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Found 544402 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:95002 (history)  Vaccinated:1997-02-05
Age:0.1  Onset:1997-02-05, Days after vaccination: 0
Gender:Female  Submitted:1997-02-06, Days after onset: 1
Location:New York  Entered:1997-02-12, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, PT/PTT
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4380870IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2148A21IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES756K30PO 
Administered by: Private     Purchased by: Public
Symptoms: Anorexia, Crying, Injection site oedema, Pyrexia, Unevaluable event, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad)
Write-up: pt recv vax & devel swelling-piercing high pitch cry-vomiting, anorexia, feb, inc sleeping pattern;

VAERS ID:95035 (history)  Vaccinated:1997-02-05
Age:5.9  Onset:1997-02-05, Days after vaccination: 0
Gender:Male  Submitted:1997-02-06, Days after onset: 1
Location:Washington  Entered:1997-02-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM62151A2  LA
Administered by: Military     Purchased by: Military
Symptoms: Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: high temp up to 105 w/some malaise;

VAERS ID:95043 (history)  Vaccinated:1997-02-05
Age:1.4  Onset:1997-02-05, Days after vaccination: 0
Gender:Male  Submitted:1997-02-06, Days after onset: 1
Location:West Virginia  Entered:1997-02-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: PPD by Lederle lot# 438676 given 5FEB97;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, chem 7, CXR, blood cult @ hosp
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4319661 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1470B0 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES741H11PO 
Administered by: Other     Purchased by: Public
Symptoms: Agitation, Convulsion, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt recv vax & APAP given;pt c/o leg pain & cranky around 730PM;APAP given 730PM 1/2dropper;mom states had sz 1220AM;went to ER t104 given Ibuprofen & sponge bath;

VAERS ID:94926 (history)  Vaccinated:1997-02-05
Age:5.0  Onset:1997-02-06, Days after vaccination: 1
Gender:Male  Submitted:1997-02-12, Days after onset: 6
Location:Pennsylvania  Entered:1997-02-18, Days after submission: 6
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: 10FEB97 CPK 1758;
CDC Split Type: 970029351
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2032A20  
Administered by: Private     Purchased by: Private
Symptoms: Hepatic function abnormal, Hypokinesia, Infection, Laboratory test abnormal, Myalgia, Myasthenic syndrome, Myositis, Renal impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Retroperitoneal fibrosis (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad)
Write-up: 1 to 2 days p/vax pt devel fever to 103;10FEB97 presented @ hosp w/bilat myositis in legs, w/o joint involvement;pt was unable to support weight;could not stand or walk;CPK was 1758 & considered to be risk for renal failure;

VAERS ID:95156 (history)  Vaccinated:1997-02-05
Age:26.2  Onset:1997-02-05, Days after vaccination: 0
Gender:Female  Submitted:1997-02-07, Days after onset: 2
Location:New Jersey  Entered:1997-02-20, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Humulin insulin
Current Illness:
Preexisting Conditions: IDDM
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F713130IM 
Administered by: Private     Purchased by: Private
Symptoms: Chills, Myalgia, Nausea, Pharyngitis, Pyrexia, Rhinitis, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt stated that 3hr p/vax devel t103, body aches, chills, vomiting, sore throat;pt was seen in office 16hr p/vax initiated temp was 101.2, vomiting stopped;still c/o nausea, runny nose, body aches;

VAERS ID:95300 (history)  Vaccinated:1997-02-05
Age:1.1  Onset:1997-02-05, Days after vaccination: 0
Gender:Female  Submitted:1997-02-06, Days after onset: 1
Location:Pennsylvania  Entered:1997-02-24, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin
Current Illness: had an ear infect 5-6 days ago
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: PA9708
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES6E711133IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES6E711133IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0895D0 RL
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: mom states pt has a rash which started evening of 5FEB96;appearing first on cheeks,then on stomach, arms, legs & now all over;no fever-pt is playing & active;no itching;rash just red on body;

VAERS ID:95388 (history)  Vaccinated:1997-02-05
Age:0.3  Onset:1997-02-05, Days after vaccination: 0
Gender:Male  Submitted:1997-02-06, Days after onset: 1
Location:New Jersey  Entered:1997-03-03, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: well baby
Preexisting Conditions:
Diagnostic Lab Data: pt was worked up in ER-currently following up w/pt
CDC Split Type: NJ973
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4386220 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0743A0PO 
Administered by: Other     Purchased by: Public
Symptoms: Dyspnoea, Face oedema, Rash, Tongue oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: @ home, about 1-1 1/2hr p/vax mom noticed the baby''s eye swollen along w/tongue swollen, rash all over body;baby trouble breathing;mom proceeded to ER;

VAERS ID:95555 (history)  Vaccinated:1997-02-05
Age:0.5  Onset:1997-02-07, Days after vaccination: 2
Gender:Male  Submitted:1997-03-05, Days after onset: 26
Location:Pennsylvania  Entered:1997-03-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rash 20SEP96 @ 6wk w/DTAP/HIB
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES6D813962IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS6E711132IMRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site abscess, Injection site hypersensitivity, Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: papulovesicular eruption @ both needle sites;+sterile abscess by description;

VAERS ID:96359 (history)  Vaccinated:1997-02-05
Age:55.5  Onset:1997-02-05, Days after vaccination: 0
Gender:Male  Submitted:1997-03-07, Days after onset: 30
Location:Minnesota  Entered:1997-03-19, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BP meds
Current Illness: HTN
Preexisting Conditions: HTN;no allergies
Diagnostic Lab Data: NONE
CDC Split Type: MN97007
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2128B60IMLA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: extensive hives on trunk, extremities, head, ears, eye area;denies any SOB or resp problems;onset eve of 5FEB97;notified PHN 8AM 6FEB97;advised MD;

VAERS ID:96369 (history)  Vaccinated:1997-02-05
Age:0.8  Onset:1997-02-15, Days after vaccination: 10
Gender:Male  Submitted:1997-03-12, Days after onset: 25
Location:New Jersey  Entered:1997-03-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES6H710402IMRA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2144A22IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis contact, Rash, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & reported exanthem;reporter felt it was contact dermatits but parental concern of rash;pt referred to dermatologist who felt it was a Gianotti Crosti synd secondary to hep B vax;

VAERS ID:96522 (history)  Vaccinated:1997-02-05
Age:16.3  Onset:1997-02-08, Days after vaccination: 3
Gender:Male  Submitted:1997-02-10, Days after onset: 2
Location:Georgia  Entered:1997-03-28, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: step mom states test came back OK CAT scan & lab work @ ER;
CDC Split Type: GA97021
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0129B1 RA
Administered by: Public     Purchased by: Public
Symptoms: Muscle twitching, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: pt to ER 8FEB97 p/couldn''t wake pt up-step mother went in & found pt half-awoke & jerking-was about 45min p/this pt was completely awake @ ER;pt took unk pill for pain from hx of sz as child;

VAERS ID:96639 (history)  Vaccinated:1997-02-05
Age:21.5  Onset:1997-02-05, Days after vaccination: 0
Gender:Female  Submitted:1997-03-17, Days after onset: 40
Location:Arkansas  Entered:1997-04-01, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OBC & FeSO4
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NA
CDC Split Type: AR9721
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1622B0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Headache, Malaise, Pyrexia, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: 5hr p/vax pt began intestinal cramping, vomiting, fever, malaise, h/a, weakness, sleepy;24hr later diarrhea began-all sx persisted for 4-5 days;took pepto bismol w/no relief;

