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Case Details (Sorted by Vaccination Date)

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VAERS ID:109000 (history)  Vaccinated:1998-03-26
Age:0.6  Onset:1998-03-27, Days after vaccination: 1
Gender:Male  Submitted:1998-03-27, Days after onset: 0
Location:Maryland  Entered:1998-03-31, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Avavaid
Current Illness: NONE
Preexisting Conditions: RAD & OM
Diagnostic Lab Data: NONE
CDC Split Type: MD98002
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4502942IMRL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2404A22IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM285RJ2IMLL
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: generalized urticaria;

VAERS ID:109010 (history)  Vaccinated:1998-03-26
Age:2.4  Onset:1998-03-26, Days after vaccination: 0
Gender:Female  Submitted:1998-03-27, Days after onset: 1
Location:Georgia  Entered:1998-03-31, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Motrin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4504942IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4501872PO 
Administered by: Private     Purchased by: Other
Symptoms: Hypokinesia, Injection site oedema, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: morning p/vax pt has pain & will not walk;some swelling @ site of inj;motrin as needed for leg pain;

VAERS ID:109392 (history)  Vaccinated:1998-03-26
Age:51.9  Onset:1998-03-26, Days after vaccination: 0
Gender:Male  Submitted:1998-03-30, Days after onset: 4
Location:West Virginia  Entered:1998-04-03, Days after submission: 4
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: HTN, hypercholesterolemia;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER   A
Administered by: Private     Purchased by: Private
Symptoms: Malaise, Myalgia, Oedema peripheral, Pain, Pyrexia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: redness-heat-pain;swelling up to shoulder & down to elbow;rash-itching later; low grade fever, chills, malaise, aches;

VAERS ID:109704 (history)  Vaccinated:1998-03-26
Age:28.6  Onset:1998-03-28, Days after vaccination: 2
Gender:Female  Submitted:1998-03-30, Days after onset: 2
Location:Colorado  Entered:1998-04-13, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: codeine allergy
Diagnostic Lab Data:
CDC Split Type: CO98014
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1230E SCLA
Administered by: Public     Purchased by: Public
Symptoms: Ear pain, Headache, Lymphadenopathy, Pain
SMQs:
Write-up: Saturday afternoon started having pain up by lt ear hurt when drank cole beverages, pain then got worse, radiated to lt jaw;glands swollen by both ears;painful to chew hard foods;h/a started the day p/vax;went to ER;

VAERS ID:109716 (history)  Vaccinated:1998-03-26
Age:18.5  Onset:1998-03-26, Days after vaccination: 0
Gender:Female  Submitted:1998-04-01, Days after onset: 6
Location:Iowa  Entered:1998-04-18, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness:
Preexisting Conditions: NKA, hx migraines, hx earaches, hx tubes to ear;skin graft to rt ear drum
Diagnostic Lab Data: NA
CDC Split Type: IA98006
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1237E1SC 
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Lymphadenopathy, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 26MAR98 & that evening & next day c/o arm being sore;no redness or swelling;cont weakness through 1APR98;mom to ER T99-100;lymph nodes in neck swollen;rash between breast & lt spots on face;

VAERS ID:110009 (history)  Vaccinated:1998-03-26
Age:0.1  Onset:1998-03-27, Days after vaccination: 1
Gender:Female  Submitted:1998-04-16, Days after onset: 19
Location:Pennsylvania  Entered:1998-04-23, Days after submission: 7
Life Threatening? No
Died? Yes
   Date died: 1998-03-27
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: +suspected sepsis @ birth treated x 7 days
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4484510IMRL
HIBV: HIB (HIBTITER)LEDERLE LABORATORIESM255RJ0IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N00320SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)
Write-up: pt recv vax 26MAR98 & died 27MAR98;

VAERS ID:111765 (history)  Vaccinated:1998-03-26
Age:40.7  Onset:1998-03-26, Days after vaccination: 0
Gender:Female  Submitted:1998-05-29, Days after onset: 63
Location:West Virginia  Entered:1998-06-02, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unknown
Current Illness:
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC Split Type: WAES98032236
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Eye disorder, Eye pain, Headache, Pharyngitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: Pt indirectly exposed to MMR when she was squirted in the eye. Later that day pt presented w/"throat burning, eye burning & h/a". Additional information has been requested.

VAERS ID:111564 (history)  Vaccinated:1998-03-26
Age:0.2  Onset:1998-03-26, Days after vaccination: 0
Gender:Male  Submitted:1998-05-29, Days after onset: 63
Location:New York  Entered:1998-06-09, 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: some vomiting
Preexisting Conditions: benigh sleep myoclonus;EEG WNL
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES0916490  LL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1037E  RL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES0927140  LL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N0146  RL
Administered by: Private     Purchased by: Unknown
Symptoms: Hypotonia, Stupor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: mom reported an episode of laying limp but responded to mom as picked up, lasting for few min??

VAERS ID:115871 (history)  Vaccinated:1998-03-26
Age:43.0  Onset:1998-03-28, Days after vaccination: 2
Gender:Female  Submitted:1998-10-26, Days after onset: 212
Location:Wisconsin  Entered:1998-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 19980085781
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2607A22IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Myalgia, Osteoarthritis, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recv vax 26MAR98 & 28MAR98 started feeling achy;29MAR98 noticed a light rash on arms & legs & the joints of fingers, elbows & knees were aching;30MAR98 pt reported puffiness of the joints of fingers, elbows & knees;

VAERS ID:116006 (history)  Vaccinated:1998-03-26
Age:0.4  Onset:0000-00-00
Gender:Unknown  Submitted:1998-10-26
Location:Virginia  Entered:1998-11-02, 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:
Diagnostic Lab Data:
CDC Split Type: 19980197071
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES 0IM 
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0  
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD. 0  
Administered by: Other     Purchased by: Other
Symptoms: Agitation, Conjunctivitis, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: pt recv vax 26MAR98 & devel fever of 102.5 & irritability;6 days post vax 1APR98 pt devel conjunctivitis;

VAERS ID:118869 (history)  Vaccinated:1998-03-26
Age:  Onset:0000-00-00
Gender:Unknown  Submitted:1998-09-30
Location:Virginia  Entered:1999-02-11, Days after submission: 134
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: UNK
Diagnostic Lab Data: UNK
CDC Split Type: U199800420
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES  IM 
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM    
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD. 0  
Administered by: Other     Purchased by: Other
Symptoms: Agitation, Conjunctivitis, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: Pt recv vax on 3/26/98;post vax pt exp fever (102.5F) & irritable; 6 day post vax pt exp conjunctivitis

VAERS ID:108963 (history)  Vaccinated:1998-03-27
Age:2.8  Onset:1998-03-27, Days after vaccination: 0
Gender:Female  Submitted:1998-03-27, Days after onset: 0
Location:New Hampshire  Entered:1998-03-30, Days after submission: 3
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: sulfa & erythromycin
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1101E0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv vax to lt deltoid site immed devel flat red rash, no hives, no edema;rash 2" above & below inj site;same area as alcohol wipe;

VAERS ID:109221 (history)  Vaccinated:1998-03-27
Age:1.2  Onset:1998-03-29, Days after vaccination: 2
Gender:Female  Submitted:1998-03-31, Days after onset: 2
Location:Michigan  Entered:1998-04-03, Days after submission: 3
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: LP;CBC/diff done;blood cult;CT;EEG;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4490673IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS4494213IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES773A32PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Febrile convulsion
SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: prolonged febrile seizure w/in 48hr post vax administration;

