MedAlerts Home
  Read the MedAlerts Blog Subscribe to the MedAlerts Blog 

Found 573164 cases in entire database

Case Details (Sorted by Vaccination Date)

This is page 1346 out of 5732

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


VAERS ID:88226 (history)  Vaccinated:1996-07-22
Age:5.6  Onset:1996-07-22, Days after vaccination: 0
Gender:Female  Submitted:1996-07-24, Days after onset: 2
Location:Ohio  Entered:1996-07-30, 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:
Diagnostic Lab Data: NONE
CDC Split Type: OH96106
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5K610154 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0730C3PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Myalgia, Pyrexia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: w/in 24hr pt exp body aches, fever (no temp taken by parent) swelling of upper arm w/redness & tenderness;inc sleeping;

VAERS ID:88725 (history)  Vaccinated:1996-07-22
Age:17.9  Onset:1996-07-23, Days after vaccination: 1
Gender:Male  Submitted:1996-07-24, Days after onset: 1
Location:South Dakota  Entered:1996-08-07, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: dog bite rt thigh
Preexisting Conditions: has had mononucleosis recently
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6A81015 IMLA
Administered by: Private     Purchased by: Public
Symptoms: Myalgia, Pyrexia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: dog bite on 22JUL96 rt thigh;22JUL96 given vax & 23JUL96 gen achiness, low grade fever, soreness, redness in lt deltoid;

VAERS ID:88961 (history)  Vaccinated:1996-07-22
Age:0.8  Onset:1996-07-30, Days after vaccination: 8
Gender:Female  Submitted:1996-08-09, Days after onset: 10
Location:Texas  Entered:1996-08-14, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: urine blood-both nl
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0097D0 L
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: high temp to 104-w/bath & fever reducing meds able to bring temp down-temp up & down x 2 days;

VAERS ID:89736 (history)  Vaccinated:1996-07-22
Age:0.4  Onset:1996-07-22, Days after vaccination: 0
Gender:Female  Submitted:1996-07-22, Days after onset: 0
Location:Georgia  Entered:1996-09-09, Days after submission: 49
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: GA96100
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4348081IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0740B1PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: mom returned 445PM w/pt;area on lt thigh reddened w/knot;pt content @ present in fathers arm;mom contacted MD office regarding above;instructed to put warm wet compresses on thigh;notify MD if problem does not resolve;

VAERS ID:90564 (history)  Vaccinated:1996-07-22
Age:0.2  Onset:1996-07-22, Days after vaccination: 0
Gender:Female  Submitted:1996-07-23, Days after onset: 1
Location:Texas  Entered:1996-10-07, Days after submission: 76
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: TX9615
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES07813400 LL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1744A21 RL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES07813400 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0735L0PO 
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: skin rash over body;to MD w/in 15min time course pt recovered well no tx;

VAERS ID:90635 (history)  Vaccinated:1996-07-22
Age:1.0  Onset:1996-07-22, Days after vaccination: 0
Gender:Female  Submitted:1996-10-02, Days after onset: 72
Location:Texas  Entered:1996-10-09, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4348073 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0320D0SCRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0741K3PO 
Administered by: Private     Purchased by: Private
Symptoms: Otitis media, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 22JUL96;PE was nl;had t103.4 ax temp p/vax;seen in office 23JUL w/poss ear infect (early) & MD presumed vaccine rxn;

VAERS ID:90715 (history)  Vaccinated:1996-07-22
Age:0.5  Onset:1996-07-25, Days after vaccination: 3
Gender:Female  Submitted:1996-07-25, Days after onset: 0
Location:Kansas  Entered:1996-10-15, Days after submission: 82
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type: KS96023
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5J610692 RL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1963A22 RL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5L611742 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4335132PO 
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt seen by MD 26JUL96-indicated to mom that rash had nothing to do w/vax;pt recovered completely by 29JUL96 w/rash of unk cause only on lower limbs;

VAERS ID:93945 (history)  Vaccinated:1996-07-22
Age:0.2  Onset:1996-07-22, Days after vaccination: 0
Gender:Female  Submitted:1996-10-28, Days after onset: 98
Location:Kansas  Entered:1997-01-21, Days after submission: 85
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: KS96038
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5J610690IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1963A21IMRL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5L611740IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0740K0PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Crying, 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), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: mom reports that gave pt one dose of APAP prior to vax & pt vomited this;pt temp not higher than 99 ax;pt vomited again;130PM pt started crying, screaming inconsolably until 4PM that day;

VAERS ID:100792 (history)  Vaccinated:1996-07-22
Age:1.3  Onset:1997-04-22, Days after vaccination: 274
Gender:Female  Submitted:0000-00-00
Location:Indiana  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97041957
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0328E0  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax & approx 9mo later pt devel 40 plus lesions;

VAERS ID:104137 (history)  Vaccinated:1996-07-22
Age:51.0  Onset:0000-00-00
Gender:Female  Submitted:1996-12-16
Location:Kentucky  Entered:1997-10-30, Days after submission: 318
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp swollen hands & feet w/Engerix-B dose 1;
Other Medications: Nizoral (ketocconazole);Dicloxacillin;
Current Illness:
Preexisting Conditions: poss rheumatoid arthritis, rt ankle edema, rt foot rash (since 1995), shingles rt side face;no allergies;
Diagnostic Lab Data: MRI;SEP96 bone scan inflammtion;
CDC Split Type: 960161331B
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
Administered by: Private     Purchased by: Private
Symptoms: Bursitis, Dermatitis bullous, Hypokinesia, Infection, Oedema peripheral, Pain, Rheumatoid arthritis, Similar reaction on previous exposure to drug, Skin discolouration
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (narrow), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt exp foot infect w/white blisters;pt was seen by many specialists;MD reported 22SEP95 (96?) c/o was enlarged & painful backs of both heels;pt exp pain when back heel pulled & when walked;dx poss rheumatoid arthritis;bursitis;discoloration

VAERS ID:123539 (history)  Vaccinated:1996-07-22
Age:4.0  Onset:1998-06-18, Days after vaccination: 696
Gender:Male  Submitted:1999-05-14, Days after onset: 330
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: unk
Diagnostic Lab Data: lab test varicella abs: seronegative;
CDC Split Type: WAES98061570
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0252D0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt devel pox;pt had multiple lesions on face, trunk & extremities;pt required a visit to MD office;it was also reported that vaccine failed;

VAERS ID:171404 (history)  Vaccinated:1996-07-22
Age:10.0  Onset:2001-06-03, Days after vaccination: 1777
Gender:Male  Submitted:2001-06-05, Days after onset: 2
Location:California  Entered:2001-06-14, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD / Connaught
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESGG710164IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0742F4PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0250D0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Erythema, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt experienced Varicella vaccine failure. Was vaccinated in 1996 and was seen in the office with approx 30 spots, red based, fluid filled first appearing on 6/3/01.