VAERS ID:97042 (history)  Vaccinated:1997-02-05
Age:0.5  Onset:1997-02-05, Days after vaccination: 0
Gender:Male  Submitted:1997-02-13, Days after onset: 8
Location:Kansas  Entered:1997-04-18, Days after submission: 63
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Vantin
Diagnostic Lab Data: NONE
CDC Split Type: KS97009
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4391921IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4381191PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Crying, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)
Write-up: shaking, tremors, fever of 102 & screaming for 1hr straight;

VAERS ID:107781 (history)  Vaccinated:1997-02-05
Age:1.6  Onset:1998-02-13, Days after vaccination: 373
Gender:Male  Submitted:1998-02-16, Days after onset: 3
Location:New Jersey  Entered:1998-02-20, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: URI
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1363D0 LA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt 2wk p/varicella exposure devel 4 distinct papules-2 were vesicles & 2 were scabbed lesions consistent w/varicella;

VAERS ID:95038 (history)  Vaccinated:1997-02-06
Age:0.4  Onset:1997-02-06, Days after vaccination: 0
Gender:Male  Submitted:1997-02-07, Days after onset: 1
Location:Texas  Entered:1997-02-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: sickle cell anemia
Preexisting Conditions: sickle cell anemia
Diagnostic Lab Data: NONE
CDC Split Type: TX97092
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES0804210   
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES0804210   
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0748L PO 
Administered by: Public     Purchased by: Public
Symptoms: Ecchymosis, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: leg swollen, black & blue, t101

VAERS ID:95047 (history)  Vaccinated:1997-02-06
Age:0.5  Onset:1997-02-06, Days after vaccination: 0
Gender:Female  Submitted:1997-02-07, Days after onset: 1
Location:Illinois  Entered:1997-02-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4380901IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4386431PO 
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Anorexia, Crying, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)
Write-up: temp-max 102.5;screaming spell lasting followed by intermittent crying 1/2h-3/4h over a 12hr period;refused to feed;

VAERS ID:95124 (history)  Vaccinated:1997-02-06
Age:0.2  Onset:1997-02-06, Days after vaccination: 0
Gender:Female  Submitted:1997-02-07, Days after onset: 1
Location:Michigan  Entered:1997-02-18, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ATB (ceclor)
Current Illness: OM
Preexisting Conditions: OM
Diagnostic Lab Data:
CDC Split Type: MI97046
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4386210IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1308D1IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0755H0PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Injection site hypersensitivity, Injection site oedema
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt slept until 1030PM when became irritable lt leg became swollen & hot & APAP given per mom;pt taken to MD office 7FEB97 no redness or fever present but pt irritable w/4cm area of swelling @ inj site;

VAERS ID:95129 (history)  Vaccinated:1997-02-06
Age:1.0  Onset:1997-02-06, Days after vaccination: 0
Gender:Female  Submitted:1997-02-07, Days after onset: 1
Location:North Carolina  Entered:1997-02-18, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: phenlketonuria
Diagnostic Lab Data: WBC count 17,000;nl electrolytes & Magnesium;
CDC Split Type: NC97015
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4411033IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.088400SCLA
Administered by: Private     Purchased by: Public
Symptoms: Convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt recv vax 6FEB97 & devel fever to 103.7 on the evening 6FEB97 & had gen sz which was very brief when fever rose from 101+ to 103.7;

VAERS ID:95140 (history)  Vaccinated:1997-02-06
Age:1.3  Onset:1997-02-06, Days after vaccination: 0
Gender:Male  Submitted:1997-02-10, Days after onset: 4
Location:Iowa  Entered:1997-02-18, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: IA97004
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES4386103IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM240NB3IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0391D0IMLL
Administered by: Public     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: pt devel red blotches on mouth et cheeks, filling w/white fluid, afeb;mom denied pt exp any other sx;

VAERS ID:95257 (history)  Vaccinated:1997-02-06
Age:0.2  Onset:1997-02-10, Days after vaccination: 4
Gender:Female  Submitted:1997-02-14, Days after onset: 4
Location:Illinois  Entered:1997-02-24, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: IL97013
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4380900 LL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0279D0 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0748M0PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: red, hard swelling on lt leg appeared 4 days p/vax;

VAERS ID:95333 (history)  Vaccinated:1997-02-06
Age:0.8  Onset:1997-02-06, Days after vaccination: 0
Gender:Male  Submitted:1997-02-21, Days after onset: 15
Location:Massachusetts  Entered:1997-03-03, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: prematurity, developmental delay
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES6M711842 RL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1025D2 LL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESM330NO2 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0743E2PO 
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Crying, Hypotonia, Insomnia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: pt adm to hosp overnoc for poss sz;pt exp screaming followed by 2hr of limpness;grandma felt pt not self;pt began to arch back;mom though pt was not breathing;did not sleep;wanted to be held by one person;pt did not recognize family

VAERS ID:95374 (history)  Vaccinated:1997-02-06
Age:11.9  Onset:1997-02-07, Days after vaccination: 1
Gender:Female  Submitted:1997-02-10, Days after onset: 3
Location:Oklahoma  Entered:1997-03-03, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NA
Diagnostic Lab Data: NONE
CDC Split Type: OK979
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1345A0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site oedema, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax & arms was swollen from site to fingertips;referred to MD took APAP & use ice pack;spoke to father 10FEB97 said still had small amount of swelling in fingers but thought was fine;

VAERS ID:95394 (history)  Vaccinated:1997-02-06
Age:1.1  Onset:1997-02-06, Days after vaccination: 0
Gender:Female  Submitted:1997-02-06, Days after onset: 0
Location:California  Entered:1997-03-03, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: finished amoxicillin
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4348123IMRA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1279D2IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1415B0SCLA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Cyanosis, Hyperventilation, Hypotonia, Somnolence, Tremor
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: mom states pt was sleeping & was breathing very rapidly states body was shaking & that hands & feet were cold & blue;pt taken to clinic; pt appeared groggy closing eyes, sl dec in muscle tone & floppy;some cyanosis;feet cool to touch

VAERS ID:95468 (history)  Vaccinated:1997-02-06
Age:34.0  Onset:1997-02-12, Days after vaccination: 6
Gender:Male  Submitted:1997-02-20, Days after onset: 8
Location:Unknown  Entered:1997-03-05, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESEJN124B1 RA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: redness & itching @ the site of inj lasting 2 days;determined to be mild rxn;pt refused tx & released instructed to return if not resolved;

VAERS ID:95563 (history)  Vaccinated:1997-02-06
Age:5.1  Onset:1997-02-06, Days after vaccination: 0
Gender:Female  Submitted:1997-02-21, Days after onset: 15
Location:Michigan  Entered:1997-03-10, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MI97016
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5B711724IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1308D0IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0476D1SCRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0749C3PO 
Administered by: Public     Purchased by: Public
Symptoms: Hyperhidrosis, Pruritus, Rash, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow)
Write-up: 6FEB97 7PM rash on neck inc to hives;tx w/DPH;7FEB97 welts size of quarters on neck;inc over body cont DPH;8FEB97 seen by MD dec itching;10FEB97 hives cont;21FEB97 cont to break out in raised welts when touched or if hot & sweaty;

VAERS ID:95599 (history)  Vaccinated:1997-02-06
Age:1.2  Onset:1997-02-07, Days after vaccination: 1
Gender:Male  Submitted:1997-02-13, Days after onset: 6
Location:Tennessee  Entered:1997-03-10, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: TN97017
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4348142IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0214D0 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4398672PO 
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt recv vax 6FEB97 & next day pt had temp & had sz;pt taken to ER t102.1;given Ibuprofen & transferred from ER to another hosp

