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Found 459176 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:115492 (history)  Vaccinated:1998-10-21
Age:9.7  Onset:1998-10-21, Days after vaccination: 0
Gender:Male  Submitted:1998-10-21, Days after onset: 0
Location:Alabama  Entered:1998-10-30, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: bronchitis
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': AL9813
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09784900IMRA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2634A22IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & returned about 1 1/2hr later w/pruritic skin rash;

VAERS ID:115624 (history)  Vaccinated:1998-10-21
Age:0.2  Onset:1998-10-21, Days after vaccination: 0
Gender:Male  Submitted:1998-10-26, Days after onset: 5
Location:Missouri  Entered:1998-11-03, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': MO98091
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4557250IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2612A20IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM195RF0IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N00320SCRL
Administered by: Public     Purchased by: Public
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: immed devel of diffuse somewhat splotchy erythematous rash w/scattered erythematous papules over face, primarily forehead;resolved w/o tx over 20-30min;

VAERS ID:115723 (history)  Vaccinated:1998-10-21
Age:47.1  Onset:1998-10-21, Days after vaccination: 0
Gender:Female  Submitted:1998-10-26, Days after onset: 5
Location:Maryland  Entered:1998-11-04, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E20228KC0 LA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Bradycardia, Dizziness, Headache, Hypertension, Hypotension, Myasthenic syndrome, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Hypertension (narrow), Vestibular disorders (broad)
Write-up: Pt recv vax on 10/21/98; 1/2 hr later pt exp headache & dizziness, weak &tingling legs, popping sound in head

VAERS ID:116103 (history)  Vaccinated:1998-10-21
Age:51.8  Onset:1998-10-21, Days after vaccination: 0
Gender:Female  Submitted:1998-11-01, Days after onset: 11
Location:Minnesota  Entered:1998-11-09, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: premarin;tagamet
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dizziness, Dyspnoea, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: 4hr p/vax very tired;8hr faint, nausea, chills, fever, diff breathing, ache all over;24hr nausea, fever, ache all over;p/6 days sx passed;ASA, bed rest, lots of fluids;

VAERS ID:116141 (history)  Vaccinated:1998-10-21
Age:76.2  Onset:1998-10-21, Days after vaccination: 0
Gender:Male  Submitted:1998-11-04, Days after onset: 14
Location:Texas  Entered:1998-11-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: Work up at Baylor Univ. Hospital-negative
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E20258KC IMLA
Administered by: Private     Purchased by: Private
Symptoms: Malaise, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt recv vax on 10/21/98; on same day pt exp vomiting & illness; pt seen in E.R.

VAERS ID:116251 (history)  Vaccinated:1998-10-21
Age:46.9  Onset:1998-10-24, Days after vaccination: 3
Gender:Male  Submitted:1998-10-29, Days after onset: 5
Location:Colorado  Entered:1998-11-12, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil prn
Current Illness: None
Preexisting Conditions: Prostate cancer treated with prostectomy
Diagnostic Lab Data:
CDC 'Split Type': 898303003A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4988216 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Dysuria, Migraine, Pollakiuria
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax & devel severe abd pain;pt hosp & dx w/kidney failure;

VAERS ID:116473 (history)  Vaccinated:1998-10-21
Age:43.4  Onset:1998-10-21, Days after vaccination: 0
Gender:Female  Submitted:1998-10-27, Days after onset: 6
Location:Michigan  Entered:1998-11-18, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Premarin;Toprol XL
Current Illness: NONE
Preexisting Conditions: h
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
Administered by: Other     Purchased by: Private
Symptoms: Hypertonia, Myalgia, Nausea, Oedema peripheral, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: swelling of arm, sore & stiffness traveled up to neck & shoulder;T101, nausea;

VAERS ID:116591 (history)  Vaccinated:1998-10-21
Age:88.4  Onset:1998-10-25, Days after vaccination: 4
Gender:Female  Submitted:1998-10-29, Days after onset: 4
Location:Massachusetts  Entered:1998-11-20, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Fluid pill
Current Illness: NONE
Preexisting Conditions: High blood pressure, s/p Basal skin cancer
Diagnostic Lab Data: UNK
CDC 'Split Type': MA9821
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09757902IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dizziness, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: Pt recv vax on 10/21/98; on 10/25/98 pt exp lightheadedness, woozy, chills, fever, achiness, weakness; 1 wk illness, still weak - washed out

VAERS ID:116593 (history)  Vaccinated:1998-10-21
Age:46.8  Onset:1998-10-22, Days after vaccination: 1
Gender:Female  Submitted:1998-10-30, Days after onset: 8
Location:Massachusetts  Entered:1998-11-20, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': MA9823
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09757900IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 10/21/98; on 10/22/98 pt exp red/swollen/warm/firm/sensitive/increased in size vax site

VAERS ID:116626 (history)  Vaccinated:1998-10-21
Age:14.3  Onset:1998-10-22, Days after vaccination: 1
Gender:Male  Submitted:1998-11-18, Days after onset: 27
Location:Pennsylvania  Entered:1998-11-23, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications:
Current Illness:
Preexisting Conditions: ceclor allergy
Diagnostic Lab Data:
CDC 'Split Type': WAES98102115
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES  IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1542E0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Injection site hypersensitivity, Injection site oedema, Oedema peripheral, Pain, Pyrexia, Vasodilatation, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 21OCT98 & 22OCT98 pt exp fever & vomiting;23OCT98 pt exp facial & arm swelling & redness;24OCT98 facial swelling & fever had decreased however arm was still red & swollen w/3" inches of erythema & swelling;

VAERS ID:116896 (history)  Vaccinated:1998-10-21
Age:33.2  Onset:0000-00-00
Gender:Female  Submitted:1998-11-20
Location:Wisconsin  Entered:1998-11-27, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09818000 LA
Administered by: Public     Purchased by: Private
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt exp hives/rash all over body;

VAERS ID:120153 (history)  Vaccinated:1998-10-21
Age:38.3  Onset:1998-10-24, Days after vaccination: 3
Gender:Female  Submitted:1999-03-02, Days after onset: 129
Location:Texas  Entered:1999-03-10, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Depo Provera
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09696005IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site atrophy
SMQs:
Write-up: post flu vax pt presents w/an indentation to lt deltoid area, measuring approx 2cm diameter & 2cm deep;

VAERS ID:120864 (history)  Vaccinated:1998-10-21
Age:42.7  Onset:1998-10-24, Days after vaccination: 3
Gender:Female  Submitted:1998-12-01, Days after onset: 38
Location:North Carolina  Entered:1999-04-02, Days after submission: 122
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09805701IMLA
Administered by: Private     Purchased by: Private
Symptoms: Laryngospasm, Lymphadenopathy, Neck pain
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Pt recv vax on 10/21/98; on 10/24/98 pt exp swollen lymph glands, swollen glands across clavicles w/ neck & thyroid discomfort, lump in throat; tx=Ibuprofen

