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Found 583703 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:86305 (history)  Vaccinated:1996-05-17
Age:4.9  Onset:1996-05-17, Days after vaccination: 0
Gender:Female  Submitted:1996-05-20, Days after onset: 3
Location:California  Entered:1996-05-23, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5B711720IMLA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1663A91IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0738B3PO 
Administered by: Private     Purchased by: Private
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: very swollen, hot, red upper arm;

VAERS ID:86367 (history)  Vaccinated:1996-05-17
Age:0.2  Onset:1996-05-17, Days after vaccination: 0
Gender:Female  Submitted:1996-05-20, Days after onset: 3
Location:Massachusetts  Entered:1996-05-24, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, glucose, sed rate nl
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MASS. PUB HLTH BIOL LABDTP2960IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM230NB0IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0739D0PO 
Administered by: Private     Purchased by: Public
Symptoms: Dyspnoea, Hyperhidrosis, Hypertonia, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: pt became pale, clammy, grunting appeared to stiffen but no other sz movement, lasted min, no remaining abnormalities;

VAERS ID:86598 (history)  Vaccinated:1996-05-17
Age:1.5  Onset:1996-05-27, Days after vaccination: 10
Gender:Male  Submitted:1996-05-30, Days after onset: 3
Location:Maryland  Entered:1996-06-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4326563 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1428B0 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0763L3PO 
Administered by: Private     Purchased by: Private
Symptoms: Cough, Lung disorder, Otitis media, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: congestive, cough, t102, OM for 3-4 days beginning 10 days p/vax

VAERS ID:87478 (history)  Vaccinated:1996-05-17
Age:49.9  Onset:0000-00-00
Gender:Female  Submitted:1996-06-14
Location:Rhode Island  Entered:1996-07-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
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 LABORATORIES5D71014 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Chills, Headache, Myalgia, Oedema, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt c/o severe h/a, fever, chills, arms swollen, arthralgia, & myalgias

VAERS ID:88657 (history)  Vaccinated:1996-05-17
Age:3.2  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:California  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES96052659
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 17MAY96 & 26MAY96 pt devel a rash, described as a few raised bumps, @ inj site;a few days later pt devel a fever of about 104;the fever was alleviated w/Ibuprofen;

VAERS ID:88113 (history)  Vaccinated:1996-05-17
Age:0.1  Onset:1996-05-17, Days after vaccination: 0
Gender:Male  Submitted:1996-07-19, Days after onset: 63
Location:New Mexico  Entered:1996-07-26, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4326540 LL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1223B1 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES073710PO 
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Hypotonia, Somnolence, Stupor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: 1hr p/vax pt was lethargic, staring, dec tone but fairly responsive lasted about 30-60 min (report by mom);12 hr later pt was crying vigorously & very cranky/irritable lasted 1hr-cranky for several days thereafter;

VAERS ID:90859 (history)  Vaccinated:1996-05-17
Age:13.8  Onset:1996-06-15, Days after vaccination: 29
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1996-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96061853
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Pruritus, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 17MAY96 & 15JUN96 pt devel a gen rash w/papules, blisters & itch which was dx as varicella;there was no assoc fever;pt recovered;

VAERS ID:91365 (history)  Vaccinated:1996-05-17
Age:3.2  Onset:1996-09-23, Days after vaccination: 129
Gender:Male  Submitted:1996-10-04, Days after onset: 11
Location:California  Entered:1996-10-28, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD by Connaught lot# 240911 given 17MAY96;
Current Illness: cough x 3 days
Preexisting Conditions: NONE
Diagnostic Lab Data: visual of servance
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1659B0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt came down w/chicken pox p/receiving the vax;

VAERS ID:97652 (history)  Vaccinated:1996-05-17
Age:4.4  Onset:1996-12-20, Days after vaccination: 217
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1997-04-18
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:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96121719
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1655B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 17MAY96 & 20DEC96 pt devel more than 25 chicken pox lesions on chest, back & face, & a fever;presented to MD;tx w/DPH, APAP & Aveeno;reporter described the exp as a good case of chickenpox;

VAERS ID:99781 (history)  Vaccinated:1996-05-17
Age:30.0  Onset:1996-05-21, Days after vaccination: 4
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1997-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96061425
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Dizziness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: pt recv vax 17MAY96 & 21MAY96 pt exp paresthesia & tingling which began in lt arm & spread to other areas, including toes, shins & knees;also exp dizziness;pt exp joint aches revealed some hypesthesia of lt arm;

VAERS ID:101137 (history)  Vaccinated:1996-05-17
Age:1.3  Onset:1997-03-05, Days after vaccination: 292
Gender:Female  Submitted:0000-00-00
Location:Virginia  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hemangioma
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97061404
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0390B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 17MAY96 & 5MAR97 pt devel @ least 50 vesicles severe case;by 15MAR97 pt recovered;

VAERS ID:86474 (history)  Vaccinated:1996-05-18
Age:0.4  Onset:1996-05-18, Days after vaccination: 0
Gender:Female  Submitted:1996-05-20, Days after onset: 2
Location:North Dakota  Entered:1996-05-31, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Lorbid for ear infect;Acetominophin
Current Illness: recovering ear infect
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: ND96008
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4326541IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES734C41PO 
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 1145AM & APAP given prior to vax & instructed to cont for at least 24hr-grandma states that pt temp was 103 that evening w/APAP;

VAERS ID:87186 (history)  Vaccinated:1996-05-18
Age:16.3  Onset:0000-00-00
Gender:Female  Submitted:1996-06-11
Location:Ohio  Entered:1996-06-18, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Motrin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4G610805 LA
Administered by: Private     Purchased by: Public
Symptoms: Abscess
SMQs:
Write-up: injection abscess

VAERS ID:92651 (history)  Vaccinated:1996-05-18
Age:0.2  Onset:1996-06-28, Days after vaccination: 41
Gender:Female  Submitted:1996-07-02, Days after onset: 4
Location:New York  Entered:1996-12-02, Days after submission: 153
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI, CT Scan, LP all nl;
CDC Split Type: 896190002L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4326580IML
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0737C0PO 
Administered by: Private     Purchased by: Private
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: pt recv vax 18MAY96 & 28JUN96 pt exp two, short, gen sz;pt was hosp for diagnostic workup, which was negative @ the time of this report;no further sz activity has been detected;

VAERS ID:117401 (history)  Vaccinated:1996-05-18
Age:0.0  Onset:1996-05-18, Days after vaccination: 0
Gender:Male  Submitted:1998-12-11, Days after onset: 937
Location:Tennessee  Entered:1998-12-15, 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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt recv vax on 5/18/96; 30 min post vax pt exp hives over body

VAERS ID:123443 (history)  Vaccinated:1996-05-18
Age:2.5  Onset:1998-05-30, Days after vaccination: 742
Gender:Male  Submitted:1999-05-14, Days after onset: 349
Location:Virginia  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: un
Diagnostic Lab Data:
CDC Split Type: WAES98060300
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Pyrexia, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/ pt recv vax approx 2 yrs later rpt low grade fever, pt presented to MD chickenpox, had maculopapular & vesicular lesions all over body.

VAERS ID:123437 (history)  Vaccinated:1996-05-18
Age:3.8  Onset:1998-05-19, Days after vaccination: 731
Gender:Male  Submitted:1999-05-14, Days after onset: 360
Location:Missouri  Entered:1999-05-24, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98060186
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Pruritus, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/ pt recv vax approx 2 yr later pt broke out in rash, then pt devel approx 45 very itchy lesions all over.

