National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

Found 603547 cases in entire database

Case Details (Sorted by Vaccination Date)

This is page 1346 out of 6036

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


VAERS ID: 79925 (history)  
Age: 0.2  
Gender: Female  
Location: Oregon  
Vaccinated:1995-12-05
Onset:0000-00-00
Submitted: 1995-12-06
Entered: 1995-12-12
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 428034 / 0 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0739B / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 428338 / 0 - / PO

Administered by: Private       Purchased by: Private
Symptoms: Screaming
SMQs:, Hostility/aggression (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: stuffy nose
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt screaming for 34 hrs afternoon vax was given; no fever;APAP, comfort measures;


VAERS ID: 81688 (history)  
Age: 0.2  
Gender: Unknown  
Location: Indiana  
Vaccinated:1995-12-05
Onset:1995-12-13
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 1996-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429973 / 0 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. K1024 / 0 RL / IM

Administered by: Private       Purchased by: Private
Symptoms: Convulsion, Mental retardation severity unspecified, Thinking abnormal
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: all tests neg
CDC Split Type:

Write-up: focal seizures 8 days p/vax;


VAERS ID: 93108 (history)  
Age: 25.0  
Gender: Female  
Location: California  
Vaccinated:1995-12-05
Onset:1995-12-10
   Days after vaccination:5
Submitted: 1996-01-24
   Days after onset:45
Entered: 1996-10-30
   Days after submission:280
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1442A6 / 0 - / IM L

Administered by: Other       Purchased by: Other
Symptoms: Face oedema, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: phad had mild allergies as a child
Diagnostic Lab Data:
CDC Split Type: 960007411

Write-up: pt recv vax & 5 days post vax pt began to exp urticaria, pruritus, round lesions around elbow, & swelling around eyes;tx DPH sx resolved in 3 days;


VAERS ID: 80006 (history)  
Age: 1.0  
Gender: Male  
Location: Michigan  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1995-12-07
   Days after onset:1
Entered: 1995-12-13
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429967 / 2 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. S91379A / 0 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0729M / 2 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Convulsion, Crying, Febrile convulsion, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: ROM dx''d @ ER p/ episode
CDC Split Type: MI95151

Write-up: fever 104;shaking-questionable febrile sz called same by fire dept witness;shrill loud unconsolable crying


VAERS ID: 80117 (history)  
Age: 15.0  
Gender: Female  
Location: California  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1995-12-08
   Days after onset:2
Entered: 1995-12-18
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 5E71025 / 5 - / IM

Administered by: Other       Purchased by: Public
Symptoms: Back pain, Neck pain, Oedema, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: unk~ ()~~~In patient
Other Medications: Advil for freqeunt h/a
Current Illness: NONE
Preexisting Conditions: dust, cows, rabbits, cleft palate-repaired, short leg
Diagnostic Lab Data: NONE
CDC Split Type: CA95164

Write-up: 24hrs p/shot fever 102;48hrs p/ t101;sl inflammation, swelling, minimal back pain;taken to MD-findings: hurt on lt neck when turn head


VAERS ID: 80143 (history)  
Age: 0.4  
Gender: Male  
Location: Texas  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1995-12-15
   Days after onset:9
Entered: 1995-12-19
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429965 / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0729L / 1 - / PO

Administered by: Private       Purchased by: Public
Symptoms: Injection site reaction
SMQs:

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: local rxn rt leg 9 days later 1 1/2 x 2 1/2cm rxn site;


VAERS ID: 80153 (history)  
Age: 23.0  
Gender: Female  
Location: Hawaii  
Vaccinated:1995-12-06
Onset:1995-12-11
   Days after vaccination:5
Submitted: 1995-12-12
   Days after onset:1
Entered: 1995-12-19
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0181A / - RA / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 5C71115 / - LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: HI9510

Write-up: 11DEC95 pt noticed rashes when awoke in AM;described rash as bright red, raised pinpoint to rice sized, non-blanching when pressed & mildly itchy;rash first appeared on rt forearm near wrist & 3hrs later similar type rash appeared lt wrist


VAERS ID: 80162 (history)  
Age: 0.2  
Gender: Female  
Location: Ohio  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1995-12-14
   Days after onset:8
Entered: 1995-12-19
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 4E6116 / 0 LL / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES 4E61008 / 0 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 427179 / 0 - / PO

Administered by: Private       Purchased by: Private
Symptoms: Hypotonia, Somnolence
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: ?viral illness
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: lethargy for 7hrs (?hypotonic) started 1/2 hrs p/vax lasted 7hrs;went to ER & was fine by the time pt got to ER


VAERS ID: 80189 (history)  
Age: 0.7  
Gender: Female  
Location: Tennessee  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1995-12-07
   Days after onset:1
Entered: 1995-12-21
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 428040 / 2 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1163A / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0732C / 2 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Cyanosis, Dyspnoea, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: Neg
Preexisting Conditions: Neg
Diagnostic Lab Data:
CDC Split Type: TN95129

Write-up: 6DEC95 5PM pt recvd phone call from grandma;stating pt was crying cont,hands were blue,legs shaking&appeared to be having diff breathing;was told to go to ER;7DEC95 recvd call from mom stating took pt to ER&was told had a rxn;fever 1


VAERS ID: 80232 (history)  
Age: 19.0  
Gender: Male  
Location: Oregon  
Vaccinated:1995-12-06
Onset:1995-12-08
   Days after vaccination:2
Submitted: 1995-12-19
   Days after onset:11
Entered: 1995-12-26
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Other       Purchased by: Other
Symptoms: Lymphadenopathy, Myalgia, Oedema, Pain, Pyrexia, Rash, Vasodilatation
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), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES95120768

Write-up: pt recvd vax; on 8dec95 in MD ofc w/ fever,"erythema of rt deltoid";swollen node on rt axilla;erythema was warm to touch;the shoulder & arm were tender but appeared to be mobile;reporting RN felt that pt''s exp was life threatening;


VAERS ID: 80380 (history)  
Age: 1.1  
Gender: Male  
Location: New York  
Vaccinated:1995-12-06
Onset:1995-12-13
   Days after vaccination:7
Submitted: 1995-12-19
   Days after onset:6
Entered: 1995-12-28
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 11728 / 0 LA / -

Administered by: Private       Purchased by: Private
Symptoms: Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: BASO47

Write-up: fever 105, measles type rash x 3-5 days;


VAERS ID: 80699 (history)  
Age: 1.3  
Gender: Female  
Location: Texas  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1995-12-08
   Days after onset:2
Entered: 1996-01-03
   Days after submission:26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429964 / 3 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0730A / 2 - / PO

Administered by: Private       Purchased by: Other
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, blood culture, UA, WBC 19;
CDC Split Type:

Write-up: fever 105.5 less then 24hrs p/vax given subjective fever the afternoon p/vax;


VAERS ID: 80859 (history)  
Age: 0.3  
Gender: Female  
Location: Mississippi  
Vaccinated:1995-12-06
Onset:1995-12-07
   Days after vaccination:1
Submitted: 1995-12-15
   Days after onset:8
Entered: 1996-01-16
   Days after submission:32
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0726C / 1 - / PO
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 428038 / 1 RL / -

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Crying, Dyspnoea, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: MS95054

Write-up: fretful on the evening of inj;3PM 7DEC95 pt woke w/high pitched shrill cry;was calmed,then went back to sleep;5PM awoke w/high pitched crying & fever of 101 ax;resp distress;had whelps on head 8DEC95;saw MD was told had a rxn to pertussis


VAERS ID: 80901 (history)  
Age: 39.0  
Gender: Female  
Location: Georgia  
Vaccinated:1995-12-06
Onset:1995-12-07
   Days after vaccination:1
Submitted: 1995-12-08
   Days after onset:1
Entered: 1996-01-16
   Days after submission:39
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1056A / 0 RA / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 5H71003 / 1 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Myalgia, Nausea, Oedema peripheral, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: GA95199

Write-up: 7DEC95 pain from lt arm to shoulder & to back;low grade fever;sl nausea arm swollen & tender to touch;8DEC95 sxs cont; unable to contact-back @ work won''t return call


VAERS ID: 81088 (history)  
Age: 27.0  
Gender: Female  
Location: Virginia  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1996-01-11
   Days after onset:36
Entered: 1996-01-23
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (IMOVAX ID) / PASTEUR MERIEUX INST. K0526 / 3 - / -

Administered by: Other       Purchased by: Other
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Loestrin FE
Current Illness: NONE
Preexisting Conditions: bees, Keflexin
Diagnostic Lab Data:
CDC Split Type:

