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Found 466004 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:114927 (history)  Vaccinated:1998-09-29
Age:39.6  Onset:1998-09-29, Days after vaccination: 0
Gender:Female  Submitted:1998-09-30, Days after onset: 1
Location:Michigan  Entered:1998-10-13, 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:
Current Illness: hx of asthma
Preexisting Conditions: allergy PCN, ASA, epi (susphrine)
Diagnostic Lab Data: 145PM PDH P88, R34 wheezing;155PM to ER 02 w/staff driving/assisting;
CDC 'Split Type': MI98111
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09657600IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthma, Dizziness, Dyspnoea, Hyperventilation, Hypoxia, Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 29SEP98 1PM & 115PM wheezing-inhaled 2 puffs proventil @ work site;130PM c/o wheezing, itchiness @ inj site;130PM DPH given P86, R24;redness noted @ inj site;cont wheezing c/o lightheadedness noted;diff breathing;

VAERS ID:114956 (history)  Vaccinated:1998-09-29
Age:47.4  Onset:1998-09-30, Days after vaccination: 1
Gender:Female  Submitted:1998-10-02, Days after onset: 2
Location:Puerto Rico  Entered:1998-10-14, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prinventyl;pred;theodur
Current Illness: AB
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0971880 IM 
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09081801IMA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: resp distress;rx solumedrol, DPH, FFT w/ proventyl;

VAERS ID:114957 (history)  Vaccinated:1998-09-29
Age:32.4  Onset:1998-09-29, Days after vaccination: 0
Gender:Male  Submitted:1998-10-05, Days after onset: 6
Location:Alabama  Entered:1998-10-14, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recv hep b vax by Merck lot# 0435H given 26AUG98
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0438H1IMLA
Administered by: Public     Purchased by: Other
Symptoms: Dizziness, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: 30min p/vax pt became lightheaded, nausea/vomiting severe;dizzy;

VAERS ID:115051 (history)  Vaccinated:1998-09-29
Age:11.5  Onset:1998-09-29, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Colorado  Entered:1998-10-16
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
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1164H1 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1004H1 RA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: immed p/vax pt rt deltoid turned red 2 1/2" in diameter;immed p/hep b vax pt lt deltoid turned red 2 1/2" in diameter;

VAERS ID:115073 (history)  Vaccinated:1998-09-29
Age:36.9  Onset:1998-10-01, Days after vaccination: 2
Gender:Male  Submitted:1998-10-13, Days after onset: 12
Location:Minnesota  Entered:1998-10-19, 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: Ibuprofen, Amitryptiline, stadol (PRN), antacids
Current Illness: NONE
Preexisting Conditions: environmental allergies (pollens, etc)
Diagnostic Lab Data: NONE
CDC 'Split Type': MN98024
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2700A43 LA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Tinnitus, Vasodilatation
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad)
Write-up: lightheadedness, dizzy sensation, flushing, lt ear tinnitus, w/lightheadedness episodes;

VAERS ID:115151 (history)  Vaccinated:1998-09-29
Age:27.4  Onset:1998-09-29, Days after vaccination: 0
Gender:Female  Submitted:1998-10-01, Days after onset: 2
Location:Massachusetts  Entered:1998-10-21, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TB Mantoux test;Welbtrin;Zyban
Current Illness: well
Preexisting Conditions: NONE;no allergies;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0899H1IM 
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0950740 IM 
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Hypokinesia, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: unbearable pain up into shoulder & down into hand for 3 days;shot on 29SEp cant even pick up an object;also c/o stomach cramps;one episode of pain (like menstrual cramps);no lump or nodule, no redness;not febrile, no nausea;

VAERS ID:116380 (history)  Vaccinated:1998-09-29
Age:0.2  Onset:1998-09-29, Days after vaccination: 0
Gender:Female  Submitted:1998-11-12, Days after onset: 44
Location:Pennsylvania  Entered:1998-11-13, Days after submission: 1
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':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09258800IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES09464500IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N014670IMRL
Administered by: Private     Purchased by: Public
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: profuse vomiting for 6hr p/vax;

VAERS ID:120724 (history)  Vaccinated:1998-09-29
Age:43.9  Onset:1998-10-20, Days after vaccination: 21
Gender:Male  Submitted:1998-11-17, Days after onset: 28
Location:New York  Entered:1999-03-29, Days after submission: 132
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cellulitis from human bite
Preexisting Conditions: NONE
Diagnostic Lab Data: X-ray of left upper extremity-negative
CDC 'Split Type': U199800699
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0941330  LA
Administered by: Other     Purchased by: Other
Symptoms: Hypertonia, Injection site pain
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt recv vax on 9/29/98; on 10/20/98 pt exp pain/ muscle spasm at vax site; tx=Ibuprofen

VAERS ID:114789 (history)  Vaccinated:1998-09-30
Age:36.0  Onset:1998-10-03, Days after vaccination: 3
Gender:Male  Submitted:1998-10-05, Days after onset: 2
Location:North Carolina  Entered:1998-10-08, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: M.R.I. of spine-negative
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0433H1IMRA
Administered by: Private     Purchased by: Private
Symptoms: Myelitis
SMQs:
Write-up: Pt recv vax on 9/30/98; on 10/3/98 pt exp transverse myelitis.

VAERS ID:114796 (history)  Vaccinated:1998-09-30
Age:38.1  Onset:1998-10-02, Days after vaccination: 2
Gender:Female  Submitted:1998-10-05, Days after onset: 3
Location:California  Entered:1998-10-08, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: ANA anti-SD-DNA+
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES452841 IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 2 days p/vax inj site red, sl indurated, warm to touch, painful pruritus 14x14cm area;

VAERS ID:114840 (history)  Vaccinated:1998-09-30
Age:4.0  Onset:0000-00-00
Gender:Male  Submitted:1998-10-05
Location:California  Entered:1998-10-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD by Connaught lot# 248711 given 30SEP98;
Current Illness: upper respiratory inj
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4538464 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.08341 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES792C13PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: large erythemic, warm, raised area surrounding inj site - rt arm DTAP;

VAERS ID:114864 (history)  Vaccinated:1998-09-30
Age:13.8  Onset:1998-09-30, Days after vaccination: 0
Gender:Female  Submitted:1998-10-07, Days after onset: 7
Location:Ohio  Entered:1998-10-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp sl h/a @ 13yr odl w/hep b vax dose 1;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: had strep throat 4x last year
Diagnostic Lab Data: NA
CDC 'Split Type': OH98072
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2699A21IMLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Nausea, Neck pain, Pallor, Pyrexia, Somnolence
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), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: 30SEp98 pt was playing volleyball (4 games) starting just 2hr p/vax turned white as a ghost;c/o pain in neck & head was nauseated;went to bed 7PM;sl sore neck & h/a;lethargic;T101;sleepy;severe h/a;

VAERS ID:114868 (history)  Vaccinated:1998-09-30
Age:13.2  Onset:1998-10-01, Days after vaccination: 1
Gender:Female  Submitted:1998-10-02, Days after onset: 1
Location:Alaska  Entered:1998-10-13, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1359E0 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0900E1 LA
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES6L81392  LA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Face oedema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: facial edema, hives, itching, SOB;

VAERS ID:114881 (history)  Vaccinated:1998-09-30
Age:3.2  Onset:1998-10-02, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1998-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Augmentin;
Current Illness: sinusitis
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': FL98049
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0304H0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Injection site hypersensitivity, Injection site oedema, Injection site pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: onset 2OCT98 330AM child woke up vomiting & loose stroll (one each), T101.7 & c/o arm hurt then MOC noticed swelling & redness on lt arm @ the site where recv vax;

VAERS ID:114896 (history)  Vaccinated:1998-09-30
Age:72.8  Onset:1998-09-30, Days after vaccination: 0
Gender:Male  Submitted:1998-10-01, Days after onset: 1
Location:Minnesota  Entered:1998-10-13, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0978690 IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4485161IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Hypertonia, Hypothermia, Injection site oedema, Injection site pain, Pain, Tremor, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 30SEP98 AM pt recv vax x 2 noted discomfort, stiffness & swelling in lt arm surrounding inj site @ 5PM;pt applied ice & took ecotrin for pain;shaking, chills during PM;swelling noted 2" above antecubital space;pain, warm & tender;T36.6;