VAERS ID:109390 (history)  Vaccinated:1998-03-27
Age:1.2  Onset:1998-03-28, Days after vaccination: 1
Gender:Male  Submitted:1998-03-30, Days after onset: 2
Location:North Carolina  Entered:1998-04-03, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: no meds
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES4490703 RL
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: 5x3cm warm, red area next to inj site;

VAERS ID:109518 (history)  Vaccinated:1998-03-27
Age:1.8  Onset:0000-00-00
Gender:Female  Submitted:1998-04-03
Location:New Jersey  Entered:1998-04-06, Days after submission: 2
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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Herpes zoster, Infection, Pain, Vasodilatation
SMQs:
Write-up: red mark noticed behind the ear-appears to be a shingle patterson going down trigeminal nerve, painful blisters w/drainage very red;

VAERS ID:109544 (history)  Vaccinated:1998-03-27
Age:0.4  Onset:1998-03-27, Days after vaccination: 0
Gender:Male  Submitted:1998-03-30, Days after onset: 3
Location:Iowa  Entered:1998-04-06, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC Split Type: IA98005
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4477881 LL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N084421 RL
Administered by: Public     Purchased by: Other
Symptoms: Agitation, Injection site hypersensitivity, Injection site mass, Injection site oedema, Vasodilatation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 27MAR98 & 6PM began to cry non stop for 1 1/2hr;mom called hosp both legs appeared to have bad sunburn from thighs to mid-shin w/ankles swollen;both legs appearance was equal;lt leg had 1/2 dollar size red, warm & firm @ site;

VAERS ID:109584 (history)  Vaccinated:1998-03-27
Age:6.5  Onset:1998-03-30, Days after vaccination: 3
Gender:Male  Submitted:1998-03-30, Days after onset: 0
Location:Florida  Entered:1998-04-07, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: temp of 100
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1579E0SC 
Administered by: Private     Purchased by: Unknown
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: broke out in full blown chickenpox;

VAERS ID:109591 (history)  Vaccinated:1998-03-27
Age:0.2  Onset:1998-03-27, Days after vaccination: 0
Gender:Male  Submitted:1998-03-31, Days after onset: 4
Location:New York  Entered:1998-04-07, 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: vomit x 1 prev wk
Preexisting Conditions: poor feeding @ bath
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES0916900IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.M0007H1IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N03480IMRL
Administered by: Private     Purchased by: Public
Symptoms: Agitation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: screaming on & off x 3 days even w/APAP;

VAERS ID:109567 (history)  Vaccinated:1998-03-27
Age:0.5  Onset:0000-00-00
Gender:Male  Submitted:1998-04-01
Location:Pennsylvania  Entered:1998-04-08, 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: given nystatin oral solution;APAP for 24hr p/vax
Current Illness: thrush, nasal yellow dry mucous secretions
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES4506392IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM289RJ2IMRL
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Febrile convulsion, Hypocalcaemia, Infection, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad)
Write-up: fever 103 of unk origin (poss viral synd) w/febrile sz activity for the first time occurred in 3 days post vax;

VAERS ID:109643 (history)  Vaccinated:1998-03-27
Age:2.0  Onset:1998-03-27, Days after vaccination: 0
Gender:Male  Submitted:1998-04-01, Days after onset: 5
Location:Rhode Island  Entered:1998-04-09, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM195RF   
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES0937090   
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0768H   
Administered by: Private     Purchased by: Unknown
Symptoms: Febrile convulsion, Rash
SMQs:, Anaphylactic reaction (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow)
Write-up: 27MAR98 febrile seizure in PM-ER visit;30MAR98 PCP visit-roseola rash;

VAERS ID:109685 (history)  Vaccinated:1998-03-27
Age:0.2  Onset:1998-03-27, Days after vaccination: 0
Gender:Female  Submitted:1998-03-30, Days after onset: 3
Location:Ohio  Entered:1998-04-10, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type: OH98023
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4484510IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0092E0IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N003220SCRL
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Insomnia, Screaming, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: mom noticed that around 5PM Friday evening pt rt leg was very swollen & extremely red;mom said child was very hot but did not take temp;did give APAP q 4hr;mom applied cold cloths through noc;also called MD & told to cont cold cloths & APAP

VAERS ID:109688 (history)  Vaccinated:1998-03-27
Age:36.4  Onset:1998-03-27, Days after vaccination: 0
Gender:Female  Submitted:1998-03-27, Days after onset: 0
Location:Oklahoma  Entered:1998-04-10, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: had allergic rxn to inhaling too much pesticides & carries epi-pen w/her
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES09157200SCRA
Administered by: Private     Purchased by: Private
Symptoms: Hypotension, Injection site hypersensitivity, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow)
Write-up: 15min p/vax pt had redness about 3" across @ site;no other problem;BP 116/70;seen by MD & given med;redness w/o itching appeared on neck & upper body & chest;no wheezing, tightness in throat or other rxn sx;p/35min of observation BP 100/70;

VAERS ID:109767 (history)  Vaccinated:1998-03-27
Age:0.2  Onset:1998-03-27, Days after vaccination: 0
Gender:Female  Submitted:1998-03-30, Days after onset: 3
Location:Georgia  Entered:1998-04-16, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: GA98021
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAMA841A20IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2356A21IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1363E0IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.M09380SCRL
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Hypotonia, Pallor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: p/vax pt immed started gasping was limp, turned white was transported to ER & then was transferred to hosp;

VAERS ID:109772 (history)  Vaccinated:1998-03-27
Age:1.4  Onset:0000-00-00
Gender:Male  Submitted:1998-04-07
Location:Mississippi  Entered:1998-04-16, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: high temp 104 x 2 1/2 days-severe red rash on 3rd day;covering entire body;

VAERS ID:109781 (history)  Vaccinated:1998-03-27
Age:30.6  Onset:1998-04-08, Days after vaccination: 12
Gender:Female  Submitted:1998-04-10, Days after onset: 2
Location:Massachusetts  Entered:1998-04-16, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: rash, posterior adenopathy
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1003D1SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: rubella-rash like;

VAERS ID:109852 (history)  Vaccinated:1998-03-27
Age:1.0  Onset:1998-04-10, Days after vaccination: 14
Gender:Male  Submitted:1998-04-14, Days after onset: 4
Location:Minnesota  Entered:1998-04-20, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1019E0 RL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1326E0 L
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: rash 1wk p/vax;

VAERS ID:110588 (history)  Vaccinated:1998-03-27
Age:1.1  Onset:1998-04-08, Days after vaccination: 12
Gender:Female  Submitted:1998-04-22, Days after onset: 14
Location:New York  Entered:1998-05-04, 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: fluoride
Current Illness: eczema
Preexisting Conditions: mild eczema
Diagnostic Lab Data: CBC & throat cult;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1312E0 RA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1564E0 LA
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Febrile convulsion, Infection, Otitis media, Pharyngitis, Pyrexia, Rhinitis
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: irritability on 8APR, 9APR, 10APR;? fever on 11APR;inc irritability & fever 12APR;3min gen sz on 12APR;tx in ER lt otitis med & viral urine confirmed;WBC 6,100, Hgb 11.7, platelets 209,00 diff 63.9%, lymph 36.1% polys;febrile sz;