Write-up: throat, eyes & arms started to itch about 45mins p/vax;


VAERS ID: 82322 (history)  
Age: 17.0  
Gender: Male  
Location: Wisconsin  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1995-12-07
   Days after onset:1
Entered: 1996-02-12
   Days after submission:67
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0788B / 1 RA / SC
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 429310 / 4 RA / IM

Administered by: Public       Purchased by: Other
Symptoms: Chest pain, Chills, Dysgeusia, Headache, Leukocytosis, Migraine, Parosmia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: prev lab work indicated inc WBC per mom;had work up for migraine h/a''s;
CDC Split Type: WI95079

Write-up: pt recvd vax 6DEC95 1150PM & 12:30 while eating exp severe pressure in chest,went upward to top of head,smelled ammonia & tasted ammonia type taste;had severe h/a became cold & shaking;mom called clinic instructed to call MD:


VAERS ID: 82328 (history)  
Age: 1.2  
Gender: Female  
Location: Wisconsin  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1995-12-15
   Days after onset:9
Entered: 1996-02-12
   Days after submission:59
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 428035 / - LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1688W / 0 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0788B / 0 LL / SC

Administered by: Public       Purchased by: Other
Symptoms: Agitation, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: diaper rash & chapped cheeks
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WI95073

Write-up: taken to local hosp ER @ 845PM for crying;seen by ER MD T100.1, fussy & crying;no reference to character of cry;given rx for Nystatin cream to be applied to diaper rash alternately w/cornstarch;


VAERS ID: 84329 (history)  
Age: 8.0  
Gender: Female  
Location: Minnesota  
Vaccinated:1995-12-06
Onset:1995-12-13
   Days after vaccination:7
Submitted: 1995-12-29
   Days after onset:16
Entered: 1996-04-02
   Days after submission:95
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1252A / 0 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0719C / 0 - / PO
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4H61156 / 0 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Headache, Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt''s sibling exp illness @ 2mo w/DTP dose 1~ ()~~~In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MN95033

Write-up: red, bumpy rash, h/a, fever (not determined by thermometer);no tx other than APAP for sx;rash appeared 6 days p/vax given;disappeared 3 days later;


VAERS ID: 84347 (history)  
Age: 0.4  
Gender: Male  
Location: Minnesota  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1996-03-20
   Days after onset:105
Entered: 1996-04-02
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429965 / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0727A / 1 - / PO

Administered by: Private       Purchased by: Private
Symptoms: Crying, Screaming
SMQs:, Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: screaming x 2 days high pitch


VAERS ID: 84671 (history)  
Age: 48.0  
Gender: Female  
Location: Michigan  
Vaccinated:1995-12-06
Onset:1995-12-08
   Days after vaccination:2
Submitted: 1996-03-25
   Days after onset:108
Entered: 1996-04-09
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958147 / - - / IM

Administered by: Other       Purchased by: Other
Symptoms: Abdominal distension, Constipation, Diarrhoea, Dyspnoea, Hepatic function abnormal, Pain, Pericardial effusion, Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: 99 temp & some hoarseness;
Preexisting Conditions: hx of pericardial effusion 1981
Diagnostic Lab Data: 19DEC95 LFT''s doubled;2JAN96 echocardiogram revealed massive pericardial effusion w/cardiac tamponade
CDC Split Type:

Write-up: w/in 3 days of vax pt devel lt upper jaw pain & w/in 5 days became SOB (pt thought might be having MI);also devel abd distention,constipation/diarrhea;ER r/o sinusitis,hepatitis,bowel obstruction;echocardiogram done 2JAN96;fever


VAERS ID: 85499 (history)  
Age: 3.0  
Gender: Male  
Location: Washington  
Vaccinated:1995-12-06
Onset:1995-12-22
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 1996-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 0 - / -

Administered by: Other       Purchased by: Other
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: allergy, cefaclor
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96010591

Write-up: pt recv vax 6DEC95 & 22DEC95 pt devel a rash which was described by Md as non-vesicular, 2cm fleshy papules on an erythematous base;MD concluded that rash was not related to the vax;


VAERS ID: 85216 (history)  
Age: 0.5  
Gender: Male  
Location: Arkansas  
Vaccinated:1995-12-06
Onset:1995-12-22
   Days after vaccination:16
Submitted: 1996-03-25
   Days after onset:94
Entered: 1996-04-24
   Days after submission:29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 4E61024 / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1359A / 2 LL / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES 4E61024 / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 072HL / 1 - / PO

Administered by: Public       Purchased by: Other
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Died? Yes
   Date died: 1995-12-22
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: AR9617

Write-up: no known COD-death certificate pending to r/o SIDS


VAERS ID: 86168 (history)  
Age: 19.0  
Gender: Male  
Location: California  
Vaccinated:1995-12-06
Onset:1995-12-07
   Days after vaccination:1
Submitted: 1996-02-08
   Days after onset:63
Entered: 1996-05-13
   Days after submission:94
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00195P / 0 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Eczema, Face oedema, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE reported
CDC Split Type: 0010150950304

Write-up: pt recv vax 6DEC95 & the next day devel a whole body rash, red swollen eyelids & lips & a frantic allergic itch;tx w/inj of Pred & a medrol dose pack;rash resolved into an eczema type scaly rash;itching cont for wk;


VAERS ID: 92004 (history)  
Age: 0.4  
Gender: Male  
Location: Indiana  
Vaccinated:1995-12-06
Onset:1995-12-08
   Days after vaccination:2
Submitted: 1996-02-13
   Days after onset:67
Entered: 1996-10-30
   Days after submission:260
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1943A2 / 1 RL / -

Administered by: Other       Purchased by: Other
Symptoms: 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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 960015621

Write-up: pt recv vax 6DEC95 & 36hr p/vax pt exp urticaria on thighs, face, arms & back of neck & swelling of hands;MD visit was required;tx antihistamine;pt has mad a full recovery;


VAERS ID: 93070 (history)  
Age: 42.0  
Gender: Female  
Location: Indiana  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1996-04-25
   Days after onset:140
Entered: 1996-10-30
   Days after submission:188
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1396A6 / 1 - / IM A

Administered by: Public       Purchased by: Other
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp latex rxn rash & latex rxn itching @ 42yr old w/Engerix-B dose 1;~ ()~~~In patient
Other Medications: Prozac, Sinequan
Current Illness:
Preexisting Conditions: allergy to PCN, allergy to Tetracycline;
Diagnostic Lab Data: APR96 HBSA not converted prior to 3rd dose;
CDC Split Type: 950136351

Write-up: pt recv vax 6DEC95 & w/in 12hr pt devel a rash on hands w/itching;also noted a similar rash on inner thighs that resolved over next 24-48hr;


VAERS ID: 93081 (history)  
Age: 34.0  
Gender: Female  
Location: Alabama  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1995-12-21
   Days after onset:15
Entered: 1996-10-30
   Days after submission:314
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1594A4 / 1 - / IM A

Administered by: Private       Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt recv vax & exp rash on hands & neck w/dose 1 Engerix B~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: allergic to acetylsalicylic acid;
Diagnostic Lab Data:
CDC Split Type: 950141631

Write-up: pt recv vax 6DEC95 & w/in 5hr p/vax pt exp rash on hands & neck;tx in ER w/med;


VAERS ID: 93109 (history)  
Age: 25.0  
Gender: Female  
Location: New Jersey  
Vaccinated:1995-12-06
Onset:1995-12-10
   Days after vaccination:4
Submitted: 1996-01-25
   Days after onset:46
Entered: 1996-10-30
   Days after submission:279
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1746A4 / 0 - / IM A

Administered by: Private       Purchased by: Private
Symptoms: Dizziness, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 960008421

Write-up: pt recv vax 6DEC95 & exp nausea, h/a & dizziness;sx resolved untreated in 24 hr;vaccination series was discontinued;


VAERS ID: 95850 (history)  
Age: 29.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1997-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / 0 - / SC

Administered by: Other       Purchased by: Other
Symptoms: Angioneurotic oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: pt recv flu vax & PPD same wk of vax
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES96061850

Write-up: pt recv vax 6DEC95 & 6DEC95 pt exp angioedema & urticaria & was hosp;


VAERS ID: 95903 (history)  
Age:   
Gender: Male  
Location: New York  
Vaccinated:1995-12-06
Onset:1995-12-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1997-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / 0 - / -

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Gait disturbance, Hypokinesia, Myasthenic syndrome
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96011615