VAERS ID:86600 (history)  Vaccinated:1996-05-19
Age:1.2  Onset:1996-05-29, Days after vaccination: 10
Gender:Male  Submitted:1996-05-31, Days after onset: 2
Location:Iowa  Entered:1996-06-04, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ferrisol, Phenobarb
Current Illness: breatholding/sz
Preexisting Conditions: breatholding/sz, GE reflux/milk intolerance
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Agitation, Conjunctivitis, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: fever, conjunctivitis, rash, irritability

VAERS ID:87164 (history)  Vaccinated:1996-05-19
Age:19.9  Onset:1996-05-19, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:1996-06-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WA961233
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2033A20 LA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Chills, Dizziness, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up:

VAERS ID:96014 (history)  Vaccinated:1996-05-19
Age:  Onset:1996-05-19, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96052083
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1429A   
Administered by: Other     Purchased by: Other
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: pt recv vax 19MAY96 & & approx 20min p/vax pt exp tingling on lt side of body;pt recovered;

VAERS ID:109486 (history)  Vaccinated:1996-05-19
Age:53.9  Onset:0000-00-00
Gender:Male  Submitted:1997-03-04
Location:Florida  Entered:1998-03-10, Days after submission: 371
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Silvadene cream; Tylenol #3
Current Illness: 1st & 2nd degree burns
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 897118004L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4968006 IM 
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 1 mon p/vax pt exp periods of difficulty opening jaw lasting approx 1 min. This progressed until date of report when pt could only partially open jaw & exp pain moving jaw left & right. Pt saw MD 2/13/97.SEE comments.

VAERS ID:86407 (history)  Vaccinated:1996-05-20
Age:1.1  Onset:1996-05-20, Days after vaccination: 0
Gender:Female  Submitted:1996-05-21, Days after onset: 1
Location:Georgia  Entered:1996-05-29, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: denied by mom;
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type: GA96048
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0883B0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Apnoea, Cyanosis, Infection, Pharyngitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (narrow), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax; cyanosis devel; resp arrest; rescue breathing instituted; to hosp; Acute viral Upper resp infect;

VAERS ID:86426 (history)  Vaccinated:1996-05-20
Age:0.5  Onset:1996-05-20, Days after vaccination: 0
Gender:Male  Submitted:1996-05-23, Days after onset: 3
Location:Arizona  Entered:1996-05-29, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp knot in leg @4mo w/DTP/HIB dose 2
Other Medications: APAP
Current Illness: UTI
Preexisting Conditions: hyperbilirubinemia @ birth
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES 2IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES 2PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site mass, Screaming, Similar reaction on previous exposure to drug
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: on same day of vax pt devel a localized red rash & cried for a prolonged time (all noc) w/no relief;also had a knot @ inj site;

VAERS ID:86436 (history)  Vaccinated:1996-05-20
Age:0.2  Onset:1996-05-20, Days after vaccination: 0
Gender:Male  Submitted:1996-05-21, Days after onset: 1
Location:Texas  Entered:1996-05-29, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: congestion
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4299640IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0338B1IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4333850PO 
Administered by: Private     Purchased by: Private
Symptoms: Screaming
SMQs:, Hostility/aggression (broad)
Write-up: 3hr of persistent crying

VAERS ID:86444 (history)  Vaccinated:1996-05-20
Age:0.1  Onset:1996-05-20, Days after vaccination: 0
Gender:Male  Submitted:1996-05-20, Days after onset: 0
Location:New York  Entered:1996-05-29, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0113D1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 20MAY96 pt recv vax & rash noted 5min later on upper arm 2"x3" rash disappeared-phone call to home 2hr later

VAERS ID:86447 (history)  Vaccinated:1996-05-20
Age:0.6  Onset:1996-05-20, Days after vaccination: 0
Gender:Female  Submitted:1996-05-21, Days after onset: 1
Location:Massachusetts  Entered:1996-05-29, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Intal, albuterol
Current Illness: otitis media w/effusion
Preexisting Conditions: reative airway disease
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MASS. PUB HLTH BIOL LABDTP2922IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM015ALL2IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0734L2PO 
Administered by: Private     Purchased by: Public
Symptoms: Asthma, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: fever 103-APAP, amoxicillin tid;wheezing-albuterol nebulizer pediapred;

VAERS ID:86450 (history)  Vaccinated:1996-05-20
Age:1.0  Onset:1996-05-20, Days after vaccination: 0
Gender:Male  Submitted:1996-05-20, Days after onset: 0
Location:Wisconsin  Entered:1996-05-29, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: nONE
Preexisting Conditions: allergy to sulfa
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES6J710063IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0100D0SCRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: hive noted @ site of vax;w/in 5min of inj given DPH elixir;when rechecked p/20-30min-hive gone, doing well

VAERS ID:86476 (history)  Vaccinated:1996-05-20
Age:39.0  Onset:1996-05-21, Days after vaccination: 1
Gender:Female  Submitted:1996-05-22, Days after onset: 1
Location:North Carolina  Entered:1996-05-31, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: prev substance abuse history
Diagnostic Lab Data:
CDC Split Type: NC96054
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0099D1SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6A810071IMLA
Administered by: Public     Purchased by: Other
Symptoms: Hypokinesia, Injection site hypersensitivity
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: redness @ inj site of inj lt arm voiced inability to use arm;also recv TD in lt arm IM;sx began w/in 24hr of vax;

VAERS ID:86552 (history)  Vaccinated:1996-05-20
Age:0.2  Onset:1996-05-22, Days after vaccination: 2
Gender:Female  Submitted:1996-05-22, Days after onset: 0
Location:Massachusetts  Entered:1996-06-03, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Ba swollow, EEG, 24hr pneumogram, apnea monitor, CXR, various blood work, EKG, CXR ordered
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MASS. PUB HLTH BIOL LABDTP2960IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1592B1 RL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM010LP0IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0730H0PO 
Administered by: Private     Purchased by: Public
Symptoms: Apnoea, Hypotonia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (narrow)
Write-up: 15min p/vax mom found pt limp ?stopped breathing;called 911-began CPR-p/2breaths, pt began breathing cried instantly, vomited x 1;paramedics arrived pt totally well-transported to pediatrician

VAERS ID:86579 (history)  Vaccinated:1996-05-20
Age:2.2  Onset:1996-05-21, Days after vaccination: 1
Gender:Male  Submitted:1996-05-22, Days after onset: 1
Location:Georgia  Entered:1996-06-04, 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: none
Current Illness: none
Preexisting Conditions: hx of sz
Diagnostic Lab Data:
CDC Split Type: GA96063
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4335672IMRA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0894B2IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0740B2PO 
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Febrile 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax; had sz; to ER & had fever of 106; dx of febrile sz;

VAERS ID:86622 (history)  Vaccinated:1996-05-20
Age:0.3  Onset:1996-05-20, Days after vaccination: 0
Gender:Male  Submitted:1996-05-20, Days after onset: 0
Location:Maryland  Entered:1996-06-05, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4335661IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4320001PO 
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: urticaria starting on face & extremities-spread to trunk-lasted 10min then faded-starting w/trunk of body then extremities & face

VAERS ID:86834 (history)  Vaccinated:1996-05-20
Age:24.9  Onset:1996-05-20, Days after vaccination: 0
Gender:Female  Submitted:1996-06-05, Days after onset: 16
Location:Alaska  Entered:1996-06-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: AK9613
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES430109  LA
Administered by: Public     Purchased by: Public
Symptoms: Hypertonia, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: same as mom-fever that noc then stiff, sore arm;took ASA thru 24MAY for relief of pain