VAERS ID:110757 (history)  Vaccinated:1998-03-27
Age:36.9  Onset:1998-03-30, Days after vaccination: 3
Gender:Male  Submitted:1998-04-06, Days after onset: 6
Location:Washington  Entered:1998-05-11, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Niacin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WA981444
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1286E1IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Dermatitis exfoliative, Photosensitivity reaction, Vasodilatation
SMQs:, Severe cutaneous adverse reactions (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow)
Write-up: 29MAR used sunscreen 15 (has used it before);went skiing;got sunburn to face;skin peeled for 1wk;since 4APR has had intermittent episodes of facial flushing;referred to MD;

VAERS ID:110791 (history)  Vaccinated:1998-03-27
Age:1.0  Onset:1998-04-03, Days after vaccination: 7
Gender:Female  Submitted:1998-04-22, Days after onset: 18
Location:California  Entered:1998-05-12, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1397E0  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1160E0  
Administered by: Military     Purchased by: Military
Symptoms: Drug ineffective, Infection, Pyrexia
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Broke out with measles--had fever, rash, 1 week following vax

VAERS ID:111871 (history)  Vaccinated:1998-03-27
Age:0.5  Onset:1998-03-27, Days after vaccination: 0
Gender:Male  Submitted:1998-03-30, Days after onset: 3
Location:Arkansas  Entered:1998-06-15, Days after submission: 76
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type: AR9832
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM255RJ1IMLL
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: mom stated pt got a rash p/vax 27MAR98;rash still present on 30MAR98;took pt to MD 30MAR98;MD said it was poss rxn to vax & not to given HIB in future;

VAERS ID:114621 (history)  Vaccinated:1998-03-27
Age:49.8  Onset:1998-03-27, Days after vaccination: 0
Gender:Female  Submitted:1998-03-31, Days after onset: 4
Location:Colorado  Entered:1998-09-30, Days after submission: 182
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Provera 5mg, Premarin .9mg,Calcium 1000mg,Amitriptyline 30mg,Prilosec 20mg,Esgic PRN,Metamucil,Vancenase,Luvox
Current Illness: NONE
Preexisting Conditions: Depression, anxiety, allergies
Diagnostic Lab Data: UNK
CDC Split Type: 898091068A
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4517960IMLA
Administered by: Private     Purchased by: Other
Symptoms: Hypokinesia, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt recv vax on 3/27/98; on same day pt exp severe arm pain; pt was unable to move arm.Pt seen in clinic; tx=immobilizer &Keflex.

VAERS ID:115248 (history)  Vaccinated:1998-03-27
Age:0.3  Onset:1998-03-29, Days after vaccination: 2
Gender:Female  Submitted:1998-05-15, Days after onset: 46
Location:California  Entered:1998-10-21, Days after submission: 159
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: UNK
Diagnostic Lab Data: UNK
CDC Split Type: 898203001Y
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES 1IM 
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES 1IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES 1PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Agitation, Melaena, Personality disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: Pt recv vax on 3/27/98; on 3/29/98 pt became cranky, irritable, inconsolable (not herself), blood stains in pt diaper &stool. Pt imp 1 wk.

VAERS ID:115992 (history)  Vaccinated:1998-03-27
Age:27.5  Onset:1998-03-27, Days after vaccination: 0
Gender:Female  Submitted:1998-10-26, Days after onset: 213
Location:Michigan  Entered:1998-11-02, 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: Keflex
Current Illness:
Preexisting Conditions: asthma, chicken pox as child;evelated WBC count;
Diagnostic Lab Data:
CDC Split Type: 19980165791
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2506A42IMLA
Administered by: Other     Purchased by: Other
Symptoms: Adverse drug reaction, Back pain, Chest pain, Diarrhoea, Dysphagia, Injection site pain, Neck pain, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 27MAR98 & 20min p/vax pt exp sore arm injite;over the period of the next 45min to an hr, pt also devel worsened arm pain extending into neck w/some difficulty swallowing;28MAR98 pt c/o pains in chest & back along, w/n/v/d;

VAERS ID:118499 (history)  Vaccinated:1998-03-27
Age:17.1  Onset:0000-00-00
Gender:Female  Submitted:1999-01-26
Location:New York  Entered:1999-02-01, 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: unk
Current Illness:
Preexisting Conditions: pregnancy;herpetic infection
Diagnostic Lab Data: 19JAN99 computed axial tomograph lt orbital roof defect;computed axial tomograph lt orbital mass w/encephaloecle;computed axial tomograph lt supraseller archnoid cyst;FAMA-neg (suggests more likely neural tube defect)
CDC Split Type: WAES99011253
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1225E1  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1108E0SC 
Administered by: Other     Purchased by: Other
Symptoms: Foetal disorder, Herpes simplex
SMQs:, Foetal disorders (narrow)
Write-up: pt recv vax in first month of pregnancy;in approx NOV98 pt delivered child;the child was born w/o a lt eye;19JAN99 CT scan revealed lt orbital roof defect, lt orbital mass w/encephalocele & lt suprasellar arachnoid cyst;Annual follow-up dated 11/27/00 provided no additional data.

VAERS ID:122806 (history)  Vaccinated:1998-03-27
Age:1.1  Onset:1998-05-01, Days after vaccination: 35
Gender:Female  Submitted:1999-05-14, Days after onset: 378
Location:Texas  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unknown
Current Illness:
Preexisting Conditions: unknown
Diagnostic Lab Data: dx lab te: no detectable VZV antibody.
CDC Split Type: WAES98032444
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: after pt recv vax some of the vax spilled out of the syringe. A titer was done 6 wk p/vax & no detectable VZV antibody was found

VAERS ID:123456 (history)  Vaccinated:1998-03-27
Age:18.0  Onset:0000-00-00
Gender:Female  Submitted:1999-05-14
Location:Wisconsin  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:
Other Medications:
Current Illness:
Preexisting Conditions: anemia; drug allergy; sickle cell trait
Diagnostic Lab Data: test: amniocentesis, norm; ultrasound , norm
CDC Split Type: WAES98060432
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Infection
SMQs:
Write-up: p/ pt recv vax subsequently pt was found to be preg, test results norm. also 12 wks of gestation pt dx w/gonorrhea & pubic lice which were treated.

VAERS ID:227428 (history)  Vaccinated:1998-03-27
Age:33.0  Onset:0000-00-00
Gender:Male  Submitted:2004-09-21
Location:Georgia  Entered:2004-10-07, Days after submission: 16
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: Pt had rheumatology consultation in Jan 04, ANA, Rheumatoid factor, sedimentation rate, c-reactive protein, CPK, TSK, B12, Insulin like growth factor I all normal.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0200SC 
Administered by: Military     Purchased by: Military
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Pt came in to be seen today because he showed up on a list being delinquent for an Anthrax vaccine. After restarting the Anthrax regime last year, pt states he has been having unknown pains in his arms, back and legs. After several visits and a referral to a board certified Rheumatoloist it has been determined that the Anthrax vaccne most likely has caused his unknown pains and is recommended pt be deferred from any additional Anthrax shots.

VAERS ID:256924 (history)  Vaccinated:1998-03-27
Age:3.0  Onset:2005-11-16, Days after vaccination: 2791
Gender:Male  Submitted:2006-05-12, Days after onset: 176
Location:Maryland  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Body Temp-11/16/05-103.2F
CDC Split Type: WAES0511USA04480
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Headache, Infection, Pyrexia
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Info has been received from a CMA concerning a healthy 11 year old male pt with no allergies, who on 3/27/98 was vaccinated with a dose of varicella virus vaccine live. On 11/16/05, the pt developed 20-30 lesions, fever (103.2F) and headache. He was treated with Tylenol and supportive care. There was no product quality complaint reported. There was no other info available regarding the adverse event or the pt''s outcome. Additional info has been requested.

