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Found 489662 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:110552 (history)  Vaccinated:1998-04-27
Age:12.4  Onset:1998-04-27, Days after vaccination: 0
Gender:Male  Submitted:1998-04-28, Days after onset: 1
Location:North Carolina  Entered:1998-05-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: NC98013
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7K919381 LA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Myalgia, Oedema peripheral, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: dizzy, fever, lt arm swollen & sore;fever began last noc;atarax, advil, augmentin given;

VAERS ID:110574 (history)  Vaccinated:1998-04-27
Age:5.2  Onset:1998-04-28, Days after vaccination: 1
Gender:Male  Submitted:1998-04-28, Days after onset: 0
Location:Hawaii  Entered:1998-05-04, 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:
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4506391IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0011E1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4469833PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema multiforme
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: erythema multiforme since last noc 27APR98 pertussis rxn;tx pediapred x 5 days;

VAERS ID:110589 (history)  Vaccinated:1998-04-27
Age:0.3  Onset:1998-04-27, Days after vaccination: 0
Gender:Female  Submitted:1998-05-01, Days after onset: 4
Location:New York  Entered:1998-05-05, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: BA005
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES0916470 IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1484E IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N0032 SCLA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: approx 10min p/vax pt exp gen urticaria w/wheal & flare starting from the face & working it, way down rxn restricted to skin;adm to hosp for observation;given epi & solumedrol, DPH;

VAERS ID:110629 (history)  Vaccinated:1998-04-27
Age:0.2  Onset:1998-04-27, Days after vaccination: 0
Gender:Male  Submitted:1998-04-29, Days after onset: 2
Location:Kansas  Entered:1998-05-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: healthy except recurrent cough
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM826A20IMLL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIESM05450IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N01470SCRL
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Rash
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: rash-all over body & very irritable;

VAERS ID:110630 (history)  Vaccinated:1998-04-27
Age:13.9  Onset:1998-04-27, Days after vaccination: 0
Gender:Female  Submitted:1998-04-30, Days after onset: 3
Location:California  Entered:1998-05-05, 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: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7H918394 RA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2488A20 LA
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis
SMQs:
Write-up: spreading cellulitis p/inj started 27APR & cont through 30APR;

VAERS ID:110633 (history)  Vaccinated:1998-04-27
Age:5.4  Onset:0000-00-00
Gender:Female  Submitted:1998-04-29
Location:Ohio  Entered:1998-05-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES839A2  LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES450134 PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Serum sickness, Vomiting
SMQs:, Acute pancreatitis (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: +local rxn of erythema & swelling 5cm x 3cm 48hr;+ system reaction nausea/vomit 48hr;

VAERS ID:110645 (history)  Vaccinated:1998-04-27
Age:15.0  Onset:1998-04-28, Days after vaccination: 1
Gender:Male  Submitted:1998-04-28, Days after onset: 0
Location:Texas  Entered:1998-05-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7F916795IMRA
Administered by: Other     Purchased by: Public
Symptoms: Asthenia, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad)
Write-up: temp elevated of 101 @ approx 1240PM 28APR98;student c/o h/a & feeling weak @ 9AM 28APR98;

VAERS ID:110666 (history)  Vaccinated:1998-04-27
Age:9.7  Onset:1998-04-28, Days after vaccination: 1
Gender:Female  Submitted:1998-05-05, Days after onset: 7
Location:Maryland  Entered:1998-05-06, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: rhinocort, azmacort
Current Illness: NONE
Preexisting Conditions: pneumonia 6APR98
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0994E0SC 
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Headache, Injection site hypersensitivity, Injection site mass, Injection site reaction, Myalgia, Pharyngitis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: cellulitis @ inj site 3x3cm erythema/induration systemic sx fever, myalgias, sore throat & h/a;sx resolved 48hr p/vax;

VAERS ID:110684 (history)  Vaccinated:1998-04-27
Age:0.2  Onset:1998-04-28, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Georgia  Entered:1998-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CSF,CBC, UA-septic work up
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4502940IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0167H0IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N03480SCRL
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Infection, Malaise, Meningitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: mom called office 28APR98 w/sx of temp 102, listless, diarrhea;temp not dec p/vax APAP;pt adm to hosp, dx viral meningitis;