VAERS ID:114899 (history)  Vaccinated:1998-09-30
Age:4.5  Onset:0000-00-00
Gender:Male  Submitted:1998-10-05
Location:California  Entered:1998-10-13, 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: PPD by connaught lot# 248711 given 30SEP98
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES453846  LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0509H  LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES792C1 PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: large erythemic, warm raised area surrounding inj area-lt leg DTAP

VAERS ID:114930 (history)  Vaccinated:1998-09-30
Age:0.7  Onset:1998-09-30, Days after vaccination: 0
Gender:Male  Submitted:1998-10-01, Days after onset: 1
Location:D.C.  Entered:1998-10-13, Days after submission: 12
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp hives w/ACEL imune & HIB;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 898275042A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES 2IM 
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS 2IM 
Administered by: Military     Purchased by: Military
Symptoms: Asthma, Hypersensitivity, Laboratory test abnormal, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: MD skin tested pt w/ACEL immune & HIB both negative so pt recv vax;p/HIB pt devel bronchospasm;

VAERS ID:114969 (history)  Vaccinated:1998-09-30
Age:1.2  Onset:1998-09-30, Days after vaccination: 0
Gender:Female  Submitted:1998-10-01, Days after onset: 1
Location:Illinois  Entered:1998-10-14, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: URI
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4538482IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2710A22IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4525962PO 
Administered by: Private     Purchased by: Private
Symptoms: Hypertonia, Respiratory disorder, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: pt had been crying during inj appeared to be breath holding;pt took 2 deep breaths p/mom blew gently in face then pt eyes became fixed & body became stiff;MD notified;

VAERS ID:114978 (history)  Vaccinated:1998-09-30
Age:1.1  Onset:1998-10-02, Days after vaccination: 2
Gender:Male  Submitted:1998-10-07, Days after onset: 5
Location:Ohio  Entered:1998-10-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Diarrhoea, Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: T102.6 temp x 4 days, diarrhea x 2 days, measles like rash 6 days post vax;

VAERS ID:114981 (history)  Vaccinated:1998-09-30
Age:2.3  Onset:1998-10-04, Days after vaccination: 4
Gender:Female  Submitted:1998-10-06, Days after onset: 2
Location:Alaska  Entered:1998-10-15, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, UA
CDC 'Split Type': AK98038
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4515003IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0259H2IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.100980SCRL
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Urinary tract infection, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: child w/fever, vomiting beginning 4OCT;seen in ER on 5OCT by MD;mom report''s child dx w/UTI but told could still be a rxn to immun @ least in part as fits time frame;T103 @ hosp, 2hr p/baby motrin;

VAERS ID:115040 (history)  Vaccinated:1998-09-30
Age:48.0  Onset:1998-10-01, Days after vaccination: 1
Gender:Female  Submitted:1998-10-15, Days after onset: 14
Location:Florida  Entered:1998-10-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to PCN
Diagnostic Lab Data: NONE
CDC 'Split Type': FL98051
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM568A60IMRA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4528410IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Chest pain, Dyspnoea, Injection site hypersensitivity, Nausea, Oedema, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: edematous, reddened area lt deltoid approx 2" diameter;pt c/o pain (arthritic type), hot to touch area 12hr post vax;24-36hr later pt c/o SOB, tightness in chest, sl nausea;

VAERS ID:115072 (history)  Vaccinated:1998-09-30
Age:6.3  Onset:1998-09-30, Days after vaccination: 0
Gender:Female  Submitted:1998-10-09, Days after onset: 9
Location:Oklahoma  Entered:1998-10-19, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp syncope @ 5yr old w/DTAP dose 5;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: skull xrays-no fracture;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1110H0 RL
Administered by: Private     Purchased by: Private
Symptoms: Bradycardia, Injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: syncope 10min later;closed head trauma @ fall;bradycardia <- 40-02 applied & transported to ER in arms;

VAERS ID:115074 (history)  Vaccinated:1998-09-30
Age:11.6  Onset:1998-09-30, Days after vaccination: 0
Gender:Female  Submitted:1998-10-12, Days after onset: 12
Location:Mississippi  Entered:1998-10-19, 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: APAP
Current Illness: NONE
Preexisting Conditions: viral meningitis @ 4mos @ age;partial sz (duration 3 yrs)
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2628A20IMRA
Administered by: Other     Purchased by: Public
Symptoms: Face oedema, Headache, Injection site pain, Malaise
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: on vaccination date, child c/o inj site pain & c/o felt funny, but denied SOB w/confirmation h/a;instructed to take OTC APAP & place ice on inj site;child presented to clinic 2 days p/vax c/o swollen eyelids, h/a, severe inj site pain;

VAERS ID:115109 (history)  Vaccinated:1998-09-30
Age:1.2  Onset:0000-00-00
Gender:Female  Submitted:1998-10-16
Location:Unknown  Entered:1998-10-20, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp application site rxn w/HIB & Hep B vax;
Other Medications: NONE
Current Illness:
Preexisting Conditions: fetal cocaine exposure;
Diagnostic Lab Data:
CDC 'Split Type': WAES98100940
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypersensitivity, Immune system disorder
SMQs:, Angioedema (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 30SEP98 & pt exp a severe allergic rxn & was immed hosp for one day;the reporter felt that the child immune system may have been compromised as a result of mom''s cocaine addiction;

VAERS ID:115127 (history)  Vaccinated:1998-09-30
Age:82.0  Onset:1998-09-30, Days after vaccination: 0
Gender:Female  Submitted:1998-10-02, Days after onset: 2
Location:New Mexico  Entered:1998-10-20, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Atrovent, Proventil, Aerobid
Current Illness: follow up SOB
Preexisting Conditions: COPD, positional vertigo prior CVA phlebitis;
Diagnostic Lab Data: CBC nl
CDC 'Split Type': NM98016
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4517961IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Pyrexia, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: lt deltoid red, hot to touch, pt had T99.5;CBC nl no elevated WBC;

VAERS ID:115135 (history)  Vaccinated:1998-09-30
Age:1.0  Onset:1998-10-09, Days after vaccination: 9
Gender:Male  Submitted:1998-10-13, Days after onset: 4
Location:Massachusetts  Entered:1998-10-20, 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: Amox
Current Illness: NONE
Preexisting Conditions: NA
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES786F2PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1057H0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Rash, Rash maculo-papular, Skin nodule
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: papular lesions surrounding an erythematous firm subcutaneous lesion approx 1cm;afeb;had been on ATB for otitis;

VAERS ID:115173 (history)  Vaccinated:1998-09-30
Age:57.2  Onset:1998-10-12, Days after vaccination: 12
Gender:Female  Submitted:1998-10-19, Days after onset: 7
Location:North Carolina  Entered:1998-10-22, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Gemfibrozil;Premarin;Diovan;Medroxyprogestene
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC
CDC 'Split Type': NC98062
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1170M0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Asthenia, Conjunctivitis, Face oedema, Myalgia, Oedema, Rash, Visual disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 13OCT achy all over (10-12);rash over entire body;swelling of face & neck;14OCT weak, bloodshot eyes, joints hurting, vision impaired;16OCT rash almost gone, still weak, achy joints;19OCT achy joints;

VAERS ID:115480 (history)  Vaccinated:1998-09-30
Age:65.1  Onset:1998-10-02, Days after vaccination: 2
Gender:Female  Submitted:1998-10-27, Days after onset: 25
Location:Maryland  Entered:1998-10-30, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: RAD, inc chol;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0870H1 LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: lt deltoid tenderness & erythema post vax;tx w/cipro;

VAERS ID:115577 (history)  Vaccinated:1998-09-30
Age:22.4  Onset:1998-10-01, Days after vaccination: 1
Gender:Female  Submitted:1998-10-08, Days after onset: 7
Location:Ohio  Entered:1998-11-02, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recv hep b vax by SKB lot# 2706A2 given 1OCT98
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': OH98074
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1245H0 LA
Administered by: Public     Purchased by: Other
Symptoms: Chest pain, Dermatitis bullous, Dyspnoea, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 1OCT98 noticed pruritic area mid line lower lumbar area & was examined by MD who found bubble type eruption 2-3;they were scabbed over & don''t'' itch;pt exp chest pain & hard to catch breath;

VAERS ID:115620 (history)  Vaccinated:1998-09-30
Age:65.6  Onset:1998-09-30, Days after vaccination: 0
Gender:Female  Submitted:1998-10-29, Days after onset: 29
Location:Wyoming  Entered:1998-11-03, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Cataflam, Premarin/Proventil
Current Illness: NONE
Preexisting Conditions: NKA, COPD/ primary hyperparathyroidism, DJD/ s/p colon cancer
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES448189 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: Pt recv vax on 9/30/98; on same day pt exp erythema &warmth of LA; tx=Benadryl & ice.