VAERS ID:112465 (history)  Vaccinated:1998-03-27
Age:  Onset:1998-03-30, Days after vaccination: 3
Gender:Female  Submitted:1998-07-10, Days after onset: 101
Location:Foreign  Entered:1998-07-13, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp pregnancy hemorrhage w/dose 2 rabies;
Other Medications: NONE
Current Illness:
Preexisting Conditions: dog bite on 24MAR98, 24wk gestation
Diagnostic Lab Data:
CDC Split Type: 3508
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION2180111  
Administered by: Other     Purchased by: Other
Symptoms: Foetal disorder, Premature labour, Stillbirth
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: pt recv 3rd dose of vax 31MAR98 & 8APR98 delivered prematurely & the newborn died on 9APR98;tx of the dog bite included wound treatment, but administration of immunoglobulins was not mentioned in the report;

VAERS ID:110400 (history)  Vaccinated:1998-03-28
Age:37.6  Onset:1998-03-29, Days after vaccination: 1
Gender:Male  Submitted:1998-04-13, Days after onset: 14
Location:Michigan  Entered:1998-04-27, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp n,flu sx, aching in muscles, h/a, discomfort w/rabies #1, IPV,TD#4;
Other Medications: oral typhoid x 4 caps
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: rabies titer 9APR98
CDC Split Type: MI98030
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (NO BRAND NAME)MICHIGAN DEPT PUB HLTHRV1571IM 
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 27MAR98 & next day was working out & broke out in hives described as large elevated blotches on arms & legs lasting 1-2hr;

VAERS ID:110697 (history)  Vaccinated:1998-03-28
Age:44.8  Onset:1998-03-28, Days after vaccination: 0
Gender:Female  Submitted:1998-03-30, Days after onset: 2
Location:New York  Entered:1998-05-07, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: pt takes med for asthma
Current Illness: NA
Preexisting Conditions: asthmatic, allergies to eggs;
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1014E SC 
Administered by: Other     Purchased by: Unknown
Symptoms: Dyspnoea, Laryngospasm, Myalgia, Pharyngitis, Pruritus, Tongue disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Agranulocytosis (broad), Dystonia (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 28MAR98 & about 5-10min p/vax c/o itching on tongue & throat;itching around neck;Epi given;needs to go to ER dept;

VAERS ID:122482 (history)  Vaccinated:1998-03-28
Age:2.0  Onset:1998-04-05, Days after vaccination: 8
Gender:Female  Submitted:1999-05-21, Days after onset: 410
Location:New York  Entered:1999-05-24, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98060317
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Conjunctivitis, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: pt recv vax & exp mild conjunctivitis & fever of 105;

VAERS ID:157040 (history)  Vaccinated:1998-03-28
Age:1.0  Onset:1999-01-01, Days after vaccination: 279
Gender:Male  Submitted:2000-05-16, Days after onset: 500
Location:Pennsylvania  Entered:2000-07-17, Days after submission: 62
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99051532
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1564E0SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: In January, 1999 the pt experienced chickenpox.

VAERS ID:210923 (history)  Vaccinated:1998-03-28
Age:29.0  Onset:1998-03-30, Days after vaccination: 2
Gender:Male  Submitted:2003-10-15, Days after onset: 2024
Location:California  Entered:2003-10-24, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0202SC 
Administered by: Military     Purchased by: Military
Symptoms: Amnesia, Dizziness, Tinnitus, Vertigo
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (narrow), Vestibular disorders (narrow)
Write-up: Memory loss, tinitus, vertigo/dizziness

VAERS ID:109525 (history)  Vaccinated:1998-03-30
Age:1.5  Onset:1998-03-30, Days after vaccination: 0
Gender:Male  Submitted:1998-03-31, Days after onset: 1
Location:California  Entered:1998-04-06, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1541D0SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: fever 103.7 R occurring w/in 24hr of vax administration;

VAERS ID:109595 (history)  Vaccinated:1998-03-30
Age:1.1  Onset:1998-04-03, Days after vaccination: 4
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1998-04-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Triamcindone
Current Illness: NONE
Preexisting Conditions: allergies to pears, carrots, peaches, squash;heart murmur, eczema
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0900E0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0712E0SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 5 days p/vax pt had rash on back, forehead, cheeks & around eyes;no other symptoms;

VAERS ID:109672 (history)  Vaccinated:1998-03-30
Age:1.3  Onset:1998-04-05, Days after vaccination: 6
Gender:Male  Submitted:1998-04-06, Days after onset: 0
Location:Tennessee  Entered:1998-04-10, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM035PE3 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0739E0 LL
Administered by: Private     Purchased by: Private
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: small, red papules on forehead, abd & back;

VAERS ID:109726 (history)  Vaccinated:1998-03-30
Age:0.4  Onset:1998-03-31, Days after vaccination: 1
Gender:Male  Submitted:1998-03-31, Days after onset: 0
Location:New Mexico  Entered:1998-04-14, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Johns Hopkins sutdy pninme given 30MAR98 lot# WLVPT100
Current Illness: NONE
Preexisting Conditions: rt ptosis
Diagnostic Lab Data: CBC/SMA-7/LP, blood, CSF, UV cult all negative;
CDC Split Type: NM98007
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4455401IML
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS001H1IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.M04431IML
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt had onset of sz activity x2 w/fever approx 18hr p/vax;

VAERS ID:109731 (history)  Vaccinated:1998-03-30
Age:32.2  Onset:1998-03-30, Days after vaccination: 0
Gender:Female  Submitted:1998-04-07, Days after onset: 7
Location:Virginia  Entered:1998-04-14, 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: paxil
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.0154E1SCLA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES449578 IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site pain, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: devel swelling under skin p/vax (later in day) that has persisted;pt recv vax 30MAR98;area sl tender;no redness, no inc warmth;denies fever, chills;advised warm soaks, advil PCN;pt to return to clinic if inc size, inc warmth fever or rednes

VAERS ID:109742 (history)  Vaccinated:1998-03-30
Age:10.6  Onset:1998-03-30, Days after vaccination: 0
Gender:Female  Submitted:1998-04-04, Days after onset: 5
Location:Massachusetts  Entered:1998-04-14, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: mild allergic rhinitis
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0818E0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Chills, Headache, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: 30min p/vax c/o bilat hip & thigh pain;90min p/vax crying w/h/a;sx improve w/Ibuprofen but were present for 2 days p/vax;nl neuro exam;anterior thighs legs feel cold & numb;

VAERS ID:109783 (history)  Vaccinated:1998-03-30
Age:1.2  Onset:1998-04-07, Days after vaccination: 8
Gender:Male  Submitted:1998-04-09, Days after onset: 2
Location:Kentucky  Entered:1998-04-17, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EEG-nl
CDC Split Type: U1998001530
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER09161204  
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER09150504  
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1312E4  
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES786E22  
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Muscle twitching, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: 7 days p/vax pt started having fever & jerking motions;cont for 2 days;went to PCP 1st day & hosp admission 2nd day;phenobarb was started in hosp & no further episodes occurred;

