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Case Details (Sorted by Vaccination Date)

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VAERS ID:111317 (history)  Vaccinated:1998-05-26
Age:5.3  Onset:1998-05-26, Days after vaccination: 0
Gender:Male  Submitted:1998-05-29, Days after onset: 3
Location:New Jersey  Entered:1998-06-01, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp urticaria on 20FEB96 w/varivax dose 1;
Other Medications:
Current Illness: NONE
Preexisting Conditions: similar rxn to varivax;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0234H1SCA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: gen urticaria immed p/vax;resolved w/DPH in 24hr;

VAERS ID:111319 (history)  Vaccinated:1998-05-26
Age:0.2  Onset:1998-05-26, Days after vaccination: 0
Gender:Male  Submitted:1998-05-26, Days after onset: 0
Location:California  Entered:1998-06-01, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: rash on head
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES7J815440 LL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES7H915470 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0789D0PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Screaming
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: non-stop crying since child went home p/shot;redness & sl swelling lt thigh;given DPH elixir;place warm compress @ inj site;

VAERS ID:111368 (history)  Vaccinated:1998-05-26
Age:6.9  Onset:1998-05-27, Days after vaccination: 1
Gender:Male  Submitted:1998-05-28, Days after onset: 1
Location:Massachusetts  Entered:1998-06-02, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt sibling exp fever, vomit, pain @ 8yr w/hepB/DTAP/OPV/MMR
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7B918242 L
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1165E0 L
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.101BE1 L
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES771A40PO 
Administered by: Military     Purchased by: Military
Symptoms: Anorexia, Conjunctivitis, Hypokinesia, Injection site hypersensitivity, Injection site pain, Myalgia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: 1st day p/vax pt woke up throwing up, couldn''t eat & feverish 99.5;couldn''t walk on or near leg;blood shot eyes & pain in shoulder;2nd day fever 101.1, extreme redness & pain @ inj site;

VAERS ID:111369 (history)  Vaccinated:1998-05-26
Age:8.4  Onset:1998-05-26, Days after vaccination: 0
Gender:Male  Submitted:1998-05-29, Days after onset: 3
Location:Massachusetts  Entered:1998-06-02, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt sibling exp vomit, red, could not walk, fever w/HepB/TD/OPV/MMR
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1165D0 L
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1011E1 L
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES771A20PO 
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD632 L
Administered by: Military     Purchased by: Military
Symptoms: Hypokinesia, Pain, Pyrexia, Skin discolouration, Vasodilatation, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: pt began throwing up right p/taking OPV & threw up all day of the shots;the next day leg was red & mottled & extremely sore;could not walk on it at all & had a fever of 100;took pt to clinic;

VAERS ID:111853 (history)  Vaccinated:1998-05-26
Age:62.4  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Michigan  Entered:1998-06-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: Denies
Preexisting Conditions: pt was told had lupus dermatitis 1990;current states no lupus;sensitive to hismanal & horse serum;
Diagnostic Lab Data: FEB98 MRI;scan ot T1 & T2 WNL;
CDC 'Split Type': MI98058C
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1222E2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Neck pain, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: pt exp pain rt shoulder, neck & arms;daily pain or itching in affected area;

VAERS ID:111943 (history)  Vaccinated:1998-05-26
Age:56.6  Onset:1998-05-28, Days after vaccination: 2
Gender:Female  Submitted:1998-06-01, Days after onset: 4
Location:North Carolina  Entered:1998-06-16, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Propulsed;Zantac;Prempro
Current Illness: NONE
Preexisting Conditions: PCN, sulfa allergies;hx prolapsed mitral valve, reflux
Diagnostic Lab Data: NONE
CDC 'Split Type': NC98023
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7F91694 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site pain, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 28MAY98 soreness @ inj site;29MAY98 redness & heat 6cm diameter;31MAY98 inc redness;1JUN98 inc redness & itching 18cm diameter;

VAERS ID:111946 (history)  Vaccinated:1998-05-26
Age:23.0  Onset:1998-06-01, Days after vaccination: 6
Gender:Male  Submitted:1998-06-01, Days after onset: 0
Location:Unknown  Entered:1998-06-16, Days after submission: 15
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
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Injection site reaction, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt presented to ER on 26MAY w/finger laceration;pt recv tetanus shot upper arm;1JUN98 returned w/large red, hot painful cellulitis @ area of tetanus shot;pt states redness started 2 days ago;

VAERS ID:111989 (history)  Vaccinated:1998-05-26
Age:4.7  Onset:1998-05-27, Days after vaccination: 1
Gender:Female  Submitted:1998-05-27, Days after onset: 0
Location:California  Entered:1998-06-19, Days after submission: 23
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: chicken
Diagnostic Lab Data:
CDC 'Split Type': CA980056
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (NO BRAND NAME)UNKNOWN MANUFACTURER08873604 LA
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER1600E1 A
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4508513PO 
Administered by: Public     Purchased by: Public
Symptoms: Pain, Skin nodule, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: lt arm red & sl indurated 16mm in length, 12mm in width;no fever c/o pain;

VAERS ID:112058 (history)  Vaccinated:1998-05-26
Age:30.0  Onset:1998-06-14, Days after vaccination: 19
Gender:Female  Submitted:1998-06-19, Days after onset: 5
Location:North Carolina  Entered:1998-06-23, 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: Routine weekly allergy shots (ariborne desensitization)
Current Illness: NONE
Preexisting Conditions: allergic rhinitis, allergic rxn to hydrocodone, tylox
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM557B60IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: onset 14JUN98 @ of joint pain in hips;since that time has had migratory arthralgias (no swelling or stiffness of joints);over 48hr from 19JUN98 has had gen myalgias & fatigue;T99.1;

VAERS ID:112157 (history)  Vaccinated:1998-05-26
Age:5.0  Onset:1998-05-27, Days after vaccination: 1
Gender:Male  Submitted:1998-05-28, Days after onset: 1
Location:Idaho  Entered:1998-06-24, Days after submission: 27
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': ID98023
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7G814895IMLA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0399E2IMA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0787M5PO 
Administered by: Public     Purchased by: Public
Symptoms: Headache, Malaise, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: approx 3PM became listless, vomited about 15min later & c/o h/a;vomited x 5-last time about 430PM;no other neuro sx;did not require med to stop vomiting;by AM on 28MAY98 pt appears to be fully recovered;

VAERS ID:112209 (history)  Vaccinated:1998-05-26
Age:52.9  Onset:1998-05-28, Days after vaccination: 2
Gender:Male  Submitted:1998-06-05, Days after onset: 8
Location:Ohio  Entered:1998-06-26, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: DPH ointment
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': OH98042
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1531E2 LA
Administered by: Public     Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 26MAY98 pt recv vax & reported fine body rash which started on 28MAY98 still has pruritus & rash on 5JUN98;has body rash;

VAERS ID:112362 (history)  Vaccinated:1998-05-26
Age:31.5  Onset:1998-05-27, Days after vaccination: 1
Gender:Female  Submitted:1998-05-28, Days after onset: 1
Location:Arkansas  Entered:1998-07-06, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': AR9840
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0736E0SC 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: erythema, (3in in diameter), pain, warmth @ inj site;

VAERS ID:112371 (history)  Vaccinated:1998-05-26
Age:1.2  Onset:1998-05-28, Days after vaccination: 2
Gender:Male  Submitted:1998-06-29, Days after onset: 32
Location:Ohio  Entered:1998-07-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: diarrhea by history
Preexisting Conditions: hosp 11MAY-14MAY98 for post infectious cerebellar ataxia;
Diagnostic Lab Data: UA C&S WNL;
CDC 'Split Type': OH98049
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4514953IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM195RC3IMRL
Administered by: Public     Purchased by: Public
Symptoms: Febrile convulsion, Injection site mass, Leukocytosis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: fever 104.4 had febrile sz 48-60hr s/p immun;no rx @ ER;fever persisted x 2 more days;inc WBC w/lt shift;rx w/ATB 30MAY98;small mass @ lt immunization site (ventral legs)