Write-up: pt recv vax 6DEC95 & 7DEC95 pt exp weakness in legs, dizziness, problems walking & was unable to lift arms easily;


VAERS ID: 97925 (history)  
Age: 21.0  
Gender: Female  
Location: New York  
Vaccinated:1995-12-06
Onset:1997-03-11
   Days after vaccination:461
Submitted: 0000-00-00
Entered: 1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0427B / 1 - / SC

Administered by: Other       Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Headache, Infection, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: exposure, varicella;
Diagnostic Lab Data: varicella antibody-seropositive;
CDC Split Type: WAES97030998

Write-up: pt recv vax 6DEC95 & varicella antibody titer was performed on 5MAR96& was positive for seroconversion;MAR97 pt exposed to children w/chickenpox & devel a vesicular pustular rash consisting of <50 lesions;devel fever & body aches;


VAERS ID: 101444 (history)  
Age: 47.0  
Gender: Male  
Location: Georgia  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1997-03-31
   Days after onset:481
Entered: 1997-07-22
   Days after submission:112
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (IMOVAX) / PASTEUR MERIEUX INST. - / 2 LA / IM

Administered by: Other       Purchased by: Other
Symptoms: Lymphadenopathy, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: CO6405

Write-up: lump under lt arm 6hr p/3rd doses in series w/accompanying soreness & aching;


VAERS ID: 123592 (history)  
Age: 7.0  
Gender: Male  
Location: Missouri  
Vaccinated:1995-12-06
Onset:1998-01-27
   Days after vaccination:783
Submitted: 1999-05-14
   Days after onset:471
Entered: 1999-05-21
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0442B / 0 - / -

Administered by: Other       Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98070103

Write-up: p/ pt recv vax pt exp chickenpox


VAERS ID: 125589 (history)  
Age:   
Gender: Female  
Location: New York  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1999-02-12
   Days after onset:1164
Entered: 1999-07-12
   Days after submission:149
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4C61076 / - LA / -

Administered by: Private       Purchased by: Unknown
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U199900091

Write-up: p/vax pt devel a lump in lt arm @ the inj site;pt reportedly was seen by several MD & finally had the lump removed surgically;pt stated the lump came back;pt was asked if ever exp trauma or an inj to this arm;


VAERS ID: 157001 (history)  
Age: 10.0  
Gender: Female  
Location: Oregon  
Vaccinated:1995-12-06
Onset:1999-05-03
   Days after vaccination:1244
Submitted: 2000-05-16
   Days after onset:379
Entered: 2000-07-17
   Days after submission:62
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0427B / 0 - / SC

Administered by: Private       Purchased by: Private
Symptoms: Blister, Drug ineffective, Erythema, Infection, Pruritus, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WAES99051097

Write-up: On 5/3/99 (four years post vax), the pt developed breakthrough chicken pox characterized by typical rash with fever of 103 degrees. The rash was described as "pruritic vesicles on red base scattered on arms, legs, trunk, face, and mucus membranes". It was noted that the chicken pox was a mild case with total of 45 vesicles. The pt recovered from symptoms on 5/10/99. No further details were provided.


VAERS ID: 80839 (history)  
Age: 1.3  
Gender: Female  
Location: Foreign  
Vaccinated:1995-12-06
Onset:1995-12-14
   Days after vaccination:8
Submitted: 1996-01-10
   Days after onset:27
Entered: 1996-01-16
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Convulsion, Drug ineffective, Febrile convulsion, Infection, Influenza, Pharyngitis, Pyrexia, Rhinitis
SMQs:, Agranulocytosis (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Oropharyngeal infections (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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES95121624

Write-up: pt recvd vax;14dec95 pt exp fever, febrile convuls, flu-like sxs & was hosp;


VAERS ID: 80956 (history)  
Age: 0.2  
Gender: Male  
Location: Foreign  
Vaccinated:1995-12-06
Onset:1995-12-06
   Days after vaccination:0
Submitted: 1996-01-15
   Days after onset:40
Entered: 1996-01-19
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTIPV: DT + IPV (FOREIGN) / PASTEUR MERIEUX INST. - / - - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / 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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: atopic family
Diagnostic Lab Data:
CDC Split Type: CO6426

Write-up: generalized urticaria the same day as receipt of 1st dose of combination product;pt hospitalized;treated w/Antihistamine & fully recovered w/in 24hrs;


VAERS ID: 176053 (history)  
Age: 17.0  
Gender: Male  
Location: Foreign  
Vaccinated:1995-12-06
Onset:0000-00-00
Submitted: 2001-10-02
Entered: 2001-10-05
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / - - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Diabetes mellitus
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow)

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: UNK
Diagnostic Lab Data:
CDC Split Type: 20010230281

Write-up: On 12/6/95 and 1/24/96, the pt received an injection of Engerix-B at a dose of 20 mcg. In 3/96, the pt developed insulin-dependent diabetes. On 7/1/96, the pt received another injection of Engerix-B, still at a dose of 20 mcg. This was considered as disabling. The most recent information received on 9/27/01, reports the outcome of the pt as not yet recovered. Causality assessment was reported as dubious for Engerix-B.


VAERS ID: 79932 (history)  
Age: 35.0  
Gender: Female  
Location: Ohio  
Vaccinated:1995-12-07
Onset:1995-12-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 LA / -

Administered by: Public       Purchased by: Other
Symptoms: Dyspnoea, Face oedema, Laryngospasm, Oedema peripheral, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Provera, Bentyl, Beconase, Estrace, Ativan (PRN), nasal spray, APAP
Current Illness: injury to lt knee @ work;
Preexisting Conditions: Cefzil, demerol, EES; panic attacks; early meanapaus
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: pt recvd vax & w/in 10mins hands, ears, mouth, nose, eyes began to swell & rash;sxs inc to entire body;trouble breathing, throat closing;given Epi, Cortisone, DPH & transferred to ER-given Phenegran, monitored in ER 2hrs;sxs subsided


VAERS ID: 79934 (history)  
Age: 15.0  
Gender: Female  
Location: Texas  
Vaccinated:1995-12-07
Onset:1995-12-07
   Days after vaccination:0
Submitted: 1995-12-08
   Days after onset:1
Entered: 1995-12-11
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4A61008 / - RA / -

Administered by: Public       Purchased by: Private
Symptoms: Face oedema, Injection site hypersensitivity, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: swelling of lips on rt side 2hrs post vax-expanded to entire rt side of face;rash on body-itch-red dot @ inj site


VAERS ID: 80122 (history)  
Age: 11.0  
Gender: Male  
Location: Missouri  
Vaccinated:1995-12-07
Onset:1995-12-07
   Days after vaccination:0
Submitted: 1995-12-07
   Days after onset:0
Entered: 1995-12-18
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1203B / 0 LA / IM

Administered by: Other       Purchased by: Public
Symptoms: Dizziness, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: hx of fainting
Diagnostic Lab Data: NA
CDC Split Type: MO95093

Write-up: palor became pale; skin diaphoretic;verbalized dizziness; local MD was called;stated it seemed to be from stress; no SOB experienced; hx of fainting; father states is doing fine @ 2PM;


VAERS ID: 80225 (history)  
Age: 71.0  
Gender: Female  
Location: Kansas  
Vaccinated:1995-12-07
Onset:1995-12-07
   Days after vaccination:0
Submitted: 1995-12-21
   Days after onset:14
Entered: 1995-12-26
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1284B / 0 - / -

Administered by: Other       Purchased by: Other
Symptoms: Anxiety, Dyspnoea, Hypersensitivity, Hypotension, Miosis, Vasodilatation
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: allergic: iodine & tussi-organidine
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES95120854

Write-up: pt recvd vax; immed following vax, had an allergic rxn & devel red face, SOB & pinpoint pupils; tx w/ epinephrine & oth meds;adm to hosp;subsequently recovered & was discharged later in eve;


VAERS ID: 80366 (history)  
Age: 1.3  
Gender: Female  
Location: Indiana  
Vaccinated:1995-12-07
Onset:1995-12-16
   Days after vaccination:9
Submitted: 1995-12-18
   Days after onset:2
Entered: 1995-12-27
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0790B / 0 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Convulsion, Pyrexia, Stupor
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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 9 days p/vax pt devel new fever;w/in 4 hrs of fever onset exp 1min tonic clonic sz w/postictal period;fever 102 w/sz, 104 soon after