VAERS ID:109797 (history)  Vaccinated:1998-03-30
Age:6.5  Onset:1998-03-31, Days after vaccination: 1
Gender:Male  Submitted:1998-04-10, Days after onset: 9
Location:New Hampshire  Entered:1998-04-17, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NH98
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES833A24 LA
Administered by: Private     Purchased by: Public
Symptoms: Injection site inflammation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: suspect acute inflammatory rxn lt upper extremity secondary to vax;ice, motrin rest, then heat p/2 days;

VAERS ID:109876 (history)  Vaccinated:1998-03-30
Age:27.9  Onset:1998-04-01, Days after vaccination: 2
Gender:Female  Submitted:1998-04-01, Days after onset: 0
Location:Pennsylvania  Entered:1998-04-21, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7F91679 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Injection site hypersensitivity, Injection site oedema, Injection site pain, Pain
SMQs:, Severe cutaneous adverse reactions (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 1APR98 tenderness only;2APR98 erythema, tenderness swelling @ inj site;seen in office @ 4PM 2APR98 erythema progressing 6cm diameter w/vesicle formation;

VAERS ID:110362 (history)  Vaccinated:1998-03-30
Age:10.7  Onset:1998-04-01, Days after vaccination: 2
Gender:Female  Submitted:1998-04-02, Days after onset: 1
Location:Michigan  Entered:1998-04-27, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type: MI98031
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1221E2 LA
Administered by: Public     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: pt recv vax 30MAR98 & grandfather brought child to clinic 2APR98 w/ c/o swelling @ inj site;area was swollen, sl red area, warm to touch;father stated swelling was noticed 1APR98;no ice for warm compress were given when initially noted;

VAERS ID:110505 (history)  Vaccinated:1998-03-30
Age:15.0  Onset:0000-00-00
Gender:Female  Submitted:1998-04-24
Location:New Jersey  Entered:1998-04-29, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: headache
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2587A20IMA
Administered by: Private     Purchased by: Private
Symptoms: Alopecia
SMQs:
Write-up: hair loss

VAERS ID:110663 (history)  Vaccinated:1998-03-30
Age:4.0  Onset:1998-03-30, Days after vaccination: 0
Gender:Male  Submitted:1998-03-30, Days after onset: 0
Location:Texas  Entered:1998-05-06, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: TX98055
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4484514IMRA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES0738E1SCLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv vax 30MAR98 220PM & pt was instructed to wait for 10 to 15min in the waiting room;approx 230PM noticed red spot on site of immun;MD was informed pt was asked to wait for another 15min;

VAERS ID:110767 (history)  Vaccinated:1998-03-30
Age:11.6  Onset:1998-03-30, Days after vaccination: 0
Gender:Female  Submitted:1998-05-06, Days after onset: 36
Location:Minnesota  Entered:1998-05-11, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1679E1SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6L813924IMLA
Administered by: Other     Purchased by: Public
Symptoms: Malaise, Pruritus, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: felt sick-chills, lo grade temp;p/morning rash started on arms to body to legs; about 1/4" red bumps w/itching;mom called ER said to give DPH & calamine lotion;back to school next day;

VAERS ID:111005 (history)  Vaccinated:1998-03-30
Age:42.8  Onset:1998-03-31, Days after vaccination: 1
Gender:Female  Submitted:1998-05-15, Days after onset: 44
Location:Indiana  Entered:1998-05-20, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: IN98016
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2398A60 RA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Malaise, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: feeling bad, tired, hives sick for 3 days;stayed home for 3 days;

VAERS ID:111341 (history)  Vaccinated:1998-03-30
Age:1.5  Onset:1998-03-30, Days after vaccination: 0
Gender:Male  Submitted:1998-05-22, Days after onset: 52
Location:Vermont  Entered:1998-06-01, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Actigall (Ursodiol)
Current Illness: Poss upper resp infect/chest congestion
Preexisting Conditions: myotubular myopathy, upper resp infect; NKA
Diagnostic Lab Data:
CDC Split Type: 19980111121
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM841A20IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site mass, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Approx 2 hr p/vax pt devel fever 101.3. Also redness & firmness @inj site.

VAERS ID:111366 (history)  Vaccinated:1998-03-30
Age:31.4  Onset:1998-04-13, Days after vaccination: 14
Gender:Male  Submitted:1998-05-29, Days after onset: 46
Location:Michigan  Entered:1998-06-02, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: atrial septal defect repair @ eyr
Diagnostic Lab Data: titer done 8NOV97 vegative for varicella;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1103E0SCLA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Headache, Skin ulcer
SMQs:, Guillain-Barre syndrome (broad)
Write-up: $g120 lesions, bad headaches, tired;lesions appeared in waves;onset 13 days p/vax;

VAERS ID:111997 (history)  Vaccinated:1998-03-30
Age:5.7  Onset:1998-04-01, Days after vaccination: 2
Gender:Female  Submitted:1998-05-05, Days after onset: 33
Location:Colorado  Entered:1998-06-19, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO98016
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES7J916854 LL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1038E2 RL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES7K816464 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1682E1 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES786B63PO 
Administered by: Private     Purchased by: Public
Symptoms: Hypersensitivity, Injection site hypersensitivity
SMQs:, Angioedema (broad), Hypersensitivity (narrow)
Write-up: severe local allergic rxn 10x15cm area of redness, no sign of infect on lt thigh;

VAERS ID:112065 (history)  Vaccinated:1998-03-30
Age:19.1  Onset:1998-03-30, Days after vaccination: 0
Gender:Female  Submitted:1998-04-04, Days after onset: 5
Location:South Carolina  Entered:1998-06-23, Days after submission: 79
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKDA no defects identified
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7J819100IMA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1611E0SC 
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4495790IMLA
Administered by: Military     Purchased by: Military
Symptoms: Asthma, Stupor, Tremor
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: sudden onset shaking-pt placed supine w/leg elevated-lung sounds CTA;responsive but dazed;pulse ox 99% during entire time;began to hear faint wheezing;given epi;

VAERS ID:112430 (history)  Vaccinated:1998-03-30
Age:1.5  Onset:1998-04-16, Days after vaccination: 17
Gender:Female  Submitted:1998-07-06, Days after onset: 81
Location:Illinois  Entered:1998-07-10, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: exam
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES7J916623 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0879D0 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES 3PO 
Administered by: Private     Purchased by: Private
Symptoms: Dehydration, Otitis media, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: fever, vomiting, dehydration, BOM;

VAERS ID:114097 (history)  Vaccinated:1998-03-30
Age:5.0  Onset:1998-03-30, Days after vaccination: 0
Gender:Female  Submitted:1998-04-01, Days after onset: 2
Location:Connecticut  Entered:1998-09-09, Days after submission: 160
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: NONE
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data: UNK
CDC Split Type: U199800120
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7J815350  
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 3/30/98; on the same day pt exp welts&itchiness from shoulder, upper trunk&upper extremities.Pt tx=Benadryl every 6 hrs prn-alleviated welts.

VAERS ID:114105 (history)  Vaccinated:1998-03-30
Age:0.4  Onset:1998-03-30, Days after vaccination: 0
Gender:Male  Submitted:1998-04-05, Days after onset: 6
Location:Pennsylvania  Entered:1998-09-09, Days after submission: 156
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: U199800175
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164901IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1484E1IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.NO3481SCRL
Administered by: Private     Purchased by: Private
Symptoms: Agitation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: Pt recv vax on 3/30/98; 6 hrs later pt was fussy and very irritable. Pt seen by Dr and given Tylenol.