VAERS ID:112431 (history)  Vaccinated:1998-05-26
Age:1.1  Onset:1998-05-28, Days after vaccination: 2
Gender:Male  Submitted:1998-06-25, Days after onset: 28
Location:Oregon  Entered:1998-07-10, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: inc temp 2 days before
Preexisting Conditions: PCN & sulfa;
Diagnostic Lab Data: CAT scan;ECG;MRI;EEG x 2;blood work q day;
CDC 'Split Type': OR9815
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES7D917173IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0030H0SCA
Administered by: Public     Purchased by: Other
Symptoms: Apnoea, Cardiac arrest, Grand mal convulsion, Somnolence
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: 2 days later 28MAY98 630AM grand mal sz-requiring EMT & transported by amb to hosp-full resuscitation recovered-lethargic-transferred to another hosp;

VAERS ID:112684 (history)  Vaccinated:1998-05-26
Age:63.1  Onset:1998-06-09, Days after vaccination: 14
Gender:Female  Submitted:1998-06-23, Days after onset: 14
Location:Minnesota  Entered:1998-07-17, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: prempro (hormones)
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': MN98011
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.0154E4SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09239103 LA
Administered by: Private     Purchased by: Public
Symptoms: Malaise, Pruritus, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: states felt ill & then got a rash mild on 9JUN98;rash started neck upper chest to arms & legs;lasted a couple of days;site of inj itchy & warm;

VAERS ID:112763 (history)  Vaccinated:1998-05-26
Age:55.4  Onset:0000-00-00
Gender:Female  Submitted:1998-07-09
Location:Oregon  Entered:1998-07-20, 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:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2599A40 A
Administered by: Private     Purchased by: Private
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv vax 26MAY98 2PM & onset 28MAY98 rash on ear lobes progressing to face & neck;then on upper anterior chest;none @ inj site;blotchy, erythematous & finely macular;tx w/medrol dosepak & DPH;

VAERS ID:112957 (history)  Vaccinated:1998-05-26
Age:1.3  Onset:1998-05-26, Days after vaccination: 0
Gender:Male  Submitted:1998-07-30, Days after onset: 65
Location:South Carolina  Entered:1998-07-31, Days after submission: 1
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: sz
Preexisting Conditions: NONE
Diagnostic Lab Data: EEG-2nd sz 30JUL98;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER4490993  
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER449099   
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER1013E0  
Administered by: Public     Purchased by: Other
Symptoms: Apnoea, Convulsion, Diarrhoea, Hypotonia, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Noninfectious diarrhoea (narrow)
Write-up: 9hr p/vax pt went limp, stopped breathing, had sz;treated @ ER;fever followed diarrhea & vomiting 2x/day for 5-6 days p/fever;2nd sz 27JUL;

VAERS ID:113010 (history)  Vaccinated:1998-05-26
Age:0.2  Onset:1998-05-26, Days after vaccination: 0
Gender:Male  Submitted:1998-07-21, Days after onset: 56
Location:Idaho  Entered:1998-08-03, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': ID98029
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4477880IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2425A20IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURERM12950SCLL
Administered by: Private     Purchased by: Public
Symptoms: Crying, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Depression (excl suicide and self injury) (broad)
Write-up: had increased temp & high pitched screaming for $g2hr starting about 2hr p/vax given;

VAERS ID:113173 (history)  Vaccinated:1998-05-26
Age:25.9  Onset:1998-05-27, Days after vaccination: 1
Gender:Female  Submitted:1998-07-30, Days after onset: 64
Location:Unknown  Entered:1998-08-03, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: Levbid;Claritin;
Current Illness:
Preexisting Conditions: splenectomy
Diagnostic Lab Data:
CDC 'Split Type': WAES98051828
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0490E   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 26MAY98 & 27MAY98 pt devel fever 103, redness @ the inj site & a rash;pt was seen by MD;

VAERS ID:113451 (history)  Vaccinated:1998-05-26
Age:0.5  Onset:1998-05-26, Days after vaccination: 0
Gender:Female  Submitted:1998-08-10, Days after onset: 76
Location:Alabama  Entered:1998-08-17, Days after submission: 7
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: blood & Urinalysis-nl
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164802IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2888A22IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS7E919272IMLL
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Anorexia, Malaise, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad)
Write-up: T102 R 2hr p/vax;APAP given q4hr x 4 1st 24hr;vomited x 3 during noc;seen @ clinic 2 days later-still had T102-listless, crying, poor appetite-o tx @ hosp;was told illness related to vax;

VAERS ID:114166 (history)  Vaccinated:1998-05-26
Age:1.0  Onset:1998-06-06, Days after vaccination: 11
Gender:Female  Submitted:1998-09-09, Days after onset: 95
Location:Minnesota  Entered:1998-09-15, 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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0024H0SCLL
Administered by: Private     Purchased by: Other
Symptoms: Anorexia, Coordination abnormal, Hypokinesia, Hypotonia, Malaise, Pyrexia, Somnolence
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: 7 days p/vax pt had 5 days of T105, lethargy, inability to eat & play;3 1/2wk p/vax temp pt had cerebral ataxia-unable to walk or lift head for 3 1/2wk;

VAERS ID:114388 (history)  Vaccinated:1998-05-26
Age:4.7  Onset:1998-05-26, Days after vaccination: 0
Gender:Male  Submitted:1998-07-17, Days after onset: 52
Location:Maryland  Entered:1998-09-23, Days after submission: 68
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: NON
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC 'Split Type': U199800280
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES0916490   
MMR: MEASLES + MUMPS + RUBELLA (MMR I)MERCK & CO. INC.0034H1 A
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0719E3PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Oedema peripheral, Pruritus, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt recv vax on 5/26/98; on the same dy pt exp itching, warmth, &swelling at site to elbow. Pt tx=Benadryl. As of 7/17/98 pt imp.

VAERS ID:117381 (history)  Vaccinated:1998-05-26
Age:32.2  Onset:1998-05-28, Days after vaccination: 2
Gender:Female  Submitted:1998-12-02, Days after onset: 188
Location:New Jersey  Entered:1998-12-15, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Zertec, Doxipan
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Steroids
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Ear disorder, Oedema, Rash, Serum sickness, Tongue oedema, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 5/26/98; on 5/28/98 pt exp swollen tongue, hives, swollen ears, rash/swelling over body; dx=serum sickness

VAERS ID:121974 (history)  Vaccinated:1998-05-26
Age:1.0  Onset:1999-03-23, Days after vaccination: 301
Gender:Male  Submitted:1999-04-22, Days after onset: 29
Location:Maryland  Entered:1999-05-07, 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:
Current Illness:
Preexisting Conditions: hypospadias
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM240RF3IMA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1573E0SCA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Herpes zoster, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: vesicular rash consistent w/zoster lt head, eye;

VAERS ID:123470 (history)  Vaccinated:1998-05-26
Age:2.5  Onset:1998-06-05, Days after vaccination: 10
Gender:Female  Submitted:1999-05-14, Days after onset: 343
Location:New Jersey  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: diarrhea; nasal congestion
Diagnostic Lab Data:
CDC 'Split Type': WAES98060606
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0062H0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Pain, Rash maculo-papular, Skin hypertrophy
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: p/ pt recv vax approx 10 days later pt devel painful, irritating & severe react which include over 200 lesions described as multiple erythematous macules scattered over the body. f/u rpt 5mos later pt has scarring.