VAERS ID: 80577 (history)  
Age: 1.8  
Gender: Male  
Location: Maine  
Vaccinated:1995-12-07
Onset:1995-12-17
   Days after vaccination:10
Submitted: 1995-12-28
   Days after onset:11
Entered: 1996-01-02
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 4C61144 / 3 RA / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0656A / 2 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0614A / 0 LA / SC

Administered by: Unknown       Purchased by: Public
Symptoms: Dermatitis bullous, Pruritus, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: ME95030

Write-up: rash onset 17DEC95 10days p/vax small blisters draining clear fluids-itchy groin area-spreading to buttock, stomach, lower abd;8DEC95 fever 102 days following inj for 3-4 days relieved w/APAP


VAERS ID: 80590 (history)  
Age: 0.9  
Gender: Female  
Location: New Jersey  
Vaccinated:1995-12-07
Onset:1995-12-07
   Days after vaccination:0
Submitted: 1995-12-11
   Days after onset:4
Entered: 1996-01-02
   Days after submission:22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 428034 / 0 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 430175 / 3 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Myalgia, Pyrexia, Rhinitis, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: NJ9554

Write-up: pt recvd vax 7DEC95 1145AM & 1-130PM pt became irritable, face reddened, lt leg tender to touch;230 APAP given T105 warm tepid bath given & pedialyte;mom contacted MD who ordered motrin;7AM t102, 12noon t100-101; devel rhinnorrhea


VAERS ID: 80821 (history)  
Age: 5.0  
Gender: Male  
Location: Arkansas  
Vaccinated:1995-12-07
Onset:1995-12-07
   Days after vaccination:0
Submitted: 1995-12-21
   Days after onset:14
Entered: 1996-01-11
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 4M61085 / 4 RA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0726K / 3 - / PO

Administered by: Private       Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp mild redness w/prev shots~ ()~~~In patient
Other Medications: sulfa drug discont
Current Illness: sinus infect 2 wks prior
Preexisting Conditions: allergy to house dust, molds
Diagnostic Lab Data: CBC WNL;WBC 6.0
CDC Split Type: AR962

Write-up: reported by parents 5 days post vax requiring MD visit;rt deltoid area edematous,w/firmness in center beneath scabbed inj site w/surrounding area red,raised,warm,itchy,measuring 3x4 inches;center of area clearing w/o rash,sl discolor


VAERS ID: 82326 (history)  
Age: 46.0  
Gender: Female  
Location: Wisconsin  
Vaccinated:1995-12-07
Onset:1995-12-08
   Days after vaccination:1
Submitted: 1995-12-28
   Days after onset:20
Entered: 1996-02-12
   Days after submission:46
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958100 / - RA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 394936 / 0 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Chills, Oedema peripheral, Pain, Paraesthesia
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Vasotec
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WI95075

Write-up: lt am edematous x 2 size-w/in 24hrs was cool, numb, lost feeling & pain hurt like the devil;tx DPH w/relief-swelling x 72hrs-dec during that time;


VAERS ID: 82327 (history)  
Age: 62.0  
Gender: Female  
Location: Wisconsin  
Vaccinated:1995-12-07
Onset:1995-12-08
   Days after vaccination:1
Submitted: 1995-12-11
   Days after onset:3
Entered: 1996-02-12
   Days after submission:63
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4H61156 / 2 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Influenza, Myalgia, Rash, Skin nodule, Skin striae, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WI95074

Write-up: 8DEC95 sore lt arm,hard area underarm also;flu like sx;9DEC95 sore lt arm,flu sx,lethargic,noticed red splotches on outer lt arm & on breast;instructed to take APAP or ASA & see MD


VAERS ID: 82764 (history)  
Age: 0.7  
Gender: Male  
Location: Ohio  
Vaccinated:1995-12-07
Onset:1995-12-07
   Days after vaccination:0
Submitted: 1996-02-08
   Days after onset:63
Entered: 1996-02-20
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429319 / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1358A / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0725B / 1 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Pharyngitis, Pyrexia, Rhinitis, Somnolence
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none~ ()~~~In patient
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type: OH96014

Write-up: pt recvd vax; a few hrs p/ vax, became lethargic w/ T 101-102; to MD who stated not to cont DTP;pt ill for 2 wks;resistance was lower & pt devel cold


VAERS ID: 83053 (history)  
Age: 0.2  
Gender: Female  
Location: Maryland  
Vaccinated:1995-12-07
Onset:1995-12-07
   Days after vaccination:0
Submitted: 1996-02-19
   Days after onset:74
Entered: 1996-02-26
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429321 / 0 - / IM L
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0056A / 1 - / IM L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 428486 / 0 - / PO

Administered by: Private       Purchased by: Other
Symptoms: Crying, Screaming
SMQs:, Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: mom reports high pitched crying greater than 3 to 4hrs p/1st tetramune;


VAERS ID: 83317 (history)  
Age: 49.0  
Gender: Female  
Location: Ohio  
Vaccinated:1995-12-07
Onset:1995-12-07
   Days after vaccination:0
Submitted: 1996-02-08
   Days after onset:63
Entered: 1996-02-29
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0896B / 0 LA / IM

Administered by: Public       Purchased by: Private
Symptoms: Dyspnoea, Pain, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ceclor, Premarin, Synthroid
Current Illness: URI 27NOV95 prior
Preexisting Conditions: allergic-Iodine, reno graphine 76, valium, darvocet, poss flu vax; hypothyroid
Diagnostic Lab Data: NONE
CDC Split Type: OH96016

Write-up: pt recv vax 2PM & around 11Pm woke up w/burning sensation in entire body broke out in hives over entire body;on way to ER began having breathing diff;ER tx consisted of Epi & atarax,Pred


VAERS ID: 83669 (history)  
Age: 8.0  
Gender: Female  
Location: Virginia  
Vaccinated:1995-12-07
Onset:1995-12-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1996-03-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
JEV: JAPANESE ENCEPHALITIS (J-VAX) / CONNAUGHT LABORATORIES ESN1097 / 1 LA / -

Administered by: Public       Purchased by: Private
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type: VA95089

Write-up: gen rash & urticaria over body;taken to PMD dx immunization rxn to vax;given DPH & not to have 3rd vaccine in series


VAERS ID: 83677 (history)  
Age: 0.3  
Gender: Female  
Location: Iowa  
Vaccinated:1995-12-07
Onset:1995-12-07
   Days after vaccination:0
Submitted: 1996-02-29
   Days after onset:84
Entered: 1996-03-14
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 386987 / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1405A / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0728A / 0 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Asthenia, Crying, Pyrexia
SMQs:, 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), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: IA96009

Write-up: pt returned to clinic 15FEB96 mom reported that pt had fever of 105 p/last vax 7DEC95;states pt given APAP 430PM prior to vax fever, & screaming began 7PM;did given APAP;phoned MD but did not return call for 2hrs;9PM t102R & tired


VAERS ID: 84338 (history)  
Age: 0.2  
Gender: Female  
Location: Missouri  
Vaccinated:1995-12-07
Onset:1995-12-10
   Days after vaccination:3
Submitted: 1996-03-22
   Days after onset:103
Entered: 1996-04-02
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 426150 / 0 LL / -
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0893B / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0720D / 0 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Injection site mass, Injection site oedema
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MO96022

Write-up: 14MAR96 pt was brought in for 2nd series of vax upon review prior to vax mom stated p/last vax pt cried & was cranky for 3 days & had a very large goose egg size swelling on area where pt recv shot;2nd series w/held pt referred to pvt MD;


VAERS ID: 85330 (history)  
Age: 18.0  
Gender: Male  
Location: Washington  
Vaccinated:1995-12-07
Onset:1995-12-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1996-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - - / -

Administered by: Other       Purchased by: Other
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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: varicella exposure
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES95121335

Write-up: pt recv vax;devel fever,devel rash similar to chicken pox;seen by MD;MD thought pt had devel chicken pox 3 days p/ vax,pt was exposed to the live varicella virus 20 days earlier;


VAERS ID: 86254 (history)  
Age: 2.0  
Gender: Male  
Location: Michigan  
Vaccinated:1995-12-07
Onset:1996-05-12
   Days after vaccination:157
Submitted: 1996-05-15
   Days after onset:3
Entered: 1996-05-21
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0745B / 0 RA / SC

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: varicella serum titers, CBC differential, quantitative immunoglobulins, IgE, IgG sub classes, p/illness will do skin test for t-cell function
CDC Split Type:

Write-up: pt broke out w/chicken pox on 12MAY96 & cont to have further eruptions on following days;seen @ MD office 14MAY96;