VAERS ID:114106 (history)  Vaccinated:1998-03-30
Age:0.2  Onset:0000-00-00
Gender:Female  Submitted:1998-04-06
Location:Pennsylvania  Entered:1998-09-09, Days after submission: 156
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: U199800176
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09164900IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0007H0IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.NO3480SCRL
Administered by: Private     Purchased by: Private
Symptoms: Screaming
SMQs:, Hostility/aggression (broad)
Write-up: Pt recv vax on 3/30/98; 24 hrs later pt exp unconsolable crying; tx=Tylenol, pt seen by Dr.

VAERS ID:114680 (history)  Vaccinated:1998-03-30
Age:57.0  Onset:1998-04-02, Days after vaccination: 3
Gender:Male  Submitted:1998-08-19, Days after onset: 138
Location:Texas  Entered:1998-10-02, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NA
Preexisting Conditions: diabetes
Diagnostic Lab Data:
CDC Split Type: TX98145
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM553860IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Tendon disorder
SMQs:
Write-up: devel tendinitis in lt elbow 72hr p/vax;pt recv cortisone inj by MD;

VAERS ID:115874 (history)  Vaccinated:1998-03-30
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:1998-10-26
Location:California  Entered:1998-11-02, 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:
Diagnostic Lab Data:
CDC Split Type: 19980089951
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 2  
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax & exp pain @ the inj site & numbness in the arm;

VAERS ID:119883 (history)  Vaccinated:1998-03-30
Age:45.3  Onset:1998-04-09, Days after vaccination: 10
Gender:Female  Submitted:1999-03-01, Days after onset: 326
Location:Illinois  Entered:1999-03-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98041120
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 30MAR98 & 9APR98 pt devel a rash that started @ the inj site & disseminated generally over trunk & extremities;

VAERS ID:120670 (history)  Vaccinated:1998-03-30
Age:31.0  Onset:1998-03-31, Days after vaccination: 1
Gender:Female  Submitted:1998-04-10, Days after onset: 9
Location:North Carolina  Entered:1999-03-19, Days after submission: 343
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: U199800133
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0923910   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv vax 30MAR98 & between 24 to 48hr post vax NP reported a fine papular rash devel on pt entire body;pt has had tetanus shots in the past;

VAERS ID:122901 (history)  Vaccinated:1998-03-30
Age:28.2  Onset:1998-04-10, Days after vaccination: 11
Gender:Female  Submitted:1999-05-14, Days after onset: 399
Location:New Jersey  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unknown
Current Illness:
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC Split Type: WAES98040800
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.   RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Injection site reaction
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: p/ recv vax 3/98 approx 11 days later pt exp irritation around inject site & devel a vesicular lesion in the left ear

VAERS ID:122932 (history)  Vaccinated:1998-03-30
Age:33.0  Onset:1998-04-17, Days after vaccination: 18
Gender:Male  Submitted:1999-05-14, Days after onset: 392
Location:Arizona  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: therapy unspecified
Current Illness:
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC Split Type: WAES98041272
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1104E0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous, Rash, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv 1 dose of varicella vax 3/30/98 & 18 days later pt devel ``rash over entire body'' rash was described atypical chickenpox, red papules w/some vesicles.

VAERS ID:122939 (history)  Vaccinated:1998-03-30
Age:33.0  Onset:1998-04-16, Days after vaccination: 17
Gender:Male  Submitted:1999-05-14, Days after onset: 393
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: unknown
Current Illness:
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC Split Type: WAES98041342
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv 1st dose of varicella vax 3/30/98 & 4/16/98 devel lesions that looked like ``mosquito bites'''' over body, 4/17/98 devel approx 100 papules. 4/20 pt saw m.d. lesions had started to heal

VAERS ID:123141 (history)  Vaccinated:1998-03-30
Age:31.2  Onset:1998-12-29, Days after vaccination: 274
Gender:Female  Submitted:1999-05-14, Days after onset: 135
Location:Texas  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:
Current Illness:
Preexisting Conditions: hypothyroidism
Diagnostic Lab Data: dx te: 7/22/98amniocentesis, 46chromosomes; ultrasound, level II r/o abnorm. Lab te: 12/28/98, apgar score, 8 @ 1 min&9 @5 min, 12/29hemoglobin, low; hematocrit, low,WBC ct high, rbc ct, low, 7/22 serum alpha-fetoprotein inc risk of twins.
CDC Split Type: WAES98051263
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anaemia, Leukocytosis
SMQs:, Haematopoietic erythropenia (broad), Neuroleptic malignant syndrome (broad)
Write-up: MD rpt pt recv 2nd dose varivax 3//98 & 12/29/98 pt became preg, took vitamin during preg & delivered normal healthy baby. 12/30/98, lab test on pt 12/29 revealed WBC (high) RBC (low) hem (low), hematocrit (low)

VAERS ID:122436 (history)  Vaccinated:1998-03-30
Age:1.0  Onset:1998-04-07, Days after vaccination: 8
Gender:Male  Submitted:1999-05-21, Days after onset: 409
Location:Arizona  Entered:1999-05-24, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications:
Current Illness: LOM
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES97060545
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER 2IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0993D0SC 
Administered by: Private     Purchased by: Private
Symptoms: Oedema peripheral, Pain, Pyrexia, Rash maculo-papular
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & devel a raised confluent rash all over;pt devel swollen & tender feet & a fever of 102-103;4/8/98 pt devel new single spots;tx w/pred, APAP & Ibuprofen;

VAERS ID:123217 (history)  Vaccinated:1998-03-30
Age:35.0  Onset:1998-04-21, Days after vaccination: 22
Gender:Male  Submitted:1999-05-28, Days after onset: 402
Location:Massachusetts  Entered:1999-06-02, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EMG reveals Denervation of serratus anterior;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER2512A2   
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM55386   
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES7F91679   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Laboratory test abnormal, Malaise, Myasthenic syndrome, Neuritis, Neuropathy, Pain, Post vaccination syndrome, Pyrexia
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad)
Write-up: fever, malaise followed by severe pain in shoulder area for 24hr, followed by weakness/fatigue in shoulder;EMG reveals rt long thoracic neuropathy/brachial neuritis;physical therapy not successful;Annual follow up / no additional data.

VAERS ID:164748 (history)  Vaccinated:1998-03-30
Age:3.5  Onset:2001-01-05, Days after vaccination: 1012
Gender:Male  Submitted:2001-01-04, Days after onset: 1
Location:Michigan  Entered:2001-01-16, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09073803IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1363E1IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0770E0SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1610E0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This child received vaccination on 03/30/98 at the age of 12 1/2 months. Onset of varicella disease 01/04/01 and possibly father of child also.

VAERS ID:181411 (history)  Vaccinated:1998-03-30
Age:4.0  Onset:2002-02-01, Days after vaccination: 1404
Gender:Male  Submitted:2002-02-08, Days after onset: 7
Location:New Mexico  Entered:2002-02-14, 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: UNK
Current Illness: UNK
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Unknown
Symptoms: Herpes zoster, Infection
SMQs:
Write-up: Received varivax on 3/30/98 through a previous MD. Dx''d with Herpes Zoster on 2/8/02.