VAERS ID:95621 (history)  Vaccinated:1997-02-06
Age:0.4  Onset:1997-02-06, Days after vaccination: 0
Gender:Male  Submitted:1997-02-25, Days after onset: 19
Location:North Carolina  Entered:1997-03-12, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NC97020
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4407441IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0750H1PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Crying, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)
Write-up: mom reported p/pt recv vax 6FEB97 exp inc temp of 104 & given APAP & prolonged high pitched, inconsolable crying;sx cont x 3 days;taken to ER 9FEB97 & was seen by MD who recommended pt only have DT dx immun rxn;

VAERS ID:96269 (history)  Vaccinated:1997-02-06
Age:32.4  Onset:1997-02-14, Days after vaccination: 8
Gender:Female  Submitted:1997-03-10, Days after onset: 24
Location:New York  Entered:1997-03-14, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Advil
Current Illness: NONE
Preexisting Conditions: tests for unk condition
Diagnostic Lab Data: MD did test-nothing noted;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST. 2IMA
Administered by: Private     Purchased by: Other
Symptoms: Amblyopia, Dizziness, Vasodilatation, Vertigo
SMQs:, Anticholinergic syndrome (broad), Optic nerve disorders (broad), Vestibular disorders (narrow)
Write-up: beginning 14FEB97 day p/3rd vax pt dizzy, eye sight blurry, felt hot;lasted about 1 day-vertigo cont sporadically;

VAERS ID:96316 (history)  Vaccinated:1997-02-06
Age:24.9  Onset:1997-02-06, Days after vaccination: 0
Gender:Male  Submitted:1997-02-11, Days after onset: 5
Location:Georgia  Entered:1997-03-18, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: GA97017
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0309D0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Face oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: swollen eyes, hives went to ER 6FEB97;had shot of epi, cortisone, DPH; was given a prescription;

VAERS ID:96458 (history)  Vaccinated:1997-02-06
Age:36.3  Onset:1997-02-06, Days after vaccination: 0
Gender:Female  Submitted:1997-02-11, Days after onset: 5
Location:North Carolina  Entered:1997-03-24, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: NC97024
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6F811890 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Hypokinesia, Pallor
SMQs:, Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt came to door & opened it;pt looked very pale, grabbed the door & sate down on floor;had pt lay down;pt stated was dizzy;pt stated read back of Td info sheet & panicked;pt sat a few min then color was good;

VAERS ID:96459 (history)  Vaccinated:1997-02-06
Age:44.0  Onset:1997-03-01, Days after vaccination: 23
Gender:Male  Submitted:1997-03-04, Days after onset: 3
Location:North Carolina  Entered:1997-03-24, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: NC97023
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6F811890 RA
Administered by: Public     Purchased by: Unknown
Symptoms: Hypokalaemia, Myalgia, Pharyngitis
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: no local rxn;both arms aching/hurting (six pillows to sleep on) per nurse - pt saw pvt MD;K+ low placed on K+ supplement by MD;pt also had URI & on ATB;

VAERS ID:96487 (history)  Vaccinated:1997-02-06
Age:1.6  Onset:1997-02-06, Days after vaccination: 0
Gender:Male  Submitted:1997-02-18, Days after onset: 12
Location:Colorado  Entered:1997-03-25, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Cephalexin
Current Illness: cat scratch taking cephalexin
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: CO97009
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4391953IMLL
Administered by: Public     Purchased by: Public
Symptoms: Cystitis, Leukocytosis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax 6FEB97 & started vomiting that afternoon;8FEB97 went to family MD in AM WBC''s were inc placed on Suprax;went again to family MD 1wk later had a bladder infect;placed on a sulfa containing ATB;

VAERS ID:96773 (history)  Vaccinated:1997-02-06
Age:1.3  Onset:1997-02-10, Days after vaccination: 4
Gender:Male  Submitted:1997-03-06, Days after onset: 24
Location:Montana  Entered:1997-04-07, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MT97002
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES6C813470IMLL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES6E711132IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0891D0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Anorexia, Dehydration, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (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)
Write-up: 10FEB97 fever started & v once;started dec in appetite;fever lasted till Wednesday;12FEB97 rash started on torso & moved up to neck;very irritable-crying during the noc;eye started looking like hadn''t slept, no appetite;didn''t drink fluids;

VAERS ID:97400 (history)  Vaccinated:1997-02-06
Age:0.2  Onset:1997-02-06, Days after vaccination: 0
Gender:Male  Submitted:1997-04-28, Days after onset: 80
Location:Iowa  Entered:1997-05-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4326550IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4369570PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Agitation, Injection site hypersensitivity, Injection site mass, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: devel inc temp to 102, very reddened thigh, w/palpable lump persisting for 3wk, persistent crying;

VAERS ID:99241 (history)  Vaccinated:1997-02-06
Age:0.4  Onset:1997-02-06, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Unknown  Entered:1997-06-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES  IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Crying, Screaming
SMQs:, Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)
Write-up: high-pitched screaming, unconsolable crying for 3-4hr;

VAERS ID:99537 (history)  Vaccinated:1997-02-06
Age:5.2  Onset:1997-02-06, Days after vaccination: 0
Gender:Male  Submitted:1997-02-14, Days after onset: 8
Location:Virginia  Entered:1997-07-01, Days after submission: 136
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: reactive airway disease
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 897070012L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES438825 IMRA
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS  IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0189D   
Administered by: Private     Purchased by: Private
Symptoms: Anorexia, Cough, Injection site hypersensitivity, Injection site oedema, Pharyngitis, Pyrexia, Rhinitis, Somnolence
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & devel a fever which persisted for 2 days, loss of appetite, & was sleepy;pt also devel an inj site rxn characterized by redness & swelling @ the site of vax;one day post vax pt devel cough & congestion;

VAERS ID:100523 (history)  Vaccinated:1997-02-06
Age:1.9  Onset:1997-02-06, Days after vaccination: 0
Gender:Male  Submitted:1997-02-14, Days after onset: 8
Location:Virginia  Entered:1997-07-18, Days after submission: 153
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 897063016L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4410973IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0189D0  
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4412412PO 
Administered by: Private     Purchased by: Private
Symptoms: Cough, Diarrhoea, Injection site hypersensitivity, Injection site oedema, Insomnia, Pyrexia, Rash, Rhinitis
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax & had 4 loose stools;pt also devel a white rash on stomach, an inj site rxn characterized by redness & swelling @ site of vax & fitful sleep;1 days post vax devel a cough & congestion which persisted @ the date of this report;

VAERS ID:100437 (history)  Vaccinated:1997-02-06
Age:1.4  Onset:1997-02-10, Days after vaccination: 4
Gender:Female  Submitted:1997-07-09, Days after onset: 148
Location:Pennsylvania  Entered:1997-07-23, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC Split Type: PA9749
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1358120SC 
Administered by: Public     Purchased by: Unknown
Symptoms: Agitation, Pyrexia, Skin nodule
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad)
Write-up: pt devel fever & fussiness 3 days p/vax;also devel pimple like nodes on rt eye lid;cont to have eye problems mo later;has 1-2 sty-like protrusions on rt eye & is now devel same on lt eye;

VAERS ID:105995 (history)  Vaccinated:1997-02-06
Age:25.0  Onset:1997-02-06, Days after vaccination: 0
Gender:Male  Submitted:1997-10-20, Days after onset: 255
Location:New York  Entered:1997-10-30, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: 970030071
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Back pain, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax 6FEB97 & on the day recv vax suffered nausea, malaise, loss of appetite, back pain & felt tired;@ the time of this report 10FEB97 sx were becoming worse;vax discount;