VAERS ID:127976 (history)  Vaccinated:1998-10-21
Age:82.6  Onset:1998-10-22, Days after vaccination: 1
Gender:Male  Submitted:1998-10-28, Days after onset: 6
Location:Missouri  Entered:1999-09-03, Days after submission: 309
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vasotec; meclizine; multivitamin
Current Illness: unk
Preexisting Conditions: hypertension; esophageal stricture; previous dose of Pnu-Imune 23 given at least 6yr ago
Diagnostic Lab Data: none
CDC 'Split Type': 898302055A
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4566901SCA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt devel inj site rxn of swelling & erythema; tx: Atarax; prednisone & ceftin

VAERS ID:127985 (history)  Vaccinated:1998-10-21
Age:  Onset:1998-10-23, Days after vaccination: 2
Gender:Unknown  Submitted:1998-10-28, Days after onset: 5
Location:South Carolina  Entered:1999-09-03, Days after submission: 309
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 898306051A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES454959 SCA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: p/vax pt devel redness @ the inj site;pt recovered;

VAERS ID:127995 (history)  Vaccinated:1998-10-21
Age:  Onset:1998-10-23, Days after vaccination: 2
Gender:Female  Submitted:1998-10-30, Days after onset: 7
Location:Missouri  Entered:1999-09-03, Days after submission: 307
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 898307086A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES454956  A
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: p/vax pt devel a severe site rxn characterized by redness, warmth & pain;tx w/NSAIDS & oral ATB;

VAERS ID:315707 (history)  Vaccinated:1998-10-21
Age:0.0  Onset:2007-04-29, Days after vaccination: 3112
Gender:Female  Submitted:2008-05-16, Days after onset: 383
Location:Illinois  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Secondary transmission~Varicella (no brand name)~~8~In Sibling|Skin lesion~Varicella (no brand name)~~8~In Sibling
Other Medications: vitamins (unspecified)
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: body temp - 101 F
CDC 'Split Type': WAES0705USA00066
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0666H SCUN
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Skin lesion, Varicella
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Information has been received from a health professional concerning an 8 year old female with no medical history and no allergies who on 21-OCT-1998 was vaccinated with 0.5ml subcutaneous dose of varicella virus vaccine live (Oka/Merck) (Lot# 626409/0666H). Concomitant therapy included a multivitamin. On 29-APR-2007 the patient developed a varicella rash. The patient had about 40 lesions and had a fever of 101 degrees Fahrenheit. At the time of this report. The patient had not recovered. No further information was available at the time of this report. Unspecified medical attention was sought. No product quality complaint was involved. The patient''s twin sister experienced one questionable lesion following this vaccination with varicella virus vaccine live (Oka/Merck) (WAES#0705USA03172). Additional information has been requested.

VAERS ID:115319 (history)  Vaccinated:1998-10-22
Age:43.0  Onset:1998-10-22, Days after vaccination: 0
Gender:Male  Submitted:1998-10-23, Days after onset: 1
Location:Ohio  Entered:1998-10-26, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Conjunctivitis, Eye pain, Headache, Pain, Pyrexia, Vasodilatation
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: h/a, fever, eyes, face, cheek warm & hurting lot of pressure on eyes, h/a severe;

VAERS ID:115333 (history)  Vaccinated:1998-10-22
Age:62.1  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-23, Days after onset: 1
Location:Iowa  Entered:1998-10-26, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': IA98029
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: rt upper arm swollen, warm, sl reddened;got shot pneumonia 22OCT98 rt arm 1PM;

VAERS ID:115415 (history)  Vaccinated:1998-10-22
Age:66.5  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Nevada  Entered:1998-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: slocay;lotensin, premarin, lasix, zocor
Current Illness: NONE
Preexisting Conditions: shellfish, tofu, codeine
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Oedema peripheral, Pain, Pruritus, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: @ site down arm itched;extremely swollen & red then top of arm to wrists hot & sore;

VAERS ID:115428 (history)  Vaccinated:1998-10-22
Age:46.1  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-10-23, Days after onset: 0
Location:Missouri  Entered:1998-10-28, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp chills @ 44yr w/flu vax;
Other Medications:
Current Illness: NONE
Preexisting Conditions: PCN, seclor, hx mitral valve prolapse
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Private     Purchased by: Other
Symptoms: Anxiety, Chills, Dizziness, Similar reaction on previous exposure to drug, Tachycardia, Tongue oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: severe chills, almost passed out, anxiety, dizzy, rapid heart rate, thick tongue x 10-20min;

VAERS ID:115549 (history)  Vaccinated:1998-10-22
Age:69.3  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-27, Days after onset: 5
Location:Michigan  Entered:1998-11-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zantac;Verelan;halcion;Clinoril;Lasix;tenormin;
Current Illness: HTN, arthritis
Preexisting Conditions: HCTL, vasotec, flu vax
Diagnostic Lab Data: EKG, sed rat 31mm/hr;pulse ox 97% room air;CBC, chem 7, UA (urine specimen) WNL;all test done @ ER;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09772201IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Nausea, Neck pain, Oedema peripheral, Red blood cell sedimentation rate increased, Vasodilatation
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: pt recv vax 22OCT98 & 23OCT98 redness from shoulder to elbow w/swelling;c/o pain @ inj site lt deltoid, lt shoulder & lt side of neck;started to improve on 24OCT98;c/o nausea off & on since 22OCT98;

VAERS ID:115582 (history)  Vaccinated:1998-10-22
Age:37.0  Onset:1998-10-26, Days after vaccination: 4
Gender:Female  Submitted:1998-10-27, Days after onset: 1
Location:Iowa  Entered:1998-11-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: cold sx
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': IA98031
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0978720  LA
Administered by: Public     Purchased by: Public
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: noted several small pimples like scattered on abd, 2-3 pimples on arms;no redness around pimples-no itching;

VAERS ID:115724 (history)  Vaccinated:1998-10-22
Age:46.3  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-30, Days after onset: 8
Location:North Carolina  Entered:1998-11-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Wellbutran,Synthroid
Current Illness: NONE
Preexisting Conditions: Clinical depression,Hypothyroidism,right club foot, S/P, cortisone injection 10/21/98
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882040IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Hypotension, Hypothermia, Nausea, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Pt recv vax on 10/22/98; on same day pt exp wooziness, hot face, dizziness, nausea

VAERS ID:115725 (history)  Vaccinated:1998-10-22
Age:5.5  Onset:1998-10-23, Days after vaccination: 1
Gender:Male  Submitted:1998-10-26, Days after onset: 3
Location:Kentucky  Entered:1998-11-04, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Triotann BID; Allergy shots (2) LA, RA, 10/19/98
Current Illness: Morning allergies
Preexisting Conditions: Allergic to pollen, grass, trees, mold, mildew, cats, milk
Diagnostic Lab Data: UNK
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882041IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 10/22/98; on 10/23/98 pt exp swelling at vax site, redness

VAERS ID:115740 (history)  Vaccinated:1998-10-22
Age:80.8  Onset:1998-10-23, Days after vaccination: 1
Gender:Male  Submitted:1998-10-27, Days after onset: 4
Location:Florida  Entered:1998-11-04, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Diagnostic Lab Data: NONE
CDC 'Split Type': FL98053
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E20158HC  LA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash, Skin nodule, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & reported 2 days later noted red spots, hives, itching, rash, no fever, knots on head;refused to see MD;