VAERS ID:116301 (history)  Vaccinated:1998-09-30
Age:80.7  Onset:1998-09-30, Days after vaccination: 0
Gender:Female  Submitted:1998-10-14, Days after onset: 14
Location:Florida  Entered:1998-11-09, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': FLU88071098
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS03788P1IMA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Diarrhoea, Myalgia, Pyrexia, Urine analysis abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Pt recv vax on 9/30/98; on same day pt exp muscle pain, stomach pain, fever, dark urine, diarrhea

VAERS ID:116199 (history)  Vaccinated:1998-09-30
Age:45.5  Onset:1998-10-04, Days after vaccination: 4
Gender:Female  Submitted:1998-11-05, Days after onset: 32
Location:D.C.  Entered:1998-11-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: h/o IM doses of IGM on 2 different occasions & devel side effects
Diagnostic Lab Data: hep c antibody positive;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1443E0 LA
Administered by: Private     Purchased by: Private
Symptoms: Anorexia, Arthralgia, Asthenia, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: pt recv vax 30SEP98 & noted onset of extreme fatigue, nausea gen joint pain (large & small), dec appetite starting 4OCT98;sx remained until 16OCT98;

VAERS ID:116257 (history)  Vaccinated:1998-09-30
Age:22.2  Onset:1998-09-30, Days after vaccination: 0
Gender:Male  Submitted:1998-10-25, Days after onset: 25
Location:Missouri  Entered:1998-11-12, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Hypokinesia, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt recv vax on 9/30/98; post vax pt exp pain in LA & hard to move x 2wk

VAERS ID:116960 (history)  Vaccinated:1998-09-30
Age:15.4  Onset:1998-09-30, Days after vaccination: 0
Gender:Female  Submitted:1998-11-25, Days after onset: 56
Location:Iowa  Entered:1998-11-30, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Zyrtec
Current Illness: NONE
Preexisting Conditions: Environmental allergies, Ampidillin
Diagnostic Lab Data: Allergy testing
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.1495E0 LA
Administered by: Other     Purchased by: Other
Symptoms: Malaise, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt recv vax on 9/30/98; 5 min post vax pt exp numb tingling of LA x 15 min, bad feeling x 1 hr

VAERS ID:117804 (history)  Vaccinated:1998-09-30
Age:1.2  Onset:1998-10-07, Days after vaccination: 7
Gender:Male  Submitted:1998-10-08, Days after onset: 1
Location:Alaska  Entered:1998-12-29, Days after submission: 82
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': AK98023
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4514980IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM255RJ0IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0219H0SCLL
Administered by: Public     Purchased by: Public
Symptoms: Conjunctivitis, Photosensitivity reaction, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: pt recv vax 30SEP98 mom stated child has T100.7 & photosensitivity;8OCT pt temp remains 100.7 w/red & irritated eyes;no rash;

VAERS ID:117981 (history)  Vaccinated:1998-09-30
Age:56.4  Onset:1998-09-30, Days after vaccination: 0
Gender:Male  Submitted:1999-01-06, Days after onset: 98
Location:New Jersey  Entered:1999-01-11, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Prednisone
Current Illness: UNK
Preexisting Conditions: Occular myasthenia
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09758200 LA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Pt recv vax on 9/30/98; post vax pt exp shoulder pain at vax site; pain when shoulder rotation; joint pain in legs

VAERS ID:118243 (history)  Vaccinated:1998-09-30
Age:12.1  Onset:1998-09-30, Days after vaccination: 0
Gender:Male  Submitted:1998-09-30, Days after onset: 0
Location:South Carolina  Entered:1999-01-21, Days after submission: 113
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic to Penicillin, Ceclor, Sulfa
Diagnostic Lab Data: Blood pressure 110/74, Pulse 72 regular/ strong
CDC 'Split Type': SC98069
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2567A90IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR I)MERCK & CO. INC.1312E1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Hypertension, Hypotonia, Rash maculo-papular
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 9/30/98; 5 min post vax pt exp buckling knees & slumping over, pt hit counter when falling, pt had red splotching on front neck/ LA/ rt arm x 20 min

VAERS ID:118280 (history)  Vaccinated:1998-09-30
Age:12.7  Onset:1998-09-30, Days after vaccination: 0
Gender:Female  Submitted:1998-09-30, Days after onset: 0
Location:North Dakota  Entered:1999-01-22, Days after submission: 114
Life Threatening? Yes
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': ND9823
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2712A20IMLA
Administered by: Other     Purchased by: Public
Symptoms: Anaphylactoid reaction, Chest pain, Dyspnoea, Headache, Laryngospasm
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 9/30/98; 5 min post vax pt exp headache, shortness of breath, tight throat & chest; pt hosp for anaphylaxis

VAERS ID:118686 (history)  Vaccinated:1998-09-30
Age:11.0  Onset:1998-09-30, Days after vaccination: 0
Gender:Female  Submitted:1999-02-02, Days after onset: 125
Location:Kansas  Entered:1999-02-09, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt & sibling exp fever/aches w/MMR vax;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: spring allergies
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Back pain, Hypokinesia, Injection site hypersensitivity, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt exp numbness of arm & legs;entire body began to hurt w/lower back aches;40min post vax unable to walk by self & unable to carry a book;over 5hr to regain some feeling;13NOV98 general aches & pains in back of legs, joints, rash @ inj site

VAERS ID:120015 (history)  Vaccinated:1998-09-30
Age:25.0  Onset:1998-10-01, Days after vaccination: 1
Gender:Female  Submitted:1999-03-01, Days after onset: 151
Location:Pennsylvania  Entered:1999-03-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES98100087
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Injection site hypersensitivity, Injection site oedema, Peripheral vascular disorder
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 9/30/98; on 10/1/98 pt exp erythema & raised area at vax site, lightheaded, cold extremities, dizzy

VAERS ID:120016 (history)  Vaccinated:1998-09-30
Age:9.3  Onset:1998-09-30, Days after vaccination: 0
Gender:Male  Submitted:1999-03-01, Days after onset: 152
Location:Hawaii  Entered:1999-03-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES98100100
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0342H0IM 
Administered by: Other     Purchased by: Public
Symptoms: Bradycardia, Dizziness, Hyperhidrosis, Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt recv vax on 9/30/98; 4-10 min post vax pt fainted, exp hypotension, dizzy, diaphoretic, dec pulse x 10 min

VAERS ID:119779 (history)  Vaccinated:1998-09-30
Age:28.7  Onset:1998-10-01, Days after vaccination: 1
Gender:Male  Submitted:1999-02-25, Days after onset: 147
Location:Mississippi  Entered:1999-03-08, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Two degree burns
Preexisting Conditions:
Diagnostic Lab Data: 10/1/98: BP 134/90, P 74, R 20, Temp 98.1
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Hypertension, Hypothermia, Malaise, Oedema peripheral, Paraesthesia
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Accidents and injuries (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow)
Write-up: Pt recv vax on 9/30/98; on 10/1/98 pt exp swollen hands w/ funny feeling, funny feeling in legs & arms; tx=Benadryl PO

VAERS ID:124034 (history)  Vaccinated:1998-09-30
Age:  Onset:0000-00-00
Gender:Female  Submitted:1999-05-14
Location:Ohio  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98100298
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt devel several lesions on lower back;pt sought unspecified medical attention;

VAERS ID:124072 (history)  Vaccinated:1998-09-30
Age:24.0  Onset:1998-10-12, Days after vaccination: 12
Gender:Female  Submitted:1999-05-14, Days after onset: 214
Location:Illinois  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC 'Split Type': WAES98101048
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0665H0 RA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: approx 13 days p/ vax pt devel a chickenpox like rash w/10-12 lesions. f/u fr MD described rash as erythematous papules w/vesicle eruption.