VAERS ID:110776 (history)  Vaccinated:1998-04-27
Age:0.4  Onset:1998-04-28, Days after vaccination: 1
Gender:Male  Submitted:1998-05-07, Days after onset: 9
Location:California  Entered:1998-05-11, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4504971IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0785D1PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site abscess
SMQs:
Write-up: lt thigh abscess devel 1 day p/vax;drained thick yellow pus p/7 days 5MAY98;now is healing w/pt on ATB;

VAERS ID:110810 (history)  Vaccinated:1998-04-27
Age:0.2  Onset:1998-04-29, Days after vaccination: 2
Gender:Male  Submitted:1998-05-04, Days after onset: 5
Location:California  Entered:1998-05-13, 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:
Preexisting Conditions: sickle cell trait, ?ringworm of scalp
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES7K816460IM 
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2596A21IM 
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES7K816460IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES449084 PO 
Administered by: Other     Purchased by: Public
Symptoms: Alopecia
SMQs:
Write-up: onset of diffuse hair loss 2 days p/vax;

VAERS ID:110820 (history)  Vaccinated:1998-04-27
Age:69.0  Onset:1998-04-28, Days after vaccination: 1
Gender:Female  Submitted:1998-05-08, Days after onset: 10
Location:Ohio  Entered:1998-05-14, Days after submission: 6
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: CBC-nl
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)PFIZER/WYETH49780630IMLA
Administered by: Public     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: redness/swelling entire upper arm given IV ATB sent home on oral ATB;

VAERS ID:110854 (history)  Vaccinated:1998-04-27
Age:15.8  Onset:1998-05-01, Days after vaccination: 4
Gender:Female  Submitted:1998-05-14, Days after onset: 13
Location:Florida  Entered:1998-05-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP, madox
Current Illness: NONE
Preexisting Conditions: asthma, allergies (air borne)
Diagnostic Lab Data: platelet, liver, mono, complete blood work WNL;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Back pain, Diarrhoea, Dizziness, Neck pain, Photosensitivity reaction, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: 4 days post vax-diarrhea, severe nausea, vomit, cannot tolerate sun exposure or heat, dizzy, low grade temp, h/a, pain in back of neck going down back;

VAERS ID:110907 (history)  Vaccinated:1998-04-27
Age:1.1  Onset:1998-04-29, Days after vaccination: 2
Gender:Female  Submitted:1998-05-04, Days after onset: 5
Location:Missouri  Entered:1998-05-18, 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:
Current Illness: NA
Preexisting Conditions: mom states pt has had eczema off & on
Diagnostic Lab Data:
CDC Split Type: MO98021
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1595E0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: reported rash on most of body;no temp;very itchy stated by mom;pt seen by MD 30APR;

VAERS ID:110994 (history)  Vaccinated:1998-04-27
Age:45.8  Onset:1998-04-30, Days after vaccination: 3
Gender:Male  Submitted:1998-05-12, Days after onset: 12
Location:Missouri  Entered:1998-05-20, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: hyperlipidemia, hypertension, obesity
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09081800IMLA
Administered by: Private     Purchased by: Private
Symptoms: Lymphadenopathy, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: swelling in neck & supraclavicular fossae on same side as inj;

VAERS ID:111208 (history)  Vaccinated:1998-04-27
Age:1.0  Onset:1998-05-21, Days after vaccination: 24
Gender:Male  Submitted:1998-05-27, Days after onset: 6
Location:Massachusetts  Entered:1998-05-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES772B5   
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0055H   
Administered by: Private     Purchased by: Public
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: 6 scattered varicella vesicles on an erythemic base were noted on pt trunk;

VAERS ID:112335 (history)  Vaccinated:1998-04-27
Age:38.0  Onset:1998-05-04, Days after vaccination: 7
Gender:Male  Submitted:1998-06-25, Days after onset: 52
Location:Hawaii  Entered:1998-07-06, Days after submission: 11
Life Threatening? No
Died? Yes
   Date died: 1998-05-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: varicella IGG teston 25APR98 was negative;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0052H0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Apnoea, Arteriosclerosis, Brain oedema, Cardiac arrest, Coronary artery disease, Myocardial ischaemia
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 (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)
Write-up: pt exposed to chickenpox 12wk prior to first visit;varicella IGG test was negative 25APR98;pt recv vax 27APR98 no subsequent sx;pt was found lifeless on 4MAY98 while taking a nap;autopsy was performed;