VAERS ID:86835 (history)  Vaccinated:1996-05-20
Age:50.4  Onset:1996-05-20, Days after vaccination: 0
Gender:Female  Submitted:1996-06-05, Days after onset: 16
Location:Alaska  Entered:1996-06-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: AK9614
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4301091 LA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: vax recv 20MAY96, feverish that noc (did not take temp) arm to sore to use next day;22MAY could move arm back & forth & 23MAY could gently raise arm;did not consult MD;took ASA thru 24MAY

VAERS ID:86872 (history)  Vaccinated:1996-05-20
Age:1.3  Onset:1996-05-22, Days after vaccination: 2
Gender:Female  Submitted:1996-05-29, Days after onset: 7
Location:Michigan  Entered:1996-06-10, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp hives p/all DTP''s
Other Medications: Insulin
Current Illness:
Preexisting Conditions: down''s synd, diabetes mellitus, type I
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1414B0SCLL
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Similar reaction on previous exposure to drug, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: hives @ site of inj-also hives behind ears & cheeks;pt has had hive rxn from knee to thigh p/all DTP''s;

VAERS ID:86901 (history)  Vaccinated:1996-05-20
Age:35.0  Onset:1996-05-22, Days after vaccination: 2
Gender:Female  Submitted:1996-05-31, Days after onset: 9
Location:Maine  Entered:1996-06-11, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: ME96013
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA485A60 RA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L710720 LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Oedema, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: approx 30hr p/inj, lt arm became swollen to elbow, sore & hot;low grade temp-but reached 102; 10 days later, arm OK, recurring low grade fever

VAERS ID:86906 (history)  Vaccinated:1996-05-20
Age:18.1  Onset:1996-05-20, Days after vaccination: 0
Gender:Female  Submitted:1996-06-07, Days after onset: 18
Location:Louisiana  Entered:1996-06-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pills
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: LA960701
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Diarrhoea, Hypokinesia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: diarrheal x 2 days, fever x 2 days, weak last 3 days;APAP for adult & diarrheal med-bed rest for 3 days

VAERS ID:86911 (history)  Vaccinated:1996-05-20
Age:0.5  Onset:1996-05-20, Days after vaccination: 0
Gender:Female  Submitted:1996-06-04, Days after onset: 15
Location:California  Entered:1996-06-12, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5J510712 RL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5J510712 RL
Administered by: Private     Purchased by: Other
Symptoms: Gaze palsy, Injection site oedema, Injection site pain, Somnolence, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Ocular motility disorders (narrow), Hypoglycaemia (broad)
Write-up: episode of lethargy, unresponsive staring & eyes rolling for 30min, thigh swollen tender;seen @ hosp

VAERS ID:87144 (history)  Vaccinated:1996-05-20
Age:4.8  Onset:1996-05-21, Days after vaccination: 1
Gender:Male  Submitted:1996-05-22, Days after onset: 1
Location:Alabama  Entered:1996-06-18, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: AL9610
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES5G610014IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0609B1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0734A4PO 
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 presented to clinic today w/redness, swelling & warm to touch in the lt upper arm;pt recv vax 20MAy96;no other complaints;mom says swelling has resolved somewhat

VAERS ID:87153 (history)  Vaccinated:1996-05-20
Age:76.6  Onset:1996-05-21, Days after vaccination: 1
Gender:Female  Submitted:1996-06-11, Days after onset: 21
Location:Connecticut  Entered:1996-06-18, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES 0 LA
Administered by: Private     Purchased by: Private
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: severe swelling, erythema & heat of inj site & arm

VAERS ID:87172 (history)  Vaccinated:1996-05-20
Age:41.7  Onset:1996-05-21, Days after vaccination: 1
Gender:Male  Submitted:1996-06-13, Days after onset: 23
Location:Illinois  Entered:1996-06-18, 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
DT: DT ADSORBED (NO BRAND NAME)PFIZER/WYETH49680020 LA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4318030IMRA
Administered by: Private     Purchased by: Private
Symptoms: Oedema peripheral, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: arm swelling next day p/vax w/redness, followed by fevers, resolved w/2 days of pred

VAERS ID:87215 (history)  Vaccinated:1996-05-20
Age:1.1  Onset:1996-05-26, Days after vaccination: 6
Gender:Male  Submitted:1996-05-29, Days after onset: 3
Location:Nevada  Entered:1996-06-21, Days after submission: 23
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:
CDC Split Type: NV96012
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES1861A22IMLA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM4348122IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1320B0SCRA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES073402  
Administered by: Unknown     Purchased by: Public
Symptoms: Face oedema, Hypersensitivity, Oedema peripheral, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 20MAY96 & devel bumps on legs, 26MAY96 in the evening, they resembled hives per mom;then by 2PM 27MAY96, pt completely covered w/bumps, puffy face, swollen around eyes, puffy feet;pt taken to ER;parents told allerg to MMR

VAERS ID:87594 (history)  Vaccinated:1996-05-20
Age:51.0  Onset:1996-05-29, Days after vaccination: 9
Gender:Female  Submitted:1996-06-10, Days after onset: 12
Location:Washington  Entered:1996-07-08, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: calcium blocker, Verelan
Current Illness:
Preexisting Conditions: inc BP (border line)
Diagnostic Lab Data:
CDC Split Type: WA961238
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1320B0 LA
Administered by: Public     Purchased by: Public
Symptoms: Cough, Drug ineffective, Headache, Infection, Osteoarthritis, Pharyngitis, Photophobia, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Agranulocytosis (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 20MAY96 & 2JUN96 rt knee swelling, rash all over, t101 x 3 days/cough, light sensitivity, h/a, sore throat;seen in ER but not contagious-measles?;5JUN96 rash cont w/other sx;seen in MD office 6JUN96;

VAERS ID:88123 (history)  Vaccinated:1996-05-20
Age:4.8  Onset:1996-05-20, Days after vaccination: 0
Gender:Female  Submitted:1996-05-24, Days after onset: 4
Location:California  Entered:1996-07-15, Days after submission: 52
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ppd
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896149006L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIESF309571IMLA
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM005LN3IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.088B1IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0733164PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 24 post vax pt devel inject site rxn w/ swelling, redness, warmth and tenderness.

VAERS ID:88125 (history)  Vaccinated:1996-05-20
Age:5.5  Onset:1996-05-22, Days after vaccination: 2
Gender:Female  Submitted:1996-05-31, Days after onset: 9
Location:Pennsylvania  Entered:1996-07-15, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896158005L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4309550IMLA
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt exp diarrhea for 10 days.