VAERS ID:124595 (history)  Vaccinated:1998-09-30
Age:33.1  Onset:0000-00-00
Gender:Female  Submitted:1999-05-14
Location:Arizona  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: codeine allergy; influenza
Diagnostic Lab Data:
CDC 'Split Type': WAES99030164
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Adverse drug reaction, Headache
SMQs:
Write-up: a pt recv vax 30sep98 & 5nov98 & following the 1st vax the pt exp a little bit itching over body & tenderness @ inject site. following 2nd pt exp a few headaches. no further info avail

VAERS ID:125001 (history)  Vaccinated:1998-09-30
Age:33.2  Onset:1998-09-30, Days after vaccination: 0
Gender:Male  Submitted:1999-06-16, Days after onset: 259
Location:Delaware  Entered:1999-06-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPDNo by Connaught lot# 248811 given 9/30/98;
Current Illness: unk
Preexisting Conditions: unk
Diagnostic Lab Data: RF, ANA, Sed rate, CBC, Chem 7;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0433  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: pt reports severe rt shoulder joint pain post vax;pt expected some soreness p/each vax but not lasting this long;it was so bad during a mission that pt had to stand up to throw switches;

VAERS ID:127952 (history)  Vaccinated:1998-09-30
Age:71.6  Onset:1998-10-01, Days after vaccination: 1
Gender:Female  Submitted:1998-10-06, Days after onset: 5
Location:Indiana  Entered:1999-09-03, Days after submission: 332
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: oscal; synthroid; lasix;coumadin;k-dur;imdur;atenolol;premarin;provera
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 898281071A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4489190 A
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Injection site oedema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: p/vax pt devel swelling & pain at inj site;also devel fever; MD Dx cellulitis & rx biaxin

VAERS ID:154747 (history)  Vaccinated:1998-09-30
Age:29.0  Onset:2000-01-03, Days after vaccination: 460
Gender:Male  Submitted:2000-05-16, Days after onset: 133
Location:Ohio  Entered:2000-06-19, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES00010271
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1566E SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt developed generalized chickenpox with 20 lesions mainly on his trunk, head and legs. Pt was afebrile. The pt sough medical attention. The reporting physician expressed concern with the vaccine lot. At the time of reporting, the pt''s condition persisted. Additional information has been requested.

VAERS ID:167215 (history)  Vaccinated:1998-09-30
Age:46.0  Onset:1998-10-26, Days after vaccination: 26
Gender:Female  Submitted:2001-03-04, Days after onset: 860
Location:Maryland  Entered:2001-03-15, Days after submission: 11
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: EMG on 1/99-acute denervation in paraspinal muscles at low lumbar/sacral levels bilaterally; EMG on 8/99-acute denervation intrinsic foot muscles bilaterally; acute and chronic denervation proximal muscles; DX; active polyradicular process involving lumbar and sacral roots bilaterally; EMG on 8/00-Diffuse axonalmotor sensory peripheral neuropathy; some improvement in sensory c/w 8/99.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0175SC 
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER 1IM 
Administered by: Military     Purchased by: Military
Symptoms: Carpal tunnel syndrome, Congenital foot malformation, Demyelination, Fatigue, Muscle atrophy, Muscle contractions involuntary, Muscular weakness, Paraesthesia, Subcutaneous nodule
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Congenital, familial and genetic disorders (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Optic nerve disorders (broad), Demyelination (narrow)
Write-up: Onset of numbness/paresthesias of feet bilaterally. 10/27/98; onset fasciculations of calves bilaterally. On 10/29/98, onset exacerbation of carpal tunnel-like symptoms, bilaterally. In 1/99, Weakness/fatigability, low back, buttocks, and hip flexors noted.; 5/99, Motor abnormality of left foot noted; 8/00, Intrinsic muscle atrophy/weakness in both feet noted. Course: Numbness/paresthesias of feet progressed to proximal anterior legs by May/99; noted improvement in legs/feet sensory reactions in 3/00; intrinsic muscle atrophy/weakness in feet persists; have clawfoot-type deformity of left foot; weakness of low back, buttocks-essentially resolved. Note: At time of onset of neurologic symptoms in 10/98, still had tender SQ nodule from AVA.

VAERS ID:175633 (history)  Vaccinated:1998-09-30
Age:  Onset:0000-00-00
Gender:Female  Submitted:2001-09-10
Location:California  Entered:2001-09-24, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: 0     Purchased by: 0
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: The pt experienced varicella.

VAERS ID:230082 (history)  Vaccinated:1998-09-30
Age:  Onset:0000-00-00
Gender:Female  Submitted:2004-12-01
Location:West Virginia  Entered:2004-12-06, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES456816   
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1002H   
Administered by: Private     Purchased by: Unknown
Symptoms: Dermatitis bullous, Viral infection
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Patient developed chicken pox after having vaccine.

VAERS ID:248513 (history)  Vaccinated:1998-09-30
Age:1.1  Onset:2005-11-30, Days after vaccination: 2618
Gender:Male  Submitted:2005-12-01, Days after onset: 1
Location:Georga  Entered:2005-12-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1026H0 LA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Temp 103. Rash on back and stomach (itching)

VAERS ID:120244 (history)  Vaccinated:1998-09-30
Age:20.0  Onset:1998-11-01, Days after vaccination: 32
Gender:Male  Submitted:1999-03-09, Days after onset: 128
Location:Foreign  Entered:1999-03-12, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pt recv Anthrax vax 3/17, 3/31, 4/18/98~~ ~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURERFAC0573  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash, Skin discolouration, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 3/17/98,3/31/98, 4/18/98, 9/30/98; in 11/98 pt exp rash on belly button w/ soreness& brown color

VAERS ID:124852 (history)  Vaccinated:1998-09-30
Age:42.4  Onset:1998-09-30, Days after vaccination: 0
Gender:Male  Submitted:1999-05-27, Days after onset: 239
Location:Foreign  Entered:1999-06-07, 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: codoliprane/paracetamol; codien, tahor/atorvastatin
Current Illness:
Preexisting Conditions: none rpt
Diagnostic Lab Data: none rpt
CDC 'Split Type': EMF981895
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Lymphadenopathy
SMQs:
Write-up: approx 90 min p/vax pt exp bilateral sub maxillary adenopathy. resolved p/48hrs. treated w/lysine aspirin for 3days.

VAERS ID:124921 (history)  Vaccinated:1998-09-30
Age:40.4  Onset:1998-10-02, Days after vaccination: 2
Gender:Female  Submitted:1999-06-03, Days after onset: 244
Location:Foreign  Entered:1999-06-07, Days after submission: 4
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': REG982112
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.    
Administered by: Other     Purchased by: Other
Symptoms: Cough, Headache, Meningism, Oedema, Pharyngitis, Photophobia, Thinking abnormal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Agranulocytosis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal infections (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: p/vax pt exp swelling, sore throat & coughing;4 days p/vax pt had strong h/a, photophobia (short time), neck stiffness (short time) & subfebrile temp 37.9;dx meningeal irritation;also disturbed concentration;

VAERS ID:239523 (history)  Vaccinated:1998-09-30
Age:36.0  Onset:1998-10-01, Days after vaccination: 1
Gender:Female  Submitted:2005-06-03, Days after onset: 2437
Location:Foreign  Entered:2005-06-09, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0505USA03325
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cardiovascular disorder, Cognitive disorder, Dizziness, Dysphagia, Fatigue, Headache, Hypotension, Influenza like illness, Insomnia, Malaise, Memory impairment, Neuropathy, Photophobia, Premenstrual syndrome, Somnolence, Tremor, Urinary incontinence, Vertigo, Vision blurred
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (narrow)
Write-up: Information has been received from a 36 year old female with no known medical history who "in 1999 and 2000" was vaccinated with a "three dose course" of hepatitis B virus vaccine rHBsAg. In 1999, within one week of vaccination with her first dose of hepatitis b vaccine the pt experience flu like symptoms, which she reported never fully recovered. "Since vaccination", in approximately 1999, the pt had experienced many symptoms, including the following: dizziness, malaise, "neuro toxins in brain", severe cognitive problems (severe difficulty reading and writing, cannot drive as she cannot remember how to get home, lost her job), attention deficit, tremor, headache, low blood pressure, blurred vision, exhaustion, PMT (which she did not suffer from prior to vaccination), vertigo, sensitive to light, (cannot look at a computer due to flickering light), circulation problems, weak bladder, and difficulty swallowing. the pt stated that "she is 36 but feels 96 years old". The pt "feels very old and forgetful". The pt experienced periods of insomnia followed by days where she slept in excess of 16 hours per day. It was reported that the pt had seen many doctors, including a neurology consultant, who informed her that the vaccination had caused her illness. The pt "is certain this is the case". It was reported that the pt was reluctant to allow the company to follow up with her doctor. Prior to vaccination the pt was a student nurse, however she had to stop studying due to her adverse events and could no longer work. The pt''s adverse events were considered to be disabling and an other important medical event (OMIC). Other business partner numbers include E200502069. Additional information has been requested.