VAERS ID:115746 (history)  Vaccinated:1998-10-22
Age:68.2  Onset:1998-10-22, Days after vaccination: 0
Gender:Male  Submitted:1998-10-26, Days after onset: 4
Location:California  Entered:1998-11-04, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: neuropathy (elavil) no other
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E20128GC5IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0870H0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site oedema, Injection site pain, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: c/o pain @ inj site w/notable swelling from upper arm to elbow-onset approx 4hr p/vax;saw MD stated severe localized rxn;

VAERS ID:115748 (history)  Vaccinated:1998-10-22
Age:1.6  Onset:1998-10-23, Days after vaccination: 1
Gender:Male  Submitted:1998-10-26, Days after onset: 3
Location:California  Entered:1998-11-04, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: Dairy-wheezing
Diagnostic Lab Data:
CDC 'Split Type': CA980115
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09157803IMLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: Pt recv vax on 10/22/98; on 10/23/98 pt exp redness & hotness of vax site; tx=antibiotics

VAERS ID:115900 (history)  Vaccinated:1998-10-22
Age:55.1  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-26, Days after onset: 4
Location:Virginia  Entered:1998-11-05, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Lithium;Tegretol
Current Illness: NONe
Preexisting Conditions: bipoler diagnosis
Diagnostic Lab Data: NONE
CDC 'Split Type': VA98072
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882121IMLA
Administered by: Other     Purchased by: Public
Symptoms: Chills, Nausea, Vasodilatation, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax 22OCT98 3PM & that noc pt had chills;no fever;felt hot during noc;did not take temp;vomited x 1 23OCT98 & 25OCT98;nausea several days;

VAERS ID:115901 (history)  Vaccinated:1998-10-22
Age:70.7  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-29, Days after onset: 7
Location:California  Entered:1998-11-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp erythema @ 36yr old w/tetanus
Other Medications:
Current Illness: NONE
Preexisting Conditions: prior tetanus-erythema;HTN/thalaosemial;
Diagnostic Lab Data: NOEn
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0977170 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: very painful w/site of inj w/severe swell & redness;

VAERS ID:115909 (history)  Vaccinated:1998-10-22
Age:65.7  Onset:1998-10-22, Days after vaccination: 0
Gender:Male  Submitted:1998-10-28, Days after onset: 6
Location:Florida  Entered:1998-11-06, Days after submission: 9
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: resp insufficency & chronic obstructive pulmonary disease;
Diagnostic Lab Data:
CDC 'Split Type': U199800715
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0984530   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cardiac arrest
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad)
Write-up: pt recv vax 22OCT98 & pt exp an arrest p/vax & had to be resuscitated;pt hosp

VAERS ID:115939 (history)  Vaccinated:1998-10-22
Age:5.1  Onset:1998-10-22, Days after vaccination: 0
Gender:Male  Submitted:1998-11-02, Days after onset: 11
Location:North Carolina  Entered:1998-11-06, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0058H   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pharyngitis, Stomatitis
SMQs:, Severe cutaneous adverse reactions (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: pt recv vax 22OCT98 & parents returned w/child on 29OCT98 w/ulcers in the back of throat & lips;

VAERS ID:116064 (history)  Vaccinated:1998-10-22
Age:27.7  Onset:1998-10-27, Days after vaccination: 5
Gender:Female  Submitted:1998-11-06, Days after onset: 10
Location:California  Entered:1998-11-09, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Triphasil 28 BC
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02988P0 RA
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Headache, Nausea, Pharyngitis, Photosensitivity reaction, Pyrexia, Rhinitis
SMQs:, Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow)
Write-up: nausea, diarrhea, fever also following vaccine congestion, light sensitivity, h/a, runny nose;

VAERS ID:116069 (history)  Vaccinated:1998-10-22
Age:25.2  Onset:1998-10-24, Days after vaccination: 2
Gender:Male  Submitted:1998-10-26, Days after onset: 2
Location:North Carolina  Entered:1998-11-09, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: MMR by MERCK lot# 0957H given 21SEP98 & Td by Wyeth lot# 4978240 given 21SEP98
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0033H1 LA
Administered by: Public     Purchased by: Unknown
Symptoms: Sialoadenitis
SMQs:, Oropharyngeal infections (narrow)
Write-up: sialadenitis-rt submandibular;

VAERS ID:116074 (history)  Vaccinated:1998-10-22
Age:61.9  Onset:1998-10-24, Days after vaccination: 2
Gender:Female  Submitted:1998-10-28, Days after onset: 4
Location:Tennessee  Entered:1998-11-09, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Asthma &blood pressure med
Current Illness: NONE
Preexisting Conditions: Asthma, "Bad lungs"
Diagnostic Lab Data: 10/26/98: Chest X-ray-showed pneumonia
CDC 'Split Type': TN98047
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1247H0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Dyspepsia, Myalgia, Pneumonia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Pt recv vax on 10/22/98; on 10/24/98 pt exp sore arm, stomach ache, fever (100.4), rib pain. DX=Pneumonia

VAERS ID:116098 (history)  Vaccinated:1998-10-22
Age:50.2  Onset:1998-10-25, Days after vaccination: 3
Gender:Male  Submitted:1998-10-26, Days after onset: 1
Location:D.C.  Entered:1998-11-09, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NA
Preexisting Conditions: allergic to ragweed, pollen, trees, grass
Diagnostic Lab Data: NONE
CDC 'Split Type': DC9801
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E201186A0IMA
Administered by: Public     Purchased by: Public
Symptoms: Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: malaise, muscle aches, chills, fever 99.1-101;

VAERS ID:116319 (history)  Vaccinated:1998-10-22
Age:0.8  Onset:1998-10-22, Days after vaccination: 0
Gender:Male  Submitted:1998-10-22, Days after onset: 0
Location:Minnesota  Entered:1998-11-09, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': FLU89041098
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02788P0IMRL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2712A22IMLL
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: Pt recv vax on 10/22/98; pt given incorrect dosage (.5cc rather than .25cc)

VAERS ID:116121 (history)  Vaccinated:1998-10-22
Age:65.7  Onset:1998-10-22, Days after vaccination: 0
Gender:Male  Submitted:1998-10-29, Days after onset: 7
Location:Florida  Entered:1998-11-10, Days after submission: 12
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Serevent MDI, Allopurinol
Current Illness: COPD, asthma
Preexisting Conditions: respiratory insufficiency and COPD
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0984350   
Administered by: Private     Purchased by: Private
Symptoms: Anaphylactoid reaction, Apnoea, Asthma, Cardiac arrest
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Asthma/bronchospasm (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: resp distress following inj of flu vax;adm to hosp for 24hr;

VAERS ID:116204 (history)  Vaccinated:1998-10-22
Age:50.9  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-11-05, Days after onset: 13
Location:Maryland  Entered:1998-11-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp unk rxn w/tetanus?
Other Medications: multiple other
Current Illness: NONE
Preexisting Conditions: ?tetanus allergy?, sulfa
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS03088P0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Diarrhoea, Headache, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: prolonged malaise, h/a, low grade temp, diarrhea, for 1wk;