VAERS ID:90190 (history)  Vaccinated:1996-07-22
Age:22.8  Onset:1996-07-22, Days after vaccination: 0
Gender:Female  Submitted:1996-08-13, Days after onset: 22
Location:Foreign  Entered:1996-09-25, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Mefloquine;Gamma Globulin by Armour lot# L5708 given 19JUL96;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA447A60IMA
Administered by: Other     Purchased by: Public
Symptoms: Face oedema, Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 6PM & 12noon noticed blotches on body;next morning had hives all over body & by mid morning rt side of lip swelled;DPH given orally every 4hr condition remained same for 2 days then gradually resolved;no breathing problems;

VAERS ID:318413 (history)  Vaccinated:1996-07-22
Age:34.0  Onset:1996-11-01, Days after vaccination: 102
Gender:Female  Submitted:2008-07-07, Days after onset: 4265
Location:Foreign  Entered:2008-07-07
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: The subject had no relevant medical history.
Diagnostic Lab Data: anticardiolipin antibodies, 2000, negative; MRI brain, 2000, see text. In 2000: -Brain MRI: several white matter demyelinating plaques. -Serologies (NOS): Negative
CDC Split Type: B0527924A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Cardiolipin antibody negative, Central nervous system lesion, Demyelination, Extrapyramidal disorder, Motor dysfunction, Multiple sclerosis, Neck pain, Nervous system disorder, Nuclear magnetic resonance imaging brain abnormal, Paraparesis, Serology negative, Urinary tract disorder
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Optic nerve disorders (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad)
Write-up: This case was reported by a foreign regulatory authority (PO20080281) and described the occurrence of multiple sclerosis in a 34-year-old female subject who was vaccinated with ENGERIX B adult (GlaxoSmithKline). The subject belongs to an association under reference 2323. The subject had no relevant familial or personal medical history. On 19 June 1996, the subject received the first injection of ENGERIX B adult (intramuscular, unknown batch reference). On 22 July 1996 the subject received 2nd dose of ENGERIX B adult (20 mcg, intramuscular, unknown batch reference). In November 1996, 4 months after the second dose of ENGERIX B adult, the subject experienced cervicalgia. Then, in unspecified date, she developed distal disorder of upper limbs (coded as neurological disorder), lower limbs motor difficulties and urinary disorder. On 28 May 1997, she received the third dose of ENGERIX B adult (intramuscular, unknown batch reference). In March 2000, she visited a physician for paraparesis and lower limbs extrapyramidal syndrome. Brain MRI evidenced several white matter demyelinating lesions. Serologies (NOS) were negative and anti-cardiolipine antibody was negative. The subject was treated with SOLUMEDROL, 500 mg, during 5 days without any improvement. According to the neurologist, a possible progressive multiple sclerosis was evoked. At the time of reporting, multiple sclerosis was unresolved. At the time of reporting, multiple sclerosis was unresolved. The outcome of the other events was unknown. The regulatory authority reported that the events were disabling. The authority reported that multiple sclerosis was dubiously related to ENGERIX B adult vaccine.

VAERS ID:490759 (history)  Vaccinated:1996-07-22
Age:28.0  Onset:0000-00-00
Gender:Female  Submitted:2013-05-03
Location:Foreign  Entered:2013-05-03
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Attempted suicide; Depressive episode; Malt lymphoma
Preexisting Conditions: Cervical conisation; Uterine cervix dysplasia
Diagnostic Lab Data: Biopsy muscle, 11Jan2010, See text; 11 January 2010: Right deltoid muscular biopsy: Tissues frozen, embedded in paraffin with histochemistry staining (hematein eosine, Masson Trichrome, oxidative reaction to NADHTR, mitochondria cox reaction PAS and black Sudan) and immunoperoxidase staining to analyse tissular expression of human major histocompatibility complex of class 1 (Hm-ABC), class 11 (Hm-DR), membrane attack complex (C5b-9 complement) and leukocytes antigen CD3, CD4, CD8, CD20, CD56/NCAM, CD68 et CD138. The muscle had histological architecture within normal limits. Perimysial inflammatory lesions were identified with cohesive macrophages with large cytoplasm evoking macrophagic myofascitis lesions. There was no myocytic anomaly, no
CDC Split Type: B0887102A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 1SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Arthralgia, Asthenia, Back pain, Biopsy muscle abnormal, Fatigue, Headache, Myalgia, Myofascitis, Pain in extremity, Paraesthesia, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: This case was reported by the foreign regulatory authority (reference PC20130236) and described the occurrence of macrophagic myofasciitis in a 29-year-old female subject who was vaccinated with ENGERIX B (GlaxoSmithKline). This case was taken within the framework of data collecting in neuromuscular diseases unit. The subject''s medical history included uterine cervix dysplasia treated by conisation in 1992. Desensitization was reported (date not specified). Co-suspect vaccination included DT POLIO MERIEUX (non-gsk). On 15 May 1996 and 21 June 1996, the subject received 1st dose and 2nd dose (batch number M5390) of DT POLIO MERIEUX. On 24 June 1996 and 22 July 1996, the subject received 1st dose and 2nd dose of ENGERIX B (batch, route injection site unknown). On 29 July 1996, the subject received 3rd dose (batch number M5380) and 4th dose of DT POLIO MERIEUX (batch number M62831). (Route and site were unknown). In 1996, a few months after the vaccination with ENGERIX B, the subject presented with unusual asthenia and then pain in four limbs, sensation of weakness, headaches and paresthesia in extremities. On 04 February 1997, the subject received 3rd dose of ENGERIX B (batch, route injection site unknown) (drug dose interval too long). In 1998, due to progressive worsening of the events, the subject had to stop working. In 2008, the subject developed lymphoma of MALT type (incidental event). On 11 January 2010, right deltoid muscular biopsy evidenced macrophagic myofascitis. In 2011, the subject experienced major depressive episode with suicide attempt (incidental events). In 2012, the subject was seen in consultation: fatigue of fluctuating intensity was persistent associated with periods of exhaustion. Four limbs pain characterized by myalgia and arthralgia, and lumbar rachis pain were associated with headache. Pains were present on waking-up and worsened with exertion. Upon physical examination, four painful tender points were identified, muscle pain was within normal limits and deep tendon reflexes were present and symmetrical without long nerves impairment. The regulatory authority reported that the events were disabling. At the time of reporting, macrophagic myofasciitis was unresolved. According to the regulatory authority, based on the foreign method of assessment, macrophagic myofasciitis was dubiously related to ENGERIX B and/or DT POLIO MERIEUX.

VAERS ID:88189 (history)  Vaccinated:1996-07-23
Age:30.3  Onset:1996-07-24, Days after vaccination: 1
Gender:Male  Submitted:1996-07-24, Days after onset: 0
Location:North Carolina  Entered:1996-07-29, 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
Current Illness: NONE
Preexisting Conditions: epidermolysis bullosa simplex
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Chills, Diarrhoea, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: severe joint aching, skin irritation, sl temp, chills, diarrhea

VAERS ID:88211 (history)  Vaccinated:1996-07-23
Age:58.1  Onset:1996-07-24, Days after vaccination: 1
Gender:Female  Submitted:1996-07-25, Days after onset: 1
Location:Florida  Entered:1996-07-29, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergic PCN, iodine, merculiydin
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H71005  LA
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity, Malaise, Oedema, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: allergic rxn-red, raised, hot;5cm in diameter, fever, gen malaise;advised APAP ES DPH for comfort;

VAERS ID:88237 (history)  Vaccinated:1996-07-23
Age:14.2  Onset:1996-07-23, Days after vaccination: 0
Gender:Female  Submitted:1996-07-23, Days after onset: 0
Location:Florida  Entered:1996-07-30, 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: Ceclor
Diagnostic Lab Data: pt in for physical, immun up date
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2072A2 IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0320D1SCRL
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES6E841148 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: pt devel wheal @ site of MMR inj, 2 1/2mm long x 1 1/2mm wide;ice applied to site;

VAERS ID:88240 (history)  Vaccinated:1996-07-23
Age:1.2  Onset:1996-07-23, Days after vaccination: 0
Gender:Male  Submitted:1996-07-24, Days after onset: 1
Location:California  Entered:1996-07-30, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4348090IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1622B0IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.L02290SCRL
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Crying, Screaming
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)
Write-up: high pitched cry for 6hr, irritable;

VAERS ID:88259 (history)  Vaccinated:1996-07-23
Age:16.5  Onset:1996-07-25, Days after vaccination: 2
Gender:Female  Submitted:1996-07-27, Days after onset: 2
Location:New York  Entered:1996-07-30, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5C71115 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site pain, Rash, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax & devel blanching, erythema, tenderness @ deltoid inj site;no fever, no induration;otherwise well;onset w/in 24hrs of inj;