VAERS ID:123507 (history)  Vaccinated:1998-05-26
Age:31.2  Onset:1998-06-11, Days after vaccination: 16
Gender:Female  Submitted:1999-05-14, Days after onset: 337
Location:Colorado  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: NONE
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: diagnostic lab test 6/15/98 vesicular sample;inadequate to analyze;
CDC 'Split Type': WAES98061123
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Dermatitis bullous, Headache, Injection site hypersensitivity, Myalgia, Nausea, Pyrexia, Rhinitis
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: p/vax pt devel subjective fever (no temp was actually recorded(, h/a, nausea & congestion;pt devel 25 vesicular lesions;following day a red, raised rash appeared @ inj site;pt devel myalgia & a cough;

VAERS ID:123510 (history)  Vaccinated:1998-05-26
Age:37.0  Onset:1998-06-10, Days after vaccination: 15
Gender:Female  Submitted:1999-05-14, Days after onset: 338
Location:New Jersey  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98061212
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt devel approx 15 lesions on body;

VAERS ID:123645 (history)  Vaccinated:1998-05-26
Age:26.4  Onset:1998-07-09, Days after vaccination: 44
Gender:Female  Submitted:1999-05-14, Days after onset: 309
Location:Illinois  Entered:1999-06-21, Days after submission: 38
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: 7/9/98 diag lab test negative titer;
CDC 'Split Type': WAES98070947
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: p/vax lab eval revealed a negative titer;

VAERS ID:134283 (history)  Vaccinated:1998-05-26
Age:2.0  Onset:2000-02-15, Days after vaccination: 630
Gender:Female  Submitted:2000-02-15, Days after onset: 0
Location:Maryland  Entered:2000-02-29, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES0944750 IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1596E SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1567E0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Dx with varicella.

VAERS ID:173068 (history)  Vaccinated:1998-05-26
Age:4.0  Onset:2001-04-03, Days after vaccination: 1043
Gender:Male  Submitted:2001-06-27, Days after onset: 85
Location:Virginia  Entered:2001-07-09, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0603B   
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient developed 20-25 lesions on his face, trunk and hands. Patient had 2 lesions in his mouth.

VAERS ID:185180 (history)  Vaccinated:1998-05-26
Age:4.0  Onset:2001-07-11, Days after vaccination: 1142
Gender:Male  Submitted:2002-05-15, Days after onset: 308
Location:New Jersey  Entered:2002-05-23, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Varicella exposure
Diagnostic Lab Data: body temperature-07/11/01-1005 degrees F
CDC 'Split Type': WAES01071327
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0310H0SC 
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Rash vesicular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a health professional concerning a 4 year old male with no known illness at the time of vaccination who on 05/26/93 was vaccinated with the first dose of varicella virus vaccine vaccine live, administered SC, in the right arm. On 07/11/01, the patient presented with chicken pox and was reported to have approximately 36 lesions on his head, trunk, and extremities. It was also reported that he developed a temperarure of 100.5 degrees F. Subsequently, on 07/20/01, the patient recovered. It was reported that the patient''s sibling had a varicella infection 2 wks prior to the outbreak. Unspecified medical attention was sought. No further information is expected.

VAERS ID:193537 (history)  Vaccinated:1998-05-26
Age:4.0  Onset:2000-05-16, Days after vaccination: 721
Gender:Male  Submitted:2002-09-09, Days after onset: 846
Location:North Carolina  Entered:2002-11-19, Days after submission: 71
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
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Private     Purchased by: Private
Symptoms: Autism, Neurodevelopmental disorder, Sensory disturbance, Speech disorder
SMQs:, Peripheral neuropathy (narrow), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Developmental speech apraxia with sensory integration/ fine motor control issues. Occupational therapy until 02/26/2002. Speech therapy ongoing, Mild Autism

VAERS ID:256253 (history)  Vaccinated:1998-05-26
Age:3.0  Onset:2005-06-06, Days after vaccination: 2568
Gender:Female  Submitted:2006-05-12, Days after onset: 340
Location:Massachusetts  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Headache, Pharyngitis Streptococcal.
Preexisting Conditions: NONE
Diagnostic Lab Data: Diagnostic microbiology strept quick test negative, throat culture negative
CDC 'Split Type': WAES0506USA02984
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0 UN
Administered by: Private     Purchased by: Public
Symptoms: Blister, Pharyngitis, Rash, Skin ulcer
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 10 year old female patient with no pre existing allergies or medical conditions, who on 5/26/1998 was vaccianted with a first dose of varicella virus vaccine live. It was noted that at the time of vaccination the patient had strept throat and headache. On 6/6/2005 the patient broke out, and on 6/7/05 at a physician appointment there were approximately 50 vesicle lesions over her abdomen and a few on her scalp. The patient was also diagnosed with pharyngitis at the physician office visit. A strept quick test and throat culture were negative. It was noted that the patient did not have adverse events following prior vaccination. The patients outcome is recovered. No additional information is expected.

VAERS ID:264814 (history)  Vaccinated:1998-05-26
Age:1.3  Onset:2006-09-19, Days after vaccination: 3038
Gender:Male  Submitted:2006-10-11, Days after onset: 22
Location:Georgia  Entered:2006-10-17, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Rash papular
SMQs:
Write-up: Started with rash on trunk, groin, hairline. Spreading and now has approximately 25-30 papules. To give BENADRYL and use Calamine lotion.

VAERS ID:113281 (history)  Vaccinated:1998-05-26
Age:0.5  Onset:1998-06-02, Days after vaccination: 7
Gender:Male  Submitted:1998-07-31, Days after onset: 59
Location:Foreign  Entered:1998-08-07, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': U199800443
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES 1IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax 26MAY98 & 7 days later suddenly became weak, pale & dizzy while being in mom arms;episode lasted approx 2min & disappeared spontaneously;pt hosp;results of blood nl EEG, ECG,C1 scan brain, 02 sat nl;

VAERS ID:114943 (history)  Vaccinated:1998-05-26
Age:13.1  Onset:1998-06-07, Days after vaccination: 12
Gender:Male  Submitted:1998-06-07, Days after onset: 0
Location:Foreign  Entered:1998-10-13, Days after submission: 128
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: state p/arthritis of unk origin;
Diagnostic Lab Data: LP LEUCO 3, gluc 67, prot 16.3;MRI spinal small syrinx in TH 12;neurophysiology nerve conduction of n suralis rt sided dec;proprioception rt toes lost;superficial sensory function clearly reduced;toe extensor muscles strenthg reduced;
CDC 'Split Type': 19980181331
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM    
Administered by: Unknown     Purchased by: Unknown
Symptoms: CSF test abnormal, Depressed level of consciousness, Hypokinesia, Myasthenic syndrome, Neck pain, Neuropathy, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad)
Write-up: pt recv vax & exp neck pain;7JUN exp rt sided muscle weakness of rt foot (unable to elevate the foot), sensibility disorder & hypoesthesia @ rt leg;w/in following days sensibility disorder;sl reduced nerve conduction velocity;

VAERS ID:162758 (history)  Vaccinated:1998-05-26
Age:1.9  Onset:1998-05-26, Days after vaccination: 0
Gender:Male  Submitted:2000-11-22, Days after onset: 911
Location:Foreign  Entered:2000-11-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES00111058
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.VV230A1000SC 
Administered by: Other     Purchased by: Other
Symptoms: Abnormal behaviour, Aphasia, Autism, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Information has been received from the parents of a 22 month old male who on 5/26/98 was vaccinated with the 1st dose of MMR II. On 5/26/98, the pt experienced fever. The fever persisted for 4-5 days. On "7/20" the parents called the healthcare center because only the mother could get eye contact with the pt. His language had disappeared and he preferred to play alone. Later, autism was dx''d. Fever and autism were considered to be disabling. Outcome of "sequelae" was noted. No further information is available.