VAERS ID:116250 (history)  Vaccinated:1998-10-22
Age:39.7  Onset:1998-10-27, Days after vaccination: 5
Gender:Female  Submitted:1998-10-29, Days after onset: 2
Location:Colorado  Entered:1998-11-12, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac, stool softener
Current Illness: unk
Preexisting Conditions: pregnancy in twenty-fifth week
Diagnostic Lab Data:
CDC 'Split Type': 898303002A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4988216   
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Abnormal labour
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: pt recv vax & was pregnant;pt exp severe abd pain & was hosp w/dx of kidney failure;

VAERS ID:116370 (history)  Vaccinated:1998-10-22
Age:1.1  Onset:1998-10-22, Days after vaccination: 0
Gender:Male  Submitted:1998-10-26, Days after onset: 4
Location:Louisiana  Entered:1998-11-13, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': LA981102
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09425403IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS1100H3IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1186H0SCLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0792H0PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0312H0SC 
Administered by: Public     Purchased by: Unknown
Symptoms: Agitation, Face oedema, Insomnia, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 22OCT98 & around 2PM cranky, unable to sleep;5OCT edematous, flushed w/a rash both lower legs;redness has decreased;

VAERS ID:116476 (history)  Vaccinated:1998-10-22
Age:22.0  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-26, Days after onset: 4
Location:Minnesota  Entered:1998-11-18, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt sick for 3 days p/flu vax 2yr ago;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: demerol, vistaril, codeine
Diagnostic Lab Data:
CDC 'Split Type': MN98021
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882241IMRA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Hypertension, Malaise, Pallor, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: pt became pale & weak w/in min p/vax;pt did not feel very good, BP 120/90 usually 110/70;felt hot inside;taken to MD stated rxn to flu vax;

VAERS ID:116554 (history)  Vaccinated:1998-10-22
Age:32.1  Onset:1998-10-24, Days after vaccination: 2
Gender:Female  Submitted:1998-10-26, Days after onset: 2
Location:Missouri  Entered:1998-11-19, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': MO98071
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09818000IMRA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: reports rash, itching 24OCT98 2 days p/vax;

VAERS ID:116603 (history)  Vaccinated:1998-10-22
Age:71.6  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-26, Days after onset: 4
Location:Mississippi  Entered:1998-11-20, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC 'Split Type': MS98029
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E20158HG0 LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0906E0 RA
Administered by: Other     Purchased by: Other
Symptoms: Anorexia, Myalgia, Oedema peripheral, Pain, Somnolence, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Pt recv vax on 10/22/98; 2 hr later pt exp lethargy, achiness, nausea, vomit, arm swelling & pain, unable to eat, chills; tx=ice on arm

VAERS ID:116658 (history)  Vaccinated:1998-10-22
Age:53.4  Onset:1998-10-29, Days after vaccination: 7
Gender:Female  Submitted:1998-11-16, Days after onset: 18
Location:Ohio  Entered:1998-11-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Heart disease
Diagnostic Lab Data: X-rays of lung-pneumonia in right lung
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Public
Symptoms: Pneumonia
SMQs:, Eosinophilic pneumonia (broad)
Write-up: Pt recv vax on 10/22/98; on 10/29/98 pt exp pneumonia; tx=antibiotics

VAERS ID:116753 (history)  Vaccinated:1998-10-22
Age:50.3  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-11-18, Days after onset: 26
Location:Massachusetts  Entered:1998-11-24, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Premarin, Provera
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09757802IMRA
Administered by: Other     Purchased by: Public
Symptoms: Skin nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt recv vax on 10/22/98; on 10/23/98 pt exp a mass at base of neck (right)

VAERS ID:116776 (history)  Vaccinated:1998-10-22
Age:46.4  Onset:1998-10-22, Days after vaccination: 0
Gender:Unknown  Submitted:1998-10-30, Days after onset: 8
Location:Texas  Entered:1998-11-24, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: AN
Other Medications: Daypro
Current Illness: NA
Preexisting Conditions:
Diagnostic Lab Data: NA
CDC 'Split Type': TX98169
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0971880 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site pain, Rash maculo-papular, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 23OCT98 redness around inj site, warm to touch, soreness, then turned into splotches which were warm to touch;Friday splotches spread to bilat legs & patches on posterior back area;

VAERS ID:116887 (history)  Vaccinated:1998-10-22
Age:75.3  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-25, Days after onset: 3
Location:North Carolina  Entered:1998-11-27, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hytrin;Folic acid;MVI
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': NC98051
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0980580  LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1510E0 RA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: approx 10hr p/vax rt arm became swollen down to the elbow;the swelling remained & pt had redness & itching the next day;

VAERS ID:116915 (history)  Vaccinated:1998-10-22
Age:61.6  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-23, Days after onset: 1
Location:New Jersey  Entered:1998-11-27, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09771803SCLA
Administered by: Public     Purchased by: Public
Symptoms: Ecchymosis, Haemorrhage, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: 22OCT98 immed devel hematoma p/vax;23OCt98 ecchymotic area the size of tennis ball;edema subsided;

VAERS ID:116963 (history)  Vaccinated:1998-10-22
Age:78.7  Onset:1998-11-10, Days after vaccination: 19
Gender:Female  Submitted:1998-11-18, Days after onset: 8
Location:Maryland  Entered:1998-11-30, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Triamterene, Atenol
Current Illness: NONE
Preexisting Conditions: Possible Alzheimer''s -per husband; Hypertension
Diagnostic Lab Data: NONE
CDC 'Split Type': MD98022
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882120 LA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Diarrhoea, Gait disturbance, Hypokinesia, Myalgia, Pain, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Pt recv vax on 10/22/98; on 11/10/98 pt exp pain of right knee & calf, difficulty walking, vomiting & diarrhea

VAERS ID:116968 (history)  Vaccinated:1998-10-22
Age:53.9  Onset:1998-10-25, Days after vaccination: 3
Gender:Male  Submitted:1998-11-06, Days after onset: 12
Location:Indiana  Entered:1998-11-30, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09696000IMLA
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Anorexia, Cough, Diarrhoea, Insomnia, Myalgia, Pharyngitis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Pt recv vax on 10/22/98; on 10/25/98 pt exp fever, achiness, disturbed sleep, sore throat, productive cough, diarrhea, stomach cramps, dec appetite & headache x 1 wk

VAERS ID:116971 (history)  Vaccinated:1998-10-22
Age:35.0  Onset:1998-10-24, Days after vaccination: 2
Gender:Female  Submitted:1998-11-04, Days after onset: 11
Location:Massachusetts  Entered:1998-11-30, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: WBC-15.7
CDC 'Split Type': MA9842
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09757900IMRA
Administered by: Public     Purchased by: Other
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: Pt recv vax on 10/22/98; on 10/24/98 pt exp raised erythema