VAERS ID:88451 (history)  Vaccinated:1996-07-23
Age:0.1  Onset:1996-07-23, Days after vaccination: 0
Gender:Female  Submitted:1996-07-26, Days after onset: 3
Location:California  Entered:1996-08-05, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4367920IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1404B1IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0742F0PO 
Administered by: Private     Purchased by: Private
Symptoms: Pallor, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: pt exp loss of color w/dec responsiveness to environmental stimuli which occurred approx 5hr p/vax;pt was taken by amb to ER where was noted to have nl VS, but d/t poor color & responsiveness was observed overnoc in hosp

VAERS ID:88475 (history)  Vaccinated:1996-07-23
Age:8.5  Onset:1996-07-23, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1996-08-05
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: physical exam sheet
Diagnostic Lab Data: unk
CDC Split Type: FL96052
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1408B0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Hypertonia, Mydriasis, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)
Write-up: it was observed in rigid physical state;pupils were dilated & fixed;it was unresponsive to verbal stimuli approx 60 sec;pt was positioned is a supine position, called & physical stimuli introduced;

VAERS ID:88694 (history)  Vaccinated:1996-07-23
Age:0.7  Onset:1996-07-23, Days after vaccination: 0
Gender:Unknown  Submitted:1996-08-02, Days after onset: 10
Location:Kentucky  Entered:1996-08-06, 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: Trimoxaccillan, Child Advil, Child APAP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER 2  
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER 2  
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Cough, Dysphagia, Dyspnoea, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: t102 x 2 days, airway problem thick coating from nose, coughing spasms;hard time eating, drinking, breathing;

VAERS ID:88721 (history)  Vaccinated:1996-07-23
Age:7.4  Onset:1996-07-23, Days after vaccination: 0
Gender:Female  Submitted:1996-07-29, Days after onset: 6
Location:Florida  Entered:1996-08-06, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6806
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0270D0IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1314B1SC 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4326672PO 
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5D710143IM 
Administered by: Private     Purchased by: Private
Symptoms: Malaise, Pallor, Somnolence, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: listless, lethargic, hypoconscious, pale 10 p/inj;no resp distress, pt assessed;v/s started w/in 30min pt alert w/no sx;

VAERS ID:88727 (history)  Vaccinated:1996-07-23
Age:14.7  Onset:1996-07-23, Days after vaccination: 0
Gender:Female  Submitted:1996-07-29, Days after onset: 6
Location:Florida  Entered:1996-08-07, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: PPD by Connaught given 23JUL96;
Current Illness: NONE
Preexisting Conditions: sulfa
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5D710143IM 
Administered by: Private     Purchased by: Private
Symptoms: Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: pt felt fain & pale p/vax;blood work;VS assessed by MD stat 225PM; 235PM asymptomatic;

VAERS ID:88835 (history)  Vaccinated:1996-07-23
Age:0.2  Onset:1996-07-23, Days after vaccination: 0
Gender:Male  Submitted:1996-08-02, Days after onset: 10
Location:Wyoming  Entered:1996-08-08, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WY969
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4333640IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4326680PO 
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Anorexia, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: elevated temp, irritable dec in intake;spitting up

VAERS ID:88907 (history)  Vaccinated:1996-07-23
Age:1.2  Onset:1996-08-01, Days after vaccination: 9
Gender:Male  Submitted:1996-08-04, Days after onset: 3
Location:California  Entered:1996-08-12, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC; physical exam;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1422B0SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0730A0PO 
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Rash maculo-papular, Rhinitis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 23JUL96 & 1AUG96 pt devel fever & coryza & on 1AUG96 devel florid moribilliform rash which cont to spread;4 days now of illness w/fever to 104.8 R;

VAERS ID:88909 (history)  Vaccinated:1996-07-23
Age:62.3  Onset:1996-07-25, Days after vaccination: 2
Gender:Female  Submitted:1996-08-02, Days after onset: 8
Location:Delaware  Entered:1996-08-12, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: premarin;caltrate D
Current Illness: NONE
Preexisting Conditions: sulfa drugs;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES5L71072 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: localized swelling, redness & pain in lt deltoid, fever, malaise;tx Cefadroxil, ice, DPH, Ibuprofen;

VAERS ID:88914 (history)  Vaccinated:1996-07-23
Age:1.0  Onset:1996-07-23, Days after vaccination: 0
Gender:Male  Submitted:1996-07-30, Days after onset: 7
Location:Missouri  Entered:1996-08-12, Days after submission: 13
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: NKA & no past medical problems
Diagnostic Lab Data: No tests
CDC Split Type: MO96048
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1198B2IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0874B0SCLA
Administered by: Public     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt devel hives on face, arms, & legs approx 2hr p/vax;mom took pt to MD who prescribed DPH;hives gone by 24JUL96;pt father has allergy to eggs;MD suggests pt see an allergist a/receiving the 2nd MMR;

VAERS ID:88916 (history)  Vaccinated:1996-07-23
Age:46.2  Onset:1996-08-02, Days after vaccination: 10
Gender:Male  Submitted:1996-08-06, Days after onset: 4
Location:Texas  Entered:1996-08-12, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: PPD tuberculin skin test given 23JUL96; Papaverine HCL
Current Illness: NONE
Preexisting Conditions: allergic to PCN; 1961 abd hernia, 1985 rt & lt ing hernia, impotence, anxiety, seasonal allergies;
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1383B0IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0110D0SCLA
Administered by: Public     Purchased by: Other
Symptoms: Pain, Purpura, Rash, Thrombocytopenia
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: thrombocytopenia purpura? (large multiple wine spot rashes bilat thighs, legs, 6") was given steroid by mouth, no blood work done, c/o tenderness only;only noticed patches Friday PM 2AUG96, went to MD;

VAERS ID:88918 (history)  Vaccinated:1996-07-23
Age:45.8  Onset:0000-00-00
Gender:Female  Submitted:1996-07-30
Location:Illinois  Entered:1996-08-12, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin;TB skin test by Connaught lot# 242211 given 23JUL96;
Current Illness: NONE
Preexisting Conditions: allergic to PCN
Diagnostic Lab Data:
CDC Split Type: IL960077
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L710954 LA
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Face oedema, Laryngospasm, Oedema peripheral, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 23JUL96 11AM mild local raised welt over TB skin test;t100, achy joints, puffiness around eyes & both hands;later in day mouth & throat felt thick;24JUL96 saw MD, rx DPH, APAP & fluids;25JUL96 sting like sunburn to touch (hot & sore);

VAERS ID:88920 (history)  Vaccinated:1996-07-23
Age:0.2  Onset:1996-07-23, Days after vaccination: 0
Gender:Male  Submitted:1996-08-02, Days after onset: 10
Location:Oregon  Entered:1996-08-12, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: acetaminophen;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4348140IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1190B1IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES741E0PO 
Administered by: Private     Purchased by: Public
Symptoms: Hypotonia, Pallor, Pyrexia, Somnolence
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: mom described pt as being limp & pale & sleeping alot over 48hr p/vax;on direct questioning pt was responsive & cont to feed during the same period;highest temp reported by mom during above was 100.3a;

VAERS ID:88954 (history)  Vaccinated:1996-07-23
Age:0.0  Onset:1996-07-27, Days after vaccination: 4
Gender:Male  Submitted:1996-08-09, Days after onset: 13
Location:Missouri  Entered:1996-08-14, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
    Extended hospital stay? Yes
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI, CT Scan, Sepsis, multiple cult-all WNL-liver enzyme elevated treated w/phenobarb, adavan, dilantin meds
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2076A20 RL
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Hepatic function abnormal, Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: t102, developed sz;

VAERS ID:88969 (history)  Vaccinated:1996-07-23
Age:25.1  Onset:1996-07-23, Days after vaccination: 0
Gender:Male  Submitted:1996-07-31, Days after onset: 8
Location:Ohio  Entered:1996-08-14, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mautoux by Connaught lot# 242511 given 23JUL96;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1905A20IMRA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4332555IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Dizziness, Headache, Hypertonia, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 25JUL student reported started fever of 102, h/a, dizziness, itchy & stiffness of joints (knees & back & shoulders) from 23JUL-25JUL;temp was 97.6 25JUL 230PM;