VAERS ID:232120 (history)  Vaccinated:1998-05-26
Age:30.0  Onset:1998-06-01, Days after vaccination: 6
Gender:Female  Submitted:2005-01-10, Days after onset: 2415
Location:Foreign  Entered:2005-01-11, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data: At an unspecified date, performed scan showed suggestive images of multiple sclerosis, according to the subjects physician.
CDC 'Split Type': B0363138A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Other     Purchased by: Other
Symptoms: Difficulty in walking, Hearing impaired, Multiple sclerosis, Paresis, Visual disturbance
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (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), Hearing impairment (narrow)
Write-up: This case was reported by a foreign regulatory authority and described the occurrence of multiple sclerosis in a 30 year old female subject who was vaccinated with hepatitis B vaccine for prophylaxis. On 4/22/96, the subject received the first dose of Engerix B at 20mcg, then at an unspecified date, she received the second dose of Engerix B at 20mcg. On 5/26/98, the subject received the third dose of Engerix B at 20mcg. In June 1998, she presented with a paresis of a lower limb. According to the subject''s physician, the diagnosis of multiple sclerosis was confirmed by several flare up and a scan (unspecified date) which showed suggestive images of multiple sclerosis. Since then, the subject''s health status progressively aggravated with walking difficulties (within the perimeter of 100 meters), audition disorders (auditory disturbance of ear) and reduced visual acuity. The subject stopped to work. The agency reported the events as disabling. At the time of reporting, the subject had recovered with sequelae. The agency considered the events as unlikely related to Engerix B. 08/18/2005: No further information is available.

VAERS ID:232770 (history)  Vaccinated:1998-05-26
Age:1.9  Onset:1998-05-26, Days after vaccination: 0
Gender:Male  Submitted:2005-01-18, Days after onset: 2429
Location:Foreign  Entered:2005-01-24, 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: NONE
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0501USA01819
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Autism, Pyrexia, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Information has been received from a health authority concerning a 23 month old male who on 5/26/98 was vaccinated SC with a dose of MMR (batch # not reported). On 5/26/98, the child developed a high fever which lasted for one week. During this week, the child had speech disturbance and did not make eye contact. He followed back in his development. At the present time, the child is 8 years old and has been diagnosed with infantile autism. The autism is considered to be an other medically important event. The outcome is not reported. Case is closed. Other business partner numbers include E200500170.

VAERS ID:111219 (history)  Vaccinated:1998-05-27
Age:0.2  Onset:0000-00-00
Gender:Female  Submitted:1998-05-27
Location:Georgia  Entered:1998-05-28, Days after submission: 1
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: hemangioma-back & estrophia
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4504970IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.M13510IMLL
Administered by: Private     Purchased by: Unknown
Symptoms: Screaming
SMQs:, Hostility/aggression (broad)
Write-up: pt recv vax & mom states on-going crying x 4hr;irritable & crying & handling;2Pm quiet;APAP given q 4hr;

VAERS ID:111289 (history)  Vaccinated:1998-05-27
Age:13.6  Onset:1998-05-27, Days after vaccination: 0
Gender:Female  Submitted:1998-05-27, Days after onset: 0
Location:New York  Entered:1998-06-02, Days after submission: 6
Life Threatening? Yes
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: BP 140/60
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES0908940  A
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1019E  LA
Administered by: Private     Purchased by: Other
Symptoms: Agitation, Dizziness, Dyspnoea, Hypertonia, Stupor, Syncope, Tinnitus
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: shortly p/vax pt turned to the rt groaned & went unconscious, eyes open, glassy eyed, did not respond to name, body went rigid, dizzy, extreme ringing in ears, crying, breathing erratically;

VAERS ID:111389 (history)  Vaccinated:1998-05-27
Age:1.3  Onset:1998-05-27, Days after vaccination: 0
Gender:Female  Submitted:1998-05-29, Days after onset: 2
Location:Indiana  Entered:1998-06-03, Days after submission: 5
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': IN98018
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7B919233IMRL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES7M919433IMRL
Administered by: Public     Purchased by: Public
Symptoms: Hypothermia, Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Accidents and injuries (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & 1/2hr p/vax pt back to clinic w/T98.4 & welts on legs and spreading;welts described as little red dots;

VAERS ID:111482 (history)  Vaccinated:1998-05-27
Age:33.4  Onset:1998-05-28, Days after vaccination: 1
Gender:Female  Submitted:1998-06-01, Days after onset: 4
Location:Wisconsin  Entered:1998-06-05, 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: depakote, estorgen
Current Illness: NONE
Preexisting Conditions: sachrine, sz disorder
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH497812610 LA
Administered by: Other     Purchased by: Private
Symptoms: Injection site mass, Paraesthesia, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: rash on lt arm, indurated area approx 4" circumference c/o numbness, pruritus;

VAERS ID:111507 (history)  Vaccinated:1998-05-27
Age:45.9  Onset:1998-05-27, Days after vaccination: 0
Gender:Female  Submitted:1998-05-27, Days after onset: 0
Location:Washington  Entered:1998-06-08, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: no MD dx conditions, but pt states skin on fingers cracked & bled p/being on achromycin
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1222E1IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0991D1SCA
Administered by: Public     Purchased by: Unknown
Symptoms: Anaphylactoid reaction, Bradycardia, Dyspnoea, Hypertension, Hyperventilation, Pruritus
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: anaphylactoid rxn onset approx 20min p/vax;began w/a pruritus of scalp spread to back & UE''s;diff breathing;returned to clinic BP 156/102, P140, R32;epi & DPH given;02 initiated;

VAERS ID:111512 (history)  Vaccinated:1998-05-27
Age:13.8  Onset:1998-05-28, Days after vaccination: 1
Gender:Male  Submitted:1998-06-03, Days after onset: 6
Location:Illinois  Entered:1998-06-08, Days after submission: 5
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: allergic rhinitis;attention deficit disorder, depression
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1558E0IMA
Administered by: Private     Purchased by: Unknown
Symptoms: Chest pain, Face oedema, Injection site oedema, Oedema peripheral, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: initially devel swelling over deltoid area 30min p/vax;over 24hr entire rt arm had edema;seen in ER devel severe urticarial rxn all over body;chest discomfort & facial edema;

VAERS ID:111529 (history)  Vaccinated:1998-05-27
Age:1.0  Onset:1998-05-27, Days after vaccination: 0
Gender:Female  Submitted:1998-06-04, Days after onset: 8
Location:Georgia  Entered:1998-06-09, Days after submission: 5
Life Threatening? Yes
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: lumbar puncture w/no growth;negative sepsis work-up;urinalysis negative;blood cullt negative;glucose-nl;CBC-WBC 19400 otherwise nl
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM200RS3 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.130620  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1325E0  
Administered by: Private     Purchased by: Private
Symptoms: Febrile convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt devel T105 on APAP every 4hr;sx dx febrile sz;

VAERS ID:111540 (history)  Vaccinated:1998-05-27
Age:1.5  Onset:1998-05-29, Days after vaccination: 2
Gender:Female  Submitted:1998-06-03, Days after onset: 5
Location:New Hampshire  Entered:1998-06-09, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp rxn w/tetramune 16MAY97 & 18JAN98 w/dose 2
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': NH9807
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM827A20 LL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0596H0 LL
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, 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: cellulitis, redness & swelling around each inj site (the size of a lemon);firm to touch;hot soaks & APAP;this is the 3rd this this happened on ATB 1st 2 times;

VAERS ID:111542 (history)  Vaccinated:1998-05-27
Age:1.3  Onset:0000-00-00
Gender:Male  Submitted:1998-06-02
Location:Massachusetts  Entered:1998-06-09, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM265RF3IMRL
Administered by: Private     Purchased by: Other
Symptoms: Erythema multiforme
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: had erythema multiform rash p/vax;

VAERS ID:111546 (history)  Vaccinated:1998-05-27
Age:28.9  Onset:1998-05-29, Days after vaccination: 2
Gender:Male  Submitted:1998-06-02, Days after onset: 4
Location:Kentucky  Entered:1998-06-09, 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES02295900IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site abscess, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt devel sterile abscess @ site of inj;sl swelling;

