaccine live on 11/6/95, the pt experienced varicella (100-150 lesions) and a fever of 102-103 axillary for 48 hours, on 3/18/99. The pt was treated with Tylenol and Benadryl. The pt also experienced increased itching, increased restlessness, and headache. Pt was treated with Atarax.


VAERS ID: 171847 (history)  
Age: 6.0  
Gender: Male  
Location: New Jersey  
Vaccinated:1995-11-06
Onset:2000-10-27
   Days after vaccination:1817
Submitted: 2001-05-15
   Days after onset:200
Entered: 2001-06-01
   Days after submission:17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 6164561179B / 0 LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 6092830428B / 0 RA / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Drug ineffective, Erythema, Rash vesicular, Viral infection
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: NONE
Diagnostic Lab Data:
CDC Split Type: WAES00102444

Write-up: On 10/27/2000 or 10/25/2000 the patient presented with chickenpox. The nurse reported that the patient had a rash for 2 days consisting of 5-10 red itchy pustules/vesicular lesions with erythema at the base on his neck, back, face, and chest. It was reported that the physician expected more. The rash increased in number over 12-24 hours prior to the visit. Subsequently, the patient recovered from his experience. No further information is available.


VAERS ID: 171920 (history)  
Age: 6.0  
Gender: Female  
Location: Ohio  
Vaccinated:1995-11-06
Onset:2000-11-21
   Days after vaccination:1842
Submitted: 2001-05-15
   Days after onset:174
Entered: 2001-06-01
   Days after submission:17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 8102550748B / 0 - / SC

Administered by: Private       Purchased by: Private
Symptoms: Blister, Pruritus, Pyrexia, Vaginal infection, Viral infection
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Varicella exposure
Diagnostic Lab Data: NONE
CDC Split Type: WAES00120447

Write-up: Post vax, on 11/20/2000, the patient was exposed to a child who had chicken pox at school. On 11/11/2000 the patient was seen in her physician''s office and chicken pox was confirmed by the physician. The patient then developed 30 red spots with blisters on top on numerous areas of her body. The patient had a fever of 102F. The patient was treated with Benadryl as needed for the itching, Aveeno Bath and calamine lotion. In November 2000 the patient also had a vaginal yeast infection and was treated with Diflucan. On 12/08/2000 the patient recovered. No further details were provided.


VAERS ID: 182847 (history)  
Age: 7.0  
Gender: Female  
Location: Wisconsin  
Vaccinated:1995-11-06
Onset:2001-05-16
   Days after vaccination:2018
Submitted: 2002-03-10
   Days after onset:298
Entered: 2002-03-26
   Days after submission:16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER 015U / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0880B / - LL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0403B / - RL / SC

Administered by: Private       Purchased by: Other
Symptoms: Drug ineffective, Viral infection
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: slight cold possibly
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diagnosed with chicken pox twice after being vaccinated with varicella on 05/16/2001 and 02/22/2002-no temp, fluid filled poxs, $g 100, 5 days till scattered over, Benadryl liqued and oatmeal baths.


VAERS ID: 256842 (history)  
Age: 1.13  
Gender: Female  
Location: Unknown  
Vaccinated:1995-11-06
Onset:2005-03-24
   Days after vaccination:3426
Submitted: 2006-05-12
   Days after onset:413
Entered: 2006-05-17
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - - / -

Administered by: Other       Purchased by: Other
Symptoms: Skin ulcer
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0510USA0902

Write-up: Information has been received from a physician and a school nurse concerning a 10 year old female who on 06-NOV-1995 was vaccinated with a dose of varicella virus vaccine live (Oka/Merck). It was also noted that the child was vaccinated with a dose of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar RA 27/3) on 21-SEP-1995 and 28-SEP-1998. A school nurse reported to the physician that between 24-MAR-2005 and 09-MAY-2005, the child developed a "more severe case" of chickenpox, noted to be breakthrough with 50 to 250 lesions. Unspecified medical attention was sought. The outcome is recovered. A product quality complaint was not involved. No additional information is expected.


VAERS ID: 79818 (history)  
Age: 1.3  
Gender: Female  
Location: Foreign  
Vaccinated:1995-11-06
Onset:1995-11-11
   Days after vaccination:5
Submitted: 1995-11-29
   Days after onset:18
Entered: 1995-12-04
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Convulsion, Laboratory test abnormal, Leukopenia, Pyrexia, Rash, Thrombocytopenia
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: no relevant history
Diagnostic Lab Data: 14NOV95 Platelet count 68,000; hemoglobin 14NOV95 110;14NOV95 RBC count nl
CDC Split Type: WAES95111377

Write-up: pt recvd vax 6NOV95 & 11NOV95 pt exp fever of 39-40 & convuls & was hospitalized;12NOV95 pt exp an unspecified eruption & thrombocytopenia & neutropenia;14NOV95, lab analysis revealed platelet count 68,000 & hemoglobin 110;Neutrophil count


VAERS ID: 91908 (history)  
Age: 35.0  
Gender: Female  
Location: Foreign  
Vaccinated:1995-11-06
Onset:1995-12-22
   Days after vaccination:46
Submitted: 1996-11-07
   Days after onset:321
Entered: 1996-11-12
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1389A4 / - - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abortion
SMQs:, Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 950135431

Write-up: pt recv vax & 6NOV95 & had a miscarriage on 22DEC95 w/complete disintegration of fetus;it is noted that 3rd dose of vax was given 12JUN96;reporting MD considers the event to be poss r/t vax;


VAERS ID: 198676 (history)  
Age: 1.75  
Gender: Unknown  
Location: Foreign  
Vaccinated:1995-11-06
Onset:0000-00-00
Submitted: 2003-02-26
Entered: 2003-03-04
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0251B / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Autism, Gastrointestinal disorder
SMQs:

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES99031638

Write-up: Information has been received regarding a case in litigation in which a 21 month old patient was vaccinated on 11/6/95 with a dose of MMR (second generation) (batch HA4022: Lot 613947/0251B). Subsequently the patient developed autism and inflammatory bowel disease. Upon internal review, autism was considered to be an other important medical event (OMIC). No further information is available.


Result pages: prev   1247 1248 1249 1250 1251 1252 1253 1254 1255 1256 1257 1258 1259 1260 1261 1262 1263 1264 1265 1266 1267 1268 1269 1270 1271 1272 1273 1274 1275 1276 1277 1278 1279 1280 1281 1282 1283 1284 1285 1286 1287 1288 1289 1290 1291 1292 1293 1294 1295 1296 1297 1298 1299 1300 1301 1302 1303 1304 1305 1306 1307 1308 1309 1310 1311 1312 1313 1314 1315 1316 1317 1318 1319 1320 1321 1322 1323 1324 1325 1326 1327 1328 1329 1330 1331 1332 1333 1334 1335 1336 1337 1338 1339 1340 1341 1342 1343 1344 1345 1346 1347 1348 1349 1350 1351 1352 1353 1354 1355 1356 1357 1358 1359 1360 1361 1362 1363 1364 1365 1366 1367 1368 1369 1370 1371 1372 1373 1374 1375 1376 1377 1378 1379 1380 1381 1382 1383 1384 1385 1386 1387 1388 1389 1390 1391 1392 1393 1394 1395 1396 1397 1398 1399 1400 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 1427 1428 1429 1430 1431 1432 1433 1434 1435 1436 1437 1438 1439 1440 1441 1442 1443 1444 1445   next

New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=1346&PERPAGE=100&ESORT=VAX-DATE


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166