VAERS ID: 87028 (history)  
Age: 1.5  
Gender: Female  
Location: New York  
Vaccinated:1995-12-07
Onset:1995-12-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 1996-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429972 / 3 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 - / -

Administered by: Private       Purchased by: Private
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES95121242

Write-up: pt recv vax;17dec95 devel a morbilliform rash which was generalized & most pronounced on cheeks & rt anterior thigh; nurse felt that rash related to vax;


VAERS ID: 89506 (history)  
Age: 49.0  
Gender: Female  
Location: Minnesota  
Vaccinated:1995-12-07
Onset:0000-00-00
Submitted: 1996-06-20
Entered: 1996-08-23
   Days after submission:64
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 5F71086 / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Oedema, Skin nodule, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6419

Write-up: arm swollen, shoulder to wrist, 6cm knot red & raised, subsided some but knot persists;


VAERS ID: 91128 (history)  
Age: 29.0  
Gender: Female  
Location: Minnesota  
Vaccinated:1995-12-07
Onset:1996-07-01
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 1996-10-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0412B / 1 - / SC

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: JUL96 varicella antibody 0.30 negative
CDC Split Type: WAES96080288

Write-up: pt recv 2 dose of varicella & JUL96 did not seroconvert (ELISA 0.30 for varicella antibody);


VAERS ID: 92689 (history)  
Age: 0.2  
Gender: Male  
Location: Arkansas  
Vaccinated:1995-12-07
Onset:1995-12-07
   Days after vaccination:0
Submitted: 1996-11-07
   Days after onset:336
Entered: 1996-12-09
   Days after submission:32
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429965 / 0 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1359A / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0726F / 0 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Crying, Rash, Rash maculo-papular, Screaming
SMQs:, Anaphylactic reaction (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: upper resp infect
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type: AR9681

Write-up: mom reported red, blotchy rash (to ER personnel) on face & forehead & uncontrollable/inconsolable crying episode $g3hr;


VAERS ID: 99320 (history)  
Age: 38.0  
Gender: Male  
Location: Ohio  
Vaccinated:1995-12-07
Onset:1995-12-27
   Days after vaccination:20
Submitted: 1997-06-06
   Days after onset:526
Entered: 1997-06-25
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1902A2 / 2 RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Purpura, Vasculitis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Vasculitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NA
Preexisting Conditions: aeasonal allergies
Diagnostic Lab Data: skin biopsy;extensive bloodwork preliminary dx of leukocytoclastic vasculitis;
CDC Split Type: OH97040

Write-up: recurring rash (purpura) of extremities & abd lasting 10-14 days;sx recur intermittently;dx of leukocytoclastic vasculitis;


VAERS ID: 106856 (history)  
Age: 6.0  
Gender: Male  
Location: New Jersey  
Vaccinated:1995-12-07
Onset:1997-01-27
   Days after vaccination:417
Submitted: 1998-01-12
   Days after onset:350
Entered: 1998-01-15
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 0 - / -

Administered by: Other       Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES97120406

Write-up: pt recv vax 7dEC95 & pt devel a breakthrough case of chickenpox;pt devel vesicles & papules on the face, chest, arms;sx were resolving @ the time of the report;


VAERS ID: 122029 (history)  
Age: 1.5  
Gender: Male  
Location: Florida  
Vaccinated:1995-12-07
Onset:1999-05-01
   Days after vaccination:1241
Submitted: 1999-05-04
   Days after onset:3
Entered: 1999-05-10
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0422B / 0 RA / SC

Administered by: Private       Purchased by: Private
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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: breakthrough varicella 75-100 lesions on day #3;temp max 102.3;pt recv vax 7DEC95;devel clinical disease 1MAY99;


VAERS ID: 156697 (history)  
Age: 1.25  
Gender: Female  
Location: Massachusetts  
Vaccinated:1995-12-07
Onset:1999-03-24
   Days after vaccination:1203
Submitted: 2000-05-16
   Days after onset:418
Entered: 2000-07-14
   Days after submission:59
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0411B / 0 - / SC

Administered by: Private       Purchased by: Other
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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99032379

Write-up: Subsequent to receiving vaccination the pt developed 4-5 chickenpox lesions on the face and approximately 20 on her trunk. the pt was also running a low grade fever. The pt was treated with aspirin and Aveeno bath and lotion.


VAERS ID: 237768 (history)  
Age: 11.0  
Gender: Male  
Location: Ohio  
Vaccinated:1995-12-07
Onset:2003-06-01
   Days after vaccination:2733
Submitted: 2005-05-16
   Days after onset:715
Entered: 2005-05-23
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - - / -

Administered by: Other       Purchased by: Other
Symptoms: Rash, Viral infection
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0404USA00436

Write-up: Information has been received from a registered nurse concerning a 11 year old male who was vaccinated on 12/7/95 with a dose of varicella virus vaccine live (lot number was unavailable). The patient was seen in June 2003 with pox. The child was noted to have chickenpox breakthrough. Unspecified medical attention was sought. There was no product quality complaint. The reporter indicated that 19 other patients were vaccinated with a dose of varicella virus vaccine live and developed chicken pox breakthrough/shingles (WAES0404USA00205, 0404USA00418, 0404USA00419, 0404USA00420, 0404USA00421, 0404USA00422, 0404USA00423, 0404USA00424, 0404USA00425, 0404USA00426, 0404USA00427, 0404USA00428, 0404USA00429, 0404USA00430, 0404USA00431, 0404USA00432, 0404USA00433, 0404USA00434, 0404USA00435). No further information is expected.


VAERS ID: 81263 (history)  
Age: 1.0  
Gender: Male  
Location: Foreign  
Vaccinated:1995-12-07
Onset:1995-12-07
   Days after vaccination:0
Submitted: 1996-01-19
   Days after onset:43
Entered: 1996-01-24
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthma, Eczema, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: allergy eggs
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96015018

Write-up: pt recvd vax 7DEC95 & same day pt exp wheezing & blotchy rash & was hospitalized;poss allergy to eggs-comes out in blotchy eczematous rash;no action was taken w/regard to MMR;


VAERS ID: 82016 (history)  
Age: 55.0  
Gender: Male  
Location: Foreign  
Vaccinated:1995-12-07
Onset:1995-12-12
   Days after vaccination:5
Submitted: 1996-01-17
   Days after onset:36
Entered: 1996-02-07
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH - / - - / IM

Administered by: Other       Purchased by: Other
Symptoms: Condition aggravated, Infection, Respiratory disorder
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: the pt has a history of chronic obstructive airways disease
Diagnostic Lab Data:
CDC Split Type: 896018002L

Write-up: pt recvd vax 07DEC95 & 12DEC95 pt was hospitalized w/an infect causing acute exacerbation of chronic obstructive airway condition;pt recovered & was d/c on 19DEC95;


VAERS ID: 90619 (history)  
Age: 1.9  
Gender: Female  
Location: Foreign  
Vaccinated:1995-12-07
Onset:0000-00-00
Submitted: 1996-09-18
Entered: 1996-10-09
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / - LL / IM

Administered by: Other       Purchased by: Other
Symptoms: Abscess, Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data: 19JAN96 bacteriology-no bacteria of fungi present;
CDC Split Type: 896267010L

Write-up: pt devel a sterile abscess @ the inj site following vax;surgical intervention was required, & pt was hops;cult performed on the material removed during surgery revealed no presence of bacteria or fungi;9mo later pt devel an abscess @ site;


VAERS ID: 128386 (history)  
Age: 15.0  
Gender: Female  
Location: Foreign  
Vaccinated:1995-12-07
Onset:1995-12-10
   Days after vaccination:3
Submitted: 1999-09-14
   Days after onset:1373
Entered: 1999-09-20
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 3 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Arthritis, Arthropathy, Laboratory test abnormal, Rheumatoid arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: otitis media
Diagnostic Lab Data: biological tests results nl except sl inc phosphorus;alkaline;phosphatases;C-reactive protein; x-rays of pelvis;chest;hands;writs &ankles showed geodes;HLA typing indicated b27-neg
CDC Split Type: 1997003671

Write-up: pt rt arthritis w/stiffness;hosp; Dx:rheumatoid arthritis;tx:Plaquenil & Debridat;1/28/97 hosp again;recv Texodil; Rhinadvil; Salazopyrine;naprosyn&Cytotec; at d/c pain regressed; as of 9/6/99 pt was no yet recovered;