VAERS ID:88996 (history)  Vaccinated:1996-07-23
Age:1.3  Onset:1996-07-23, Days after vaccination: 0
Gender:Female  Submitted:1996-07-24, Days after onset: 1
Location:Washington  Entered:1996-08-14, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: APAP elixir 1tsp
Current Illness: NONE
Preexisting Conditions: lactose intolerance
Diagnostic Lab Data:
CDC Split Type: WA961261
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5M610853IMLA
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM230NA3IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0099D0SCRA
Administered by: Private     Purchased by: Public
Symptoms: Cyanosis, Malaise, Pallor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: slept for 2hr p/vax (usual nap time) awoke w/repetitive vomiting, pale, listless, almost bluish lips @ one point;vomited on & off x 2hr;BP nl @ MD office;perked up & regained nl activity by 3-4hr later;

VAERS ID:89005 (history)  Vaccinated:1996-07-23
Age:1.3  Onset:1996-07-27, Days after vaccination: 4
Gender:Male  Submitted:1996-08-01, Days after onset: 5
Location:Iowa  Entered:1996-08-15, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: IA96024
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5K61015 IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM015LL IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1422B0SCLL
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Erythema multiforme, Infection, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax 23JUL96 & mom noticed a rash;the next day rash spread all over;pt seen in ER;mom told it was erythema multiforme or granuloma-a minor virus;t104 R, & cranky;dx erythema multiforme confirmed;

VAERS ID:89020 (history)  Vaccinated:1996-07-23
Age:12.2  Onset:1996-07-25, Days after vaccination: 2
Gender:Male  Submitted:1996-07-29, Days after onset: 4
Location:Texas  Entered:1996-08-15, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NA
CDC Split Type: TX96109
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1744A21IMRA
Administered by: Public     Purchased by: Other
Symptoms: Dermatitis bullous, Face oedema, Pruritus, Rash, Urticaria
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: mom called on 25JUL96 child had swollen lisp, rash on chest & itchy;mom stated gave pt DPH & was sleeping;instructed to take pt to pvt MD;seen by MD stated pt had hives & blisters, med given;

VAERS ID:89260 (history)  Vaccinated:1996-07-23
Age:4.5  Onset:1996-07-29, Days after vaccination: 6
Gender:Male  Submitted:1996-07-30, Days after onset: 1
Location:Florida  Entered:1996-08-22, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NKA
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.14086   
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0737H PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: red papular rash on trunk & extremities;

VAERS ID:89291 (history)  Vaccinated:1996-07-23
Age:1.5  Onset:1996-07-27, Days after vaccination: 4
Gender:Female  Submitted:1996-08-22, Days after onset: 26
Location:Texas  Entered:1996-08-26, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: G-CSF
Current Illness:
Preexisting Conditions: neutropenia, congenital
Diagnostic Lab Data: No relevant data;27Sep96 f/u-abn blood tests,throat cult-adenovirus-see text
CDC Split Type: WAES96081094
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Condition aggravated, Infection, Laboratory test abnormal, Leukopenia, Pharyngitis, Pyrexia, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: pt recv vax & 7 to 10 days post vax pt devel pharyngitis & neutropenia & was hosp;tx w/IV ATB & did well;@ time of report pt had been d/c from hosp;

VAERS ID:89545 (history)  Vaccinated:1996-07-23
Age:33.5  Onset:1996-07-24, Days after vaccination: 1
Gender:Female  Submitted:1996-08-26, Days after onset: 33
Location:Minnesota  Entered:1996-09-03, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Clartin;steroid nasal inhaler
Current Illness:
Preexisting Conditions: APAP/codeine
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES433355 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site mass, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: moderately severe local rxn/moderation @ DT vax site;

VAERS ID:89939 (history)  Vaccinated:1996-07-23
Age:25.7  Onset:1996-09-04, Days after vaccination: 43
Gender:Female  Submitted:1996-09-10, Days after onset: 6
Location:Nevada  Entered:1996-09-16, 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: arthritis
Diagnostic Lab Data: NONE
CDC Split Type: NV96017
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1318B  LA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Arthritis, Condition aggravated, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Systemic lupus erythematosus (broad), Eosinophilic pneumonia (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad)
Write-up: 4SEP rt hand (middle finger throbbing) mild pain;5SEP soreness, calves & thigh joint;achiness & piercing pain throughout legs;hx tick bite-1yr ago w/subsequent arthritis sx;

VAERS ID:89988 (history)  Vaccinated:1996-07-23
Age:36.2  Onset:1996-07-25, Days after vaccination: 2
Gender:Female  Submitted:1996-09-10, Days after onset: 47
Location:Wisconsin  Entered:1996-09-17, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE-HTN-methodopa
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2072A IMA
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: devel rash around mouth 48hr p/vax;

VAERS ID:89999 (history)  Vaccinated:1996-07-23
Age:54.5  Onset:1996-08-19, Days after vaccination: 27
Gender:Female  Submitted:1996-09-10, Days after onset: 22
Location:Illinois  Entered:1996-09-18, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: spinal tap
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES6A71001  RA
Administered by: Public     Purchased by: Private
Symptoms: Hypokinesia, Myasthenic syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: (LE) weakness, rt leg needs AFO, lt leg sl numb, rt leg dec mobility, lt hand tingling, rt arm tingling, rt hand dec mobility, numbness abd (mid);

VAERS ID:90056 (history)  Vaccinated:1996-07-23
Age:0.1  Onset:1996-07-23, Days after vaccination: 0
Gender:Male  Submitted:1996-07-23, Days after onset: 0
Location:California  Entered:1996-09-19, Days after submission: 58
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: CA960074
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES07838400IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0165D0IMRL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES07838400IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0741B0PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)
Write-up: pt recv vax & started crying @ 12:#0, mom gave pt APAP -advised mom to come to see MD-tx motrin;

VAERS ID:90131 (history)  Vaccinated:1996-07-23
Age:0.2  Onset:1996-07-23, Days after vaccination: 0
Gender:Female  Submitted:1996-07-25, Days after onset: 2
Location:Ohio  Entered:1996-09-24, Days after submission: 61
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp screaming & throwing head from side to side, whining/fussiness @ 2.5mo;
Other Medications: Caffeine, 0.95cc, 1xday
Current Illness: NA
Preexisting Conditions: prematurity (born @ 31wk)
Diagnostic Lab Data:
CDC Split Type: OH96128
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES07760400IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0896B0IMLA
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES07760400IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0735F0PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Crying, Movement disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)
Write-up: pt recv vax 5PM & @1015PM pt started screaming & throwing head from side to side;took to ER;BY 11PM pt had calmed;some whining/fussiness for next 1/2hr to hr;ER watched pt, no medication given;

VAERS ID:90209 (history)  Vaccinated:1996-07-23
Age:0.3  Onset:1996-07-23, Days after vaccination: 0
Gender:Male  Submitted:1996-07-26, Days after onset: 3
Location:Washington  Entered:1996-09-25, Days after submission: 61
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: WA961268
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4348091IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0736K1PO 
Administered by: Private     Purchased by: Private
Symptoms: Chills, Cyanosis, Dyspnoea, Hypotonia, Hypoventilation, Pallor, Stupor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (narrow), Hypoglycaemia (broad)
Write-up: 1045AM found flat on back w/arms & legs extended;pale, cold (ax temp @ 11:30 95) flaccid, no movement, face was ashen, resp shallow;pt picked up & rubbed arms & legs, shouted @ pt p/eyes open cool cloth placed on face;gasped for air;

VAERS ID:90521 (history)  Vaccinated:1996-07-23
Age:9.9  Onset:1996-07-24, Days after vaccination: 1
Gender:Male  Submitted:1996-09-30, Days after onset: 68
Location:Michigan  Entered:1996-10-07, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: MI96141
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0280D0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 24hr p/vax pt devel rash;started on chest back spread to legs & arms & tops of feet;itchy;pink-red color;fine pinpoint;lasted 1-2wk;

VAERS ID:91002 (history)  Vaccinated:1996-07-23
Age:4.6  Onset:1996-08-07, Days after vaccination: 15
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1996-10-18
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: WAES96080876
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0252D0SC 
Administered by: Private     Purchased by: Private
Symptoms: Erythema multiforme, Pruritus, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 23JUL96 & on 7AUG96 pt devel erythema multiforme " minor rash" all over the trunk, the rash was not very itchy.