VAERS ID:117022 (history)  Vaccinated:1998-10-22
Age:1.7  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-11-27, Days after onset: 35
Location:Maryland  Entered:1998-12-02, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Long episode of RSV since 1 mo old for 2-3 mo (recv Albuterol nubulizer tx; Past rx from insect bites
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4538483 LL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2357A22 RL
Administered by: Private     Purchased by: Other
Symptoms: Conjunctivitis, Injection site hypersensitivity, Injection site mass, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 10/22/98; on 10/23/98 pt exp fever (102.6), erythematous area of Lt leg w/ induration & erythema left eye; tx=Cephalexin suspension., Tylenol & Advil

VAERS ID:117132 (history)  Vaccinated:1998-10-22
Age:24.0  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-23, Days after onset: 1
Location:Colorado  Entered:1998-12-07, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Proventil
Current Illness: NKA
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC 'Split Type': CO98050
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882164IMLA
Administered by: Public     Purchased by: Public
Symptoms: Confusional state, Cough, Dyspnoea, Headache, Pruritus, Rash, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), 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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 2Pm & 330PM had rash;about 9:30-10:00 went to ER;had sx of hives, pruritus, dyspnea, vomiting, coughing, confusion, h/a;

VAERS ID:117254 (history)  Vaccinated:1998-10-22
Age:33.5  Onset:1998-10-26, Days after vaccination: 4
Gender:Female  Submitted:1998-11-17, Days after onset: 22
Location:Rhode Island  Entered:1998-12-10, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: s/p needle stick exposure
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)LEDERLE LABORATORIES448455  LA
Administered by: Public     Purchased by: Unknown
Symptoms: Cellulitis, Oedema peripheral, Pain, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax 22OCT98 & exp arm swelling, red, painful & low grade fever & chills;possible cellulitis;

VAERS ID:117285 (history)  Vaccinated:1998-10-22
Age:45.8  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-10-29, Days after onset: 6
Location:Washington  Entered:1998-12-11, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: sulfa drugs, flagyl
Diagnostic Lab Data:
CDC 'Split Type': WA981502
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49882003 RA
Administered by: Other     Purchased by: Private
Symptoms: Paraesthesia, Paraesthesia oral, Tongue oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: swelling of tongue;numbness of lips & extremities;

VAERS ID:117328 (history)  Vaccinated:1998-10-22
Age:48.7  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-26, Days after onset: 4
Location:Arkansas  Entered:1998-12-14, Days after submission: 49
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrolase
Current Illness: NONE
Preexisting Conditions: beef-milk
Diagnostic Lab Data: NONE
CDC 'Split Type': AR9872
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0984540 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Asthma, Chest pain, Dysphonia, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: approx 5hr p/vax pt presented to nurses office @ school c/o weakness/wheezing/lightness in chest/diff breathing/hoarseness;went to PMD;racing pulse;rx decadron/clariton;

VAERS ID:117450 (history)  Vaccinated:1998-10-22
Age:72.0  Onset:1998-10-24, Days after vaccination: 2
Gender:Male  Submitted:1998-12-11, Days after onset: 48
Location:Florida  Entered:1998-12-16, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0981820  LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Pharyngitis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow)
Write-up: chills, fever, cough, sore throat;

VAERS ID:117509 (history)  Vaccinated:1998-10-22
Age:65.9  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-12-15, Days after onset: 53
Location:D.C.  Entered:1998-12-18, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Temorin, Zyloprin
Current Illness: NONE
Preexisting Conditions: Chronic HA, degenerating cervical disc
Diagnostic Lab Data: UNK
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E20118GA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Dyspepsia, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow)
Write-up: Pt recv vax on 10/22/98; on 10/23/98 pt exp chills, fever, upset stomach, sore arm

VAERS ID:117675 (history)  Vaccinated:1998-10-22
Age:27.8  Onset:1998-11-01, Days after vaccination: 10
Gender:Female  Submitted:1998-12-17, Days after onset: 46
Location:Florida  Entered:1998-12-28, Days after submission: 11
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09684100  
Administered by: Private     Purchased by: Private
Symptoms: Herpes zoster, Neuropathy
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad)
Write-up: Pt recv vax on 10/22/92; on 11/1/98 pt exp shingles

VAERS ID:117704 (history)  Vaccinated:1998-10-22
Age:1.2  Onset:1998-10-22, Days after vaccination: 0
Gender:Male  Submitted:1998-10-23, Days after onset: 1
Location:Pennsylvania  Entered:1998-12-28, Days after submission: 66
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: Runny (clear) nasal drainage
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': PA9860
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4455403IMLA
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1364E2IMRA
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Dehydration, Dysuria, Hypotonia, Malaise, Mydriasis, Pallor, Pyrexia
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Pt recv vax on 10/22/98; on same day pt exp no appetite, 10/23/98 pt had not urinated, pale, limp, dilated pupils, fever (103); tx=Tylenol

VAERS ID:117706 (history)  Vaccinated:1998-10-22
Age:0.5  Onset:1998-10-24, Days after vaccination: 2
Gender:Female  Submitted:1998-10-26, Days after onset: 2
Location:Pennsylvania  Entered:1998-12-28, Days after submission: 63
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': PA9858
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09296901IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1371E1IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS360753A1IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N01461SCRL
Administered by: Public     Purchased by: Public
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: 24OCT red blotchy rash on back -1 mark on face no fever;eating normally;25OCT rash redder;26OCT rash more pronounced, over entire trunk & face, no fever, nl appetite;

VAERS ID:117856 (history)  Vaccinated:1998-10-22
Age:56.7  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-12-21, Days after onset: 59
Location:Florida  Entered:1998-12-31, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: SOD, bisulfate (diarrhea) codeine
Diagnostic Lab Data: NONE
CDC 'Split Type': FL98063
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E20158HF0IML
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: since vax on 22OCT98 lt arm remains sore & painful;

VAERS ID:118177 (history)  Vaccinated:1998-10-22
Age:0.4  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1999-01-05, Days after onset: 74
Location:Iowa  Entered:1999-01-19, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt extra fussy p/dose 1 DTAP;
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE x/father has been on sz med since age 11;
Diagnostic Lab Data: NONE
CDC 'Split Type': IA99001
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM858A21IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2617A21IMRL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES09477901IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N003211SCLA
Administered by: Public     Purchased by: Public
Symptoms: Adverse drug reaction, Agitation, Pyrexia, Similar reaction on previous exposure to drug
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: pt recv vax 22OCT98 & had elevated temp & became irritable w/periodic bouts of screaming;mom compared this as much worse than p/#1 vax;DT given on 29DEC98 7 mom reports no problems @ this time;

VAERS ID:118214 (history)  Vaccinated:1998-10-22
Age:44.4  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-28, Days after onset: 6
Location:Washington  Entered:1999-01-20, Days after submission: 84
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Premarin
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WA981521
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4988200 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt recv vax on 10/22/98; on same day pt exp LA pain from shoulder to hand

VAERS ID:118630 (history)  Vaccinated:1998-10-22
Age:63.6  Onset:1998-10-22, Days after vaccination: 0
Gender:Male  Submitted:1999-02-05, Days after onset: 106
Location:Unknown  Entered:1999-02-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucophage, Capoten, Deltacotril, Clarityn
Current Illness: NONE
Preexisting Conditions: Diabetes mellitus, Hypertension & Cystosarcoma phyllodes; Right sided hearing loss
Diagnostic Lab Data: CT brain/MRI scan-negative, Blood tests-normal
CDC 'Split Type': MPU199900047
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E8102EA1 IM 
Administered by: Other     Purchased by: Other
Symptoms: Deafness
SMQs:, Hearing impairment (narrow)
Write-up: Pt recv vax on 10/22/98; a few hours post vax pt exp acute onset left sided sensorineural hearing loss, Annual follow-up received on 10/2/00 provided no additional data.