VAERS ID:111551 (history)  Vaccinated:1998-05-27
Age:1.5  Onset:1998-05-27, Days after vaccination: 0
Gender:Male  Submitted:1998-05-27, Days after onset: 0
Location:California  Entered:1998-06-09, 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:
Current Illness: NONE
Preexisting Conditions: egg allergy NOV97;RAD
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164703 RL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM260RJ3 LL
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: devel wheat @ site of DTAP & HIB;no resp distress;observed for 30min;no tx indicated;

VAERS ID:111787 (history)  Vaccinated:1998-05-27
Age:1.4  Onset:1998-06-01, Days after vaccination: 5
Gender:Female  Submitted:1998-06-04, Days after onset: 3
Location:Virginia  Entered:1998-06-11, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: PPD by Connaught lot# 248611 given 27MAY98;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': VA98035
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09258803 RL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0427H3 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1316E0 A
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1574E0 LA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: hives over chest back & face 1JUN98;saw PMD 2JUN98;hives fading & less apparent in cool (air conditioner);

VAERS ID:111792 (history)  Vaccinated:1998-05-27
Age:1.8  Onset:1998-05-28, Days after vaccination: 1
Gender:Male  Submitted:1998-06-04, Days after onset: 7
Location:Virginia  Entered:1998-06-11, 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: hydrocortizone cream
Current Illness: healthy-denies illness
Preexisting Conditions: denies
Diagnostic Lab Data:
CDC 'Split Type': VA98036
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164981 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1316E1 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES775K21PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site oedema, Oedema, Oedema peripheral, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: pt recv vax 27MAY98 & next morning was swollen all over;no rash-itchy;mom gave OTC cream;lt arm swelling 28MAY98-swelling in arms & lt p/8hr & head & neck & chest & back;

VAERS ID:111797 (history)  Vaccinated:1998-05-27
Age:4.0  Onset:1998-05-28, Days after vaccination: 1
Gender:Male  Submitted:1998-06-05, Days after onset: 8
Location:New York  Entered:1998-06-11, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Neupogen;Amoxicillin
Current Illness: NONE
Preexisting Conditions: dx birth w/severe congenital neutropenia
Diagnostic Lab Data: CBC, WBC 84. w/no bands or polys
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4502941IMLA
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES09315500SCA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Oedema peripheral, Pain, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt arm red, sore, swollen, seen 29MAY-arm red, swollen forearm to shoulder;changed to Augmentin;seen 30MAY, 31MAY added prelone;final dx severe inflammatory rxn to DTAP;

VAERS ID:111804 (history)  Vaccinated:1998-05-27
Age:38.8  Onset:1998-05-31, Days after vaccination: 4
Gender:Female  Submitted:1998-06-10, Days after onset: 10
Location:Mississippi  Entered:1998-06-12, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp severe flu sx @ 38yr old w/hep B dose 1 & 2;
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS98010
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Lymphadenopathy, Malaise, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 5 days post vax pt exp illness & severe joint pain lasting x 3 days-12 days post vax rash, swollen glands;

VAERS ID:111885 (history)  Vaccinated:1998-05-27
Age:10.8  Onset:1998-05-27, Days after vaccination: 0
Gender:Male  Submitted:1998-05-28, Days after onset: 1
Location:Texas  Entered:1998-06-15, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': TX98073
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1448E1IMA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Hypertension, Injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax & mom heard a moaning sound; mom saw pt falling forward from the chair;crying c/o head hurting, given ice pack to hold on head;BP 120/70, P60;

VAERS ID:111900 (history)  Vaccinated:1998-05-27
Age:20.2  Onset:1998-05-31, Days after vaccination: 4
Gender:Female  Submitted:1998-06-10, Days after onset: 10
Location:California  Entered:1998-06-15, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0623E SCA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7J91913 IMLA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Malaise, Pruritus, Rash, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: pruritic rash began 31MAY98 in AM;began to not feel well that evening, felt dizzy & poss lost consciousness;apparently went to a dermatologist & was placed on oral steroids w/improvement;

VAERS ID:111926 (history)  Vaccinated:1998-05-27
Age:0.5  Onset:1998-05-29, Days after vaccination: 2
Gender:Male  Submitted:1998-06-04, Days after onset: 6
Location:Iowa  Entered:1998-06-16, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data: MRI -normal; Electrolytes: Na-140;K-5.0;Ca-+11;Mg-2.2;Co2-24;Chl-108; EEG
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES9258802 LL
Administered by: Private     Purchased by: Unknown
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: onset of sz 2-4 days & ongoing p/vax. Not febrile. No fam hx of sz disorders

VAERS ID:112015 (history)  Vaccinated:1998-05-27
Age:1.0  Onset:1998-06-12, Days after vaccination: 16
Gender:Female  Submitted:1998-06-12, Days after onset: 0
Location:Oregon  Entered:1998-06-23, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: n/a
Other Medications:
Current Illness: N/A - well child exam
Preexisting Conditions: no
Diagnostic Lab Data: zero
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES9164703IMLA
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0164H3IMA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1600E0SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0787E3PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1320E0SCA
Administered by: Private     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: P/vax MTR noticed fine rash over thorax & lower legs. Came to clinic p/having rash 3 day.

VAERS ID:112164 (history)  Vaccinated:1998-05-27
Age:9.3  Onset:1998-05-27, Days after vaccination: 0
Gender:Female  Submitted:1998-06-12, Days after onset: 16
Location:Minnesota  Entered:1998-06-24, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Chills, Headache, Neck pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: pt recv vax 27MAY98 2PM & exp fever (100 oral), sore neck, h/a, chills @ 830PM;fever (102.9 oral) & all above sx @ 1030PM;APAP given;

VAERS ID:112263 (history)  Vaccinated:1998-05-27
Age:1.5  Onset:1998-06-03, Days after vaccination: 7
Gender:Male  Submitted:1998-06-24, Days after onset: 21
Location:Florida  Entered:1998-06-30, 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: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': FL98025
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164902IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1190E2IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS1512E2IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1303E0SCRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0771K2PO 
Administered by: Public     Purchased by: Public
Symptoms: Malaise
SMQs:
Write-up: mom called clinic 3JUN98 & states pt was having reaction to shots recv 27MAY98;sx vague & states not acting like self;advised to take child to ER & let nurse know results;

VAERS ID:112308 (history)  Vaccinated:1998-05-27
Age:0.4  Onset:1998-05-27, Days after vaccination: 0
Gender:Male  Submitted:1998-05-28, Days after onset: 1
Location:South Carolina  Entered:1998-07-02, Days after submission: 35
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': SC98031
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09073801IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM195PJ1IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.M04611SCLL
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Gaze palsy, Pyrexia, Somnolence, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Ocular motility disorders (narrow)
Write-up: pt became very drowsy around 430PM;fever rx not given p/shots because pt did not devel fever from immun;states unusual for pt to be sleepy @ that time of afternoon;pt started shaking became limp & eye rolled into head;pt restless;fever

VAERS ID:113024 (history)  Vaccinated:1998-05-27
Age:  Onset:1998-06-01, Days after vaccination: 5
Gender:Male  Submitted:0000-00-00
Location:Illinois  Entered:1998-08-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES98060411
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: On 5/27/98 Pt. recv. vax. On 6/1/98 pt. exp. shingles. Medical attention was sought

VAERS ID:113607 (history)  Vaccinated:1998-05-27
Age:0.4  Onset:1998-05-27, Days after vaccination: 0
Gender:Male  Submitted:1998-08-04, Days after onset: 69
Location:Arkansas  Entered:1998-08-24, Days after submission: 20
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: asthma
Diagnostic Lab Data: NA
CDC 'Split Type': AR9846
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES4514981IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS0318H1IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N00311IMLL
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: pt recv vax 27MAY98 & began to have inc temp from 99 to 101 x 5 days;given motrin/APAP routinely saw MD that AM to check ears;