VAERS ID:115583 (history)  Vaccinated:1998-10-01
Age:77.7  Onset:1998-10-01, Days after vaccination: 0
Gender:Female  Submitted:1998-10-27, Days after onset: 26
Location:Iowa  Entered:1998-11-02, 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: NONE
Diagnostic Lab Data:
CDC 'Split Type': IA98028
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09739303IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)
Write-up: on day of vax exp aching down arm, through elbow & n to thumb;24hr later discomfort had localized to mostly near site of inj;pt contacted 26 days p/vax report tenderness remains @ site & exp aching in the arm;

VAERS ID:115695 (history)  Vaccinated:1998-10-01
Age:67.0  Onset:1998-10-01, Days after vaccination: 0
Gender:Female  Submitted:1998-11-01, Days after onset: 31
Location:Massachusetts  Entered:1998-11-04, Days after submission: 3
Life Threatening? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: ?cardiac disorder
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI981933
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E20188HE   
Administered by: Other     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: pt recv vax & died 10hr post vax;date of vax not specified, but batch number quoted is a current season''s batch;

VAERS ID:116166 (history)  Vaccinated:1998-10-01
Age:38.3  Onset:1998-10-01, Days after vaccination: 0
Gender:Female  Submitted:1998-10-02, Days after onset: 1
Location:Washington  Entered:1998-11-10, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amytriptoline;Prempro
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': WA981491
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2700A40IMLA
Administered by: Public     Purchased by: Private
Symptoms: Diarrhoea, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 1OCT98 9AM & c/o itching all over & rash under breast;also c/o onset of diarrhea;advised pt to see MD or go to urgent care;

VAERS ID:116378 (history)  Vaccinated:1998-10-01
Age:66.5  Onset:1998-11-01, Days after vaccination: 31
Gender:Male  Submitted:1998-11-08, Days after onset: 7
Location:California  Entered:1998-11-13, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UA was done the next day p/surrounded;it showed hemo nl;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Public
Symptoms: Cough, Epistaxis, Haematuria, Pharyngitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Oropharyngeal infections (narrow)
Write-up: blood in urine before & after dinner;later coughing, chronic nose bleed & sore throat;pt still coughing;

VAERS ID:117061 (history)  Vaccinated:1998-10-01
Age:0.3  Onset:1998-10-02, Days after vaccination: 1
Gender:Male  Submitted:1998-12-01, Days after onset: 60
Location:Alabama  Entered:1998-12-04, Days after submission: 3
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: NONE
Diagnostic Lab Data: WBC count 14,900;hemoglobin 12.7;59 SEGS, 1 monos, 2 eos, 28 lymphs;UA nl;NA 142, potassium 4.55, chloride 106, glucose 113, BUN 9, creatinine .2, calcium 10.4, SGOT 44, alk phos 226, protein 28;;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4547601 LL
Administered by: Private     Purchased by: Private
Symptoms: Aspartate aminotransferase increased, Blood alkaline phosphatase increased, Diarrhoea, Dysphagia, Salivary hypersecretion, Somnolence, Stupor, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt began choking, gagging & spitting up some yellowish phlegm;pt very lethargic & sleepy;would not wake up & would not respond appropriately to mom;cont to have intermittent gagging choking spells;some lip smacking;dx gastroenteritis;

VAERS ID:117072 (history)  Vaccinated:1998-10-01
Age:76.5  Onset:1998-10-01, Days after vaccination: 0
Gender:Female  Submitted:1998-12-01, Days after onset: 61
Location:Illinois  Entered:1998-12-04, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': IL98090
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0975850 IMA
Administered by: Public     Purchased by: Public
Symptoms: Arthritis, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Systemic lupus erythematosus (broad), Eosinophilic pneumonia (broad), Arthritis (narrow)
Write-up: 3hr p/vax pt devel severe pain in hips, feet, knees, calves of legs & top of thighs got worse over 2wk 20OCT98;Saw MD dx as arthritis;rx med;

VAERS ID:117159 (history)  Vaccinated:1998-10-01
Age:47.5  Onset:0000-00-00
Gender:Female  Submitted:1998-10-08
Location:Colorado  Entered:1998-12-07, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: Chronic pain
Preexisting Conditions: Wheelchair bound, multiple joint problems, obesity
Diagnostic Lab Data: NONE
CDC 'Split Type': CO98049
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1510E0SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0944780 IMLL
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Skin nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt recv vax on 10/1/98; post vax pt exp cellulitis

VAERS ID:121022 (history)  Vaccinated:1998-10-01
Age:58.0  Onset:0000-00-00
Gender:Male  Submitted:1999-03-31
Location:Maryland  Entered:1999-04-08, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma;hay fever;
Diagnostic Lab Data: lyme test negative; ANA positive;
CDC 'Split Type': MPI982053
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.    
Administered by: Other     Purchased by: Other
Symptoms: Antinuclear antibody, Arthritis, Hypokinesia, Systemic lupus erythematosus
SMQs:, Systemic lupus erythematosus (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow)
Write-up: pt recv vax & w/in 5 days pt devel arthritic pain in hands, hips & knees;consulted MD;Ibuprofen prescribed which provided only mild relief;treating MD to r/o Lupus;pt states arthritis sx worsening, having difficulty walking & writing

VAERS ID:121056 (history)  Vaccinated:1998-10-01
Age:61.3  Onset:1998-10-04, Days after vaccination: 3
Gender:Male  Submitted:1999-03-18, Days after onset: 165
Location:Washington  Entered:1999-04-08, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: elevated sed rate 79mm;mild anemia;
CDC 'Split Type': WA991547
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 3  
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0  
Administered by: Public     Purchased by: Unknown
Symptoms: Anaemia, Myalgia, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic erythropenia (broad), Eosinophilic pneumonia (broad)
Write-up: classical sx & findings of polymyalgia rheumatica occurring w/a few days of immun for hep b treatment w/pred has been successful;

VAERS ID:124213 (history)  Vaccinated:1998-10-01
Age:20.0  Onset:1998-10-02, Days after vaccination: 1
Gender:Unknown  Submitted:1999-05-14, Days after onset: 224
Location:Florida  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98110950
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Infection
SMQs:
Write-up: p/vax pt devel a full blown case of chickenpox;pt sought unspecified medical attention;

VAERS ID:124313 (history)  Vaccinated:1998-10-01
Age:1.0  Onset:1998-10-01, Days after vaccination: 0
Gender:Female  Submitted:1999-05-14, Days after onset: 225
Location:Maryland  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98120708
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt devel two lesions;each about 4-5mm on lt lower lid;almost looked like papillomas or scalations;MD reported that the lesions are flesh colored;

VAERS ID:124853 (history)  Vaccinated:1998-10-01
Age:  Onset:0000-00-00
Gender:Female  Submitted:1999-05-27
Location:Texas  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: none rpt
Diagnostic Lab Data: none rpt
CDC 'Split Type': MPI981896
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.    
Administered by: Other     Purchased by: Other
Symptoms: Pain
SMQs:
Write-up: p/recv vax pt exp severe pain on arm. MD hypothesized vax given on deltoid close to the joint. pt referred to orthopedic MD

VAERS ID:124860 (history)  Vaccinated:1998-10-01
Age:44.5  Onset:0000-00-00
Gender:Female  Submitted:1999-05-27
Location:Pennsylvania  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergic zomax, elevatedblood pressure reading without diag of hypertension
Diagnostic Lab Data: none rpt
CDC 'Split Type': MPI981911
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.    
Administered by: Other     Purchased by: Other
Symptoms: Ecchymosis, Injection site hypersensitivity, Injection site oedema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: immed following vax pt redness & a couple of days later bruising at inject site. f/u pt exp redness & tender pancake-like swelling at inject site.