VAERS ID:112477 (history)  Vaccinated:1998-04-27
Age:0.2  Onset:0000-00-00
Gender:Male  Submitted:1998-06-18
Location:Illinois  Entered:1998-07-13, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: premature
Diagnostic Lab Data:
CDC Split Type: IL98041
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM839A20IM 
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1206E IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0778A0PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Injection site hypersensitivity, Injection site oedema, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: mom reports 18JUN98 that p/vax 27APR98 pt cried inconsolable, had glazed eyes & red swollen leg;taken to ER;mom states ER MD stated was d/t colic;PCP according to mom thinks it was d/t pertussis & pt should recv DTAP;

VAERS ID:113155 (history)  Vaccinated:1998-04-27
Age:65.5  Onset:1998-04-28, Days after vaccination: 1
Gender:Female  Submitted:1998-07-30, Days after onset: 93
Location:New York  Entered:1998-08-03, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UKN
Current Illness:
Preexisting Conditions: codeine allergy
Diagnostic Lab Data:
CDC Split Type: WAES98042127
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1389E0IM 
Administered by: Private     Purchased by: Private
Symptoms: Chest pain, Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Pt vax 27APR98, pt telephoned Dr. to complain of injection site swelling, redness and pain which radiated to the breast. She was instructed to apply cold packs. Pt telephoned Dr. 29APR98 to report swelling and pain and greatly decreased.

VAERS ID:115734 (history)  Vaccinated:1998-04-27
Age:13.0  Onset:1998-06-01, Days after vaccination: 35
Gender:Female  Submitted:1998-10-24, Days after onset: 145
Location:Wyoming  Entered:1998-11-04, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp hair loss @ 13yr old w/hep b dose 3;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WY9901
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 2  
Administered by: Public     Purchased by: Public
Symptoms: Alopecia
SMQs:
Write-up: hair loss on top of scalp & front of head;the hair started growing back p/2month

VAERS ID:118184 (history)  Vaccinated:1998-04-27
Age:33.8  Onset:1998-04-29, Days after vaccination: 2
Gender:Female  Submitted:1999-01-13, Days after onset: 259
Location:Iowa  Entered:1999-01-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications:
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: 19MAY98 ultrasound no uterine sac visible;27APR98 beta-human chorionic gon positive;27JUN98 total serum chorio less than 1;
CDC Split Type: WAES98042034
Vaccination
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Lot
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Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES9239101  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abortion, Blood gonadotrophin increased, Complication of pregnancy, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: pt recv vax 27APR98 & pt was found to be pregnant;LMP was 27MAR98;Estimated delivery date is 21DEC98;pregnancy was confirmed by UA on 27APR98;pt began spotting vaginally 2 days p/confirmation of pregnancy;noted elective abortion desired;ect

VAERS ID:119307 (history)  Vaccinated:1998-04-27
Age:1.4  Onset:1998-04-28, Days after vaccination: 1
Gender:Female  Submitted:1999-02-12, Days after onset: 290
Location:Florida  Entered:1999-02-23, Days after submission: 11
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: 4/98: Blood culture, CBC, UA, Urine culture-all negative
CDC Split Type: WAES98050091
Vaccination
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HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.6258303IM 
Administered by: Private     Purchased by: Other
Symptoms: Infection, Pyrexia, Skin disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Pt recv vax on 4/27/98; on 4/28/98 pt exp fever (103F); 5/2/98 pt exp herpangina x 2-3 days

VAERS ID:119901 (history)  Vaccinated:1998-04-27
Age:0.0  Onset:1998-04-27, Days after vaccination: 0
Gender:Male  Submitted:1999-03-01, Days after onset: 308
Location:Indiana  Entered:1999-03-03, Days after submission: 2
Life Threatening? Yes
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: unk
Diagnostic Lab Data:
CDC Split Type: WAES98050213
Vaccination
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Lot
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Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Anaphylactoid reaction, Apnoea, Cyanosis, Hypertonia, Hypoxia
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Parkinson-like events (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 29APR98 & 10min post vax pt devel possible anaphylaxis w/apnea & arm rigidity;pt transferred from the nursery to a neonatal unit or administered oxygen;

VAERS ID:150135 (history)  Vaccinated:1998-04-27
Age:6.0  Onset:2000-03-02, Days after vaccination: 675
Gender:Female  Submitted:2000-03-07, Days after onset: 5
Location:Arizona  Entered:2000-03-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1566E0SC 
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt came to the office with chicken pox rash. Dx with chicken pox.