VAERS ID:108301 (history)  Vaccinated:1997-02-06
Age:21.5  Onset:1997-02-06, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: NONE
Current Illness:
Preexisting Conditions: influenza
Diagnostic Lab Data:
CDC Split Type: WAES97030903
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Chills, Dizziness, Influenza, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: pt recv vax 6FEB97 & 1hr later pt devel severe flu-like sx, dizziness, fatigue, fever, malaise & chills;most sx persisted for 2 to 3 days but the flu like sx persisted for about 1.5wk;

VAERS ID:110214 (history)  Vaccinated:1997-02-06
Age:3.4  Onset:1998-02-15, Days after vaccination: 374
Gender:Female  Submitted:1998-04-15, Days after onset: 58
Location:Unknown  Entered:1998-04-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98021488
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1336D0  
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)
Write-up: pt recv vax 6FEB97 & 15FEB98 pt devel a varicella rash;

VAERS ID:122941 (history)  Vaccinated:1997-02-06
Age:2.0  Onset:1998-04-18, Days after vaccination: 436
Gender:Male  Submitted:1999-05-14, Days after onset: 391
Location:West Virginia  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unknown
Current Illness:
Preexisting Conditions: asthma; inhaled steriod therapy
Diagnostic Lab Data:
CDC Split Type: WAES98041427
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: pt recv 1 dose of varivax 2/97 & on 4/98 the pt devel ``mild case'''' of pox lesions

VAERS ID:122942 (history)  Vaccinated:1997-02-06
Age:5.1  Onset:1998-04-02, Days after vaccination: 420
Gender:Female  Submitted:1999-05-14, Days after onset: 406
Location:West Virginia  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unknown
Current Illness:
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC Split Type: WAES98041428
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1106D0  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 1st dose of varivax 2/97 & 4/98 pt devel a ``mild case'''' of varicella

VAERS ID:124170 (history)  Vaccinated:1997-02-06
Age:2.0  Onset:1998-10-28, Days after vaccination: 629
Gender:Female  Submitted:1999-05-14, Days after onset: 197
Location:Georgia  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98110107
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1541D0 RL
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: approx 20mos p/vax pt exp varicella rash

VAERS ID:177345 (history)  Vaccinated:1997-02-06
Age:7.0  Onset:2001-10-14, Days after vaccination: 1711
Gender:Female  Submitted:2001-10-25, Days after onset: 11
Location:California  Entered:2001-11-07, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CA010117
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0279D0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1357D0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Herpes zoster, Infection, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: On 10/16/01 Diagnosed with shingles by PMD preceded on 10/14/01 fever and painful rash for 2 days. Isolates offered by Merck to do testing to determine wild virus vs varicella vaccine per nurse at Dr''s office. No further plan-discussed with mother.

VAERS ID:251995 (history)  Vaccinated:1997-02-06
Age:1.0  Onset:2006-01-29, Days after vaccination: 3279
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:2006-02-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1342D0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Acne, Drug ineffective, Pyrexia, Rash, Skin ulcer, Viral infection
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Varicella vaccine breakthrough; Developed fever and rash on neck and trunk on 1/29/06. Temp max 101.2 oral. Had scattered papules (about 30) and 3 crusted lesions and 2 oral lesions. Diagnosed with varicella in our office on 1/30/06 by Dr.

VAERS ID:258405 (history)  Vaccinated:1997-02-06
Age:5.0  Onset:2006-06-13, Days after vaccination: 3414
Gender:Female  Submitted:2006-06-14, Days after onset: 1
Location:Wisconsin  Entered:2006-06-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1356D   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash, Viral infection
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Mother reports her daughter has chicken pox now. She was vaccinated 9 years ago.

VAERS ID:280623 (history)  Vaccinated:1997-02-06
Age:10.0  Onset:2006-05-10, Days after vaccination: 3380
Gender:Male  Submitted:2007-05-16, Days after onset: 371
Location:Ohio  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0605USA02521
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella
SMQs:
Write-up: Information has been received from a physician concerning a 10-year-old male with no pertinent medical history or allergies who on 06-FEB-1997 was vaccinated SC with a 0.5 mL dose of Varivax. There was no concomitant therapy. The physician reported that on 10-MAY-2006, the patient developed six chickenpox on his trunk. Unspecified medical attention was sought, but no laboratory/diagnostic tests were performed. At the time of this report, the patient was recovering from the chickenpox. Additional information has been requested.

VAERS ID:210442 (history)  Vaccinated:1997-02-06
Age:28.0  Onset:1997-03-01, Days after vaccination: 23
Gender:Female  Submitted:2003-10-14, Days after onset: 2417
Location:Foreign  Entered:2003-10-16, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Lumbar Scoliosis
Preexisting Conditions:
Diagnostic Lab Data: On 04/21/1997: Biological check-up and blood cell count: normal. Absence of inflammatory biological syndrome (normal C reactive protein and sedimentation rate). Hepatic check up: normal. Protein electrophoresis: normal profile. Cytological urinary exam: normal; Scan of scro iliac joints showed enlarged left symmetrical inter-ossious joint space without bone erosion, confirming the left sacro iliitis. Biological check up and blood cell count: normal: Absence of inflammatory biological syndrome (normal C reactive protein and sedimentation rate); Hepatic and renal check up: normal; Calcemia was normal; HLA type: B8 - B13. 05/20/1997: Streptococcus A serology (antistreptolysin O): 200 (N<200). 11/26/1997: Biological results: normal; Shou
CDC Split Type: B0311087A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Headache, Hemiplegia, Injection site inflammation, Laboratory test abnormal, Shoulder pain, Tinnitus, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad)
Write-up: This case was reported by a manufacturer local department and described the occurrence of unilateral paralysis in a 28 year old female subject who received Engerix B for hepatitis B prophylaxis. On 1/8/97 and 2/6/97, the subject received two injections of Engerix. Several weeks after the last injection, in March 1997, the subject experienced episodes of right shoulder inflammatory pain, which then spread to her right hip. During these episodes, she presented with right side paralysis. The symptoms were considered as invalidating and worsened with time. At the time of reporting, the subject had not yet recovered. Follow up on 11/05/2003: "The symptoms were considered as invalidating. On 04/02/1997, she experienced periarthritis of right shoulder, for which she was prescribed physical therapy and massages. On 04/21/1997, she was hospitalized in rheumatologic unit. On 04/28/1997, scan of sacro iliac and coxofemoral joint areas revealed a left sacro ilitis. Pelvie and left hip radiography was normal. In May 1997, she presented with sacro iliac pain irradiating to the left thigh which improved with non steroid anti-inflammatory treatment. Laboratory test showed no biological inflammatory syndrome (normal sedimentation rate, normal c-reactive protein). The subject was HLA B8 and B13 (HLAB27 negative). Renal and hepatic check up was normal. On 05/13/1997, a radiography of sacro iliac joints confirmed the diagnosis of left sacro ilitis. Ibuprofen (Ketum) was replaced by ketoprofen (Bi-profenid), due to absence of significant pain improvement. According to the rheumatologist, the event was related to an unknown inflammatory disease (may be linked to a spondylarthropathy), and was not related to her concomitant scoliosis. On 05/26/1997, she presented with a worsening of left sacro iliac pain. She walked with limping. Clinical examination revealed sacro iliac pains but no pain at coxo-femoral nor lumbar areas. A treatment with phenylbutazone (Butazolidine) was initiated, at 500mg daily during the first three days and then at 300mg daily. In mid June 1997, sacro iliac pain moderately reappeared but on 06/25/1997, clinical exam was asymptomatic, due to initiation of sulfasalazine (Salazopyrine) associated to ranitidine (Azantac) and ketoprofen. A diagnosis of inflammatory pathology was confirmed. At an unspecified date, she presented with axial disorders. Between June and September 1997, the subject experienced reactivation of her pain, including right shoulder pain, due to the transient stop of Salazopyrine. On 09/05/1997, clinical exam showed a sensitivity of sacro iliac area without functional discomfort nor limping and right shoulder pain when moving it. A diagnosis of axial and peripheric spondylarthritis was evoked. On 11/26/1997, clinical exam was unchanged. Biological check-up was normal. Rheumatoid factor was negative. Radiography of sacro iliac area showed no modification of the damages. Shoulder radiography revealed no inflammatory lesions. Chest radiography was normal. A treatment with omeprasol (Mopral) was initiated due to a bad digestive tolerance of ketoprofen. The diagnosis of spondyarthritis with left sacro iliitis was confirmed. On 10/14/1998, another rheumatologist concluded that the left sacro-iliac pain were the mechanical consequence of her important dorso lumbar scoliosis and were not related to an inflammatory spondylarthropathy. Sulphasalazine (Salazopyrine) was stopped and replaced by physical therapy. In August 2001, bone scintigraphy shoed hyperfixation at right shoulder and left sacro iliac level, and scoliotic deviation. On 09/10/2001, a cerebral MRI was performed for left lower limb hemiparesis and showed no abnormality. On 01/15/2002, left lower limb electromyogram showed an old, chronic and sequellar monoradicular syndrome ( at L5 level). There was no periphoric neuropathy. On 01/22/2002, a bone biospy at left sacro iliac level showed ischemic osteonscrosis of unknown eti