VAERS ID: 80208 (history)  
Age: 44.0  
Gender: Female  
Location: Tennessee  
Vaccinated:1995-12-08
Onset:1995-12-08
   Days after vaccination:0
Submitted: 1995-12-08
   Days after onset:0
Entered: 1995-12-21
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61126 / - RA / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1746A4 / 1 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Dyspnoea, Headache, Hypokinesia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt recvd vax 9NOV95 was nauseated & felt bad x 3 days w/HBV vax~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergic to PNC, hypertension
Diagnostic Lab Data:
CDC Split Type: TN95130

Write-up: pt recvd vax 8DEC95 about 10mins p/vax pt devel a rxn @ the site of inj-red raised area about the size of a quarter;states arm felt like it would pop open & had a h/a;called MD told take DPH & observe x 1hr;c/o h/a, flushed, diff breathing


VAERS ID: 80696 (history)  
Age: 0.3  
Gender: Female  
Location: Maryland  
Vaccinated:1995-12-08
Onset:1995-12-10
   Days after vaccination:2
Submitted: 1995-12-20
   Days after onset:10
Entered: 1996-01-03
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 428033 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0729L / 1 - / PO

Administered by: Private       Purchased by: Military
Symptoms: Grand mal convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, electrolytes nl
CDC Split Type:

Write-up: sz, grand mal, 2 days p/vax;


VAERS ID: 80840 (history)  
Age: 1.0  
Gender: Male  
Location: West Virginia  
Vaccinated:1995-12-08
Onset:1995-12-10
   Days after vaccination:2
Submitted: 1995-12-20
   Days after onset:10
Entered: 1996-01-16
   Days after submission:27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 4B61083 / 3 RA / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1382A / 0 LA / -

Administered by: Private       Purchased by: Private
Symptoms: Convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: na~ ()~~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: URI, otitis media
Diagnostic Lab Data: na
CDC Split Type: WV9601

Write-up: pt recvd vax; devel fever 24 hrs p/ vax then 36 hrs later devel szs; was hosp for 24 hrs w/ control of sz & fever;


VAERS ID: 80880 (history)  
Age: 0.4  
Gender: Male  
Location: Tennessee  
Vaccinated:1995-12-08
Onset:1995-12-09
   Days after vaccination:1
Submitted: 1995-12-11
   Days after onset:2
Entered: 1996-01-16
   Days after submission:36
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 429965 / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0524B / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0726D / 1 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Crying, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: TN96003

Write-up: pt fussy 8DEC95;woke up screaming 9DEC95;temp 104.6R; saw MD @ ER;was told that it was adverse rxn to pertussis;family to give advil/APAP & warm baths


VAERS ID: 80902 (history)  
Age: 33.0  
Gender: Female  
Location: Nevada  
Vaccinated:1995-12-08
Onset:1995-12-08
   Days after vaccination:0
Submitted: 1995-12-20
   Days after onset:12
Entered: 1996-01-16
   Days after submission:27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1076B / 0 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Arthralgia, Hypokinesia, Injection site hypersensitivity, Injection site mass, Injection site oedema, Oedema peripheral, Osteoarthritis, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Erythromycin since 15DEC95;Advil, Darvocet, Birth Control pills
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type: NV95046

Write-up: pt recvd vax 8DEC95 & started w/red,lumpy & swollen area where inj given;9DEC95 redness & swelling had gone to elbow;10DEC95 hand,wrist & fingers were involved;11DEC95 these sxs disappeared & achiness of joints started & has had them since


VAERS ID: 85349 (history)  
Age: 3.0  
Gender: Male  
Location: Pennsylvania  
Vaccinated:1995-12-08
Onset:1995-12-27
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 1996-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0446B / 0 - / SC

Administered by: Private       Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pred
Current Illness:
Preexisting Conditions: nephrotic synd
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95121604

Write-up: pt recv vax 8DEC95 & 27DEC95 pt devel chicken pox;f/u from patient''s MD indicated that pt devel 5 chicken pox like lesions;pt given Zovirax;MD reported lesions cont to appear up to approx 20 & mostly papular w/only a few vesicular;


VAERS ID: 85706 (history)  
Age: 29.0  
Gender: Female  
Location: Indiana  
Vaccinated:1995-12-08
Onset:1996-03-29
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 1996-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0424B / 1 RA / -

Administered by: Other       Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: lab eval 29MAR96 revealed varicella antibody negative;
CDC Split Type: WAES96022262

Write-up: pt recv 2 dose of vax & failed to seroconvert;no further details were provided;


VAERS ID: 85754 (history)  
Age: 35.0  
Gender: Female  
Location: California  
Vaccinated:1995-12-08
Onset:1995-12-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1996-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0399B / 0 - / IM

Administered by: Private       Purchased by: Other
Symptoms: Asthenia, Chest pain, Dermatitis bullous, Hyperaesthesia, Hypokinesia, Myalgia, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Blood tests negative; CXR negative; Echocardiogram neg;
CDC Split Type: WAES96011358

Write-up: pt recv vax 8DEC95 & 10DEC95 pt devel a rash consistent w/ varicella & approx 20DEC95 exp intermittent chest discomfort; routine lab tests, CXR, & echocardiogram that turned out to be negative were performed;


VAERS ID: 85806 (history)  
Age: 28.0  
Gender: Female  
Location: Rhode Island  
Vaccinated:1995-12-08
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1996-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0388B / 1 - / SC

Administered by: Other       Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: anti-HBs neg;
CDC Split Type: WAES96031022

Write-up: pt recv vax;pt failed to seroconvert p/ 2 doses;serology test revealed a neg titer;


VAERS ID: 91391 (history)  
Age: 31.0  
Gender: Female  
Location: Unknown  
Vaccinated:1995-12-08
Onset:1996-02-27
   Days after vaccination:81
Submitted: 1996-10-23
   Days after onset:238
Entered: 1996-10-29
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 - / -

Administered by: Other       Purchased by: Other
Symptoms: Abortion, Stillbirth
SMQs:, Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Vitamins, Prenatal;
Current Illness:
Preexisting Conditions: abortion, spontaneous;offspring, abn;
Diagnostic Lab Data: 31JAN96 sonogram 8wk positive fetal heart beat;27FEB96 ultrasound no fetal heart beat;
CDC Split Type: WAES96011564

Write-up: pt recv vax 8DEC95 & became pregnant (LMP 7DEC95);A sonogram on 31JAN96 revealed a positive heart beat;however an ultrasound on 27FEB96 revealed no fetal heart beat & D&C was performed 28FEB96;


VAERS ID: 91695 (history)  
Age: 52.0  
Gender: Female  
Location: Washington  
Vaccinated:1995-12-08
Onset:1995-12-09
   Days after vaccination:1
Submitted: 1996-06-25
   Days after onset:198
Entered: 1996-10-30
   Days after submission:127
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - - / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH - / - - / IM

Administered by: Other       Purchased by: Other
Symptoms: Face oedema, Pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: penicillin allergy, arthritis, chronic sinusitis, probable MS
Diagnostic Lab Data:
CDC Split Type: 896191009L

Write-up: pt recv vax & exp urticaria & swelling of the lips & eyes;cont to exp urticaria as of the date of this report;


VAERS ID: 92430 (history)  
Age: 3.0  
Gender: Male  
Location: Georgia  
Vaccinated:1995-12-08
Onset:1996-11-20
   Days after vaccination:348
Submitted: 1996-11-21
   Days after onset:1
Entered: 1996-11-26
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0746B / 0 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: wild varicella outbreak p/vax;


VAERS ID: 103793 (history)  
Age: 1.0  
Gender: Female  
Location: Florida  
Vaccinated:1995-12-08
Onset:1997-09-02
   Days after vaccination:634
Submitted: 0000-00-00
Entered: 1997-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1310B / 0 - / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1310B / 0 - / SC

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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97090259

Write-up: pt recv vax 8DEC95 & 1SEP97 pt presented w/fever & chickenpox;


VAERS ID: 119001 (history)  
Age: 36.0  
Gender: Female  
Location: Kentucky  
Vaccinated:1995-12-08
Onset:1996-04-07
   Days after vaccination:121
Submitted: 1999-02-08
   Days after onset:1037
Entered: 1999-02-16
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0182B / 1 RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Asthenia, Multiple sclerosis, Myasthenic syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Demyelination (narrow)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NA
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI, CAT scan, PET Scan;CXR, spinal tap, bone scan, mammogram, brain biopsy;
CDC Split Type:

Write-up: after second shot pt was dx w/MS-numbness on lt side;


VAERS ID: 124268 (history)  
Age: 1.0  
Gender: Male  
Location: Pennsylvania  
Vaccinated:1995-12-08
Onset:1998-11-18
   Days after vaccination:1076
Submitted: 1999-05-14
   Days after onset:176
Entered: 1999-05-21
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - - / -

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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: sister, varicella, 6yrs, varivax~ ()~~~In Sibling
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98111859

Write-up: approx 21/2yrs p/vax pt exp breakthrough chickenpox w/approx 15-20 lesions noted.