VAERS ID:88592 (history)  Vaccinated:1996-05-20
Age:  Onset:1996-05-20, Days after vaccination: 0
Gender:Unknown  Submitted:1996-05-21, Days after onset: 1
Location:New York  Entered:1996-07-29, Days after submission: 69
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896165006L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES431954 IML
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt devel fever & inj site swelling following vax;

VAERS ID:88232 (history)  Vaccinated:1996-05-20
Age:47.2  Onset:1996-05-21, Days after vaccination: 1
Gender:Male  Submitted:1996-06-24, Days after onset: 34
Location:California  Entered:1996-07-30, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Myasthenic syndrome, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Malignancy related conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: upper arm swelled for a few days then subsided;however, it is still sore & weak when doing certain exercises;

VAERS ID:88903 (history)  Vaccinated:1996-05-20
Age:0.4  Onset:1996-05-20, Days after vaccination: 0
Gender:Male  Submitted:1996-08-05, Days after onset: 77
Location:Minnesota  Entered:1996-08-12, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4333621IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0735M1PO 
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)
Write-up: p/4mo vax pt noted staring episodes lasting 20-30sec in the 48 hr p/vax;also dx as hyperirritable;no known fever; episode resolved on own;

VAERS ID:90856 (history)  Vaccinated:1996-05-20
Age:3.5  Onset:1996-05-22, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Minnesota  Entered:1996-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES96061309
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0750B0  
Administered by: Other     Purchased by: Other
Symptoms: 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), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 20MAY96 & 22MAY96 pt exp swelling & erythema @ inj site, 6cm x 8cm full thickness & a sore leg;pt seen by MD on 22MAY96 & application of ice to the site was recommended;

VAERS ID:90822 (history)  Vaccinated:1996-05-20
Age:0.2  Onset:1996-05-20, Days after vaccination: 0
Gender:Female  Submitted:1996-07-22, Days after onset: 63
Location:Michigan  Entered:1996-10-21, Days after submission: 91
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: MI96138
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5G610690IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1198B1IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES4F610000IMRL
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Pyrexia, Screaming, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: red raised area on rt leg that was hot to touch;mom reports crying non-stop for 6hr or more;not consoled by feeding or cuddling;had APAP a/vax & q 4hr;onset of crying occurred p/nap;had t100.5R;

VAERS ID:94899 (history)  Vaccinated:1996-05-20
Age:28.1  Onset:1996-05-30, Days after vaccination: 10
Gender:Female  Submitted:1996-06-10, Days after onset: 11
Location:Washington  Entered:1997-02-10, Days after submission: 245
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: 19 test on blood @ uargent care ctr all negative;
CDC Split Type: WA97130
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1320B0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Lymphadenopathy, Oedema peripheral, Pain, Pruritus, Rash maculo-papular
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 10 days p/vax swollen nodes posterior cervical & raised papular rash on fingers, hands, elbows sl itch x 1 day then tender;swelling minor in hands, fingers cont also;pt states rash relieved p/2 days using cortisone cream;

VAERS ID:96075 (history)  Vaccinated:1996-05-20
Age:9.5  Onset:1996-06-16, Days after vaccination: 27
Gender:Male  Submitted:0000-00-00
Location:Unknown  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96072517
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1SC 
Administered by: Other     Purchased by: Other
Symptoms: Ecchymosis, Peripheral vascular disorder, Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: pt recv vax 20MAY96 & on 16JUN96 pt devel black & blue lesions/petechiae & broken blood vessels primarily on feet, legs & back;

VAERS ID:97501 (history)  Vaccinated:1996-05-20
Age:2.9  Onset:1997-01-12, Days after vaccination: 237
Gender:Male  Submitted:0000-00-00
Location:Virginia  Entered:1997-04-18
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: exposure, varicella;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97011036
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1656B0SC 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Otitis media, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 20MAY96 & 12JAN97 p/an exposure to wild type chickenpox, pt devel breakthrough chickenpox w/approx 20 lesions & a temp of 99-100;pt was seen by MD on 14JAN97 & dx w/varicella & OM;

VAERS ID:99771 (history)  Vaccinated:1996-05-20
Age:36.4  Onset:1996-05-29, Days after vaccination: 9
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1997-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: allergy, insects
Diagnostic Lab Data: 8APR96 not immune;
CDC Split Type: WAES96060332
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0787B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Cough, Lymphadenopathy, Nuchal rigidity, Parotid gland enlargement, Pharyngitis, Pyrexia, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: pt recv vax 20MAY96 & 29MAY96 pt exp swollen lymph nodes & glands in neck & axilla area, sore throat & bad cough;30MAY96 pt devel a fever to 102 which reached 103 by 31MAY96;1JUN96 pt exp stiff neck & devel a fine maculopapular rash;

VAERS ID:100109 (history)  Vaccinated:1996-05-20
Age:1.0  Onset:1996-05-22, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1997-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt devel chickenpox @ 22mo w/varivax dose 1;
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97032046
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax 20NOV96 & 22MAY96 pt exp measles;mom also reported that child devel chickenpox p/varicella vax WAES97031975;

VAERS ID:101403 (history)  Vaccinated:1996-05-20
Age:39.1  Onset:1996-05-20, Days after vaccination: 0
Gender:Female  Submitted:1997-04-11, Days after onset: 326
Location:Texas  Entered:1997-07-22, Days after submission: 102
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: allergy to PCN
Diagnostic Lab Data:
CDC Split Type: CO6639
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4L61153 IMA
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: localized rxn & itchy macular type rash across chest;resolved p/tx w/Depromedrol;last dose of vax 1988;

VAERS ID:100964 (history)  Vaccinated:1996-05-20
Age:1.0  Onset:1997-05-15, Days after vaccination: 360
Gender:Male  Submitted:0000-00-00
Location:Indiana  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt siblings devel varicella @ 45mo & 5yr old w/varivax #1;
Other Medications: PPD given 20MAY96
Current Illness: NONE
Preexisting Conditions: allergy amoxil, allergy septra;allergy biaxin;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97052083
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0390B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 20MAY96 & 15MAY97 pt devel a more mild case of varicella consisting of a rash of 15-20 vesicles primarily in the trunk area;

VAERS ID:100965 (history)  Vaccinated:1996-05-20
Age:2.8  Onset:1997-05-08, Days after vaccination: 353
Gender:Male  Submitted:0000-00-00
Location:Indiana  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt siblings devel varicella @ 23mo & 5yr w/varivax #1;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97052085
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0390B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 20MAY96 & 8MAY97 pt devel breakthrough case of varicella that was attenuated consisting of a rash of approx 20 vesicles located primarily on the trunk;

VAERS ID:100966 (history)  Vaccinated:1996-05-20
Age:4.5  Onset:1997-05-27, Days after vaccination: 372
Gender:Male  Submitted:0000-00-00
Location:Indiana  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt siblings devel varicella @ 23mo & 45mo w/varivax #1;
Other Medications: Beclovent inhaler;albuterol;intal;
Current Illness: NONE
Preexisting Conditions: allergy, suprax;allergy sulfa;asthma;allergy pediazole;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97052086
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0390B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 20MAY96 & 27MAY97 pt devel breakthrough varicella that was more attenuated consisting of approx 15 vesicles;given acyclovir d/t hx of asthma;

VAERS ID:102910 (history)  Vaccinated:1996-05-20
Age:30.0  Onset:1996-06-06, Days after vaccination: 17
Gender:Male  Submitted:1997-09-10, Days after onset: 461
Location:California  Entered:1997-09-29, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC cough med
Current Illness:
Preexisting Conditions: sulfa allergy;
Diagnostic Lab Data: 6JUN96 hep A IGM 0 positive;hep A IGM positive;total bili 10JUn96 11.1;18JUn96 10.1;25 JUN96 3.8; 8JUL96 2.4; 23JUL95 2.4;LDH 10JUN96 1760 8JUL96 188;ak phos 10JUN96 253;25JUn96 191;SGOT 8JUL96 43;SGPT 8JUL96 73;GGT 10JUN96 285;18JUN96 93;
CDC Split Type: 970197001
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.VHA478B60IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood alkaline phosphatase increased, Blood lactate dehydrogenase increased, Drug ineffective, Hyperbilirubinaemia, Infection, Jaundice
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (narrow), Lack of efficacy/effect (narrow), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 20MAY96 & on 6JUN96 pt devel hep A & jaundice;pt had labwork done on 6JUn97, 10JUN97, 18JUN97 & 25JUN97, 8JUL9997 & 23JUL97;relevant consisted of hep A IGM, total bilirubin,LDH,alk phos, SGOT,SGPT,GGT, direct bilirubin,indirect