VAERS ID:94969 (history)  Vaccinated:1997-02-07
Age:0.5  Onset:1997-02-07, Days after vaccination: 0
Gender:Male  Submitted:1997-02-10, Days after onset: 3
Location:Virginia  Entered:1997-02-12, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Trimax, Dimetapp, APAP
Current Illness: recovering from ear infect
Preexisting Conditions:
Diagnostic Lab Data: 02071997
CDC Split Type: VA97038
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4326542 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0750H2PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Anorexia, Pyrexia, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: pt recv vax 7FEB97 & @ 11AM temp 104R;p/APAP temp dec 102 & stayed there for 24hr (despite dosing w/APAP & Ibuprofen);periods of crying, dazed & gen fussiness, did not eat, but took juice;

VAERS ID:95255 (history)  Vaccinated:1997-02-07
Age:10.4  Onset:1997-02-08, Days after vaccination: 1
Gender:Female  Submitted:1997-02-13, Days after onset: 5
Location:Illinois  Entered:1997-02-24, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: IL97011
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0517D0 LA
Administered by: Public     Purchased by: Public
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: severe vomiting starting @ 1030PM on 8FEB97 lasted 24hr;mom contacted family MD;

VAERS ID:95244 (history)  Vaccinated:1997-02-07
Age:5.6  Onset:1997-02-08, Days after vaccination: 1
Gender:Male  Submitted:1997-02-18, Days after onset: 10
Location:Missouri  Entered:1997-02-25, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MO97009
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES6K711274IMLA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1408B1IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0747A3PO 
Administered by: Public     Purchased by: Public
Symptoms: Hypersensitivity, Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 8FEB97 lt upper arm red, swollen, hot to touch, no fever, no pain-pt is active;itching of area;saw MD-felt it was allergic rxn to vax;no orders given;18FEB97 several messages were left on answering machine no response;unable to contact

VAERS ID:95304 (history)  Vaccinated:1997-02-07
Age:50.3  Onset:1997-02-07, Days after vaccination: 0
Gender:Female  Submitted:1997-02-14, Days after onset: 7
Location:Wisconsin  Entered:1997-02-26, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Cardura;Premarin;
Current Illness: NONE
Preexisting Conditions: elevated BP & premium for menopause
Diagnostic Lab Data: NA
CDC Split Type: WI97068
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1310D0 RA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Asthenia, Cough, Influenza, Myalgia, Rhinitis, Tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 7FEB97 3PM about 6PM felt weak;flu sx devel by 8FEB sneezing, coughing, joint pain in arm, shoulder & elbows-hurt to move;9FEB exp one fast irregular beat, felt weak in heart for 2 days;felt nl by 13FEB97;

VAERS ID:95314 (history)  Vaccinated:1997-02-07
Age:0.4  Onset:1997-02-07, Days after vaccination: 0
Gender:Female  Submitted:1997-02-10, Days after onset: 3
Location:Arkansas  Entered:1997-02-27, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: AR9710
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES08042501IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES08042501IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0749B1PO 
Administered by: Public     Purchased by: Public
Symptoms: Ecchymosis, Injection site mass, Insomnia, Pyrexia, Screaming
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad)
Write-up: 1hr p/vax pt cried constantly for approx 4hr;APAP was adm prior to immun q 4hr throughout PM-no significant temp elevation;lt leg bruised & had hard knot-warm compress applied;finally went to sleep p/4hr & was much improved next day;

VAERS ID:95321 (history)  Vaccinated:1997-02-07
Age:1.1  Onset:1997-02-18, Days after vaccination: 11
Gender:Male  Submitted:1997-02-21, Days after onset: 3
Location:Florida  Entered:1997-02-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0465D0SCLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1076D0SCRL
Administered by: Private     Purchased by: Public
Symptoms: Diarrhoea, Erythema multiforme, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: devel of temp, erythema multiforme minor;diarrhea;

VAERS ID:95490 (history)  Vaccinated:1997-02-07
Age:54.8  Onset:1997-02-07, Days after vaccination: 0
Gender:Female  Submitted:1997-02-24, Days after onset: 17
Location:Arizona  Entered:1997-03-06, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Vibramycin;CTM;dimetapp;vancenase
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4359621 RA
Administered by: Military     Purchased by: Military
Symptoms: Oedema peripheral, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: day p/vax pt states went to ER-redness-swelling-near elbow to inside arm placed on ATB;this was 2nd pneumovax <10yr apart;

VAERS ID:95540 (history)  Vaccinated:1997-02-07
Age:8.4  Onset:1997-02-20, Days after vaccination: 13
Gender:Female  Submitted:1997-02-28, Days after onset: 8
Location:California  Entered:1997-03-10, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1538D0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: Bell''s Palsy w/in 2wk of vax;no other etiology;

VAERS ID:96397 (history)  Vaccinated:1997-02-07
Age:0.3  Onset:1997-02-13, Days after vaccination: 6
Gender:Male  Submitted:1997-03-04, Days after onset: 19
Location:Tennessee  Entered:1997-03-21, Days after submission: 17
Life Threatening? No
Died? Yes
   Date died: 1997-02-13
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: autospy dx SIDS;
CDC Split Type: TN97019
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4348081IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0757F1PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cyanosis, Pharyngitis, Pulmonary oedema, Sudden infant death syndrome, Unevaluable event
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: pt died from SIDS 6 days p/vax;

VAERS ID:96691 (history)  Vaccinated:1997-02-07
Age:44.8  Onset:1997-03-03, Days after vaccination: 24
Gender:Male  Submitted:1997-03-21, Days after onset: 18
Location:Massachusetts  Entered:1997-04-03, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: No known
Diagnostic Lab Data: unk
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0319D0SCRA
Administered by: Other     Purchased by: Public
Symptoms: Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: sudden onset of lt sided facial paralysis 3MAR97 dx w/bells palsy;no tx;improving as of 10MAR97;

VAERS ID:96834 (history)  Vaccinated:1997-02-07
Age:81.3  Onset:1997-02-07, Days after vaccination: 0
Gender:Female  Submitted:1997-02-28, Days after onset: 21
Location:Georgia  Entered:1997-04-08, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin E, PRN APAP;Aldactozide;Premarin, oxybutynin, lanitidine;vancentse, hisconex;
Current Illness: e coli, UTI found @ date of physical
Preexisting Conditions: ?allergy to bactrim
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER   RA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES433344 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Oedema peripheral, Skin nodule, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax & lt arm became swollen, hand getting bigger;went to ER;10FEB ER tx notes indicate pain/swelling/red x 3 days & cellulitis noted;lt arm still large indurated/red;