VAERS ID:113680 (history)  Vaccinated:1998-05-27
Age:20.7  Onset:1998-05-27, Days after vaccination: 0
Gender:Male  Submitted:1998-07-10, Days after onset: 44
Location:North Carolina  Entered:1998-08-27, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD by Connaught lot# 245411 given 27MAY98
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': NC98032
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2251A20IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: sweating, dizziness, nausea 3hr p/vax lasting x 7hr;still c/o dizziness next day when leaning over OK by 24hr p/immun;

VAERS ID:114123 (history)  Vaccinated:1998-05-27
Age:36.0  Onset:1998-06-03, Days after vaccination: 7
Gender:Male  Submitted:1998-08-13, Days after onset: 71
Location:Idaho  Entered:1998-09-14, Days after submission: 32
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Zestril;pt recv engerix vax by SKB on 29JUN98;
Current Illness: did not mention small red bump on medial side of rt knee
Preexisting Conditions: renal cell carcinoma APR97;kidney removed;allergies-milk, oranges, compazine;
Diagnostic Lab Data: pt was tested for hepatitis and had LFT''s-unusual results 1st time-had additional test all WNL;
CDC 'Split Type': ID98035
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2506A40IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM579A40IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Lymphadenopathy, Urticaria
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt reports small red bump on medial side of rt knee 1wk a/vax;p/vax spread into rash extending w/circular lesions up both legs-dermatologist felt it was a lymphatic, systemic rxn to sometheing;rash now going away but MD wanted vax info;

VAERS ID:114389 (history)  Vaccinated:1998-05-27
Age:1.5  Onset:1998-05-27, Days after vaccination: 0
Gender:Male  Submitted:1998-07-10, Days after onset: 44
Location:Pennsylvania  Entered:1998-09-23, Days after submission: 75
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC 'Split Type': U199800281
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164803IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 5/27/98; on same dy pt exp redness &swelling ($g 1in.); tenderness $g24 hrs. As of 7/7/98 pt imp.

VAERS ID:114964 (history)  Vaccinated:1998-05-27
Age:1.1  Onset:1998-09-16, Days after vaccination: 112
Gender:Male  Submitted:1998-10-08, Days after onset: 22
Location:New York  Entered:1998-10-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: upper resp infect
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1564E0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Herpes zoster, Infection
SMQs:
Write-up: zoster p/varivax;no fever;vesicles on erythematous base;

VAERS ID:115973 (history)  Vaccinated:1998-05-27
Age:41.4  Onset:1998-05-29, Days after vaccination: 2
Gender:Male  Submitted:1998-10-26, Days after onset: 150
Location:Indiana  Entered:1998-11-02, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 19980153641
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2491B60IMLA
Administered by: Private     Purchased by: Other
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 27MAY98 & 29MAY98 pt devel nonspecific rash (few scattered papules only on trunk), & itching;ER or MD visit was required on 5JUN98;

VAERS ID:115709 (history)  Vaccinated:1998-05-27
Age:0.3  Onset:1998-05-30, Days after vaccination: 3
Gender:Female  Submitted:1998-10-23, Days after onset: 146
Location:Michigan  Entered:1998-11-04, Days after submission: 12
Life Threatening? No
Died? Yes
   Date died: 1998-05-30
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: healthy exam 27MAY98
Preexisting Conditions: tetralogy of fallot, complicated;rt aortic arch
Diagnostic Lab Data: 24JAN98 echocardiogram EKG 20JAN98, 26FEB98, 19MAR98, 28APR98;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM841A21IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1272E1IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.M13521SCRA
Administered by: Private     Purchased by: Private
Symptoms: Cardiovascular disorder
SMQs:, Cardiomyopathy (broad)
Write-up: father got up @ 3-4Am for work, child fine, given formula;mom woke @ 530, child dead;autopsy report not recv as to 23OCT98;heart disease felt to be significant probable cause of death;

VAERS ID:116728 (history)  Vaccinated:1998-05-27
Age:1.1  Onset:1998-06-05, Days after vaccination: 9
Gender:Male  Submitted:1998-06-08, Days after onset: 3
Location:Maine  Entered:1998-11-23, Days after submission: 168
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: URI
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': ME98017
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1237E0SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0783A2PO 
Administered by: Private     Purchased by: Public
Symptoms: Pruritus, Rash maculo-papular, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 1030-37hr maculopapular rash on trunk;diffuse hot, itchy;

VAERS ID:121027 (history)  Vaccinated:1998-05-27
Age:3.6  Onset:1999-04-03, Days after vaccination: 311
Gender:Female  Submitted:1999-04-05, Days after onset: 1
Location:Florida  Entered:1999-04-08, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: check-up
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1568E0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: acquired varicella;

VAERS ID:123478 (history)  Vaccinated:1998-05-27
Age:5.5  Onset:1998-05-27, Days after vaccination: 0
Gender:Male  Submitted:1999-05-14, Days after onset: 352
Location:Missouri  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': WAES98060685
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0310H0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Herpes zoster, Infection, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: p/ pt recv vax same day pt exp breakthrough chickenpox w/5-10 vesicles & rash on chest. MD rpt f/u 6/8/98 pt developed shingles.

VAERS ID:122481 (history)  Vaccinated:1998-05-27
Age:5.4  Onset:1998-05-30, Days after vaccination: 3
Gender:Male  Submitted:1999-05-21, Days after onset: 356
Location:Florida  Entered:1999-05-24, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications:
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98060187
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1  
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER  PO 
Administered by: Other     Purchased by: Other
Symptoms: Lymphadenopathy
SMQs:
Write-up: pt recv vax & exp swollen saliva glands above the curve of jaw;pt was examined by two MD;one of the MD reported that pt exp was related to vax & the other dx a swollen lymph gland;

VAERS ID:123412 (history)  Vaccinated:1998-05-27
Age:1.0  Onset:1998-05-27, Days after vaccination: 0
Gender:Female  Submitted:1999-05-14, Days after onset: 352
Location:Maryland  Entered:1999-05-24, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications:
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98051825
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0026H0SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0062H0IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: p/ pt recv vax same day devel 2 centimeter wheal around the inject site described as white bump, treated w/benadryl

VAERS ID:123428 (history)  Vaccinated:1998-05-27
Age:32.4  Onset:1998-05-27, Days after vaccination: 0
Gender:Female  Submitted:1999-05-14, Days after onset: 352
Location:Arizona  Entered:1999-05-24, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98060044
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dry mouth, Headache
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: pt recv vax & exp dry mouth & h/a;It was reported that these exp are constant & nothing seems to help;

VAERS ID:124772 (history)  Vaccinated:1998-05-27
Age:1.3  Onset:1999-05-28, Days after vaccination: 366
Gender:Female  Submitted:1999-06-09, Days after onset: 12
Location:Illinois  Entered:1999-06-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma
Diagnostic Lab Data: CBC, blood c/s;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM865A23 RA
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES09642703 RA
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site necrosis, Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: high fever 102-103;severe swelling redness inj site;small area of skin necrosis noted @ inj site;

VAERS ID:125543 (history)  Vaccinated:1998-05-27
Age:  Onset:1998-05-27, Days after vaccination: 0
Gender:Male  Submitted:1998-07-05, Days after onset: 39
Location:Ohio  Entered:1999-06-30, Days after submission: 360
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': U199800374
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES0920770   
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES0919800   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt exp a lot of swelling of the entire area;red & hard;warm to touch;

VAERS ID:127920 (history)  Vaccinated:1998-05-27
Age:2.0  Onset:1998-05-27, Days after vaccination: 0
Gender:Female  Submitted:1998-07-07, Days after onset: 41
Location:Maryland  Entered:1999-09-03, Days after submission: 423
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: penicillin oral
Current Illness: none
Preexisting Conditions: sickle cell disease
Diagnostic Lab Data:
CDC 'Split Type': 898188065A
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4425230IMRL
Administered by: Private     Purchased by: Other
Symptoms: Injection site oedema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: evening of vax pt devel T104.3 & inj site rxn of pain & swelling; taken to ER & hosp; tx w/IV fluids; IV cefuroxime & oral analgesics; disch 3days later w/prescriptions of ceftin & tylenol w/codeine; recovered

VAERS ID:156103 (history)  Vaccinated:1998-05-27
Age:3.0  Onset:2000-06-17, Days after vaccination: 752
Gender:Male  Submitted:2000-06-27, Days after onset: 10
Location:Michigan  Entered:2000-07-06, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
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.0055H0SCRL
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt experienced mild varicella

VAERS ID:208240 (history)  Vaccinated:1998-05-27
Age:  Onset:2003-07-22, Days after vaccination: 1882
Gender:Male  Submitted:2003-07-22, Days after onset: 0
Location:Unknown  Entered:2003-08-25, Days after submission: 34
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
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164804993  
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)LEDERLE LABORATORIES0787B2  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0308H80  
Administered by: Private     Purchased by: Private
Symptoms: Blister, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash with vesicles some open areas, with slight ulceration appeared all at once. Symp tx.