VAERS ID:105981 (history)  Vaccinated:1996-05-20
Age:46.0  Onset:1996-05-20, Days after vaccination: 0
Gender:Female  Submitted:1997-05-22, Days after onset: 367
Location:Kansas  Entered:1997-10-30, Days after submission: 161
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp mild rash @ 40yr old w/engerix-B dose 1;
Other Medications: Pred;DPH;Tagamet;
Current Illness: NONE
Preexisting Conditions: allergy to ampicillin;
Diagnostic Lab Data:
CDC Split Type: 970023241
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1  
Administered by: Other     Purchased by: Other
Symptoms: Face oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 20MAY96 & exp lip swelling w/in 30min of vax;there were no sx of anaphylaxis, no SOB, & the swelling resolved spontaneously;

VAERS ID:122963 (history)  Vaccinated:1996-05-20
Age:34.0  Onset:1998-04-22, Days after vaccination: 702
Gender:Female  Submitted:1999-05-14, Days after onset: 387
Location:North Carolina  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: drug allergy: iodine allergy; penicillin alergy; sulfa allergy
Diagnostic Lab Data:
CDC Split Type: WAES98041665
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 1st & 2nd doses varivax 4/3& 5/20/96 then 4/22/98 pt devel chickenpox

VAERS ID:124246 (history)  Vaccinated:1996-05-20
Age:4.9  Onset:1998-11-19, Days after vaccination: 913
Gender:Female  Submitted:1999-05-14, Days after onset: 175
Location:Pennsylvania  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:
Current Illness:
Preexisting Conditions: reactive airway disease
Diagnostic Lab Data:
CDC Split Type: WAES98111563
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0392B0SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection, Pyrexia
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: approx 30mos p/vax pt exp chickenpox w/approx 30 lesions, fever 99.7f

VAERS ID:124539 (history)  Vaccinated:1996-05-20
Age:1.0  Onset:1999-02-10, Days after vaccination: 996
Gender:Female  Submitted:1999-05-14, Days after onset: 92
Location:Oregon  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES99021082
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1655B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt exp a case of breakthrough varicella w/four pox & no fever;only one of the pox was a water blister;pt was also very itchy;pt sought unspecified medical attention;

VAERS ID:134140 (history)  Vaccinated:1996-05-20
Age:5.0  Onset:2000-02-06, Days after vaccination: 1357
Gender:Female  Submitted:2000-02-07, Days after onset: 1
Location:Texas  Entered:2000-02-17, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: eczema
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0253B0SCLL
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Received vaccine on 5/20/96, contracted varicella after school exposure 2/6/2000.

VAERS ID:156192 (history)  Vaccinated:1996-05-20
Age:3.0  Onset:1999-09-26, Days after vaccination: 1224
Gender:Male  Submitted:2000-05-16, Days after onset: 233
Location:Kentucky  Entered:2000-07-10, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: varicella exposure
Diagnostic Lab Data: NONE
CDC Split Type: WAES99092009
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1499B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Skin ulcer
SMQs:, Lack of efficacy/effect (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt developed approximately 20 - 30 skin lesions. Physician diagnosed mild chickenpox. Pt was afebrile. Pt was treated with calamine lotion and Benadryl.

VAERS ID:156247 (history)  Vaccinated:1996-05-20
Age:4.8  Onset:1999-10-09, Days after vaccination: 1237
Gender:Male  Submitted:2000-05-16, Days after onset: 220
Location:Kentucky  Entered:2000-07-10, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: varicella exposure
Diagnostic Lab Data:
CDC Split Type: WAES99100811
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection, Pyrexia
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt developed breakthrough varicella with a temperature of 99.7F. The pt had 30-40 itching lesions.

VAERS ID:157088 (history)  Vaccinated:1996-05-20
Age:4.0  Onset:1999-05-27, Days after vaccination: 1102
Gender:Male  Submitted:2000-05-16, Days after onset: 355
Location:Pennsylvania  Entered:2000-07-18, Days after submission: 63
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: varicella exposure
Diagnostic Lab Data:
CDC Split Type: WAES99060411
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1660B0SC 
Administered by: Private     Purchased by: Other
Symptoms: Blister, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On May 27, 1999 the pt developed less than 15 fluid-filled spots with low-grade temperature. Treatment with the following acetaminophen, diphenhydramine hydrochloride, aveeno baths and fluids were initiated.

VAERS ID:194451 (history)  Vaccinated:1996-05-20
Age:8.0  Onset:2002-11-25, Days after vaccination: 2380
Gender:Male  Submitted:2002-11-27, Days after onset: 2
Location:West Virginia  Entered:2002-12-03, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1655B0  
Administered by: Private     Purchased by: Unknown
Symptoms: Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever, Rash greater than 30 lesions, itching.

VAERS ID:280141 (history)  Vaccinated:1996-05-20
Age:1.1  Onset:0000-00-00
Gender:Male  Submitted:2007-05-16
Location:Unknown  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0604USA00970
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Skin lesion
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a registered nurse concerning an approximately 11 year old white male who on 20-MAY-1996 was vaccinated with a dose of Varivax (lot # not provided). Subsequently, the patient developed 50-200 lesions. The patient''s outcome was not reported. This case was MD documented/evaluated. Additional information is not expected.

VAERS ID:86824 (history)  Vaccinated:1996-05-20
Age:2.0  Onset:1996-05-21, Days after vaccination: 1
Gender:Female  Submitted:1996-06-06, Days after onset: 16
Location:Foreign  Entered:1996-06-10, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Cerebral CT scan-nl 21MAY96;CSF analysis nl;EEG-nl;22may96fundus of eye exam ORL exam-lt vestibular neveritis poss
CDC Split Type: 960072691
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Coordination abnormal, Hypotonia, Infection, Nystagmus, Optic neuritis, Rash maculo-papular, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (narrow), Demyelination (narrow), Vestibular disorders (broad), Ocular infections (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 21MAY96 pt exp ataxia w/hypotonia & vomiting;hosp was required;CSF analysis, cerebral CT scan & EEG were nl;mild rt nystagmus was also noted;

VAERS ID:87551 (history)  Vaccinated:1996-05-20
Age:0.2  Onset:1996-05-28, Days after vaccination: 8
Gender:Male  Submitted:1996-06-18, Days after onset: 21
Location:Foreign  Entered:1996-07-05, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data: AST 160;ALT 207;LDH nl; GGT nl;neutrophils decreased;lymphocytes inc;thrombocytes inc;ESR nl;CRP nl;
CDC Split Type: 896172002L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES101Y180 IM 
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER  PO 
Administered by: Other     Purchased by: Other
Symptoms: Hepatocellular damage, Lymphocytosis, Purpura, Pyrexia, Thrombocythaemia
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: 8 days p/vax pt devel purpura, fever, & hepatic & hematologic abnormalities which required hosp;MD stated these events could be d/t enterovirus or to the OPV vax;this report recv from Wyeth-Lederle in Switzerland