VAERS ID:91136 (history)  Vaccinated:1996-07-23
Age:1.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1996-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96080525
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Pyrexia, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 23JUL96 & devel a little rash on abd which looked like little red papules;It was also reported that 2 to 3 of the papules looked like they were turning into vesicles;low-grade fever;

VAERS ID:91360 (history)  Vaccinated:1996-07-23
Age:4.0  Onset:1996-07-23, Days after vaccination: 0
Gender:Male  Submitted:1996-08-01, Days after onset: 9
Location:Indiana  Entered:1996-10-28, Days after submission: 88
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Chromslia & albuterol inhalers;Pred
Current Illness:
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5J611011IMLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: temp elevation of 104.5 some evening as shot;given APAP & cool bath;leg red & swollen @ site;temp dec over next 2 days;

VAERS ID:93472 (history)  Vaccinated:1996-07-23
Age:22.0  Onset:1996-08-02, Days after vaccination: 10
Gender:Male  Submitted:1996-08-15, Days after onset: 13
Location:New Jersey  Entered:1996-10-30, Days after submission: 76
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: 960117571
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Public     Purchased by: Other
Symptoms: Amblyopia, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad)
Write-up: pt recv vax 23JUL96 & 10 days post vax pt exp blurry vision which lasted 1hr & then resolved;sx was followed by a severe h/a & nausea;

VAERS ID:93497 (history)  Vaccinated:1996-07-23
Age:17.0  Onset:1996-07-23, Days after vaccination: 0
Gender:Male  Submitted:1996-08-28, Days after onset: 36
Location:Massachusetts  Entered:1996-10-30, Days after submission: 63
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: 960125431
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2076A20IMLA
Administered by: Private     Purchased by: Other
Symptoms: Oedema, Pruritus, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax & 30min post vax pt broke out in hives, itchy & had some swelling;ER or MD visit was required;tx DPH;swelling dec 3hr later but pt was itchy for about 24hr;

VAERS ID:92364 (history)  Vaccinated:1996-07-23
Age:0.4  Onset:1996-07-23, Days after vaccination: 0
Gender:Female  Submitted:1996-07-24, Days after onset: 1
Location:Alaska  Entered:1996-11-25, Days after submission: 124
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: pre maturity
Diagnostic Lab Data: NONE
CDC Split Type: AK9617
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4348070IML
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0338B IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0736B   
Administered by: Military     Purchased by: Military
Symptoms: Agitation, Crying, Diarrhoea, Injection site hypersensitivity, Injection site oedema, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax 10AM & immed onset of high pitched cont scream last 1 1/2hr, swelling & erythema, projectile vomiting x 20hr;fever 101.2 R;green diarrhea;entire leg massively swollen;

VAERS ID:96074 (history)  Vaccinated:1996-07-23
Age:50.0  Onset:1996-07-25, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96072290
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0175D0SC 
Administered by: Other     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 23JUL96 & 25JUL96 pt exp tenderness & soreness @ inj site, w/a small knot & pink area @ the inj site;

VAERS ID:101413 (history)  Vaccinated:1996-07-23
Age:  Onset:1996-07-24, Days after vaccination: 1
Gender:Female  Submitted:1997-05-20, Days after onset: 300
Location:Georgia  Entered:1997-07-22, Days after submission: 63
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: CO6720
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hyperhidrosis, Injection site hypersensitivity, Injection site oedema, Injection site pain, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt reported swelling, soreness, redness @ site;pt exp fever, diaphoretic & felt sick;pt recv vax while away;

VAERS ID:104007 (history)  Vaccinated:1996-07-23
Age:7.4  Onset:1997-10-23, Days after vaccination: 457
Gender:Female  Submitted:1997-10-24, Days after onset: 1
Location:Maryland  Entered:1997-10-28, 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:
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.0252D0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Infection, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 24OCT97 devel rash p/exposure to chickenpox;rash typical of chickenpox;had recv vax 23JUL96;

VAERS ID:108819 (history)  Vaccinated:1996-07-23
Age:10.8  Onset:1998-03-09, Days after vaccination: 594
Gender:Male  Submitted:1998-03-13, Days after onset: 4
Location:Florida  Entered:1998-03-20, Days after submission: 7
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: well check up
Preexisting Conditions: PCN allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1654B0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Rhinitis
SMQs:, Lack of efficacy/effect (narrow)
Write-up: nares congested, varicella on face, trunk & extremities;

VAERS ID:110333 (history)  Vaccinated:1996-07-23
Age:1.1  Onset:1998-03-03, Days after vaccination: 588
Gender:Male  Submitted:1998-04-15, Days after onset: 42
Location:Florida  Entered:1998-04-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98030608
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0250D0  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 23JUL96 & 3MAR98 pt devel full blown, breakthrough varicella w/more than 60 disseminated lesions;pt was febrile;

VAERS ID:117508 (history)  Vaccinated:1996-07-23
Age:  Onset:1998-12-14, Days after vaccination: 874
Gender:Unknown  Submitted:0000-00-00
Location:Pennsylvania  Entered:1998-12-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: Microcephaly
Diagnostic Lab Data: UNK
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0563D0  
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt recv vax on 7/23/96; on 12/14/98 pt exp chicken pox

VAERS ID:117834 (history)  Vaccinated:1996-07-23
Age:4.1  Onset:1998-12-19, Days after vaccination: 879
Gender:Male  Submitted:1998-12-21, Days after onset: 2
Location:Nebraska  Entered:1998-12-30, 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:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Private     Purchased by: Unknown
Symptoms: Dermatitis bullous, Infection, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt has 10-20 erythematous macular papular lesion on back & buttocks, w/scabs, & 1 appears vesicular-felt to be chickenpox-lesions p/2-3days;

VAERS ID:150319 (history)  Vaccinated:1996-07-23
Age:1.0  Onset:2000-02-28, Days after vaccination: 1315
Gender:Female  Submitted:2000-03-13, Days after onset: 14
Location:Florida  Entered:2000-03-23, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt was given a PPD skin test, Lot #242111, on the same day.
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0096D SCLA
Administered by: Private     Purchased by: Private
Symptoms: Skin ulcer
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt developed multiple lesions on body.

VAERS ID:154735 (history)  Vaccinated:1996-07-23
Age:1.0  Onset:1999-12-09, Days after vaccination: 1234
Gender:Female  Submitted:2000-05-18, Days after onset: 160
Location:Virginia  Entered:2000-06-19, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00010054
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Approximately 3.5 years post vax pt developed chickenpox. Follow-up information reported that the pt recovered on 12/16/1999. No further information is available.

VAERS ID:157023 (history)  Vaccinated:1996-07-23
Age:2.1  Onset:1999-05-20, Days after vaccination: 1031
Gender:Male  Submitted:2000-05-16, Days after onset: 362
Location:Washington  Entered:2000-07-17, Days after submission: 62
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:
CDC Split Type: WAES99051314
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0653H0SC 
Administered by: Public     Purchased by: Public
Symptoms: Blister, Drug ineffective, Infection, Skin ulcer
SMQs:, Severe cutaneous adverse reactions (broad), Lack of efficacy/effect (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The patient was exposed to his older brother who experienced wild type varicella. On approximately May 20, 1999 the patient developed a mild course of chickenpox. The MD noted that the lesions were smaller and fewer were fluid filled than the older brother''s. The pt did not require treatment.