VAERS ID: 124300 (history)  
Age: 1.0  
Gender: Female  
Location: Delaware  
Vaccinated:1995-12-08
Onset:1998-12-05
   Days after vaccination:1093
Submitted: 1999-05-14
   Days after onset:159
Entered: 1999-05-21
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - - / -

Administered by: Unknown       Purchased by: Unknown
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)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No Relevant Data~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: allergy
Diagnostic Lab Data:
CDC Split Type: WAES98120524

Write-up: p/vax pt exp fever & devel chickenpox w/13 red raised lesions on legs, back & chin & one pustule on face;pt sought unspecified medical attention;


VAERS ID: 124672 (history)  
Age: 2.0  
Gender: Female  
Location: Texas  
Vaccinated:1995-12-08
Onset:1999-02-25
   Days after vaccination:1175
Submitted: 1999-05-14
   Days after onset:77
Entered: 1999-05-21
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 0 - / -

Administered by: Other       Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES99031195

Write-up: approx 4yrs p/vax pt devel chickenpox rash consisting of over 100 lesions. rash was maculopapular. addl info requested


VAERS ID: 279874 (history)  
Age:   
Gender: Female  
Location: New Mexico  
Vaccinated:1995-12-08
Onset:2006-04-01
   Days after vaccination:3767
Submitted: 2007-05-16
   Days after onset:409
Entered: 2007-05-24
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0745B / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Fatigue, Herpes zoster, Viral test
SMQs:

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: Diagnostic laboratory test 04/06/2006, VZV DNA - inadequate specimen with no strain ID
CDC Split Type: WAES0604USA00452

Write-up: Information has been received from a physician concerning a female patient who on 08-DEC-1995 (also reported as 18-DEC-1995) was vaccinated in the left thigh with a 0.5 ml dose of Varivax (lot 610249/0745B). There was no rash at the site of injection or elsewhere within 42 days of the vaccination, no history of chickenpox, and no recent exposure to chickenpox or herpes zoster. On 01-APR-2006 the patient experienced herpes zoster on the left back T2-T4. The patient denies any temperature and rated pain a 6-7 out of 10. It was noted that the patient also had fatigue. On 06-APR-2006 a specimen was collected. It was an inadequate specimen with no strain ID. VZV DNA was amplified and B-globin was not amplified. Additional information has been requested.


VAERS ID: 308346 (history)  
Age:   
Gender: Female  
Location: Unknown  
Vaccinated:1995-12-08
Onset:1996-04-12
   Days after vaccination:126
Submitted: 2008-03-07
   Days after onset:4347
Entered: 2008-03-19
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Hypoaesthesia, Multiple sclerosis, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Demyelination (narrow)

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: WAES0712USA06012

Write-up: Information has been received regarding a case in litigation concerning a female who on 10-NOV-1995 was vaccinated with a first dose of Recombivax HB, and a second dose on 08 DEC 1995. On 12-APR-1996 the patient was seen by a physician for complaints of pins and needles in her left foot. On 20 APR 1996 the patient was seen by a physician for complaints that "numbness in her foot had crept up her body into her arm". It was reported that in the opinion of a neurologist that the Recombivax HB had caused the patient''s atypical MS. It was noted that the onset of the MS was believed to be four months post vaccination with Recombivax HB. Upon internal review multiple sclerosis was considered to be an other medically important event (OME). Additional information is not expected.


VAERS ID: 80807 (history)  
Age: 18.0  
Gender: Male  
Location: Foreign  
Vaccinated:1995-12-08
Onset:1995-12-09
   Days after vaccination:1
Submitted: 1996-01-03
   Days after onset:25
Entered: 1996-01-11
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 2 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Delirium, Drug dependence, Headache, Meningism, Personality disorder, Psychotic disorder, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug abuse and dependence (narrow), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hx of appendectomy, occ consume of cannabis
Diagnostic Lab Data: cerebral CT Scan nl 13DEC95; CSF analysis 2WBC, 563 RBC, Chlore 117, glucose 3.05, albulin 0.18 13DEC95
CDC Split Type: 950141891

Write-up: pt vaxd 8DEC95,9DEC95 dev behavior dis,h/a appeared;pt adm hosp 13DEC95 poss meningism which was eliminated;PE nl;psych exam:logorrhea,ideas of megalomania & expansive humor;30Jan96-f/u: acute delirium devel-pt consumed cannabis on 9Dec95.


VAERS ID: 80104 (history)  
Age: 19.0  
Gender: Male  
Location: North Carolina  
Vaccinated:1995-12-09
Onset:0000-00-00
Submitted: 1995-12-11
Entered: 1995-12-15
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA433A6 / 0 RA / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. K0225 / - LA / SC
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4958021 / 1 LA / IM
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF) / BERNA BIOTECH, LTD 137702A / 0 - / PO

Administered by: Private       Purchased by: Other
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp same sxs w/dose #1 typhoid~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recvd vax 9DEC & devel red rash, itchy, flat x/where pt has scratched it; T97.6;


VAERS ID: 80241 (history)  
Age: 0.2  
Gender: Male  
Location: Ohio  
Vaccinated:1995-12-09
Onset:1995-12-09
   Days after vaccination:0
Submitted: 1995-12-18
   Days after onset:9
Entered: 1995-12-26
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 428033 / 0 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 732K5 / 0 - / PO

Administered by: Private       Purchased by: Private
Symptoms: Hypotonia, Stupor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: hypotonic/hyporesponsive


VAERS ID: 80785 (history)  
Age: 11.0  
Gender: Male  
Location: Texas  
Vaccinated:1995-12-09
Onset:1995-12-09
   Days after vaccination:0
Submitted: 1996-01-08
   Days after onset:30
Entered: 1996-01-11
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private       Purchased by: Other
Symptoms: Influenza, Malaise, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: na~ ()~~~In patient
Other Medications: "asma court", "ritalin";
Current Illness: none
Preexisting Conditions: hyperactivity, asthma
Diagnostic Lab Data: none
CDC Split Type:

Write-up: pt recvd vax; 5 min p/ vax, became nauseated; felt bad all over;3 hrs later high T; flu sxs, body aches; T 105.1 in er;


VAERS ID: 101447 (history)  
Age: 5.0  
Gender: Male  
Location: New York  
Vaccinated:1995-12-09
Onset:1995-12-09
   Days after vaccination:0
Submitted: 1997-03-31
   Days after onset:478
Entered: 1997-07-22
   Days after submission:112
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (IMOVAX) / PASTEUR MERIEUX INST. K1120 / 2 - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6417

Write-up: swelling of the toes;


VAERS ID: 82674 (history)  
Age: 49.0  
Gender: Female  
Location: Mississippi  
Vaccinated:1995-12-10
Onset:1995-12-10
   Days after vaccination:0
Submitted: 1996-01-08
   Days after onset:29
Entered: 1996-02-16
   Days after submission:39
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA465A6 / - LA / -

Administered by: Public       Purchased by: Public
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: MS96006

Write-up: feet & hands itching w/in 1 hrs p/vax;


VAERS ID: 82675 (history)  
Age: 11.0  
Gender: Female  
Location: Mississippi  
Vaccinated:1995-12-10
Onset:1995-12-10
   Days after vaccination:0
Submitted: 1996-01-08
   Days after onset:29
Entered: 1996-02-16
   Days after submission:39
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 0 LA / -

Administered by: Public       Purchased by: Public
Symptoms: Asthenia, Hyperhidrosis, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

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: NONE
CDC Split Type: MS96007

Write-up: flushing of face & sweat c/o weakness 23hrs p/vax


VAERS ID: 84942 (history)  
Age: 25.0  
Gender: Female  
Location: Michigan  
Vaccinated:1995-12-10
Onset:1995-12-11
   Days after vaccination:1
Submitted: 1995-12-13
   Days after onset:2
Entered: 1996-04-16
   Days after submission:124
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 5H71003 / 0 LA / -

Administered by: Private       Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Oedema peripheral, Pain, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: laceration rt foot
Preexisting Conditions: neg
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: swelling-redness pain @ site & inc arm;