VAERS ID:92808 (history)  Vaccinated:1996-05-20
Age:6.6  Onset:1996-06-21, Days after vaccination: 32
Gender:Female  Submitted:1996-12-05, Days after onset: 167
Location:Foreign  Entered:1996-12-12, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 960172821
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Ecchymosis, Laboratory test abnormal, Pallor, Pancytopenia
SMQs:, Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hypotonic-hyporesponsive episode (broad), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 20MAY96 & 21JUN96 exp pancytopenia causing hosp;pt has not yet recovered;

VAERS ID:114356 (history)  Vaccinated:1996-05-20
Age:9.4  Onset:1996-06-03, Days after vaccination: 14
Gender:Unknown  Submitted:1998-09-16, Days after onset: 835
Location:Foreign  Entered:1998-09-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 4JUN96 platelets 12000;15JUN96 platelets 178000;1JUL96 platelets 145000;17JUL96 platelets 213000;1998 platelets 47000;viral serologies negative;
CDC Split Type: 19960079601
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Gingival bleeding, Purpura, Thrombocytopenia, Thrombocytopenic purpura, Weight increased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Gingival disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 20MAY96 & 3JUN96 15 days later pt exp purpura & gingivorrhagia;4JUN hosp & thrombopenia 12000;pt hosp again unk date for recurrent thrombopenia;1998 platelets 47000 dx ITP;

VAERS ID:234874 (history)  Vaccinated:1996-05-20
Age:23.0  Onset:2004-05-01, Days after vaccination: 2903
Gender:Male  Submitted:2005-03-11, Days after onset: 314
Location:Foreign  Entered:2005-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The subject familial medical history included a benign multiple sclerosis at his mother
Diagnostic Lab Data: Antinuclear antibody negative; Blood protein electrophoresis normal; HIV test negative; Immunoelectrophoresis normal; Rheumatoid factor negative; Toxoplasma serology negative; In May 2004: Lumbar puncture: 21 lymphocytes without hyperprotei
CDC Split Type: B0373977A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS  IM 
Administered by: Other     Purchased by: Other
Symptoms: Delirium, Dysuria, Facial palsy, Gait disturbance, Influenza like illness, Laboratory test abnormal, Multiple sclerosis, Neuropathy, Optic neuritis retrobulbar, Paresis, Sensory disturbance, Visual acuity reduced
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Ocular infections (broad), Hypoglycaemia (broad)
Write-up: This case was reported by a foreign regulatory authority and described the occurrence of multiple sclerosis in a 23 year old male subject who was vaccinated with Engerix B for hepatitis B prophylaxis. No medical history nor concomitant medical condition was reported. The subject''s familial medical history included a multiple sclerosis for the subject''s mother. On 3/23/95, 4/25/95, 5/25/95, and 5/20/96, the subject received four injections in IM of Engerix B at 20mcg. From 5/3 to 5/6/04, around eight years after the last vaccination, the subject was hospitalized for a right retrobulbar optic neuritis with facial paralysis at the right side and sensory disorder of the left upper limb. Lumbar puncture evidenced the presence of 21 lymphocytes without hyperproteinorachia, HIV, Lyme, Toxoplasmosis and Toxocarosis serologies were negative. Antinuclear antibody and rheumatoid factors were negative. Blood proteins electrophoresis and immunoelectrophoresis were normal. MRI revealed hypersignals of the white matter which were maily present in periventricular area and right frontal subcortical hypersignals. Presence of 2 hypersignals of the cervical marrow. Several abnormal signals were present on the cervical marrow and on the left occipital area. A treatment with Corticosteroids at a daily dose of 1g over five days was initiated. Then symptoms improved. On 5/19/04, the subject was hospitalized for sensory disorders of the left heel which worsened to spreading of the lower limb and of left chest area. In unspecified date, he received a bolus of 3g of methyl prednisolone sodium succinate. CSF examination revealed an oligoclonal aspect. In unspecified date, he presented with gait disorder. On 6/23/04, he experienced a flare up with paraparesis, dysuria, Lhermitte''s sign, and bilateral vision decrease and was hospitalized. MRI revealed several periventricular and right frontal subcortical inflammatory lesions. Symptoms worsened and the subject received an infusion of 5g Solumedrol associated with two plasmaferes courses per we

VAERS ID:86433 (history)  Vaccinated:1996-05-21
Age:0.2  Onset:1996-05-21, Days after vaccination: 0
Gender:Male  Submitted:1996-05-21, Days after onset: 0
Location:California  Entered:1996-05-29, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5F610840 RL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1950A21 LL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES5F610840 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0730F0PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt devel redness, swelling & tenderness to touch on lt thigh p/4hrs of vax;t100.4 R @ 430PM;

VAERS ID:86456 (history)  Vaccinated:1996-05-21
Age:0.5  Onset:1996-05-21, Days after vaccination: 0
Gender:Female  Submitted:1996-05-23, Days after onset: 2
Location:Maryland  Entered:1996-05-29, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4333632IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES736D12PO 
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Screaming, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: temp$g105, 2hr of unresponsiveness & 4-5hr of unconsolable crying;

VAERS ID:86541 (history)  Vaccinated:1996-05-21
Age:0.6  Onset:1996-05-21, Days after vaccination: 0
Gender:Female  Submitted:1996-05-24, Days after onset: 3
Location:Utah  Entered:1996-06-03, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: unk
Preexisting Conditions: NONE
Diagnostic Lab Data: pt tested positive for strept throat inject 48hrs p/the inj
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4299682 RL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0165D2 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4335142PO 
Administered by: Public     Purchased by: Public
Symptoms: Crying, Infection, Pharyngitis, Pyrexia, Screaming
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: a screaming episode that started 3hr p/the vax it lasted for $g12hr;pt had a fever of 104 that started 24hr p/inj & lasted 72hr p/the inj;

VAERS ID:86586 (history)  Vaccinated:1996-05-21
Age:24.1  Onset:1996-05-21, Days after vaccination: 0
Gender:Male  Submitted:1996-05-27, Days after onset: 6
Location:Alabama  Entered:1996-06-04, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: mental retardation (severe)
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1430A1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cyanosis, Salivary hypersecretion, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: c/o drooling, drowsiness, arms & face turning blue @ approx 10:30-11AM;color nl on arrival;no resp distress given DPH

VAERS ID:86816 (history)  Vaccinated:1996-05-21
Age:27.7  Onset:1996-05-23, Days after vaccination: 2
Gender:Female  Submitted:1996-05-28, Days after onset: 5
Location:Illinois  Entered:1996-06-07, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: xanax, corzide
Current Illness: NONE
Preexisting Conditions: PCN; erythromycin/hypertension
Diagnostic Lab Data: NONE
CDC Split Type: IL960056
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5G71095 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: rash started 2 days later (all over, red, itching);required visit to Er;injected w/Kenalog & given DPH;2nd ER visit made d/t itching

VAERS ID:86817 (history)  Vaccinated:1996-05-21
Age:1.3  Onset:1996-05-28, Days after vaccination: 7
Gender:Male  Submitted:1996-05-30, Days after onset: 2
Location:Florida  Entered:1996-06-07, Days after submission: 8
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-diff
CDC Split Type: FL96035
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4319663IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1310B0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash maculo-papular, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 28MAY96 high fever 104 & rash on face, neck, shoulders, raised, red;seen @ MD office 29MAY96 @ 930AM;CBC + diff drawn w/hosp lab;330PM 29MAY96 t106-staring glazed look;mom gave Motrin;t101.4 @ ER;