VAERS ID:97211 (history)  Vaccinated:1997-02-07
Age:0.2  Onset:0000-00-00
Gender:Male  Submitted:1997-04-11
Location:Arkansas  Entered:1997-04-22, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES07838300IMRL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM249A21IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES07838300IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0748C0PO 
Administered by: Private     Purchased by: Private
Symptoms: Screaming
SMQs:, Hostility/aggression (broad)
Write-up: inconsolable screaming x 48hr started 12hr p/vax;

VAERS ID:97290 (history)  Vaccinated:1997-02-07
Age:0.3  Onset:1997-02-10, Days after vaccination: 3
Gender:Male  Submitted:1997-04-30, Days after onset: 78
Location:California  Entered:1997-05-01, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: block tear duct/35 week
Diagnostic Lab Data: EEG/MAZ/LP;sz activity
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES6H710401IM 
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5B711251IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0750A1PO 
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Gastrointestinal disorder
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: sz onset about 3 1/2 days p/vax initially episode felt to be done to gastroesophageal reflux;sz disorder;

VAERS ID:100174 (history)  Vaccinated:1997-02-07
Age:0.2  Onset:1997-02-11, Days after vaccination: 4
Gender:Female  Submitted:1997-02-18, Days after onset: 7
Location:Washington  Entered:1997-07-14, Days after submission: 145
Life Threatening? No
Died? Yes
   Date died: 1997-02-11
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: mild URI
Preexisting Conditions: NONE
Diagnostic Lab Data: autopsy performed 12FEB97;
CDC Split Type: WA971364
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES441098   
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1131D   
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES441188   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Gastrointestinal disorder, Petechiae, Pneumonia, Sudden infant death syndrome
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Eosinophilic pneumonia (broad), Neonatal disorders (narrow)
Write-up: death 11FEB97 6PM;autopsy result SIDS: autopsy report given pathological dx SIDS w/intrathoracic visceral petechiae, visceral congestion & minute foci of early bronchopenumonia;

VAERS ID:100326 (history)  Vaccinated:1997-02-07
Age:4.6  Onset:1997-02-08, Days after vaccination: 1
Gender:Female  Submitted:1997-06-05, Days after onset: 116
Location:Massachusetts  Entered:1997-07-15, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO7098
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES6M711840 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4373603PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site mass, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 7FEB97 following day 8FEB it was reported that pt exp cellulitis, 15cm x 12cm area of erythema which was indurated, tender & warm, in deltoid region;tx w/ATB;pt completely resolved;

VAERS ID:108028 (history)  Vaccinated:1997-02-07
Age:1.2  Onset:1997-03-21, Days after vaccination: 42
Gender:Female  Submitted:1997-04-15, Days after onset: 24
Location:South Carolina  Entered:1998-03-05, Days after submission: 324
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: SC97018
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4348113 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0372D0 LL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1102D0 RL
Administered by: Public     Purchased by: Unknown
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax 7FEB97 & had light case of chickenpox 6wk later 21MAR97 per mom;

VAERS ID:108311 (history)  Vaccinated:1997-02-07
Age:0.0  Onset:1997-03-03, Days after vaccination: 24
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: 13MAR97 MRI nl anatomy;28JAN97 otologic exam nl;3MAR97 otologic exam defecit;7MAR97 otologic exam significant rt hearing loss;6MAR97 otologic exam defecit;18APR97 otologic exam hearing loss. The same labs are reported as in the initial report.
CDC Split Type: WAES97031386
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Deafness, Nuclear magnetic resonance imaging normal
SMQs:, Hearing impairment (narrow)
Write-up: pt recv vax 7FEB97 & 28JAN97 pt underwent a hearing screening & it was determined to be nl;3MAR97 hearing deficit found p/a screening;6MAR97 hearing screening repeated & on 7MAR97 an extensive hearing test showed significant rt hearing loss. This is in follow-up to report (s) previously submitted on 03/08/1998. Information has been received from a pharmacist concerning a 5-year-old female relative who on 07FEB97 was vaccinated with the first dose of RECOMBIVAX HB vaccine. On 18JAN97 the patient underwent a hearing screening and it was determined to be deaf.

VAERS ID:110335 (history)  Vaccinated:1997-02-07
Age:4.8  Onset:1998-02-20, Days after vaccination: 378
Gender:Male  Submitted:1998-04-15, Days after onset: 53
Location:Pennsylvania  Entered:1998-04-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WAES98030612
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1107D0SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 7FEB97 & 20FEB98 pt exp 24 pruritic varicella-like lesions on head, 6 to 12 lesions on trunk as well as extremities;no fever or any other sx were noted;

VAERS ID:122281 (history)  Vaccinated:1997-02-07
Age:2.0  Onset:1999-05-11, Days after vaccination: 823
Gender:Female  Submitted:0000-00-00
Location:Colorado  Entered:1999-05-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: eczema
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1400D SCLA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax 7FEB97 & presented 12MAY99 w/severe case of varicella;

VAERS ID:182086 (history)  Vaccinated:1997-02-07
Age:2.9  Onset:1997-03-01, Days after vaccination: 22
Gender:Male  Submitted:2002-02-05, Days after onset: 1802
Location:Minnesota  Entered:2002-03-06, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ;DTP + Hib (unknown mfr);3;1;In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4407645IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES747LS3PO 
Administered by: Private     Purchased by: Public
Symptoms: Aggression, Autism, Constipation, Decreased appetite, Gastroenteritis, Neurodevelopmental disorder, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (narrow), Noninfectious diarrhoea (broad)
Write-up: The pt''s appetite dropped as did his weight. He is still thin for his height. He became very aggressive for 2 years and that is just now starting to taper. His overall development was stunted. Diagnosed with Aperger''s syndrome, gastroenteritis and constipation. *F/UP report on 3/31/03: Continued prob''s w/appetite, weight gain, and aggression.*

VAERS ID:189809 (history)  Vaccinated:1997-02-07
Age:1.1  Onset:2002-08-28, Days after vaccination: 2028
Gender:Male  Submitted:2002-08-29, Days after onset: 1
Location:Utah  Entered:2002-09-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0215D0SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1356D0SC 
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Child brought into clinic with several vesicles located throughout his face, trunk and extremities. Mom suspected varicella brought into office for varification. Daignosed confirmed in our office.

VAERS ID:198845 (history)  Vaccinated:1997-02-07
Age:33.0  Onset:1997-02-23, Days after vaccination: 16
Gender:Male  Submitted:2003-03-04, Days after onset: 2200
Location:Unknown  Entered:2003-03-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alopecia
SMQs:
Write-up: Full loss of facial hair. Partial progressive loss of pubic hair. Occasional loss of eye lashes.

VAERS ID:433372 (history)  Vaccinated:1997-02-07
Age:65.0  Onset:2008-11-28, Days after vaccination: 4312
Gender:Male  Submitted:2011-07-29, Days after onset: 972
Location:Pennsylvania  Entered:2011-08-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1010USA03540
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Asthma, Chest X-ray, Lobar pneumonia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Information has been received from a nurse concerning a 77 year old male who on 07-FEB-1997 was vaccinated with PNEUMOVAX 23 (manufacturer unspecified, lot # not reported). On 28-NOV-2008 the patient experienced pneumonia described as involved in "left lower lobe". On 25-AUG-2010 the patient experienced asthmatic bronchitis. The patient had a chest X-ray on an unspecified date (result not reported). History of other pneumococcal vaccination was not available at the time of the report. The outcome of the events was not reported. The patient contacted office. Additional information has been requested.