VAERS ID:124861 (history)  Vaccinated:1998-10-01
Age:  Onset:0000-00-00
Gender:Unknown  Submitted:1999-05-27
Location:Virginia  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: none rpt
Diagnostic Lab Data: none rpt
CDC 'Split Type': MPI981912
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.    
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site pain, Neck pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: a couple of days p/vax pt exp some redness & pain in arm radiating up into neck. treated w/tylenol

VAERS ID:124887 (history)  Vaccinated:1998-10-01
Age:  Onset:1998-10-01, Days after vaccination: 0
Gender:Unknown  Submitted:1999-05-27, Days after onset: 238
Location:Louisiana  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: none rpt
Diagnostic Lab Data: none rpt
CDC 'Split Type': MPI981978C
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.20158HF   
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction
SMQs:
Write-up: p/recv vax pt exp localized inject site react w/o other sx

VAERS ID:124894 (history)  Vaccinated:1998-10-01
Age:7.0  Onset:1998-10-01, Days after vaccination: 0
Gender:Female  Submitted:1999-05-27, Days after onset: 238
Location:Pennsylvania  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI981991
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.    
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt broke out in hives (itchy) @ inj site the day p/vax;tolerated other vaccines in the past & does not have a known allergy to eggs;the reporting MD thought the rxn was caused by the vaccine;

VAERS ID:124914 (history)  Vaccinated:1998-10-01
Age:  Onset:1998-10-01, Days after vaccination: 0
Gender:Unknown  Submitted:1999-05-27, Days after onset: 238
Location:Illinois  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI982045B
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.20238KD   
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: p/vax pt exp knee arthralgia;

VAERS ID:124927 (history)  Vaccinated:1998-10-01
Age:  Onset:1998-10-01, Days after vaccination: 0
Gender:Male  Submitted:1999-05-27, Days after onset: 238
Location:Florida  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pneumovax/pneumococcal vaccine;
Current Illness:
Preexisting Conditions: 12/15/98 sinus infect status ongoing; blocked ears status ongoing;
Diagnostic Lab Data: 12/15/98 WBC, platelets 433000;1/7/99 sed rate 129 & 243;CH 50 8.6 & 0.8;bilirubihn & phos sed rate 27;test for arthritis negative;
CDC 'Split Type': MPI199900035
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.201584A   
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Influenza, Oral candidiasis, Pain
SMQs:, Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: p/vax pt exp flu sx, joint, hand, wrist & knee discomfort, lost energy, thrush of mouth, pain in hips & arch of feet;already present sinus infect;pt came down w/flu;

VAERS ID:125873 (history)  Vaccinated:1998-10-01
Age:68.0  Onset:1998-10-01, Days after vaccination: 0
Gender:Male  Submitted:1999-07-12, Days after onset: 284
Location:Massachusetts  Entered:1999-07-14, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98101542
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: approx 3hr p/vax, pt exp pain, swelling, & erythema at inject site; 3 days p/vax, pt had fever of 105f & was hosp for 1 1/2 weeks

VAERS ID:125881 (history)  Vaccinated:1998-10-01
Age:  Onset:0000-00-00
Gender:Female  Submitted:1999-07-12
Location:New York  Entered:1999-07-14, 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: dyspnea
Diagnostic Lab Data:
CDC 'Split Type': WAES98101894
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Condition aggravated, Dyspnoea, Pneumonia
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: p/vax pt exhibited sx of pneumonia & more difficulty in breathing;

VAERS ID:154824 (history)  Vaccinated:1998-10-01
Age:9.0  Onset:1998-10-01, Days after vaccination: 0
Gender:Male  Submitted:2000-02-25, Days after onset: 512
Location:New York  Entered:2000-06-20, Days after submission: 115
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: UNK
CDC 'Split Type': FLU24060500
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02089P0IM 
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt experienced hives (urticaria) that lasted for 4 days.

VAERS ID:157136 (history)  Vaccinated:1998-10-01
Age:1.8  Onset:1999-06-08, Days after vaccination: 250
Gender:Female  Submitted:2000-05-16, Days after onset: 343
Location:New York  Entered:2000-07-18, 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: UNK
Current Illness:
Preexisting Conditions: varicella exposure
Diagnostic Lab Data: deoxyribonucleic acid specimen betaglobin neg
CDC 'Split Type': WAES99061100
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Abnormal behaviour, Anorexia, Herpes zoster, Infection, Irritability, Skin hyperpigmentation
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: Approximately October 1998, pt was vaccinated with one dose of varicella. On June 8, 1999 the pt began to develop lesions predominantly on her left forehead above the eyebrow and temporal area. Over the next several days, new lesions continued to develop, extending approximately 2 inches into her hair line. No temperature was taken because pt did not feel warm, he felt afebrile. Also reported the pt experienced irritability, anorexia, and regression in some of her behavior (ie: not verbalizing the alphabet or words as she had done previously, wanting her pacifier and blankie, which she hadn''t used recently, etc.) The MD did not know if this behavioral change was just due to her not feeling well, or to some other factor. The reporting physician noted that he add his wife (also a physician) dx''d their daughter as having herpes zoster. Additionally, they spoke with their pediatrician by phone, who prescribed acyclovir to treat the lesions. The pt was never actually seen by her pediatrician. A scab from the pt forehead lesions was sent off for PCR analysis. The physician noted that this is one of her last scabs and that as for now, all of the scabs are heeled. Additionally, it was noted that some hyperpigmentation occured in the area where the lesions were.

VAERS ID:159478 (history)  Vaccinated:1998-10-01
Age:51.0  Onset:1998-10-02, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2000-09-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: midazolam
Current Illness:
Preexisting Conditions: pancreatitis, allergy to PCN and sulfa, hyperparathyroidism
Diagnostic Lab Data:
CDC 'Split Type': MPU2000004520
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Difficulty in walking, Ear disorder, Eye disorder, Muscle spasms, Panic reaction
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: One day post vax, the pt developed whole body spasms and felt she could not walk, which lasted for less than 1 year. She also reported that her ears had become sensitive to vibration and her eyes were sensitive. These symptoms were mostly resolved except for panic attacks. On 10/98 she received a second flu vaccine and the next day experienced similar episode of body spasm and panicky feeling. 3

VAERS ID:161687 (history)  Vaccinated:1998-10-01
Age:42.0  Onset:1998-10-01, Days after vaccination: 0
Gender:Female  Submitted:2000-05-15, Days after onset: 592
Location:New Jersey  Entered:2000-10-06, Days after submission: 144
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: Biopsy skin non-diagnostic, Thyroid function tests NOS normal
CDC 'Split Type': 0964108022000
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES 0IM 
Administered by: Private     Purchased by: Other
Symptoms: Bacterial infection, Erythema, Hypoaesthesia, Myalgia, Pruritus, Pyrexia, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Pt developed a bacterial infection shortly after vax, She was treated with several courses of antibiotics and the infection resolved. She also experienced redness and swelling of her hands that extended over her body. This resolved. However, when she is exposed to heat, her skin swells and becomes red, hot and itchy. When she is exposed to cold, she feels a numbing effect. She experienced slight muscle pain and periodic slight fever both of which continued as of which continued as of 02/07/2000. Raynaud''s phenomenon was reportedly ruled out. Thyroid function tests and all hematology tests were reportedly normal. A skin biopsy was reportedly non-diagnostic. Additional information from the physician indicated that the events reported following receipt of Pnu-Imune 23 can not be medically confirmed.

VAERS ID:162171 (history)  Vaccinated:1998-10-01
Age:76.0  Onset:0000-00-00
Gender:Female  Submitted:2000-04-14
Location:Pennsylvania  Entered:2000-10-13, Days after submission: 182
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Lymphoma
Diagnostic Lab Data: CAT scan - enlarged lymph nodes in abdomen but not below the waist.
CDC 'Split Type': U1999006960
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0984580 IM 
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Lymphadenopathy, Lymphoma
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Malignant tumours (narrow), Hypersensitivity (narrow), Malignant lymphomas (narrow)
Write-up: Face edema, lymphedema. It was reported that a female pt received vax in 10/1999. Reportedly 4 days post vax, the pt experienced facial swelling and swollen lymph nodes. The pt was seen by an infectious disease doctor and had a biopsy done on one of the lymph nodes, the report was lymphoma. The pt was seen by an oncologist and went through chemotherapy. From additional information received on 10/04/99, it was reported that the pt recovered from the experience. As of 04/10/00, reported, ''Reviewed, no additional information at this time...'' per physician.

VAERS ID:163266 (history)  Vaccinated:1998-10-01
Age:12.0  Onset:1998-10-01, Days after vaccination: 0
Gender:Female  Submitted:1999-09-30, Days after onset: 364
Location:Massachusetts  Entered:2000-11-14, Days after submission: 411
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: allergic rhinitis; asthma
Diagnostic Lab Data:
CDC 'Split Type': 19990259621
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IM 
Administered by: Private     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: One hour post vax the pt experienced generalized urticaria, generalized pruritus and scratchy throat. These symptoms required a doctor visit and were treated with Benadryl. Symptoms resolved over two days. The most recent information received reported the condition of the pt is resolved.