VAERS ID:118725 (history)  Vaccinated:1998-10-22
Age:67.6  Onset:1998-10-24, Days after vaccination: 2
Gender:Female  Submitted:1999-01-25, Days after onset: 93
Location:Iowa  Entered:1999-02-09, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH09758200 A
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Pt recv vax on 10/22/98; on 10/24/98 pt exp joint aches (elbow, shoulder, hip)

VAERS ID:118958 (history)  Vaccinated:1998-10-22
Age:41.5  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-10-26, Days after onset: 3
Location:New York  Entered:1999-02-11, Days after submission: 108
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unspecified antihistamines;advil
Current Illness: NONE
Preexisting Conditions: environmental allergies
Diagnostic Lab Data:
CDC 'Split Type': 898302008A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882121IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain, Lymphadenopathy, Myalgia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 22OCT98 & w/in 24hr pt devel redness, warmth & pain @ the inj site;48hr later pt devel swelling in the lymph nodes in the lt side of neck & shoulder;

VAERS ID:118961 (history)  Vaccinated:1998-10-22
Age:  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-10-23, Days after onset: 0
Location:New York  Entered:1999-02-11, Days after submission: 111
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 898307001A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882200IMLA
Administered by: Other     Purchased by: Other
Symptoms: Osteoarthritis, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 22OCT98 & the next morning devel swollen joints in hands & erythema palmar, lt greater than right;

VAERS ID:118962 (history)  Vaccinated:1998-10-22
Age:65.0  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-10-30, Days after onset: 7
Location:New Jersey  Entered:1999-02-11, Days after submission: 104
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrodiuril;synthroid
Current Illness: NONe
Preexisting Conditions: hypothyroidism, HVD, CAD, hypercholesterolemia
Diagnostic Lab Data:
CDC 'Split Type': 898307064A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882200IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 22OCT98 & devel an inj site rxn characterized by a 12cm by 6cm rectangular shaped area of redness, swelling, itching & a raised rash w/raised border;

VAERS ID:118996 (history)  Vaccinated:1998-10-22
Age:31.3  Onset:1998-10-26, Days after vaccination: 4
Gender:Male  Submitted:1998-12-21, Days after onset: 56
Location:Colorado  Entered:1999-02-11, Days after submission: 52
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Zithromax
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': 899006003L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4988216 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Chest pain, Diarrhoea, Headache, Pharyngitis, Pyrexia, Rhinitis
SMQs:, Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)
Write-up: Pt recv vax on 10/22/98; on 10/26/98 pt exp stomach cramps, diarrhea, chest tight, congestion, sore throat, headache, fever

VAERS ID:119105 (history)  Vaccinated:1998-10-22
Age:40.6  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-12-29, Days after onset: 68
Location:Florida  Entered:1999-02-11, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': FLU92231298
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS03088P0 RA
Administered by: Private     Purchased by: Private
Symptoms: Myalgia, Pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Pt recv vax on 10/22/98; immediately post vax pt exp vax site burning, tingling of LA, aching x 45 min

VAERS ID:119335 (history)  Vaccinated:1998-10-22
Age:56.1  Onset:1998-10-23, Days after vaccination: 1
Gender:Male  Submitted:1999-02-19, Days after onset: 119
Location:D.C.  Entered:1999-02-24, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: arthritis
Current Illness:
Preexisting Conditions: arthritis;Reiter''s syndrome
Diagnostic Lab Data: MRI of spine;LP
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02888P9IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Condition aggravated, Myelitis, Neuropathy, Paraesthesia, Salivary gland enlargement, Skin disorder
SMQs:, Peripheral neuropathy (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: transverse myelitis of cervical & thoracic spinal cord;

VAERS ID:119754 (history)  Vaccinated:1998-10-22
Age:29.0  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1999-03-02, Days after onset: 131
Location:Minnesota  Entered:1999-03-05, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Provental inhaler
Current Illness: NONE
Preexisting Conditions: asthma, allergic to cats & corn dust
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09845902 LA
Administered by: Public     Purchased by: Private
Symptoms: Asthma, Condition aggravated, Eye pain, Gingival hyperplasia, Hypersensitivity, Lacrimal disorder, Tongue disorder
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Gingival disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Eosinophilic pneumonia (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow)
Write-up: allergic rxn, eyes burned & watered, tongue & gums burned had asthma attack;ER gave pt pred & DPH & sent home;

VAERS ID:120576 (history)  Vaccinated:1998-10-22
Age:  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1999-01-27, Days after onset: 96
Location:New York  Entered:1999-03-24, Days after submission: 56
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':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4549620IMA
Administered by: Public     Purchased by: Private
Symptoms: Hypokinesia, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt recv vax on 10/22/98; on 10/23/98 pt exp dec arm movement, pain, swelling

VAERS ID:120894 (history)  Vaccinated:1998-10-22
Age:11.8  Onset:1998-11-03, Days after vaccination: 12
Gender:Female  Submitted:1999-02-02, Days after onset: 91
Location:North Carolina  Entered:1999-04-05, Days after submission: 61
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergies to dust, constant resp problems 3wk to 3yr of age;
Diagnostic Lab Data: EEG abnormal
CDC 'Split Type': NC99017
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1532E1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Asthma, Cough, Electroencephalogram abnormal, Grand mal convulsion
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad)
Write-up: had grand mal sz 3NOV 1130PM & 2nd sz 6AM next AM;transport to hosp p/1st sx & sent home;had 2nd sz & was adm to hosp;EEG abn;put on tegretol & now switched to dilantin;no prior hx of sz;also devel asthma since sz;

VAERS ID:120970 (history)  Vaccinated:1998-10-22
Age:73.6  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-11-02, Days after onset: 11
Location:Wisconsin  Entered:1999-04-05, Days after submission: 153
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calan;synthroid;
Current Illness:
Preexisting Conditions: allergic to IVP dye;
Diagnostic Lab Data:
CDC 'Split Type': WI98071
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882046IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0934600 IMLA
Administered by: Public     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)
Write-up: 28OCT98 lt arm w/lump, redness, itching since 22OCT98 now has diffuse redness 8cm width 4cm height, warm to touch;advised compress;2NOV98 presents w/sl redness lt arm w/firm area approx 1/2";relief noted w/ice pack;

VAERS ID:121628 (history)  Vaccinated:1998-10-22
Age:37.7  Onset:1999-02-13, Days after vaccination: 114
Gender:Unknown  Submitted:0000-00-00
Location:Texas  Entered:1999-04-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': TX99060
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0973930 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Influenza, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: 13FEB99cough, fever, Robitussin DM, APAP;flu dx;