VAERS ID: 106876 (history)  
Age:   
Gender: Male  
Location: Illinois  
Vaccinated:1995-12-10
Onset:0000-00-00
Submitted: 1998-01-12
Entered: 1998-01-15
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 0 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Dermatitis bullous, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES97121414

Write-up: pt recv vax DEC95 & pt devel chickenpox w/50 to 100 lesions;


VAERS ID: 168453 (history)  
Age: 23.0  
Gender: Male  
Location: Foreign  
Vaccinated:1995-12-10
Onset:1996-05-01
   Days after vaccination:143
Submitted: 2001-04-09
   Days after onset:1804
Entered: 2001-04-10
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 3 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Balance disorder, CSF test abnormal, Cerebellar syndrome, Cholecystitis, Coordination abnormal, Deafness, Demyelination, Difficulty in walking, Ejaculation failure, Extensor plantar response, Laboratory test abnormal, Multiple sclerosis, Muscular weakness, Nuclear magnetic resonance imaging brain abnormal, Nystagmus, Ophthalmoplegia, Paraesthesia, Pollakiuria, Pyrexia, Tinnitus, Urinary retention, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Infectious biliary disorders (narrow), Gallbladder related disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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:
Current Illness:
Preexisting Conditions: Asthma,
Diagnostic Lab Data: MRI of brain-showed very numerous lesions in T2 and T1; LP-showed a CSF with 8 leukocytes/mm3 and a normal protein level; Auditory and visual evoked potentials were in favor of demyelinating lesions. Somesthetics evoke potentials revealed lesions of lemniscus fibers; CXR-nml; hepatic checkup-nml; bladder ultrasonography-revealed post-micturition residual urine (130cc)
CDC Split Type: 2000270591

Write-up: On 10/20/94, 12/08/94. 01/17/95, and 12/10/95, the patient was vaccinated with Engerix B for Hepatitis B prophylaxis. Approximately five months later, in May 1996, the patient developed cerebellar syndrome, balance difficulty, walking difficulty, feeling of drunkenness, muscle weakness of the lower limbs, hands and feet paresthesia, Lhermitte''s sign, lower limbs dysesthesia, hypopallesthessia of both ankles, mild ataxia of the left lower limb, bilateral deafness, and blurred vision of the left eye. He also experienced one episode of tinnitus (for one hour) and one episode of paresthesia of his right thigh (for one week), both spontaneously regressive. The diagnosis of multiple sclerosis was made and a treatment with flashes of methylprednisolone (Solumedrol) and azathioprine (Imurel) was started followed by progressively decreasing methylprednisolone per os (Medrol). In February 1997, a progressive worsening of the muscle weakness of the lower limbs occurred, with balance disorder. Pyramidal syndrome of lower limbs was noticed as well as a positive Babinski''s sign (left side). The patient was then prescribed another progressively decreasing flashes of methylprednisolone followed by prednisolone per os (Solupred). From 04/09/97 to 04/18/97, the patient was hospitalized because of multiple sclerosis flare-up. Clinical exam showed Lhermitte''s sign, positive Romberg''s sign, pyramidal tract disorder, hypopallesthesia of the lower limbs, cerebellar syndrome and nystagmus. From 01/24/98 to 02/02/98, the patient was again hospitalized because of multiple sclerosis flare-up. Clinical exam showed the same as last hospitalization. It was noticed that the knees gave way beneath him. In 04/98, the patient initiated Avonex at a dose of one injection per week. It was noticed that the patient experienced since then asthenia and stiffness, related to the Avonex. On 07/28/98, the exam showed neg - Romberg''s sign, quick tendon reflex, bilateral Babinski''s sign, hypoesthesia, nystagmus, cerebellar syndrome, micturition frequency, dysuria, ejaculation failure, dysesthesia, feeling of drunkeness. A reduction in walking perimeter was also observed with the feeling of the lower limbs were given way beneath him. From 09/02/98 to 09/09/98, the patient was hospitalized because of multiple sclerosis flare-up. Walking disorder had worsened with a decrease in walking perimeter and ataxic walk. The patient developed urinary retention requiring a urinary tube. Clinical examine showed previous diagnosis plus bilateral partial internuclear ophthalmoplegia, pyramidal tract disorder and lower limbs extrapyramidal tract disorder. The patient was treated. From 09/07/98 to 10/02/98, the patient practiced motor and urological re-education. In 05/99, an aggravation of lower limbs motor deficit was observed as well as Uthoff''s sign. From 11/23/99 to 11/25/99, the patient was hospitalized because of a multiple sclerosis flare-up. The patient developed an aggravation of walking difficulty with a decrease in walking perimeter and falls. Physical exam showed same as previous hospitalizations. From 03/23/00 to 03/31/00, the patient was hospitalized because of a fever at 38.5 degrees Celsius, asthenia, and abdominal pain. Acute cholecystitis was diagnosed for which he underwent surgery on 04/01/00. In 04/00, experienced a severe worsening of walking difficulty. From 06/05/00 to 06/09/00, the patient was hospitalized because of multiple sclerosis flare-up. Aggravation of walking difficulty was observed with major ataxia. Cerebellar syndrome as well as dysesthesia and micturition frequency were also observed. The patient was then given three flashes of methylprednisolone. Avonex was then stopped and replaced by interferon beta-1A (Rebif). The most recent information received on 03/30/01 reports the outcome of the patient as not yet recovered.


VAERS ID: 169379 (history)  
Age: 18.0  
Gender: Unknown  
Location: Foreign  
Vaccinated:1995-12-10
Onset:0000-00-00
Submitted: 2001-04-10
Entered: 2001-05-04
   Days after submission:24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / - - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Delusion, Depression suicidal, Headache, Laboratory test abnormal, Muscle spasms, Pain, Respiratory disorder
SMQs:, Suicide/self-injury (narrow), Dementia (broad), Dystonia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Respiratory failure (broad)

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: Hep B Prophylaxis, Hypochondrical Delusion, Suicidal Ideas.
Diagnostic Lab Data: Deep tendon reflex- Result text - fast, mild epicritic sensitive disorder.
CDC Split Type: 20010102861

Write-up: Report # 2001010286-1 describes the occurrence of lower limb pain in a 18 year old male patient vaccinated with Engerix-B for Hepatitis B prophylaxis. Case reported by AFSSAPS. The patient belongs to the REVAHE association. The patient''s medical history included anorexia nervosa. Concurrent medical condition included suicidal ideas and hypochondriacal delusion. Between 05/10/95 and 12/10/95, the patient received 3 injections of Engerix-B. In 1996, the patient developed lower limb pain at effort. Then, one year and a half later, pain spread over trunk, upper limb and head (cephalgia). The patient also developed severe asthenia. No vertigo, nausea or paresthesia were found. The patient also suffered from lower limb cramps and respiratory disorder. The patient was hospitalized at an unspecified date. Oesteo-tendinous reflexes were fast; mild upper limb epicritic sensitive disorder was reported. No organic cause was found. The most recent information received on 04/23/01 reports the outcome of the patient as not yet recovered. The causality assessment was reported by AFSSAPS as dubious for Engerix - B.


VAERS ID: 80958 (history)  
Age: 0.3  
Gender: Male  
Location: Foreign  
Vaccinated:1995-12-11
Onset:1995-12-12
   Days after vaccination:1
Submitted: 1996-01-15
   Days after onset:34
Entered: 1996-01-19
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES L0077 / 0 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Other       Purchased by: Other
Symptoms: Sudden infant death syndrome, Unevaluable event
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Died? Yes
   Date died: 1995-12-12
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6428

Write-up: found dead by mom in the morning the day p/vax, lying on the back, & lightly clothed; post mortem carried out on 14DEC95-nil found;


VAERS ID: 82017 (history)  
Age: 11.0  
Gender: Male  
Location: Foreign  
Vaccinated:1995-12-11
Onset:1995-12-11
   Days after vaccination:0
Submitted: 1996-02-01
   Days after onset:52
Entered: 1996-02-07
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0869W / - - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Chorioretinitis, Condition aggravated, Oedema, Optic neuritis, Uveitis, Visual disturbance
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (narrow), Cardiomyopathy (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (narrow), Ocular infections (narrow), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: pt recvd Hep b vax 30 days prior
Current Illness:
Preexisting Conditions: hx uveitis
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96011423

Write-up: pt recvd vax & 10 hrs later devel symptomatology consistent w/dx of optic neuritis,chorioretinitis & uveitis;@ the time of report,pt''s sx persisted;No further details were provided;


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

New Search

Link To This Search Result:

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


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166