VAERS ID:163691 (history)  Vaccinated:1998-10-01
Age:43.0  Onset:0000-00-00
Gender:Female  Submitted:2000-12-05
Location:New York  Entered:2000-12-13, 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:
Current Illness: GERD, Sjogren Syndrome
Preexisting Conditions: GERD, Sjogren Syndrome
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: The pt experienced pain/soreness in left side of body, root canal, physical therapy, a bunch of tests and eye drops.

VAERS ID:164135 (history)  Vaccinated:1998-10-01
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2000-11-28
Location:Unknown  Entered:2000-12-27, Days after submission: 29
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: Chronic bronchitis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: 0     Purchased by: 0
Symptoms: Bronchitis chronic, Condition aggravated
SMQs:
Write-up: Had severe reaction to flu shot and was down for 1 month. I called the health dept to report it but no one would believe me. I know several who also had reaction to shot. Flu shot stirred up my chronic bronchitis. 1

VAERS ID:167519 (history)  Vaccinated:1998-10-01
Age:  Onset:0000-00-00
Gender:Male  Submitted:2001-03-07
Location:Maryland  Entered:2001-03-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec; Levoxyl
Current Illness:
Preexisting Conditions: Allergy; thyroid dysfunction
Diagnostic Lab Data: 10/98; 12/98; 12/99 and 4/00-(100) liver functions were all high
CDC 'Split Type': WAES00060652
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Liver function test abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow)
Write-up: Information has been received from a consumer concerning her son who on 10/1/98, 12/1/98 and 12/7/99 was vaccinated with the 1st, 2nd and 3rd doses of Hep-B. Subsequently, the pt developed flu-like symptoms after each vaccination which lasted for approx. 1 week. Additionally, it was noted that liver function tests were abnormal after each vaccination. In April 2000, liver function testing was noted to be 100 which was considered high. The pt sought unspecified medical treatment. Additional information has been requested.

VAERS ID:231869 (history)  Vaccinated:1998-10-01
Age:1.0  Onset:0000-00-00
Gender:Male  Submitted:2004-12-22
Location:Unknown  Entered:2005-01-03, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Viral infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt has chicken pox on 12/21/04 received Varivax on 10/1/98

VAERS ID:237848 (history)  Vaccinated:1998-10-01
Age:7.0  Onset:2004-04-13, Days after vaccination: 2021
Gender:Female  Submitted:2005-05-16, Days after onset: 398
Location:South Carolina  Entered:2005-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pepcid
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0404USA01475
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0309H SC 
Administered by: Other     Purchased by: Other
Symptoms: Rash, Skin ulcer, Viral infection
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 7 year old female with no past medical history and no known drug allergies who in October 1998, was vaccinated SC with a 0.5ml dose of varicella virus vaccine (lot # 625382/0309H). Concomitant therapy included famotidine. On 4/13/04 the patient developed breakthrough varicella. She presented to the office on 4/14/04 with breakthrough varicella which was scattered and less than 50 lesions. She had no fever. The physician gave her diphenhydramine hydrochloride and acetaminophen for the itching and discomfort. Unspecified medical attention was sought. There was no product quality complaint. Additional information has been requested.

VAERS ID:239356 (history)  Vaccinated:1998-10-01
Age:1.0  Onset:2005-04-15, Days after vaccination: 2388
Gender:Female  Submitted:2005-06-06, Days after onset: 52
Location:Unknown  Entered:2005-06-07, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Viral infection
SMQs:
Write-up: Chicken pox disease status post vaccine

VAERS ID:242386 (history)  Vaccinated:1998-10-01
Age:51.0  Onset:2004-11-09, Days after vaccination: 2231
Gender:Female  Submitted:2005-07-29, Days after onset: 261
Location:Vermont  Entered:2005-08-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Liver function test abnormal, Osteoarthritis, Diabetes mellitus, Hypertension, Gastroesophageal reflux disease, Smoker, Drug Hypersensitivity
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0411USA01997
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0986N1 UN
Administered by: Other     Purchased by: Other
Symptoms: Chills, Erythema, Oedema, Pain, Pyrexia
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 (broad)
Write-up: Information has been received from a physician concerning a 57 year old white female with osteoarthritis, diabetes mellitus, hypertension, gastroesophageal reflux disease, smoker and ACTO''s causing increased LFT''s who in October 1988 was vaccinated with a second dose of pneumococcal 23v polysaccharide vaccine (lot 0986N), in the right deltoid. Concomitant therapy included. rabeprazole sodium (Aciphex), atorvastatin calcium (Lipitor), gabapentin (Neurontin), lisinopril (manufacturer unk), celecoxib (Celebrex), insulin lispro (Humalog), insulin glargine (Lantus), aspirin, vitamins (unspecified) and cyanocobalamin, On Nov 09 2004, in the afternoon, the patient experienced right upper arm pain, erythema, swelling, fever and chills. Subsequently, the patient recovered. There were no relevant diagnostic tests or laboratory data. The patient had no adverse events following prior vaccinations. No further information is available.

VAERS ID:264893 (history)  Vaccinated:1998-10-01
Age:41.0  Onset:1998-10-01, Days after vaccination: 0
Gender:Male  Submitted:2006-10-18, Days after onset: 2939
Location:Texas  Entered:2006-10-18
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: Numerous labs performed to rule out anything else.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV017   
Administered by: Military     Purchased by: Other
Symptoms: Arthralgia, Chronic fatigue syndrome, Dyspnoea, Erythema, Fatigue, Headache, Idiopathic urticaria, Injection site erythema, Laboratory test, Mental impairment, Neuralgia, Pain in extremity, Paraesthesia, Pruritus, Rash papular, Skin lesion, Urticaria, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (narrow), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 1st Vaccine (17 Sep 98) – 12 hours later - sore arm, redness about 4 inch in diameter, feeling of being tired (this fatigue went away after one week); common side effects according to doctor when asked the next day while at lunch; no entry in medical records of this reaction. 2nd Vaccine (1 Oct 98) – 8 hours later - sore arm, greater redness with raised bumps on most of upper arm, lasting about a week, continued feeling of being tired, slight headaches; common side effects according to doctor, no entry in medical records. Fatigue started again, but this time never went away and continues to present. 3rd Vaccine (26 Jan 99) – extremely sore arm within 12 hours, 24 hours later, severe hives started appearing all over body – extreme fatigue, headaches; 48 hours after vaccine the raised patches started to subside but itching, hives and fatigue increased; 72 hours (29 Jan 99) after vaccine, informed doctor that “this can't be normal”, doctor noted zero raised lesions even though there was slight evidence and severe redness over most of my body; doctor prescribed Benadryl and Atarax; follow up appointment (22 Feb 99), still taking Atarax to keep hives / itching away. Never was referred to an allergy clinic. Never was reported by doctors. This was the first time I asked to be taken off the Anthrax program. 4th Vaccine (9 Apr 99) – No hives due to the fact that I was taking Atarax – still suffering from fatigue and headaches. Early June 99 - Saw doctor (visit not found in my records anymore) starting to need Atarax less and less..eventually not needing it anymore and moved to creams – still slightly fatigued but improved. Asked once again to be released from vaccine program – declined by doctor. Doctor made note in records of the visit and that the reaction must have been from eating shellfish; which I had not done since mid-tour in Dec 98. 9 Aug 99 – Granted waiver for (among other issues) Idiopathic Urticaria possibly due to “shellfish / iodine allergies” – even though I had not consumed ANY shellfish for months prior to the allergic reaction to the vaccine – at this point, I clearly should have taken off the Anthrax Vaccine program – still fatigued. Of note, had difficulty breathing in 1991 after receiving IVP dye, prior to an XRay, and received epinephrine and steroids vaccine; had immediate recovery and left the hospital 45 minutes later. Never had another problem again until Anthrax Vaccine. See no correlation between this experience and the anthrax vaccine problems. Have never experienced any difficulty when eating shellfish and was skin test negative to shellfish in 2000. Because of this reaction, on 24 Oct 1991, I received an indefinite waiver from HQ ATC for Chronic Urticaria. Other waivers at this time were Hearing Loss, Microscopic Hematuria and Ulcers. See 13 Jun 96 Aeromedical Summary, pages 7-10. This was a one time problem (IVP Dye) waiver and no mention of Urticuria problems on the 20 May98 Aeromedical Summary. Jan 00 – Entered a Memo for Record into my medical records to try to stop the vaccine program. Nobody in the medical community would even discuss the subject. I would mention it to the flight surgeon's when they would come to the squadron to fly and it was quite apparent that they did not wish to discuss the subject. 5th Vaccine (17 Feb 00) – 22 hours later, 18 Feb 00, in to see doctor for, as doctor stated, “reaction to Anthrax shot”, lesions noted by doctor – extreme fatigue. Five minutes prior to receiving this vaccine, I told the administering tech that I have a history of reactions to this vaccine. He asked if I was waived and I replied no. I asked what my options were and he replied, “Well sir, unfortunately it is either the vaccine or Article 15”. I visited him a couple of weeks after the vaccine and showed him what the vaccine had done and I am sure he would remember me even to this day. He was only doing his job. Numerous appointments tested for shellfish and other aller