VAERS ID:193668 (history)  Vaccinated:1998-03-30
Age:5.0  Onset:2002-11-13, Days after vaccination: 1689
Gender:Female  Submitted:2002-11-14, Days after onset: 1
Location:New York  Entered:2002-11-20, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2357A22IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1312E0SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0802E0SC 
Administered by: Private     Purchased by: Private
Symptoms: Infection
SMQs:
Write-up: Chicken pox disease diagnosed by myself on 11/13/02. She had received chicken pox vaccine.

VAERS ID:200170 (history)  Vaccinated:1998-03-30
Age:1.0  Onset:2003-02-21, Days after vaccination: 1789
Gender:Female  Submitted:2003-03-09, Days after onset: 16
Location:Florida  Entered:2003-03-25, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ;Hib (unknown mfr);3;1;In Sibling
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Eye irritation, Infection, Viral infection
SMQs:, Lack of efficacy/effect (narrow), Corneal disorders (broad)
Write-up: On 2/22/03, breakout with chickenpox. All pox crusted by 2/28/03. At worst peak, counted over 240 pox all over body, including her scalp, ears, rectal area, under the tongue and in the mouth and under eyelids. Eye became very red and required ophthalmologist visit and viral treatment. Other treatment for chickenpox included Tylenol, Benadryl, oatmeal baths and calamine lotion. There is no lot number on the vaccine record for this vaccine or any of the others she received from this office.

VAERS ID:203043 (history)  Vaccinated:1998-03-30
Age:  Onset:0000-00-00
Gender:Male  Submitted:2003-05-08
Location:Unknown  Entered:2003-05-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES0207USA00205
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug toxicity, Nervous system disorder
SMQs:, Anticholinergic syndrome (broad), Drug abuse and dependence (broad)
Write-up: Information has been received regarding a case in litigation concerning a male child who was injected with vaccinations containing the toxic mercury-based preservative thimerosal during the period from November 1997 through April 1999. The alleged result of these vaccinations is that the pt suffers from and in the future will continue to suffer the toxic neurological effects of mercury poisoning. Vaccination history: A dose of hep B virus vaccine was given on 11/3/97, 1/9/98 and 3/30/98. A first, second, third and fourth dose of Haemophilus B conjugate vaccine and diphtheria toxoid (+) pertussis vaccie (+) tetanus toxoid were given on 11/3/97, 1/9/98, 3/3/98 and 4/21/99. Poliovirus vaccine was given orally on 11/3/97, 1/9/98 and 4/21/99. A tuberculin purified protein derivative test and MMR II were given on 9/28/98. A dose of Haemophilus B conjugate vaccine was given on 4/21/99. Upon internal review, mercury poisoning and neurological disorder were considered to be other important medical event (OMIC). Upon request a complete copy of medical records is available. No further info is available.

VAERS ID:227321 (history)  Vaccinated:1998-03-30
Age:2.0  Onset:2004-09-19, Days after vaccination: 2365
Gender:Female  Submitted:2004-09-27, Days after onset: 8
Location:New York  Entered:2004-10-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1108E0SCRA
Administered by: Private     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash appeared Sunday: Monday AM , Mom took child to ER to have confirmed. Doctor not in. Benadryl given with instructions on skin care. Appontment MD 9/24, 9/27, 9/28

VAERS ID:303395 (history)  Vaccinated:1998-03-30
Age:0.0  Onset:0000-00-00
Gender:Male  Submitted:2008-01-08
Location:New Jersey  Entered:2008-01-16, 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: Unknown
Preexisting Conditions: The subject''s medical history, concurrent conditions, and concurrent medications were not reported.
Diagnostic Lab Data: UNK
CDC Split Type: A0639898A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSENG2499A20IMUN
Administered by: Other     Purchased by: Other
Symptoms: Developmental delay, Immune system disorder, Metal poisoning, Nervous system disorder, Psychomotor skills impaired, Speech disorder
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: This case was reported by a lawyer and described the occurrence of toxic effect of mercury and its compounds in a male child who was vaccinated with ENGERIX-B (GlaxoSmithKline) for prophylaxis. A physician or other health care professional has not verified this report. The subject''s medical history, concurrent conditions, and concurrent medications were not reported. On 30 March 1998 the subject received 1st dose of Engerix-B (10 mcg, intramuscular). During the first 15 months of life, on or after 30 March 1998 and on or before 15 July 1999, the subject also received vaccinations with RECOMBIVAX, TriHIBit, ACEL-IMMUNE, HibTITER, and MMR II vaccine. According to the legal complaint, the subject was subjected to very high doses of mercury from thimerosal-containing vaccines during the first 15 months of life. As a result of the mercury contained in the thimerosal-containing vaccinations, the subject suffers from neurological and immunological damage with symptoms including developmental delay, loss of language, and failure to meet certain social and motor milestones. The outcome of the events was not reported.

VAERS ID:109598 (history)  Vaccinated:1998-03-31
Age:4.6  Onset:1998-04-01, Days after vaccination: 1
Gender:Female  Submitted:1998-04-02, Days after onset: 1
Location:California  Entered:1998-04-08, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES7J816764IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0785D3PO 
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: pt recv vax 31MAR98 & w/in 24hr began to have redness/tenderness approx 3" diameter @ site;no other sx;

VAERS ID:109741 (history)  Vaccinated:1998-03-31
Age:14.0  Onset:1998-03-31, Days after vaccination: 0
Gender:Female  Submitted:1998-04-01, Days after onset: 1
Location:Alaska  Entered:1998-04-14, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1626D0IM 
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM530A90IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Convulsion, Gaze palsy, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt recv vax & became pale & had sz activity w/eyes rolled back, upper body jerking movements;pt eased to floor & recovered;eval by MD vasovagal rxn;

VAERS ID:109799 (history)  Vaccinated:1998-03-31
Age:4.9  Onset:1998-04-01, Days after vaccination: 1
Gender:Female  Submitted:1998-04-03, Days after onset: 2
Location:California  Entered:1998-04-17, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: nONE
Diagnostic Lab Data: NONE
CDC Split Type: CA980039
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURERH827A24 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.159721 LA
Administered by: Private     Purchased by: Public
Symptoms: Hypokinesia, Injection site oedema, Injection site pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: rt arm became swollen, tender & painful to bend elbow from 1-4 days p/vax;

VAERS ID:109839 (history)  Vaccinated:1998-03-31
Age:17.3  Onset:1998-04-05, Days after vaccination: 5
Gender:Female  Submitted:1998-04-14, Days after onset: 8
Location:Iowa  Entered:1998-04-20, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC Split Type: IA98009
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7J91913 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Oedema peripheral, Pain, Paraesthesia, Vomiting
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: had the usual sore arm 1st several day p/vax but on 5APR pain inc to severe;cont to c/o pain & arm & hand became swollen & felt like it was asleep (tingling);also had an episode of vomiting 5APR & 6APR;8APR dad contacted school nurse;

VAERS ID:111510 (history)  Vaccinated:1998-03-31
Age:1.3  Onset:1998-04-03, Days after vaccination: 3
Gender:Female  Submitted:1998-05-04, Days after onset: 30
Location:California  Entered:1998-06-04, Days after submission: 31
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: resolved varicella - 10 days a/
Preexisting Conditions: amoxicillin-rash
Diagnostic Lab Data: NONE
CDC Split Type: CA980049
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES819A23IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1012E0SCRL
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: vomiting & diarrhea onset 4 days p/vax;