VAERS ID:86839 (history)  Vaccinated:1996-05-21
Age:5.9  Onset:1996-05-21, Days after vaccination: 0
Gender:Male  Submitted:1996-05-21, Days after onset: 0
Location:New York  Entered:1996-06-10, Days after submission: 20
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 known by mothers history
Diagnostic Lab Data: NONE
CDC Split Type: NYS96039
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0898B2IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1420B1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Face oedema, Lacrimal disorder, Rhinitis
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 1015AM pt began w/profuse sneezing, puffy watery eyes & diff breathing;tx epi;

VAERS ID:86896 (history)  Vaccinated:1996-05-21
Age:75.1  Onset:1996-05-24, Days after vaccination: 3
Gender:Female  Submitted:1996-05-28, Days after onset: 4
Location:Oklahoma  Entered:1996-06-11, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Noveldex
Current Illness:
Preexisting Conditions: breast CA
Diagnostic Lab Data: NONE
CDC Split Type: OK9618
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4H611191IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Skin discolouration, Vasodilatation
SMQs:, Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: rt deltoid 4cm x 4cm red-mottled, warm to touch area

VAERS ID:88643 (history)  Vaccinated:1996-05-21
Age:1.0  Onset:1996-05-21, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Alabama  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES96052270
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0098D0  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0391B0  
Administered by: Other     Purchased by: Other
Symptoms: Cyanosis, Face oedema, Oedema, Oedema peripheral, Pyrexia, Urticaria, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 21MAY96 & 21MAY96 evening exp urticaria & a fever;21MAY96 the urticaria was described as one big mass of red raised skin covering body w/some individual hives;cheek red & puffy, lips & hands were swollen;knuckles on hand bluish

VAERS ID:88756 (history)  Vaccinated:1996-05-21
Age:31.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Connecticut  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: miscarriage; pregnancy, ectopic
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96060572
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 21MAY96 & was found to be pregnant; the pt reported that devel 2 lesions on leg & a few days p/vax menstrual type cramping in abd;

VAERS ID:88780 (history)  Vaccinated:1996-05-21
Age:16.0  Onset:1996-06-09, Days after vaccination: 19
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES96061270
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax; exp vesicular rash w/ several vesicles on scalp,three on stomach and one on face and two on back;

VAERS ID:88828 (history)  Vaccinated:1996-05-21
Age:32.6  Onset:1996-05-21, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergy, sulfa drugs;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96051962
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0879B   
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0388B0SC 
Administered by: Other     Purchased by: Other
Symptoms: Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax 21MAY96 & 4hr later pt exp nausea, & very bad h/a;No further details were provided;

VAERS ID:88910 (history)  Vaccinated:1996-05-21
Age:26.3  Onset:1996-06-03, Days after vaccination: 13
Gender:Male  Submitted:1996-06-13, Days after onset: 10
Location:Minnesota  Entered:1996-08-12, Days after submission: 60
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 off & on a/vax
Preexisting Conditions: NONE
Diagnostic Lab Data: lyme disease Ab neg 22MAY96;rheumatoid arthritis test;
CDC Split Type: MN96030
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2060B60IMLA
Administered by: Public     Purchased by: Public
Symptoms: Osteoarthritis, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: lesions on hands;recurrent hives;swelling of various joints (fingers, wrists, knees, elbows, shoulder);had rash for approx 6mo a/vax to see dermatologist 17JUN;

VAERS ID:89556 (history)  Vaccinated:1996-05-21
Age:5.3  Onset:1996-06-21, Days after vaccination: 31
Gender:Female  Submitted:1996-06-23, Days after onset: 2
Location:California  Entered:1996-09-03, Days after submission: 72
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: CBC;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES5L710884IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0738L123PO 
Administered by: Private     Purchased by: Other
Symptoms: Oedema, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: 2 day hx of inc swelling, redness;

VAERS ID:89599 (history)  Vaccinated:1996-05-21
Age:0.4  Onset:1996-05-21, Days after vaccination: 0
Gender:Female  Submitted:1996-08-27, Days after onset: 98
Location:New Jersey  Entered:1996-09-04, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4335641PO 
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Crying, Screaming
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)
Write-up: moms states pt had unusual persistent crying & irritability for 2-3 days p/vax;

VAERS ID:92374 (history)  Vaccinated:1996-05-21
Age:0.3  Onset:1996-05-21, Days after vaccination: 0
Gender:Female  Submitted:1996-05-23, Days after onset: 2
Location:Alaska  Entered:1996-11-25, Days after submission: 186
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: AK9612
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4319671IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0739A1PO 
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax & 4hr later flat red ras resembling heat rash appeared @ site;then progressed up to trunk to chest, arms, face & head;didn''t appear to itch;no local swelling;

VAERS ID:93856 (history)  Vaccinated:1996-05-21
Age:34.0  Onset:1996-06-04, Days after vaccination: 14
Gender:Male  Submitted:0000-00-00
Location:Florida  Entered:1996-12-02
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: rash
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96061867
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.0119D0SC 
Administered by: Private     Purchased by: Private
Symptoms: Myalgia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 21MAY96 & 4JUN96 pt devel a rubella-type rash on trunk, which reporter felt was probably r/t w/rubella vax & was mildly achy;

VAERS ID:101486 (history)  Vaccinated:1996-05-21
Age:16.4  Onset:1996-05-21, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Indiana  Entered:1997-07-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Exgest LA;Ceftin;
Current Illness: sore throat, PND;
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: 896193005L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4333550IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & devel an inj site rxn, characterized by redness, swelling, & pain;pt also exp knots & elevated temp around inj site;sx lasted for 1wk;this is one of six pt from this site to report adverse rxn;

VAERS ID:103452 (history)  Vaccinated:1996-05-21
Age:5.0  Onset:1997-06-18, Days after vaccination: 393
Gender:Female  Submitted:0000-00-00
Location:Maryland  Entered:1997-10-20
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:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97061719
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0113D0  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1656B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 21MAY96 & 18JUN97 pt devel a mild case of varicella w/20-35 lesions & a low grade fever;

VAERS ID:108543 (history)  Vaccinated:1996-05-21
Age:1.0  Onset:1996-05-30, Days after vaccination: 9
Gender:Male  Submitted:1998-01-02, Days after onset: 582
Location:New York  Entered:1998-03-16, Days after submission: 73
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: blood test revealed platlet count of only 5,000;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Ecchymosis, Rash, Thrombocytopenia
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax a rash occurred 2wk afterward accompanied by black & blue marks to the knees & thighs;these black & blues spread to the arms waist area & got much larger;2mo later husband suggested to take blood test;

VAERS ID:169100 (history)  Vaccinated:1996-05-21
Age:5.0  Onset:2001-03-06, Days after vaccination: 1750
Gender:Male  Submitted:0000-00-00
Location:Georgia  Entered:2001-04-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Slight cough, no fever
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.131180SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0390B0SCLA
Administered by: Private     Purchased by: Other
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Had chickenpox (varicella) vaccine at age of 12 months. Had lesion (10-15) atypical with only a few being vesicular and 1 lesion. Scabbed over. R/o atypical chickenpox.

VAERS ID:241697 (history)  Vaccinated:1996-05-21
Age:5.0  Onset:2005-07-18, Days after vaccination: 3345
Gender:Female  Submitted:2005-07-18, Days after onset: 0
Location:Pennsylvania  Entered:2005-07-25, 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:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Skin ulcer
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient presented with 10 lesions.