VAERS ID:418562 (history)  Vaccinated:1998-10-01
Age:9.0  Onset:2002-12-10, Days after vaccination: 1531
Gender:Female  Submitted:2011-03-07, Days after onset: 3009
Location:Tennessee  Entered:2011-03-11, Days after submission: 4
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: Serum hepatitis B, 05/03/10, Negative; serum hepatitis B, 04/23/10, 0.0, Negative; serum hepatitis B, 08/31/09, 0.0, Negative
CDC 'Split Type': WAES1004USA04584
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Anti-HBs antibody negative
SMQs:
Write-up: Information has been received from a licensed practical nurse concerning a female patient with no known drug allergies or pertinent medical history who on 01-OCT-1998 was vaccinated with a first dose of RECOMBIVAX HB, 1 ml IM. Subsequently, on 10-DEC-2002 the patient was vaccinated with a second dose of RECOMBIVAX HB 1 ml IM and on 24-JUN-2004 the patient was vaccinated with a third dose of RECOMBIVAX HB 1 ml IM. The nurse reported that the patient''s titers were negative. Afterwards, the patient was given another series of RECOMBIVAX HB. On 04-SEP-2009 the patient was vaccinated with a fourth dose of RECOMBIVAX HB (Lot number 662115/1263X) 1 ml IM, on 09-NOV-2009 the patient was vaccinated with a fifth dose of RECOMBIVAX HB (Lot number 662115/1263X) 1 ml IM and on 22-MAR-2010 the patient was vaccinated with a sixth dose of RECOMBIVAX HB (Lot number 0727X) 1 ml IM. The patient''s titers were taken on 23-APR-2010 and they were negative. At the time of the report the patient''s outcome was unknown. It was unspecified if the patient sought medical attention. Follow up information has been received from the licensed practical nurse concerning the four year old female patient with no illness at the time of vaccination. On 31-AUG-2009, a hepatitis B surface antibody test was performed to the patient, the quantity was 0.0. Afterwards, the patient was given another series of RECOMBIVAX HB. On 23-APR-2010, a hepatitis B surface antibody test was performed to the patient, the quantity was 0.0 again. On 03-MAY-2010, another hepatitis B surface antibody test was performed to the patient, the result was negative. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.

VAERS ID:117231 (history)  Vaccinated:1998-10-01
Age:60.4  Onset:1998-10-02, Days after vaccination: 1
Gender:Female  Submitted:1998-11-30, Days after onset: 59
Location:Foreign  Entered:1998-12-09, Days after submission: 9
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: Rotator cuff syndrome-left shoulder,
Diagnostic Lab Data: UNK
CDC 'Split Type': 19980286471
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Hypertonia, Injection site pain, Myopathy, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt recv vax in 10/98; 1 day post vax pt exp fever, flu like sx, vax site pain & stiffness, difficulty moving LA; dx=tear; tx=corticosteroid prep, Lidocaine

VAERS ID:124892 (history)  Vaccinated:1998-10-01
Age:45.4  Onset:0000-00-00
Gender:Female  Submitted:1999-05-27
Location:Foreign  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergies: food allergy to fish & dust allergy;no allergy to egg
Diagnostic Lab Data: NONE
CDC 'Split Type': MPF199900104
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt exp gen pruritus, local oedema & eruption of rt upper limb p/vax;

VAERS ID:124923 (history)  Vaccinated:1998-10-01
Age:83.1  Onset:1998-10-26, Days after vaccination: 25
Gender:Female  Submitted:1999-05-27, Days after onset: 212
Location:Foreign  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': REG199900003
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.81025DB1   
Administered by: Other     Purchased by: Other
Symptoms: Infection
SMQs:
Write-up: p/vax pt exp methicillin-resistant staphylococcal aureus (MRSA) wound infect;

VAERS ID:124931 (history)  Vaccinated:1998-10-01
Age:18.3  Onset:1998-10-05, Days after vaccination: 4
Gender:Female  Submitted:1999-05-27, Days after onset: 234
Location:Foreign  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': DIS199900041A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E81020AB1   
Administered by: Other     Purchased by: Other
Symptoms: Lymphadenopathy
SMQs:
Write-up: p/vax pt exp swelling of axillary lymph nodes;

VAERS ID:124932 (history)  Vaccinated:1998-10-01
Age:18.3  Onset:1998-10-05, Days after vaccination: 4
Gender:Female  Submitted:1999-05-27, Days after onset: 234
Location:Foreign  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': DIS199900041B
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E81020AB1   
Administered by: Other     Purchased by: Other
Symptoms: Lymphadenopathy
SMQs:
Write-up: p/vax pt exp swelling of axillary lymph nodes;

VAERS ID:124933 (history)  Vaccinated:1998-10-01
Age:63.6  Onset:1998-10-01, Days after vaccination: 0
Gender:Female  Submitted:1999-05-27, Days after onset: 238
Location:Foreign  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: alk phos;globulin both elevated;
CDC 'Split Type': REG199900062
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Anorexia, Blood alkaline phosphatase increased, Laboratory test abnormal, Urine analysis abnormal, Weight decreased
SMQs:, Liver related investigations, signs and symptoms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Biliary system related investigations, signs and symptoms (broad)
Write-up: p/vax pt exp weight loss, dark urine, anorexia, alk phos inc & globulin increase;

VAERS ID:157592 (history)  Vaccinated:1998-10-01
Age:  Onset:1998-10-01, Days after vaccination: 0
Gender:Unknown  Submitted:2000-05-05, Days after onset: 582
Location:Foreign  Entered:2000-07-20, Days after submission: 76
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': MPU1999002330
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.B81024AB1 IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Subsequent to receiving vax, pt experienced injection site swelling and itching. It is reported that there were no systemic effects. The doctor requested whether further injection this year would be contraindicated. Batch number received in follow up letter.

VAERS ID:173953 (history)  Vaccinated:1998-10-01
Age:2.0  Onset:2001-06-01, Days after vaccination: 974
Gender:Female  Submitted:2001-08-02, Days after onset: 62
Location:Foreign  Entered:2001-08-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': U2001009100
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: 0     Purchased by: 0
Symptoms: Infection, Meningitis
SMQs:, Noninfectious meningitis (narrow)
Write-up: The pt experienced a severe case of Hib meningitis. It took the pt 2-3 weeks to recover. She is still requiring physiotherapy and is awaiting a hearing test but she is considered recovered. Further data is not expected. The case is to be considered as closed.

VAERS ID:258454 (history)  Vaccinated:1998-10-01
Age:  Onset:0000-00-00
Gender:Unknown  Submitted:2006-06-15
Location:Foreign  Entered:2006-06-15
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': D0050001A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS   UN
Administered by: Other     Purchased by: Other
Symptoms: Cardiomyopathy
SMQs:, Cardiomyopathy (narrow)
Write-up: This case was reported by an employee of an insurance company and described the occurrence of dilatative cardiomyopathy in an adult subject of unspecified age and gender who was vaccinated with hepatitis A inactivated and hepatitis B recombinant vaccine (Twinrix adult) for prophylaxis. A physician or other health care professional has not verified this report. On an unknown date in October 1998 the subject received an unspecified dose of Twinrix adult (unknown). At an unspecified time post vaccination with Twinrix adult the subject experienced dilatative cardiomyopathy. At the time of reporting the event was unresolved. The subject considered that the event was triggered by vaccination with Twinrix adult. The subject now claims for disability pension payments due to this event from an occupational disability insurance policy. In follow-up information, received on 13 June 2006, the reported stated that no further information will be available at the moment until further clarification of the insurance claims.

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