VAERS ID:97431 (history)  Vaccinated:1997-02-07
Age:14.0  Onset:1997-02-13, Days after vaccination: 6
Gender:Female  Submitted:1997-02-13, Days after onset: 0
Location:Foreign  Entered:1997-05-07, Days after submission: 82
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pt recv GENHEVAX vax 4JUL94;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CBC;Platelets;Proteinorrhachia .36;spinal fluid cells 16;antinuclear antibodies negative;Brain MRI 6 areas of hyper signals in T2;CT scan diffuse hypodensity areas;Medullary MRI 1 hypersignal T2/1 hyposignal T1 in C5C6;
CDC Split Type: 970078721
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: CSF test abnormal, Diplopia, Dysarthria, Extensor plantar response, Facial palsy, Headache, Hypokinesia, Multiple sclerosis, Neuropathy, Pain, Paraesthesia, Paralysis, Pollakiuria, Visual disturbance, Weight decreased
SMQs:, Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Ocular motility disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 13FEB97 7 days p/vax pt exp blurred vision & vision dec during 24hr; MAR97 pt exp lt lower limb pain, paralysis & paresthesia as well as rt facial paralysis & lower chest paresthesia causing hosp;Babinski toe sign +;demyelinating disease dx

VAERS ID:98222 (history)  Vaccinated:1997-02-07
Age:52.5  Onset:1997-02-08, Days after vaccination: 1
Gender:Male  Submitted:1997-02-08, Days after onset: 0
Location:Foreign  Entered:1997-05-23, Days after submission: 103
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 970110611
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM  IM 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIES    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Angioneurotic oedema, Face oedema, Hypersensitivity, Oedema peripheral, Serum sickness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax vax 7FEB97 & 8FEB97 2PM pt exp swelling on of the lips & face;that noc whole arm was swollen & was seen in ER;DPh & claritin were prescribed;1MAR97 was seen by allergist who felt that the pt had devel allerg rxn;

VAERS ID:96307 (history)  Vaccinated:1997-02-08
Age:12.1  Onset:1997-02-08, Days after vaccination: 0
Gender:Female  Submitted:1997-03-12, Days after onset: 32
Location:Hawaii  Entered:1997-03-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1073D  RA
Administered by: Private     Purchased by: Unknown
Symptoms: Dizziness, Hyperhidrosis, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: felt dizzy, pale-inc sweating & collapsed on the floor while standing;recovered p/few min;

VAERS ID:97785 (history)  Vaccinated:1997-02-08
Age:2.0  Onset:1997-02-21, Days after vaccination: 13
Gender:Female  Submitted:0000-00-00
Location:Hawaii  Entered:1997-04-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES97022109
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 08feb97; 21feb97 pt devel varicella-type rash in the diaper area

VAERS ID:107261 (history)  Vaccinated:1997-02-08
Age:  Onset:1997-02-21, Days after vaccination: 13
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1997-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: postpartum
Diagnostic Lab Data:
CDC Split Type: WAES97021875
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 8FEB97 & 21FEB97 pt devel red dots all over body;

VAERS ID:96491 (history)  Vaccinated:1997-02-09
Age:26.8  Onset:1997-02-10, Days after vaccination: 1
Gender:Male  Submitted:1997-03-21, Days after onset: 39
Location:California  Entered:1997-03-25, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6K81354 IMRA
Administered by: Private     Purchased by: Other
Symptoms: Nausea, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: rash on chest/abd, nausea & flushing;

VAERS ID:100327 (history)  Vaccinated:1997-02-09
Age:6.1  Onset:1997-02-10, Days after vaccination: 1
Gender:Female  Submitted:1997-06-05, Days after onset: 114
Location:Ohio  Entered:1997-07-15, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO7097
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES6B812674  
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Oedema peripheral, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 9FEB97 & the next day parents reported to local mD that pt had exp redness & swelling @ the inj site;the following day 11FEB it was reported that pt exp redness & swelling that progressed below the elbow;this was the fifth dose

VAERS ID:100812 (history)  Vaccinated:1997-02-09
Age:1.3  Onset:1997-02-13, Days after vaccination: 4
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97042239
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Anorexia, Dermatitis bullous, Pharyngitis, Rhinitis
SMQs:, Severe cutaneous adverse reactions (narrow), Agranulocytosis (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 9FEB97 & 13FEB97 pt devel a rash consisting of clumps like little blisters;some blisters were the size of a quarter;devel blisters on legs;dec appetite;devel resp/cold sx;

VAERS ID:109937 (history)  Vaccinated:1997-02-09
Age:38.0  Onset:1997-12-24, Days after vaccination: 318
Gender:Male  Submitted:1998-04-15, Days after onset: 111
Location:Illinois  Entered:1998-04-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES97121625
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1102E SC 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Haematuria, Headache, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Tubulointerstitial diseases (broad)
Write-up: Pt devel"gross hematuria,30-50 vesicles neck/trunk, h/a, t102.8. Neg titer/normal host.No immunosuppression,recent exposure to chicken pox.Reporter thought pt dx w/post-vax rash not herpes zoster. Pt tx w/Septra DS.

VAERS ID:95052 (history)  Vaccinated:1997-02-10
Age:4.1  Onset:1997-02-12, Days after vaccination: 2
Gender:Female  Submitted:1997-02-13, Days after onset: 1
Location:North Carolina  Entered:1997-02-14, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic sulfa
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES6B812672 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0884D1 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0744C3PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: lt thigh w/5x6 cm area pink raised pruritic areas;seen in office 13FEB97;to use DPH & Ibuprofen;

VAERS ID:95152 (history)  Vaccinated:1997-02-10
Age:0.4  Onset:1997-02-11, Days after vaccination: 1
Gender:Male  Submitted:1997-02-11, Days after onset: 0
Location:Utah  Entered:1997-02-20, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: UT971006
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4407451IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4381191PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Diarrhoea, Insomnia, Vasodilatation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Noninfectious diarrhoea (narrow)
Write-up: pt fussy & cried off & on the noc of 10FEB97, usual sleeping hr @ 830AM, felt very hot (temp not measured) & cried nearly nonstop all day;5-7min every 30-45min;cont until 9PM when was quieter;had 4 runny stools

VAERS ID:95256 (history)  Vaccinated:1997-02-10
Age:0.4  Onset:1997-02-11, Days after vaccination: 1
Gender:Male  Submitted:1997-02-11, Days after onset: 0
Location:Illinois  Entered:1997-02-24, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: denies
Current Illness: denies
Preexisting Conditions: denies
Diagnostic Lab Data:
CDC Split Type: IL97012
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4380901IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0754M1PO 
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Screaming
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hostility/aggression (broad)
Write-up: 10FEB APAP given @ 9PM t102, 11FEB APAP given 5AM & 1PM t102, non stop crying & screaming for 3hr on 11FEB;mom unable to comfort child;advised to discuss future DTP''s w/PMD, inc fluids;

VAERS ID:95277 (history)  Vaccinated:1997-02-10
Age:4.9  Onset:1997-02-10, Days after vaccination: 0
Gender:Female  Submitted:1997-02-11, Days after onset: 1
Location:Mississippi  Entered:1997-02-24, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: MS97002
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES6K711274IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0396D1SCLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0747M3PO 
Administered by: Public     Purchased by: Public
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt lost consciousness for approx 30sec;no resp difficulty;no swelling;no hives;contacted MD via phone on tx needed;spoke w/mom on 11FEB97 via phone-no further problems noted;