VAERS ID:265326 (history)  Vaccinated:1996-07-23
Age:4.0  Onset:0000-00-00
Gender:Male  Submitted:2006-10-25
Location:Unknown  Entered:2006-10-25
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: Subject''s mother received Macrondantin during the course of pregnancy; the subject was the product of a 40 and 3/7 weeks gestation and was born to a 40 year old female; presentation was breech and the subject was delivered by cesarean section. Birth weight six pounds nine ounces: birth height 19.5 inches. On 18 April 1993, the subject was taken to the emergency room after awakeni
Diagnostic Lab Data:
CDC Split Type: A0624776A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2072A22IMRA
Administered by: Other     Purchased by: Other
Symptoms: Abnormal behaviour, Asthma, Autism, Clumsiness, Cough, Crying, Mental retardation severity unspecified, Nervous system disorder, Pain, Pyrexia, Speech disorder, Staring
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), 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), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case was reported by a lawyer and described the occurrence of neurological damage in a male subject who was vaccinated with Hep B vaccine (Engerix B) and or unidentified Hep B vaccine for prophylaxis. On an unspecified date the subject received unspecified dose of hepatitis B vaccine. According to the legal complaint, at an unspecified time after vaccination with hepatitis B vaccine, the subject experienced neurological damage which were attributed to cumulative mercury toxicity. The following information was received via medical records: the subject received Hep B vaccination on 5/30/1995, 6/29/1995 and 7/23/1995. All vaccinations were identified in the vaccine record as manufactured by the manufacturer, however, the 7/23/1996 Hep B reflected a different manufacturer lot number and was therefore identified as Engerix B. At approx one year of age, the subject was crawling, and taking a few steps, and was speaking some identifiable words. Between birth and approx four years of age, the subject experienced recurrent fevers and chronic coughing. In Dec 1994, at 30 months of age and prior to Engerix B vaccination, the subject underwent speech and language testing and was determined to have expressive and receptive language skills at the 18 to 23 month level. A progress note dated 10/12/1998 noted that over past 3 to 4 months at night screams with severe leg pain. Between 12/98 and 1/99 the subject continued to experience fevers and coughing, and in Sept 1999 was diagnosed with probable asthma. He underwent re evaluation between 2/10/99 and 5/11/99. Evaluation revealed that the subject was communication at a higher lever overall, and was noted to maintain eye contact and to show improved memory. Between 9/99 and 12/99, the subject continued to exhibit marked phonological awareness skills. Between 6/00 and 7/00 the subject continued to show improvement without meeting all language objectives. During this third grade year, he experienced academic difficulties that were not considered to be fully explained by his ha

VAERS ID:281876 (history)  Vaccinated:1996-07-23
Age:1.0  Onset:2006-12-26, Days after vaccination: 3808
Gender:Female  Submitted:2007-05-16, Days after onset: 140
Location:Georgia  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:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0701USA01954
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure to communicable disease, Varicella
SMQs:
Write-up: Information has been received from a physician concerning an 11-year-old female with no pertinent medical history who on 23-JUL-1996 was vaccinated with her first dose of Varivax. There was no concomitant medication. On 12-DEC-2006, it was noted that the patient''s mother had shingles and it was unknown if the mother had been vaccinated with Varivax. On 26-DEC-2006, 14 days after the mother had shingles, the patient experienced "breakthrough," with an unspecified number of lesions. Unspecified medical attention was sought. The patient was "fine" at the time of this report. No additional information was available. There was no product quality complaint involved. Additional information has been requested.

VAERS ID:88245 (history)  Vaccinated:1996-07-24
Age:5.0  Onset:1996-07-24, Days after vaccination: 0
Gender:Female  Submitted:1996-07-25, Days after onset: 1
Location:North Carolina  Entered:1996-07-30, Days after submission: 5
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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES4326353IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0313D1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0741A3PO 
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: fever began on 24JUL96 PM rose to 104.9;also began vomiting;ER was called by mom & was told to give APAP & tepid bath;

VAERS ID:88438 (history)  Vaccinated:1996-07-24
Age:11.3  Onset:1996-07-24, Days after vaccination: 0
Gender:Male  Submitted:1996-07-25, Days after onset: 1
Location:Minnesota  Entered:1996-08-02, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: end of MARCH
Diagnostic Lab Data:
CDC Split Type: MN96033
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6A810155 LA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Arthralgia, Pyrexia, Somnolence, Vasodilatation, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax 5PM lt deltoid -930PM c/o stomachache/joints hurting/felt warm;1030PM APAP given;4AM threw up;feverish-lethargic today;

VAERS ID:88468 (history)  Vaccinated:1996-07-24
Age:22.8  Onset:1996-07-24, Days after vaccination: 0
Gender:Female  Submitted:1996-07-24, Days after onset: 0
Location:Mississippi  Entered:1996-08-05, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0110D1SCRL
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES430978 IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site hypersensitivity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: w/in 5min of inj pt began to devel urticaric wheals @ inj site;this spread to a 20mm x 20mm area;there was no c/o itching & no resp distress;25 mins p/inj wheals had cleared sl erythemic area remained;

VAERS ID:88470 (history)  Vaccinated:1996-07-24
Age:0.0  Onset:1996-07-25, Days after vaccination: 1
Gender:Female  Submitted:1996-07-25, Days after onset: 0
Location:Mississippi  Entered:1996-08-05, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to PCN, ceclor
Diagnostic Lab Data:
CDC Split Type: MS96027
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5M610854IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0110D1 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4342083PO 
Administered by: Public     Purchased by: Other
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: mom called clinic stated pt was fine last noc but this morning pt is running low grade temp w/rash from ankles to head;instruct mom to see PMD ASAP called later pt better, rash diminishing, did not see PMD;

VAERS ID:88472 (history)  Vaccinated:1996-07-24
Age:13.1  Onset:1996-07-24, Days after vaccination: 0
Gender:Female  Submitted:1996-07-24, Days after onset: 0
Location:Florida  Entered:1996-08-05, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: hemoglobulin 13.1
CDC Split Type: FL96053
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0017D IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1165B SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5C71114 IMRA
Administered by: Public     Purchased by: Other
Symptoms: Agitation, Cyanosis, Hypotonia, Pallor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: pt recv 1st vax & appeared apprehensive; nurse stopped & allowed pt to rest;pt stated was fine;last shot given pt allowed to sit & rest another 5min;11:20 nurse noticed pt w/cyanotic lips & pale in color, very limp but alert;

VAERS ID:88741 (history)  Vaccinated:1996-07-24
Age:1.1  Onset:1996-07-27, Days after vaccination: 3
Gender:Male  Submitted:1996-08-02, Days after onset: 6
Location:New York  Entered:1996-08-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0107D0SCRL
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Anorexia, Cough, Diarrhoea, Pyrexia, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: fever (?Tmax) beginning 3 days p/vax fluctuating assoc w/irritability & dec appetite;devel blotchy, pink, macular exanthem behind ears;mild cough & diarrhea;

VAERS ID:88744 (history)  Vaccinated:1996-07-24
Age:1.2  Onset:1996-07-24, Days after vaccination: 0
Gender:Male  Submitted:1996-07-29, Days after onset: 5
Location:Illinois  Entered:1996-08-07, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: IL960073
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4299661 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0732F1PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Anorexia, Pyrexia, Screaming
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 24JUL96 from 11-4AM crying very irritable-crying when held;APAP given t103; no appetite;29JUL96 pt better-poor appetite;

VAERS ID:88745 (history)  Vaccinated:1996-07-24
Age:5.5  Onset:1996-07-24, Days after vaccination: 0
Gender:Male  Submitted:1996-07-29, Days after onset: 5
Location:Florida  Entered:1996-08-07, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: PPD by Connaught given 26JUL96
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5K61054IM 
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0270D0IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1314D1SC 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4326674PO 
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax & during the procedure of fingerstick for blood work pt pale & dizzy;