VAERS ID:121629 (history)  Vaccinated:1998-10-22
Age:43.0  Onset:1999-02-10, Days after vaccination: 111
Gender:Unknown  Submitted:0000-00-00
Location:Texas  Entered:1999-04-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': TX99061
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0973930 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Influenza, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 10FEB99 inc temp, emesis;flu dx;

VAERS ID:121630 (history)  Vaccinated:1998-10-22
Age:57.0  Onset:1999-02-10, Days after vaccination: 111
Gender:Unknown  Submitted:0000-00-00
Location:Texas  Entered:1999-04-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': TX99062
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0973930   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Influenza, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: inc temp, nasal drainage, cough, APAP, sudafed, fluids, flu dx;

VAERS ID:121631 (history)  Vaccinated:1998-10-22
Age:43.2  Onset:1999-02-08, Days after vaccination: 109
Gender:Unknown  Submitted:0000-00-00
Location:Texas  Entered:1999-04-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': TX99063
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0973930 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Hypoxia, Influenza, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad)
Write-up: 8FEB99 inc temp, congestion, cough, APAP, 02, ATB, (bactrim),flu dx;

VAERS ID:121632 (history)  Vaccinated:1998-10-22
Age:39.4  Onset:1999-02-13, Days after vaccination: 114
Gender:Unknown  Submitted:0000-00-00
Location:Texas  Entered:1999-04-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': TX99064
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0973930 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Influenza, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: 13FEB99 nasal congestion, cough, inc temp, dimetapp, robitussin DM; flu dx;

VAERS ID:121633 (history)  Vaccinated:1998-10-22
Age:38.1  Onset:1999-02-21, Days after vaccination: 122
Gender:Unknown  Submitted:0000-00-00
Location:Texas  Entered:1999-04-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': TX99065
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0973930 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Influenza, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: 21FEB99 inc fever, nasal drainage, cough-sudafed, APAP, flu dx;

VAERS ID:121634 (history)  Vaccinated:1998-10-22
Age:38.6  Onset:1999-02-12, Days after vaccination: 113
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:1999-04-27
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: viral cult positive flu A
CDC 'Split Type': TX99066
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0973930 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Infection, Influenza, Laboratory test abnormal, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: 12FEB99 influenza A per throat cult, cough, nasal drainage, inc temp;flu dx;

VAERS ID:121636 (history)  Vaccinated:1998-10-22
Age:28.6  Onset:1999-02-17, Days after vaccination: 118
Gender:Unknown  Submitted:0000-00-00
Location:Texas  Entered:1999-04-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': TX99069
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09739305IMLA
Administered by: Other     Purchased by: Public
Symptoms: Cough, Influenza, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Pt recv vax on 10/22/98; on 2/17/99 pt exp flu-like illness of fever, nasal congestion, cough; tx=Sudafed, Tylenol

VAERS ID:121645 (history)  Vaccinated:1998-10-22
Age:39.0  Onset:1999-02-12, Days after vaccination: 113
Gender:Unknown  Submitted:0000-00-00
Location:Texas  Entered:1999-04-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': TX99078
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09739305IMRA
Administered by: Other     Purchased by: Public
Symptoms: Influenza
SMQs:
Write-up: flu-like illness;

VAERS ID:121646 (history)  Vaccinated:1998-10-22
Age:39.1  Onset:1999-02-13, Days after vaccination: 114
Gender:Unknown  Submitted:0000-00-00
Location:Texas  Entered:1999-04-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': TX99079
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09739305IMRA
Administered by: Other     Purchased by: Public
Symptoms: Influenza
SMQs:
Write-up: flu-like illness;

VAERS ID:124215 (history)  Vaccinated:1998-10-22
Age:14.0  Onset:1998-11-10, Days after vaccination: 19
Gender:Unknown  Submitted:1999-05-14, Days after onset: 184
Location:New York  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98110972
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Infection
SMQs:
Write-up: p/vax pt exp chickenpox;

VAERS ID:124241 (history)  Vaccinated:1998-10-22
Age:5.0  Onset:1998-11-09, Days after vaccination: 18
Gender:Male  Submitted:1999-05-14, Days after onset: 185
Location:Ohio  Entered:1999-05-21, Days after submission: 7
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant data~ ()~~0.00~Patient
Other Medications: Albuterol;Rhinocort;Tegretol;Clonopin;Pediapred;
Current Illness:
Preexisting Conditions: cerebral palsy;reactive airway disease;steroid therapy;
Diagnostic Lab Data: endotracheal aspirate-VZV+; DFA for VZV strongly +; PCR=Oka strain id; DFA for CMV, HSV, RSV, flu A/B=all neg; urine=pos for candida albicans; CXR pos for linglular pneumo w/ patchy infiltrate; Blood transfusion, platelets, packed cells, fresh frozen plasma; Chest X-ray, 11/09/98, lingular pneumonia, represent a current inflammatory process, Diagnostic laboratory, 11/09/98, viral culture-no virus isolated; Chest X-ray, 11/15/98, serial worsening: diffuse patchy infiltrates in both lungs: could represent varicella pneumonia; Diagnostic laboratory, 11/19/98, pneumocystis silver stain negative; Diagnostic laboratory 11/16/98, fungus culture-Candida albicans; Blood culture, 11/09/98, no growth after 5 days; Laboratory test, 11/17/98, endotrache
CDC 'Split Type': WAES98111367
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Candidiasis, Chest X-ray abnormal, Culture urine positive, Diffuse alveolar damage, Drug ineffective, Hypoxia, Infection, Pneumonia
SMQs:, Asthma/bronchospasm (broad), Lack of efficacy/effect (narrow), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: pt recv vax during 2 week "break" from steroid tx for hx reactive airway; restarted steroids 1 1/2 weeks a/ sx occurred; 18d p/ vax, presented w/ lesions; hosp w/ VZV pneumonia, decompensated, intubated-on vent; required 3 blood transfusion. This is an follow-up to report(s) previously submitted on 5/14/1999. Information has been received from a health care professional concerning a 5-year-old male patient who in 1998 was vaccinated with one dose of VARIVAX. Approximately ten days following vaccination, the patient experienced a rash (time frame unknown) and was eventually hospitalized with VZV pneumonia. At the time of the report, the patient was on a ventilator in the PICU. It was reported that in approximately 17-NOV-1998, DFA analysis of endotracheal secretions was done for CMV, HSV, flu A and B and RSV, all of which were negative; however, DFA for VZV was "strongly positive." In addition, specimens were "negative for sycoplasm IgM." Additional information received indicated that in approximately 17-NOV-1998, results of PCR analysis from an endotracheal specimen were positive for vaccine strain varicella zoster virus. It was also reported that the patient recovered and was discharged. The patient had a history of reactive airway disease and the physician believed the patient had been on a course of steroids 10 days prior to vaccination. The patient "did have a rash on admission however, it was not severe. However, the patient did decompensate quickly from a respiratory perspective and required intubation with ventilator assist. The patient required ventilatory support for approximately 6 weeks. The physician did not know if the patient acquired a noseomial infection while on the ventilator which would have complicated the patient''s course." Further additional information indicated that the child has "severe cerebral palsy (due to an abruption at birth)." The child is competely homebound and requires total care. Also, his concomitant therapy at the time of vaccination included Tegretol, Clonopine, Rhinocort and albuterol. It was reported that the patient "has a long term history of intermitent steroid use due to his severe reactive airway disease, but he was not actually on steroids at the time of vaccination. "As of of 08-OCT-1998 the patient was in the middle of a steroid taper, which was completed on approximately 15-OCT-1998. On 22-OCT-1998 the child "had been off steroids for a week and was vaccinated with VARIVAX. " He started again on steroids on 29-OCT-1998 and on 09-NOV-1998 he presented to the doctor''s office with lesions and subsequently was hospitalized due to VZV pneumonia. Follow-up information from a physician reported that on 22-OCT-1998, the patient was vaccinated with a dose of Influenza virus vaccine. In addition, it was reported that the patient was hospitalized from 09-NOV-1998 through 02-JAN-1999. While hospitalized, the patient received three transfusions. Subsequently, the patient recovered. Additional follow-up information from a physician reported that the patient''s usual dose of steroid was 1-2 mg/kg/day (2 tsps BID) of Pediapred. On 29-OCT-1998, the patient was again started on 1-2 mg/kg/day (2 tsps) of Pediapred twice daily for 5 days. Subsequently in October 2003, the patient''s experience was also reported in a published literature article. The article also mentioned three other patient''s (WAES # 96031140, 98101671 and 00120881) with similar experiences following exposure to VARIVAX. No further information is available.