VAERS ID:253768 (history)  Vaccinated:1998-05-27
Age:1.5  Onset:2006-03-30, Days after vaccination: 2864
Gender:Male  Submitted:2006-03-31, Days after onset: 1
Location:New York  Entered:2006-04-06, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: Not known
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164803  
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)LEDERLE LABORATORIES771432  
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection, Rash
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: Exposed to chicken pox 3 weeks ago, has a rash. Diagnosed with chickenpox 03/31/2006.

VAERS ID:280795 (history)  Vaccinated:1998-05-27
Age:3.0  Onset:2006-06-07, Days after vaccination: 2933
Gender:Female  Submitted:2007-05-16, Days after onset: 343
Location:Ohio  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Rhinitis allergic
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0606USA01765
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0313H1UNUN
Administered by: Private     Purchased by: Private
Symptoms: Rash erythematous, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 11 year old female with rhinitis allergic and no known drug allergies who on 27-MAY-1998 was vaccinated with a second dose of Varivax (lot # 625387/0313H). There was no concomitant medications. On 07-JUN-2006 the patient developed 17 fluid filled vesicles and bumps. Unspecified medical attention was sought. Supportive care was recommended. No laboratory diagnostic tests were performed. At the time of the report the patient was recovering. There was no product quality complaint involved. Follow-up information from the registered nurse indicated that the patient was seen on 09-JUN-2006 with a dozen ''or so'' red bumps and some vesicles x2 days. There was no complaint of fever or itch. The patient''s mother phoned the office on 10-JUN-2006 and started that the spots had all "faded" away, except for one. There was no scabbing and the patient was acting fine. It was unknown if the patient had actual chickenpox. There was no scabbing and the patient was acting fine. It was unknown if the patient had actual chickenpox. There was no illness at the time of vaccination. There were no adverse events following vaccination. Additional information is not expected.

VAERS ID:304640 (history)  Vaccinated:1998-05-27
Age:4.0  Onset:2008-02-04, Days after vaccination: 3540
Gender:Female  Submitted:2008-02-07, Days after onset: 3
Location:Massachusetts  Entered:2008-02-08, 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: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1569E0SCUN
Administered by: Private     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt presented in office on 2/6/08 with rash starting 2/4/08 15-20 lesions

VAERS ID:111839 (history)  Vaccinated:1998-05-27
Age:1.6  Onset:1998-05-31, Days after vaccination: 4
Gender:Male  Submitted:1998-06-11, Days after onset: 11
Location:Foreign  Entered:1998-06-16, 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: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: spinal tap leucocytes 19,000, CRP nl, SGOT positive, high transaminase, nl bilirubin;
CDC 'Split Type': WAES98060616
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Leukocytosis, Malaise, Meningitis, Nuchal rigidity, Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow)
Write-up: pt recv vax 27MAY98 & 31MAY97 pt presented w/neck stiffness, fever & was feeling quite unwell;4JUN98 pt hosp because the fever was still lasting;5JUN98 also exp diarrhea;dx aseptic meningitis;

VAERS ID:175924 (history)  Vaccinated:1998-05-27
Age:1.3  Onset:1999-01-16, Days after vaccination: 234
Gender:Female  Submitted:2001-09-26, Days after onset: 983
Location:Foreign  Entered:2001-10-02, Days after submission: 6
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: Arthritis
Diagnostic Lab Data: Knee biopsy-of synovial membrane; 01/01/99radionuclear scan; Diagnostic procedure-infiltrations of the left eblow,ankle and knee; Jan 1999 DNA Ab immunoprecipitation-negative, WBC count-12900, body temp-40C, Serum ANA-1/640, Serum C-reactiv
CDC 'Split Type': WAES01091583
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.02361   
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthritis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arthritis (narrow)
Write-up: A 12 month old female who on 05/27/98 was vaccinated with a 1st dose of Hepatitis B vaccine recombinant (yeast) (5mcg/0.5ml) (batch #0236-1). It was noted that this information was reported by the child''s parents. After the 1st injection she presented with the 1st symptoms of arthritis. On 07/18/98, the patient received a 2nd dose of Hepatitis B vaccine recombinant. After this injection her symptoms persisted. On 03/13/99, the patient received her 3rd dose of hepatitis B vaccine recombinant. On 12/04/99, the patient received a 1st dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live. After this injection the patient''s condition was aggravated with an effusion of the right ankle. It was reported that the child was hospitalized in 01/99 for a check up. A scintigraphy and biopsy of the knees was done and an orthopedist finally made the diagnosis of juvenile chronic arthritis. FOLLOW-UP information indicated that despite several request this file could not be medically documented. The case is closed. Information that was medically confirmed was received on 5/22/02. This contains some conflicting information. It was reported that the child''s symptoms begaon on 1/16/99. She experienced a high fever up to 40C and arthritis of the right ankle. At this time, a diagnosis of juvenile rheumatoid arthritis was made. Afterward, an arthritis of the left knee developed and a biopsy of the synovial membrane was performed on 2/22/99. This biopsy confirmed the diagnosis. She was treated with aspirin since 3/23/99. It was noted that infiltration of the left ankle, left elbow and the left knee were performed on 4/22/99. On 8/6/01 Ibuprofen was added, regarding several relapses of the disease. She has not recovered. No further information is available. The case is closed. A 15-day follow up report received 8/18/03 adds: Additional follow up info from the health authority indicated that in Feb 1999 an ankle puncture showed "synovial localization of chronic juvenile arthritis". An X-ray of the

VAERS ID:246082 (history)  Vaccinated:1998-05-27
Age:0.2  Onset:2005-01-10, Days after vaccination: 2420
Gender:Female  Submitted:2005-10-24, Days after onset: 286
Location:Foreign  Entered:2005-10-26, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC 'Split Type': GBWYE051513OCT05
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES448103   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Drug ineffective, Injection site reaction
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This case was considered medically important (OMIC). Information regarding Hib Titer vaccine (haemophilus b conjugate vaccine (diphtheria crm197 protein conjugate) injection) was received from a healthcare professional via a regulatory authority regarding a 6 yr old female pt who experienced cellulitis and vaccination failure. The pt received a dose on 04Jan99, a dose on 24Aug98 and a dose on 27May98. Relevant medical history was not provided. Indication for Hib Titer vaccine was immunization. The dose regimen was not started on 27May98, then was not stated on 24Aug98 and then was not stated on 04Jan99. Pt was not taking concomitant therapy. The pt experienced cellulitis and vaccination failure on 10Jan05. No additional information was available at the time of this report.