VAERS ID:88878 (history)  Vaccinated:1996-07-24
Age:0.2  Onset:1996-07-24, Days after vaccination: 0
Gender:Female  Submitted:1996-08-05, Days after onset: 12
Location:California  Entered:1996-08-12, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: pt given EMPMP by Lederle lot# A500 on 24JUL96;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4348090IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0742A0IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES1622B0PO 
Administered by: Private     Purchased by: Other
Symptoms: Cyanosis, Hypotonia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: pt recv vax 24JUL96 & that afternoon pt limp & blue face down in stroller;02 sat 93% RA in ER hosp overnoc w/o problems;home 25JUL;now home on apnea monitor

VAERS ID:88905 (history)  Vaccinated:1996-07-24
Age:1.3  Onset:1996-07-31, Days after vaccination: 7
Gender:Male  Submitted:1996-08-06, Days after onset: 6
Location:New York  Entered:1996-08-12, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: 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.1422B0SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1661B0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Pyrexia, Rash, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 24JUL96 pt recv vax & 31JUL96 devel t102, rash;seen office 2AUG96 w/red macular papular rash head, chest, abd, extremities, t101-102 tired/fatigued;

VAERS ID:88922 (history)  Vaccinated:1996-07-24
Age:0.5  Onset:1996-07-25, Days after vaccination: 1
Gender:Male  Submitted:1996-08-07, Days after onset: 13
Location:Texas  Entered:1996-08-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Vantin, corticosporin drops ears
Current Illness: ear infection
Preexisting Conditions: umbilical hernia, hypoimmunized
Diagnostic Lab Data: Rubeola IGM negative; WBC 9.1, Hgb 10.6, Hct 32.4, diff 20 poly, 70 lymph, 8 mono, 2 EO
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4280341IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0739D1PO 
Administered by: Private     Purchased by: Public
Symptoms: Anaemia, Erythema multiforme, Hypochromic anaemia, Injection site hypersensitivity, Injection site oedema, Laboratory test abnormal, Rash, Urticaria
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Haematopoietic erythropenia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt devel erythematous rash & edema @ inj site;1 days post vax w/progression into a urticarial rash & erythema multiforme in the next 24hr responded well to DPH & resolved in the next day w/o other problems;no fever, coryza, koplik spots;

VAERS ID:88929 (history)  Vaccinated:1996-07-24
Age:14.3  Onset:1996-07-24, Days after vaccination: 0
Gender:Male  Submitted:1996-08-02, Days after onset: 9
Location:Texas  Entered:1996-08-13, 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: NA
Current Illness: NONE
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type: TX96121
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES431019  LA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Headache, Nausea, Pyrexia, Rhinitis, Somnolence, Thirst
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: t102.4, h/a, head congestion,nausea, slept alot, drank plenty of fluids, also had chills;fever broke about 7PM & pt was fine next day;

VAERS ID:89001 (history)  Vaccinated:1996-07-24
Age:1.0  Onset:0000-00-00
Gender:Male  Submitted:1996-08-07
Location:Maryland  Entered:1996-08-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: reactive airways disease
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0382D0 RL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0394B0 LL
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: rash over entire body-cleared p/2-3 days;

VAERS ID:89015 (history)  Vaccinated:1996-07-24
Age:12.1  Onset:1996-07-24, Days after vaccination: 0
Gender:Female  Submitted:1996-07-25, Days after onset: 1
Location:Texas  Entered:1996-08-15, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: ER head x-ray neg;
CDC Split Type: TX96104
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1432B1SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L710953IMRA
Administered by: Public     Purchased by: Other
Symptoms: Dizziness, Headache, Injury, Stupor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: fainted;hit head on door knob, lt temple c/o dizziness & h/a;fainted approx 5-10sec;PEARL;

VAERS ID:89298 (history)  Vaccinated:1996-07-24
Age:1.3  Onset:1996-07-24, Days after vaccination: 0
Gender:Male  Submitted:1996-07-25, Days after onset: 1
Location:Louisiana  Entered:1996-08-19, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: LA960804
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4333643 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1470B0 LA
Administered by: Public     Purchased by: Public
Symptoms: Infection, Injection site hypersensitivity, Injection site oedema, Oedema, Vasodilatation
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 (narrow)
Write-up: excessive swelling to rt muscle & upper arm;hot to touch;poss rxn to vax;poss local rxn vs infect

VAERS ID:89207 (history)  Vaccinated:1996-07-24
Age:20.1  Onset:1996-07-24, Days after vaccination: 0
Gender:Female  Submitted:1996-07-24, Days after onset: 0
Location:Wyoming  Entered:1996-08-20, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD by Connaught lot240911 given 24JUL96;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WY9611
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0338B0IMLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5F71086 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Hyperhidrosis, Hypotension, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)
Write-up: w/in second of vax pt became extremely diaphoretic, nauseous & hypotensive (76/38);pt was watched for 25min, color returned, BP rose to 98/60;pt was advised to rest this day, see MD if sx of any kind occurred & warn next hlth provider;

VAERS ID:89306 (history)  Vaccinated:1996-07-24
Age:31.2  Onset:1996-07-26, Days after vaccination: 2
Gender:Female  Submitted:1996-08-09, Days after onset: 14
Location:Florida  Entered:1996-08-26, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC-nl 6AUG96
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0111D1 LA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: rash on lower extremities 2 days p/vax;

VAERS ID:89782 (history)  Vaccinated:1996-07-24
Age:0.2  Onset:1996-07-24, Days after vaccination: 0
Gender:Female  Submitted:1996-09-03, Days after onset: 41
Location:Missouri  Entered:1996-09-10, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MO96051
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4278390 RL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0767B0 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4319890PO 
Administered by: Public     Purchased by: Public
Symptoms: Cyanosis, Pallor
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: mom states pt had episode of losing color then lips turned blue;was taken to ER-kept approx 1hr;color returned;

VAERS ID:90044 (history)  Vaccinated:1996-07-24
Age:0.4  Onset:1996-07-24, Days after vaccination: 0
Gender:Female  Submitted:1996-08-08, Days after onset: 15
Location:California  Entered:1996-09-19, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CA960077
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4280341 LL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0279D1 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0735L1PO 
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Dyspnoea, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: pt recv vax 24JUL96 & 5PM was shaking & having diff breathing taken to hosp 11PM;ER md dx poss sz perhaps d/t vax;

VAERS ID:91116 (history)  Vaccinated:1996-07-24
Age:28.7  Onset:1996-07-28, Days after vaccination: 4
Gender:Female  Submitted:0000-00-00
Location:Illinois  Entered:1996-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pills
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Polymerase chain rxn-wild-type varicella;
CDC Split Type: WAES96072697
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0413B0  
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 24JUL96 & 28JUL96 pt exp a rash w/lesions in mouth;29JUL96 pt exp a fever;PCR analysis of a specimen from the pt revealed wild-type varicella;pt children also broke out w/varicella;

VAERS ID:91120 (history)  Vaccinated:1996-07-24
Age:1.2  Onset:1996-07-31, Days after vaccination: 7
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1996-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96080052
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 24JUL96 & on 31JUL96 pt devel hives it was also indicated that the pt had no known drug allergies;no further details were provided;

VAERS ID:91147 (history)  Vaccinated:1996-07-24
Age:23.6  Onset:1996-08-07, Days after vaccination: 14
Gender:Female  Submitted:0000-00-00
Location:North Carolina  Entered:1996-10-18
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: exposure, varicella;
Diagnostic Lab Data: 26AUG96 varicella antibody positive;
CDC Split Type: WAES96080874
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0402B1SC 
Administered by: Public     Purchased by: Private
Symptoms: Dermatitis bullous, Headache, Injection site hypersensitivity, Injection site oedema, Pruritus, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 24JUL96 & was exposed to child who devel chickenpox on 3AUG96 or 5AUG96;7AUG96 pt exp a local rxn @ inj site consisting of a quarter-sized area of raised erythema;8AUG96 pt devel 17 lesions;9AUG96 low grade fever, itching, h/a;