VAERS ID:161770 (history)  Vaccinated:1996-05-21
Age:59.0  Onset:0000-00-00
Gender:Female  Submitted:2000-11-08
Location:Foreign  Entered:2000-11-10, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Endocrinologic, ears-nose-throat, dermatologic and digestive check-ups were not conclusive. Ears-nose-throat exam showed obstruction of meatus acusticus externus without any affection of tympamis. Biological check-up was nml but a moderate
CDC Split Type: 20000320541
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM  IM 
Administered by: Other     Purchased by: Other
Symptoms: Conjunctivitis, Ear disorder, Face oedema, Hypoacusis, Inflammation, Nasal discomfort, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hearing impairment (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 5/21/96, she received the booster injection with Engerix-B and 3 days later, the pt developed hemiface and thorax urticaria. The lesions completely regressed within 2 months. The pt then experienced episodes of face edema (eyelids and meatus acusticus externus) with hypoacusia and conjunctivitis, treated with topical corticoid and antiseptic drugs. The pt also experienced nasal burning sensation. From August, 1997, the pt was incapacitated. The most recent information received on 11/6/00, reports the outcome of the pt as not yet recovered. Causality assessment was reported by the AFSSAPS as dubious for Engerix-B.

VAERS ID:174096 (history)  Vaccinated:1996-05-21
Age:41.0  Onset:1998-09-10, Days after vaccination: 842
Gender:Male  Submitted:2002-04-04, Days after onset: 1302
Location:Foreign  Entered:2001-08-09, Days after submission: 238
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: lumbago, lumbar rachialgia
Diagnostic Lab Data: MRI - hypersignals, intramedullary lesions and medullary conus lesions
CDC Split Type: 20010184111
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Bone disorder, Demyelination, Laboratory test abnormal, Nystagmus, Visual disturbance
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad)
Write-up: On 9/10/98 approximately 2 years post vax, the pt developed sensitive disorder of lower limbs which reach T10. there were no motor deficit and no sphincter disorder. MRI showed lesions with T2 hypersignals. A diagnosis of demyelinating disease was made. The pt was then treated with methylprednisolone. Thereafter, improvement was observed. In 10/99, the pt developed sensitive disorder predominant in left lower limbs and visual discomfort. Physical examination showed right eye rotatory nystagmus. In 2/01, the pt developed lower limbs sensitive disorder. MRI showed T2 intramedullary lesions localized in C2-C7 as well as medullary conus lesions. The pt was hospitalized for the events. The most recent information received on 8/1/01 reports the outcome of the pt as unknown. The most info received on 03/22/2002 reports the outcome of the pt as unknown. Causality assessment was reported fas dubious fo Engerix-B.

VAERS ID:220417 (history)  Vaccinated:1996-05-21
Age:  Onset:1996-05-28, Days after vaccination: 7
Gender:Male  Submitted:2004-05-17, Days after onset: 2911
Location:Foreign  Entered:2004-05-18, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data: Alanine aminotransferase (05/28/96): 45U/l; Alanine aminotransferase (06/24/99): 57; Alanine aminotransferase (12/03/99): 32; Alanine aminotransferase (03/29/00): 50; Alanine aminotransferase (06/30/00): 93; Alanine aminotransferase (0
CDC Split Type: D0043769A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Other     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Blood cholesterol increased, Gamma-glutamyltransferase increased, Laboratory test abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Lipodystrophy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This report described the occurrence of increased liver values in a male subject of unknown age who was vaccinated with Hepatitis A vaccine for prophylaxis. This report was received from a consumer and was not verified by a physician or other health care professional. No current medical conditions and no concurrent medications were reported. On 5/8/95, 5/22/95 and 5/21/96, the subject received three doses of hepatitis A vaccine. Seven days after the last vaccination, on 5/28/96, the subject donated blood and received the result that glutamic pyruvic transaminase, gamma-glutamyltransferase and cholesterol were increased. Sonography showed no pathological results. The subject''s blood values were tested for years every three months and the elevated values fluctuated mildly but did not resolve. This case was assessed as medically serious (OMIC). Follow up on 08/05/04 states: "The subject''s past medical history included cholecystectomy. The subject did not abuse nicotine or alcohol. The subject was frequently travelling to a developing country. Family anamnesis included cholecystectomy and bladder carcinoma of the mother and myocardial infarction and apoplexy of the late father. On 05/08/95, 05/22/95 and 05/21/96, the subject received 3 doses of hepatitis A vaccine at unknown application sites. Seven days after the third dose of hepatitis A vaccine, on 05/28/96 the subject donated blood. About 1 week later, the subject was informed that alanine aminotransferase (ALAT) was increased to 45 U/l. This case was assessed as medically serious by manufacturer''s criteria (OMIC). Serology was negative for hepatitis B virus, hepatitis C virus and HIV. Starting on an unknown date after having received this information, the subject''s blood values were tested for years nearly every 3 months. These blood examinations showed increased aspartate aminotransferase (ALAT), increased gamma-glutamyltransferase (GGT) and increased cholesterol values, additionally. Sonography, performed on 01/21/01 showed liver of about 13cm, removed

VAERS ID:386331 (history)  Vaccinated:1996-05-21
Age:  Onset:1997-11-07, Days after vaccination: 535
Gender:Male  Submitted:2010-04-29, Days after onset: 4555
Location:Foreign  Entered:2010-04-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Tissue analysis, 0.4, mineralogram; Tissue analysis, 1.2, mineralogram
CDC Split Type: WAES1004USA03651
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPIPV: DTP + IPV (NO BRAND NAME)UNKNOWN MANUFACTURER 3UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Allergy test, Autism, Blood count, Blood test, Cytogenetic analysis, Disability, Hair metal test abnormal
SMQs:
Write-up: Initial information received on 26-OCT-2009, this case is not medically confirmed. This case is linked with case E2010-01528 (1004USA03843), and is related to a general claim against Ministry of Health related to all products containing thiomersal. The claim contains 65 cases among which 41 are related to vaccines. Furthermore, this case is also linked with 2 cases related to patients who dropped their complaints. This latter is only a third party. Therefore some of the cases are poorly documented. Current case concerns a male patient. The patient received 4 doses of DTAP (manufacturer unknown, batch number, route and site of administration not reported) on 21-JUN-1994, 22-AUG-1994, 19-OCT-1994 and 21-MAY-1996. He received a booster dose of DIPHTERIA-TETANUS vaccine (manufacturer unknown, batch number, route and site of administration not reported) on 21-AUG-1995. The patient received a dose of MMR II (manufacturer unknown, batch number, route and site of administration not reported) on 21-AUG-1995. According to the report, the patient was diagnosed with autism on 07-Nov-1997, and has a disability grade of 63% evaluated on 07-AUG-1998. A test in a hair sample (dates not reported) showed that the patient had a mercury level of 0.40 and 1.20 normal range is below 0.40 (units not reported). According to the form received from the claimant, the following statements are included; urinary analysis, Hair test (mineralogram and others), blood count, blood test, food allergy test and genetic test. In the form received from the claimant it is written: "Medical report: Yes" but the company has not received this medical report. Relevant Test/Laboratory Data: A test in a hair sample (dates not reported) showed that the patient had a mercury level of 0.40 and 1.20 normal range is below 0.40 (units not reported). According to the form received from the claimant, the following states included: urinary analysis, Hair test (mineralogram and others), blood count, blood test, food allergy test and genetic test. Other business partner numbers include E2010-01891.

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