VAERS ID:111549 (history)  Vaccinated:1998-05-28
Age:5.1  Onset:1998-05-29, Days after vaccination: 1
Gender:Female  Submitted:1998-06-01, Days after onset: 3
Location:Illinois  Entered:1998-06-09, 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: TB tine by connaught lot# M03542 given 28MAY98;
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1235E1SCA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4501403PO 
Administered by: Private     Purchased by: Public
Symptoms: Rash, Skin nodule, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 2 days p/vax pt had red patch about 4", warm to touch, hard area in center;tx apply cool compress & advil;

VAERS ID:112061 (history)  Vaccinated:1998-05-28
Age:0.5  Onset:1998-05-28, Days after vaccination: 0
Gender:Female  Submitted:1998-05-29, Days after onset: 1
Location:North Carolina  Entered:1998-06-23, Days after submission: 25
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': NC98027
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164802IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2392A22IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM165RH2IMLL
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: mom reports pt w/rash to lower extremities approx 1-2hr p/vax;areas began to inc in size & number;pt was looked @ by MD who stated felt like pt was exp hives;pt to f/u w/MD r/t inc rash-widespread w/T104;

VAERS ID:112169 (history)  Vaccinated:1998-05-28
Age:8.3  Onset:1998-06-09, Days after vaccination: 12
Gender:Male  Submitted:1998-06-10, Days after onset: 1
Location:Idaho  Entered:1998-06-24, Days after submission: 14
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: interventricular hemmorage @ age 2 days-lt side of brain
Diagnostic Lab Data:
CDC 'Split Type': ID98025
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2356A20IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: 9JUN98 11PM arms itching, then progressed all of body x/palm of hands, soles of feet & testicular area;given aveeno oatmeal bath, DPH, curel lotion;

VAERS ID:112211 (history)  Vaccinated:1998-05-28
Age:14.4  Onset:1998-05-30, Days after vaccination: 2
Gender:Female  Submitted:1998-06-07, Days after onset: 8
Location:Ohio  Entered:1998-06-26, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: cough
Preexisting Conditions: allergy to strawberries (pt also eating these over this time period);
Diagnostic Lab Data:
CDC 'Split Type': OH98044
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2392A21IMRA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4528415IMLA
Administered by: Public     Purchased by: Public
Symptoms: Face oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: mom states child had onset of lips swelling on 30MAY98 in AM & had intermittent hives x 2-3 days;also relates that as a child was allergic to strawberries & has been eating berries over the weekend;instructed to contact MD;

VAERS ID:112218 (history)  Vaccinated:1998-05-28
Age:  Onset:1998-06-01, Days after vaccination: 4
Gender:Female  Submitted:1998-06-24, Days after onset: 23
Location:Oregon  Entered:1998-06-29, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications:
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98061365
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM    
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.0154E   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypokinesia, Myelitis
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax 28MAY98 & devel acute transverse myelitis w/motor skill difficulties in legs & was hosp x 3 days;attempted to go back to work part time but was told not to by neurologist;

VAERS ID:112227 (history)  Vaccinated:1998-05-28
Age:47.0  Onset:1998-05-28, Days after vaccination: 0
Gender:Female  Submitted:1998-06-08, Days after onset: 11
Location:Pennsylvania  Entered:1998-06-29, Days after submission: 21
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': PA9832
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)PFIZER/WYETH49781100 A
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Oedema peripheral, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: itching @ inj site;became very red & swollen;swelling extended to elbow;duration of local rxn-5 days;

VAERS ID:112228 (history)  Vaccinated:1998-05-28
Age:19.7  Onset:1998-05-28, Days after vaccination: 0
Gender:Female  Submitted:1998-06-08, Days after onset: 11
Location:Pennsylvania  Entered:1998-06-29, Days after submission: 21
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': PA9833
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2352A20IMLA
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES7J919390 A
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Asthenia, Hypotension, Pallor, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pale, BP 98/60, P80, numbness in rt arm & rt side of face;fatigued;had nothing to eat all day;took food & fluids by 245PM color improved, more alert, BP 98/60, P 60;no further complaints of numbness;29MAY98 mom reports pt doing well;

VAERS ID:112621 (history)  Vaccinated:1998-05-28
Age:0.0  Onset:1998-05-28, Days after vaccination: 0
Gender:Female  Submitted:1998-06-30, Days after onset: 33
Location:California  Entered:1998-07-14, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0112H0IMRL
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Anorexia, Screaming
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: inconsolable crying for 5hr p/vax; no fever;refused to nurse;no tx;

VAERS ID:114835 (history)  Vaccinated:1998-05-28
Age:12.9  Onset:1998-06-19, Days after vaccination: 22
Gender:Male  Submitted:1998-10-05, Days after onset: 108
Location:Colorado  Entered:1998-10-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: neuro work-up;EEG-MRI
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0878E0IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1304E0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Grand mal convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: mom states that 3wk p/vax pt had a grand mal sz;

VAERS ID:116656 (history)  Vaccinated:1998-05-28
Age:0.2  Onset:1998-05-28, Days after vaccination: 0
Gender:Male  Submitted:1998-11-17, Days after onset: 173
Location:Georgia  Entered:1998-11-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES7M817070 RL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES7K917680 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4501870PO 
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: pt had temp of 104 that wouldn''t come down;mom took pt to ER;crying uncontrollably, unable to be comforted;

VAERS ID:186436 (history)  Vaccinated:1998-05-28
Age:1.0  Onset:2002-02-08, Days after vaccination: 1352
Gender:Female  Submitted:2002-05-15, Days after onset: 95
Location:Unknown  Entered:2002-06-12, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Varicella exposure
Diagnostic Lab Data:
CDC 'Split Type': WAES0202USA01251
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0312H   
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Rhinorrhoea
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 4 year old female with no known allergies who on 05/28/1998 was vaccinated with varicella virus vaccine live. On 02/08/2002 the child developed a mild varicella rash and a runny nose. The child did not have a fever. It was reported that the child''s father had shingles 14 days prior. Unspecified medical attention was sought. At the time of this report, the outcome of the events was unknown. Additional info has been requested.

VAERS ID:197291 (history)  Vaccinated:1998-05-28
Age:5.7  Onset:2003-01-23, Days after vaccination: 1701
Gender:Male  Submitted:2003-01-29, Days after onset: 6
Location:Unknown  Entered:2003-02-05, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Outbreak of chickenpox with fewer than 40 lesions.

VAERS ID:197542 (history)  Vaccinated:1998-05-28
Age:5.0  Onset:2003-02-04, Days after vaccination: 1713
Gender:Male  Submitted:2003-02-05, Days after onset: 1
Location:New York  Entered:2003-02-11, 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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0538E0  
Administered by: Private     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: Neticular skin ? on trunk and scalp coutment with varicella.

VAERS ID:256519 (history)  Vaccinated:1998-05-28
Age:4.0  Onset:2005-08-13, Days after vaccination: 2634
Gender:Female  Submitted:2006-05-12, Days after onset: 272
Location:Georgia  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0508USA02585
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1329E0  
Administered by: Public     Purchased by: Public
Symptoms: Drug ineffective, Viral infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a health professional concerning a 11 year old black female with no medical history who on 28-MAY-1998 was vaccinated in the right arm with a first dose of varicella virus vaccine live (Oka/Merck)(lot # 624644/1329E). There was no illness at the time of vaccination. Concomitant therapy on an unknown date was reported as a dose of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar RA 27/3) (MSD), a dose of poliovirus vaccine and a dose of diphtheria toxoid (+) pertussis vaccine (unspecified) (+) tetanus toxoid. "Now", on approximately 15-AUG-2005, the patient has experienced full blown chicken pox with greater than 50 lesions. She is being treated with hydroxyzine hydrochloride (ATARAX) and calamine (+) camphor (+) pramoxine hydrochloride (AVEENO). No additional information is available. No product quality complaint was involved. Follow-up information indicated that on 13-AUG-2005, at 15:00, the patient developed distorted vesicles diffusely over the body. Some vesicles were dried and some still oozing. It was reported that on 20-AUG-2005 the patient recovered. The chickenpox was considered an other important medical event (OMIC) by the reporter. Additional information is not expected.

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