VAERS ID:92053 (history)  Vaccinated:1996-07-24
Age:0.2  Onset:1996-07-25, Days after vaccination: 1
Gender:Female  Submitted:1996-09-13, Days after onset: 50
Location:Georgia  Entered:1996-11-18, Days after submission: 66
Life Threatening? No
Died? Yes
   Date died: 1996-07-25
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP cold medicine
Current Illness: mom states pt had a cold & gas
Preexisting Conditions:
Diagnostic Lab Data: repeat PKU 24JUL96;
CDC Split Type: GA96133
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4348080IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0740B0PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Shock, Sudden infant death syndrome
SMQs:, Anaphylactic reaction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: mom states pt had no rxn;COD circulatory collapse-SIDS;

VAERS ID:95859 (history)  Vaccinated:1996-07-24
Age:67.2  Onset:1996-08-10, Days after vaccination: 17
Gender:Male  Submitted:1997-03-12, Days after onset: 214
Location:Colorado  Entered:1997-03-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA493A41  
Administered by: Public     Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Red blood cell sedimentation rate increased, Vasculitis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Vasculitis (narrow), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)
Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;

VAERS ID:96321 (history)  Vaccinated:1996-07-24
Age:65.9  Onset:1996-08-01, Days after vaccination: 8
Gender:Female  Submitted:1997-03-12, Days after onset: 223
Location:Colorado  Entered:1997-03-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: asthma
Diagnostic Lab Data: blood tests 12SEP96 sed rate 91;27 Sep sed rate 22 ;3 Jan sed rate 5 ;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 1  
Administered by: Public     Purchased by: Private
Symptoms: Back pain, Hypertonia, Myalgia, Pain, Red blood cell sedimentation rate increased, Rheumatoid arthritis
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad)
Write-up: contracted polymyalgia rheumatica-dx 6wk p/vax;7-10 days p/vax woke up w/stiff, sore lower back;stiff achy back became stiffer & more sore as time passed;pain in upper rt arm/shoulder followed by pain in lt arm & shoulder;

VAERS ID:96345 (history)  Vaccinated:1996-07-24
Age:23.5  Onset:1996-07-25, Days after vaccination: 1
Gender:Male  Submitted:1996-07-30, Days after onset: 5
Location:Illinois  Entered:1997-03-20, Days after submission: 233
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: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 12hr p/vax pt devel nausea & fever of 100.3;

VAERS ID:98490 (history)  Vaccinated:1996-07-24
Age:1.3  Onset:1996-07-24, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:1997-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 27JUL96 WBC count 2.7;HGB 10.9;platelet count 80,000;HCT 32.2;MCH 26.6;5AUG96 WBC count 3.7;RBC count 3.61;hgb 9.7;hct 28.0 MCH 26.9;Neutrophils 11%;lymphocytes 77%;
CDC Split Type: WAES96080519
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Private     Purchased by: Private
Symptoms: Anaemia, Convulsion, Lymphocytosis, Pharyngitis, Pyrexia, Rash, Somnolence, Thrombocytopenia
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)
Write-up: pt recv vax 24JUL96 & 24JUL96 pt devel a fever & had a sz;pt seen in ER;pt sent home & returned 12hr later & had a second sz;pt hosp;pt devel rash, lethargy;throat red;

VAERS ID:99935 (history)  Vaccinated:1996-07-24
Age:1.6  Onset:1996-07-24, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Illinois  Entered:1997-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96072291
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax 24JUL96 IM instead of SC & 24JUL96 pt devel a lump on thigh where the vax was administered;

VAERS ID:102371 (history)  Vaccinated:1996-07-24
Age:67.0  Onset:0000-00-00
Gender:Female  Submitted:1996-08-29
Location:New Jersey  Entered:1997-09-10, Days after submission: 377
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896256004L
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES    
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Chills, Dyspepsia, Insomnia, Vasodilatation
SMQs:, Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow)
Write-up: pt recv vax & exp chills, sick stomach & insomnia;pt states that felt drained of all energy & very hot all the time;

VAERS ID:105717 (history)  Vaccinated:1996-07-24
Age:13.1  Onset:1996-07-24, Days after vaccination: 0
Gender:Female  Submitted:1997-11-25, Days after onset: 489
Location:Michigan  Entered:1997-12-16, Days after submission: 21
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: MI97158
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MICHIGAN DEPT PUB HLTHTD6132B0  
Administered by: Public     Purchased by: Public
Symptoms: Apnoea, Dizziness, Visual disturbance
SMQs:, Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Respiratory failure (narrow), Hypoglycaemia (broad)
Write-up: @ that time pt states was dizzy, couldn''t breath & couldn''t see;mom took to MD epi given went home p/2hr;

VAERS ID:107287 (history)  Vaccinated:1996-07-24
Age:0.2  Onset:1996-07-24, Days after vaccination: 0
Gender:Unknown  Submitted:1997-08-06, Days after onset: 378
Location:Oregon  Entered:1997-12-23, Days after submission: 139
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: CO6698
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5J610710UNUN
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5J610710UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Crying, Screaming
SMQs:, Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)
Write-up: crying, intractable longer than 4hr p/vax. From additional information received on May 24, 1999, it was reported, "Please note - There is no patient name and any records we have would be in the patient''s chart."

VAERS ID:156832 (history)  Vaccinated:1996-07-24
Age:2.1  Onset:1999-04-15, Days after vaccination: 995
Gender:Female  Submitted:2000-05-16, Days after onset: 397
Location:Pennsylvania  Entered:2000-07-14, Days after submission: 59
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: bronchitis; PCN allergy
Diagnostic Lab Data:
CDC Split Type: WAES99041241
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Subsequent to receiving one dose of varicella virus vaccine live on 7/24/96 and on 4/15/99, the pt developed a little itchy rash in her peroneal area and small erythematous bump and a few other dotty type lesions. The following day, the pt had other lesions at different stages maculopapular and vesicular. The one in her peroneal region was fluid filled. A total of 25 lesions were reported. Pt was seen by a physician and dx''d with varicella on 4/16/99 and treated with Benadryl for itching and Tylenol for the fever. On an unspecified date the pt recovered from episodes. No further details were provided.

VAERS ID:177599 (history)  Vaccinated:1996-07-24
Age:  Onset:0000-00-00
Gender:Male  Submitted:2001-10-26
Location:California  Entered:2001-11-12, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: remove circumcision
Preexisting Conditions: 7/17/96-Circumcision and slight jaundice; 7/18/96-Diarrhea-possible gastroenteritis, slight jaundice and yellow eyes
Diagnostic Lab Data: Heavy metal lab tests, etc.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2095A0IMLL
Administered by: Private     Purchased by: Other
Symptoms: Autism, Bone disorder, Hearing impaired, Hypotonia, Muscle disorder, Speech disorder, Staring
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: 2/12/99-Hypotonia throughout extremities and trunk. 7/1/99-Speech, hearing, in-toeing and poor eye contact concerns. 8/11/99-Autism and significant delay in speech.

VAERS ID:198448 (history)  Vaccinated:1996-07-24
Age:7.0  Onset:2003-02-18, Days after vaccination: 2400
Gender:Female  Submitted:2003-02-21, Days after onset: 3
Location:Pennsylvania  Entered:2003-02-27, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.025000 LL
Administered by: Private     Purchased by: Unknown
Symptoms: Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Small red bumps on pelvic bone and one on neck, itchy. Aveeno baths, fluids.

VAERS ID:229032 (history)  Vaccinated:1996-07-24
Age:1.1  Onset:2004-11-02, Days after vaccination: 3023
Gender:Male  Submitted:2004-11-03, Days after onset: 1
Location:New Jersey  Entered:2004-11-09, 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: Luride
Current Illness: none
Preexisting Conditions: 95 VSD: Spontaneous closure
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Blister, Drug ineffective, Infection, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Lesions compatible with C-pox all over body, blisters open and scabs. Itching. Temp 99.6 Treatment Atarax

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

New Search

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


Copyright © 2016 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166