VAERS ID:95242 (history)  Vaccinated:1997-02-10
Age:5.0  Onset:1997-02-11, Days after vaccination: 1
Gender:Male  Submitted:1997-02-19, Days after onset: 8
Location:Missouri  Entered:1997-02-25, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: cat allergies
Diagnostic Lab Data:
CDC Split Type: MO97011
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES6K711271IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0214D1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0747A3PO 
Administered by: Public     Purchased by: Public
Symptoms: Hypersensitivity, Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 11FEB97 upper lt arm warm to touch, red, hard no fever, hurts, swollen 2x size, quote o mom;saw MD ordered moist warm compresses;MD felt is was an allerg rxn to vax;18FEB mom states sx are completely gone;

VAERS ID:95493 (history)  Vaccinated:1997-02-10
Age:31.3  Onset:1997-02-12, Days after vaccination: 2
Gender:Female  Submitted:1997-02-26, Days after onset: 14
Location:Arizona  Entered:1997-03-06, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD by Connaught lot# 240511 given 10FEB97
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2128B60IMRA
Administered by: Other     Purchased by: Public
Symptoms: Asthenia, Dizziness, Nausea, Paraesthesia, Pyrexia, Vertigo
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)
Write-up: 48hr p/vax pt exp sudden onset of vertigo, nausea, & fever;sx intermittent over next 4-5 days w/inc dizziness, fatigue & numbness & tingling to hands & legs, vertigo cont intermittently as well;vertigo remains but diminished;

VAERS ID:95446 (history)  Vaccinated:1997-02-10
Age:1.3  Onset:1997-02-10, Days after vaccination: 0
Gender:Male  Submitted:1997-02-18, Days after onset: 8
Location:Tennessee  Entered:1997-03-07, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: chromosome XYYY, 1-7 translocation, developmental delay
Diagnostic Lab Data: CT scan
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4411033IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0473D0SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0756A3PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Apnoea, Convulsion, Hypoxia
SMQs:, Asthma/bronchospasm (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow)
Write-up: apparent apneic event followed by possible sz;intubated @ hosp;vent x 24hr then stabilized;

VAERS ID:95557 (history)  Vaccinated:1997-02-10
Age:74.5  Onset:1997-02-11, Days after vaccination: 1
Gender:Female  Submitted:1997-02-24, Days after onset: 13
Location:North Carolina  Entered:1997-03-10, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HCTZ-Ec ASA
Current Illness: post cat bite
Preexisting Conditions: HTN
Diagnostic Lab Data:
CDC Split Type: MI97020
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (NO BRAND NAME)MICHIGAN DEPT PUB HLTHRV151SB2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: localized-red, swollen, hot from inj site to four fingers above elbow

VAERS ID:96325 (history)  Vaccinated:1997-02-10
Age:38.0  Onset:1997-02-11, Days after vaccination: 1
Gender:Female  Submitted:1997-03-12, Days after onset: 29
Location:California  Entered:1997-03-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1352D0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Rash, Skin nodule
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: large area of erythema & induration 2inches in diameter;

VAERS ID:97269 (history)  Vaccinated:1997-02-10
Age:10.7  Onset:1997-02-13, Days after vaccination: 3
Gender:Female  Submitted:1997-04-25, Days after onset: 70
Location:Massachusetts  Entered:1997-04-29, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: 24MAR97 EEG nl; 24MAR97 EKG nl;CAT scan nl 21MAR97 strep-negative;UTI negative;
CDC Split Type: QC9798
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD58 IMLA
Administered by: Private     Purchased by: Other
Symptoms: Back pain, Dizziness, Ear disorder, Headache, Influenza, Pharyngitis, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal infections (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: 3 days post vax pt devel flu-like sx;17FEB97 pt dx w/strep throat & had skin rash @ that time;24FEB97 pt cont low-grade temp, devel ear & throat pain & observed a dark discharge from nose;pt also exp sharp pain in lower back;

VAERS ID:100110 (history)  Vaccinated:1997-02-10
Age:21.0  Onset:1997-03-22, Days after vaccination: 40
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:1997-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97032097
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 10FEB97 & 22MAR97 pt devel a gen rash;

VAERS ID:99189 (history)  Vaccinated:1997-02-10
Age:25.1  Onset:1997-02-21, Days after vaccination: 11
Gender:Female  Submitted:1997-06-03, Days after onset: 101
Location:Louisiana  Entered:1997-06-19, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ventolin inhaler as needed;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0879D1SC 
Administered by: Private     Purchased by: Private
Symptoms: Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: rash came & went & was raised @ times @ other times flat spots occured on legs & chest;more from area to area;

VAERS ID:99708 (history)  Vaccinated:1997-02-10
Age:43.0  Onset:1997-02-17, Days after vaccination: 7
Gender:Female  Submitted:1997-03-19, Days after onset: 30
Location:Missouri  Entered:1997-06-24, Days after submission: 96
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: 970060991
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA503B60IMA
Administered by: Public     Purchased by: Private
Symptoms: Myalgia, Pharyngitis
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 10FEB97 & w/in 1wk exp muscle aches & scratchy throat;sx resolved w/o prescription med;

VAERS ID:99709 (history)  Vaccinated:1997-02-10
Age:45.0  Onset:1997-02-17, Days after vaccination: 7
Gender:Female  Submitted:1997-03-19, Days after onset: 30
Location:Missouri  Entered:1997-06-24, Days after submission: 96
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 970061031
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA503B60IMA
Administered by: Public     Purchased by: Private
Symptoms: Myalgia, Pharyngitis
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 10FEB97 & w/in 1wk exp muscle aches & scratchy throat;sx resolved w/o any prescription med;

VAERS ID:99711 (history)  Vaccinated:1997-02-10
Age:52.0  Onset:1997-02-17, Days after vaccination: 7
Gender:Female  Submitted:1997-03-19, Days after onset: 30
Location:Missouri  Entered:1997-06-24, Days after submission: 96
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: 970061061
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA503B60IMA
Administered by: Public     Purchased by: Private
Symptoms: Myalgia, Pharyngitis
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 10FEB97 & w/in 1 wk pt exp muscle aches & scratchy throat;sx resolved w/o any prescription meds;

VAERS ID:101544 (history)  Vaccinated:1997-02-10
Age:45.8  Onset:1997-02-10, Days after vaccination: 0
Gender:Male  Submitted:1997-03-05, Days after onset: 23
Location:Maine  Entered:1997-07-22, Days after submission: 138
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: puncture wound
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 897077010L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES436760 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site inflammation, Injection site oedema, Malaise
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax & devel a 6cm by 6cm area of swelling & inflammation @ inj site;the next day pt felt ill;tx w/motrin & ice;

VAERS ID:100983 (history)  Vaccinated:1997-02-10
Age:5.4  Onset:1997-05-22, Days after vaccination: 101
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97052280
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
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)
Write-up: pt recv vax 10FEB97 & 22MAY97 pt devel a gen rash that consisted of more than 50 lesions on face, chest, back, & legs;

VAERS ID:114086 (history)  Vaccinated:1997-02-10
Age:6.0  Onset:1998-09-01, Days after vaccination: 568
Gender:Female  Submitted:1998-09-08, Days after onset: 7
Location:Virginia  Entered:1998-09-11, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1358D0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 2/10/97; on 9/1/98 pt exp approximately 20 visicles on abdomen.

VAERS ID:123972 (history)  Vaccinated:1997-02-10
Age:3.1  Onset:1998-09-10, Days after vaccination: 577
Gender:Female  Submitted:1999-05-14, Days after onset: 246
Location:Hawaii  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: none
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: none
CDC Split Type: WAES98090950
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1081D0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: approx 18 mos p/ recv vax pt devel fever & chickenpox-like rash w/25-30 lesions all over body.

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