VAERS ID:113338 (history)  Vaccinated:1998-03-31
Age:22.0  Onset:1998-04-01, Days after vaccination: 1
Gender:Male  Submitted:1998-08-01, Days after onset: 121
Location:Unknown  Entered:1998-08-10, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0200  
Administered by: Military     Purchased by: Military
Symptoms: Headache
SMQs:
Write-up: h/a for approx 2wk p/vax;started one day p/vax given;

VAERS ID:113367 (history)  Vaccinated:1998-03-31
Age:21.1  Onset:0000-00-00
Gender:Male  Submitted:1998-08-01
Location:Pennsylvania  Entered:1998-08-11, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0200  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt exp swelling in rt arm where the shot was given;

VAERS ID:114107 (history)  Vaccinated:1998-03-31
Age:0.2  Onset:1998-03-31, Days after vaccination: 0
Gender:Female  Submitted:1998-04-05, Days after onset: 5
Location:Pennsylvania  Entered:1998-09-09, Days after submission: 156
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: U199800177
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES0916490 IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0007H IMLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.NO348 SCRL
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: Pt recv vax on 3/31/98; 6 hrs later pt exp fever (101.8F) and inconsolable crying. Pt seen by Dr; tx=Tylenol&tepid bath.

VAERS ID:122307 (history)  Vaccinated:1998-03-31
Age:  Onset:1998-04-01, Days after vaccination: 1
Gender:Female  Submitted:1998-04-06, Days after onset: 4
Location:Illinois  Entered:1999-05-21, Days after submission: 410
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:
Diagnostic Lab Data:
CDC Split Type: 898097072A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES448455 IMA
Administered by: Private     Purchased by: Private
Symptoms: Influenza, Injection site hypersensitivity, Injection site mass, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & w/in 18hr pt devel an inj site rxn characterized by redness, swelling & induration;pt also exp flu like sx which caused pt to miss 1 day of work;pt recovered;

VAERS ID:122308 (history)  Vaccinated:1998-03-31
Age:  Onset:1998-04-01, Days after vaccination: 1
Gender:Female  Submitted:1998-04-06, Days after onset: 4
Location:Illinois  Entered:1999-05-21, Days after submission: 410
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:
Diagnostic Lab Data:
CDC Split Type: 898097073A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES448455 IMA
Administered by: Private     Purchased by: Private
Symptoms: Influenza, Injection site hypersensitivity, Injection site mass, Injection site oedema, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & w/in 18hr pt devel an inj site rxn characterized by redness, swelling & induration;also exp body aches & flu like sx which caused pt to miss 1 day of work;

VAERS ID:154724 (history)  Vaccinated:1998-03-31
Age:5.0  Onset:1999-04-05, Days after vaccination: 370
Gender:Female  Submitted:2000-05-24, Days after onset: 415
Location:Ohio  Entered:2000-06-19, Days after submission: 26
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: WAES99040534
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1SC 
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Approximately 5 days post vax pt experienced an urticarial rash from head to toe. Pt was treated with Benadryl with some relief.

VAERS ID:156993 (history)  Vaccinated:1998-03-31
Age:25.0  Onset:1998-06-09, Days after vaccination: 70
Gender:Female  Submitted:2000-05-16, Days after onset: 707
Location:Indiana  Entered:2000-07-17, Days after submission: 62
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: serum varicella zoster negative after two doses
CDC Split Type: WAES99051036
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1160E1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Subsequent to receiving first and second doses of varicella virus vaccine live, laboratory evaluation revealed a lack of response.

VAERS ID:174689 (history)  Vaccinated:1998-03-31
Age:36.0  Onset:1998-04-10, Days after vaccination: 10
Gender:Male  Submitted:1998-06-30, Days after onset: 81
Location:Unknown  Entered:2001-08-27, Days after submission: 1154
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: HIV (+); stable
Diagnostic Lab Data: WBC; Joint fluid
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2424A2 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthritis, Joint swelling
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow)
Write-up: Diffuse joint swelling began on 7/2/98. Pt with frank arthritis and joint swelling/effusion. Joint fluid sterile. Resolved with PT/NSAIDS. Hospitalized X 7 days. Still disabled but improving.

VAERS ID:193594 (history)  Vaccinated:1998-03-31
Age:  Onset:0000-00-00
Gender:Male  Submitted:2002-11-15
Location:Unknown  Entered:2002-11-20, 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: Unk
Current Illness:
Preexisting Conditions: Unk
Diagnostic Lab Data: Unk
CDC Split Type: WAES0211USA01077
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1313E   
Administered by: Other     Purchased by: Other
Symptoms: Autism, Drug toxicity, Nervous system disorder
SMQs:, Anticholinergic syndrome (broad), Drug abuse and dependence (broad)
Write-up: Information has been received regarding a case in litigation concerning a male who on 9/3/97 (lot 622794/0554E), 10/30/97 (lot 622794/0554E) and 3/31/98 (lot 625097/1313E) was vaccinated with hep B vaccine recombinant. It is alleged that as a result of the pt''s exposure to thimerosal in hep b vaccine recombinant, the pt sustained neurological injuries and as a result of those injuries the pt had been diagnosed with autism spectrum disorder. Upon internal review, the pt''s autism and neurological injuries were considered important medical events (OMIC). No further info is available.

VAERS ID:218964 (history)  Vaccinated:1998-03-31
Age:  Onset:2004-04-01, Days after vaccination: 2193
Gender:Female  Submitted:2004-04-03, Days after onset: 2
Location:Texas  Entered:2004-04-13, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1004H0 LL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1055H0 RL
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Skin ulcer
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Atypical varicella; fever then 50 lesions-vesicules, pustules, scabbed lesions-mainly on trunk, fewer on extremes.

VAERS ID:240261 (history)  Vaccinated:1998-03-31
Age:1.1  Onset:2005-06-12, Days after vaccination: 2630
Gender:Male  Submitted:2005-06-16, Days after onset: 4
Location:New Jersey  Entered:2005-06-21, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0062H  UN
Administered by: Private     Purchased by: Private
Symptoms: Dry skin, Pruritus, Rash papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: On 6/12 noticed a few red papular and spread over body next 3 days, scabbed over, itchy.

VAERS ID:337568 (history)  Vaccinated:1998-03-31
Age:0.2  Onset:0000-00-00
Gender:Female  Submitted:2008-12-01
Location:Pennsylvania  Entered:2008-12-16, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: serum hepatitis B, negative; serum hepatitis C, negative; serum hepatitis B Ab, 03/25/08, none reactive; serum hepatitis B, 03/25/08, non reactive; serum hepatitis A, 03/25/08, reactive; serum hepatitis A IgM, 03/25/08, nonreactive; serum h
CDC Split Type: WAES0804USA01399
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALS  UNUN
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1176E1UNUN
Administered by: Private     Purchased by: Other
Symptoms: Antibody test negative, Hepatitis A antibody positive, Hepatitis B antibody negative, Hepatitis C antibody negative
SMQs:, Liver infections (narrow)
Write-up: Information has been received from a nurse concerning a 10 year old female who on 31-MAR-1998 was vaccinated with one dose of COMVAX (MSD) (lot # 623436/1176E). There was no concomitant medication. On 04-AUG-1998 the patient was vaccinated with COMVAX. Concomitant vaccinations included diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid, and poliovirus vaccine inactivated (unspecified). Subsequently, the patient was tested for Hepatitis B and Hepatitis C titers. The results came back as non-reactive. No other details were provided. Patient outcome was not reported. Additional information has been requested.

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