VAERS ID:124904 (history)  Vaccinated:1998-10-22
Age:66.0  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1999-05-27, Days after onset: 217
Location:New Jersey  Entered:1999-06-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Breast Cancer undergoing chemotherapy;has had radiation in the past;
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI982018B
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.20208HA   
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt exp a 1 in weal around inj site (erythema & swelling @ inj site) a few minutes p/vax;sx were treated w/warm compresses;pt is undergoing chemotherapy & has had radiation in the past for breast cancer;

VAERS ID:125880 (history)  Vaccinated:1998-10-22
Age:55.0  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1999-07-12, Days after onset: 262
Location:California  Entered:1999-07-14, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98101759
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt exp induration, redness & a raised area @ the inj site & area was warm & tender to touch;

VAERS ID:125884 (history)  Vaccinated:1998-10-22
Age:45.5  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1999-07-12, Days after onset: 263
Location:Washington  Entered:1999-07-14, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: codeine allergy;obesity;reactive airway disease;
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES98102001
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1247H0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: p/vax pt exp rash that was raised approx 1/4inch & a red, hot to touch, induration w/pain @ the inj site;pt recovered, w/o med;

VAERS ID:127972 (history)  Vaccinated:1998-10-22
Age:88.4  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Minnesota  Entered:1999-09-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 898300087A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E20178HB0IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES 1IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: p/recv vax on 10/9/98 pt inadvertently recv another inj on 10/22/98 of Pnu-Imune-23 & on 10/23 devel inj site rxn of redness 7 sl swelling

VAERS ID:127982 (history)  Vaccinated:1998-10-22
Age:74.4  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-10-27, Days after onset: 4
Location:Arkansas  Entered:1999-09-03, Days after submission: 310
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Hytrin;Prinivil;
Current Illness: NOEn
Preexisting Conditions: HTN;ruptured colon, heart stent;
Diagnostic Lab Data: NONE
CDC 'Split Type': 898306048A
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4456360IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: p/vax pt reported pain @ inj site;pt was instructed to apply heat or ice to affected area & take APAP;pt recovered;

VAERS ID:153717 (history)  Vaccinated:1998-10-22
Age:2.2  Onset:2000-05-23, Days after vaccination: 579
Gender:Male  Submitted:2000-05-26, Days after onset: 3
Location:Pennsylvania  Entered:2000-06-09, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1529H0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Skin ulcer
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Generalized lesions $g200, afebrile, first lesion 5/23/2000.

VAERS ID:154892 (history)  Vaccinated:1998-10-22
Age:69.0  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-12-23, Days after onset: 62
Location:Massachusetts  Entered:2000-06-21, Days after submission: 545
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': U19800700
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR0984530   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Chills, Dry throat, Face oedema, Fatigue, Headache, Lacrimation increased, Myalgia, Oedema, Pharyngolaryngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: It was reported that a 68 year old female received Fluzone SV 98-99 USP, on 10/22/98.Reportedly after tha vaccination, the pt experienced scratchy throat, chills, HA, and watery eyes. 3 hours later the pt experienced orbital swelling, joint pain, muscle pain, and fatigue. From additional information received on 11/23/98 It was reported that the pt also c/o upper lip swelling. Reportedly the pt recovered from this experience. reviewed and no additional inofmarion available at this time.

VAERS ID:154907 (history)  Vaccinated:1998-10-22
Age:51.0  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-12-22, Days after onset: 60
Location:California  Entered:2000-06-21, Days after submission: 546
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PCN, sulfa allergies.
Diagnostic Lab Data:
CDC 'Split Type': U199800726
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR0977170 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Venous thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow)
Write-up: It was reported that a 50 year old female received Fluzone SV 98-99 USP vaccine on 10/22/1998. Reportedly on 10/24/1998 the pt developed distal vein thrombosis out left arm. Reportedly the pt recovered from this experience. From additional information received on 11/16/1998 it was reported that the date of the adverse reaction was 10/23/98 at 11:00 PM not 10/24/98 at 6:00am as previously reported.

VAERS ID:155118 (history)  Vaccinated:1998-10-22
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:1998-11-23
Location:Connecticut  Entered:2000-06-21, Days after submission: 575
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': U1998007700
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0968410 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Chest pain, Ear pain, Headache, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Reportedly, sometime after the vaccination, the pt experienced tingling sensation of right facial area. The pt also experienced discomfort of right clavicle and sternum (injection given in right deltoid), the discomfort moved to scalp and right ear. Reportedly, the pt was seen by physician, all signs and symptoms subsided now but lasted 1 week.

VAERS ID:155214 (history)  Vaccinated:1998-10-22
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2001-05-03
Location:Indiana  Entered:2000-06-22, Days after submission: 315
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': U1999001000
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0971890 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Reportedly, sometime, post vax, the pt experienced pain in her arm at the injection site, left deltoid. From additional info received on 03/12/1999, additional pt, responsible physician and vaccine administrator info were given. From follow-up correspondence received on 04/26/2001, it was reported, "No further info available regarding this pt or this case." This case is closed.

VAERS ID:155215 (history)  Vaccinated:1998-10-22
Age:53.0  Onset:1998-11-23, Days after vaccination: 32
Gender:Female  Submitted:1999-03-12, Days after onset: 109
Location:Texas  Entered:2000-06-22, Days after submission: 467
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: MRI-shoulder
CDC 'Split Type': U1999001010
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0968380 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Reportedly, the pt developed shoulder capsulitis on 11/23/98. The pt was reportedly seen by a neurologist on 11/24/98.

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