VAERS ID:176766 (history)  Vaccinated:1998-04-27
Age:52.0  Onset:1998-08-01, Days after vaccination: 96
Gender:Male  Submitted:2001-10-09, Days after onset: 1165
Location:Maryland  Entered:2001-10-26, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Western Blot, blood work
CDC Split Type:
Vaccination
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IM 
Administered by: Private     Purchased by: Private
Symptoms: Amnesia, Arthralgia, Fatigue, Oedema peripheral, Pain, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: The pt experienced swollen feet, hands, fatigue, aches, headache, fever, joint pain, memory loss. The pt states he has been sick since 8/98. Treated with Doxycillian, Vioxx, and Tylenol. Follow up information received 04/25/2003 states: Eyesight failing, hearing loss, memory loss increased, low grade fever daily, face numbness, rash, arthritis progressed, blank staring daily. Depression. Short patience. Constant head sweats.

VAERS ID:186396 (history)  Vaccinated:1998-04-27
Age:2.5  Onset:2001-12-19, Days after vaccination: 1332
Gender:Female  Submitted:2002-05-15, Days after onset: 146
Location:Unknown  Entered:2002-06-12, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES0201USA02820
Vaccination
Manufacturer
Lot
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a registered nurse concerning a 6 year old female who on 04/27/1998 was vaccinated with varicella virus vaccine live. On 12/19/2001 the child presented to her physician who confirmed chickenpox. At the time of this report, the outcome of the event was unknown. Additional info has been requested. The nurse also reported that a 5 year old male developed chickenpox following vaccination with varicella virus vaccine live (WAES0112USA02311).

VAERS ID:202041 (history)  Vaccinated:1998-04-27
Age:0.8  Onset:0000-00-00
Gender:Male  Submitted:2003-04-22
Location:Unknown  Entered:2003-04-23, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: A0405452A
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 2  
Administered by: Other     Purchased by: Other
Symptoms: Drug toxicity, Nervous system disorder
SMQs:, Anticholinergic syndrome (broad), Drug abuse and dependence (broad)
Write-up: This report describes the occurrence of mercury poisoning in a male child of unspecified age who was vaccinated with hepatitis B vaccine for prophylaxis. This report was received as part of litigation proceedings and has not been verified by a physician or other health care professional. The subject''s medical history, concurrent conditions, and concurrent medications were not reported. The subject received injections of hepatitis B vaccine on 9/15/97, 11/17/97, and 4/27/98. he also received diphtheria and tetanus toxoids or diphtheria and tetanus toxoids and pertussis vaccine or diphtheria and tetanus toxoids and acellular pertussis vaccine 9/15/97, 11/17/97, 1/20/98, and 1/25/99; haemophilus influenzae type B conjugate vaccine 9/15/97, 11/17/97, 1/20/98, and 10/26/98; poliomyelitis virus vaccine 9/15/97, 11/17/97, and 1/25/99; MMR 10/26/98; and varicella virus vaccine. The subject''s attorney alleged that, as a result of mercury in thimerosal-adulterated infant injections that the subject received as an infant, he now suffers, and in the future will continue to suffer, from the toxic neurological effects of mercury poisoning. The attorney also alleged that the subject will be hindered and prevented from pursuing an normal course of employment.

VAERS ID:203041 (history)  Vaccinated:1998-04-27
Age:  Onset:0000-00-00
Gender:Male  Submitted:2003-05-08
Location:Unknown  Entered:2003-05-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES0207USA01185
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug toxicity, Nervous system disorder
SMQs:, Anticholinergic syndrome (broad), Drug abuse and dependence (broad)
Write-up: Information has been received regarding a case in litigation concerning a male child who was injected with vaccinations containing the mercury-based preservative thimerosal during the period from September 1997 through January 1999. The alleged result of these vaccinations is that the pt suffers from and in the future will continue to suffer toxic neurological effects of mercury poisoning. Vaccination history: a first, second, and third dose of hep B virus vaccine were given on 9/15/97, 11/17/97 and on 4/27/98. First, second, third and fourth doses of Haemophilus B conjugate vaccine was given on 9/15/97, 11/17/97, 1/20/98 and 10/26/98. First, second, third and fourth doses of diphtheria toxoid (+) tetanus toxoid vaccine was given on 9/15/97, 11/17/97, 1/20/98 and 1/25/99. First, second and third doses of poliovirus vaccine was given on 9/15/97, 11/17/97 and 1/25/99. A first dose of MMR II was given on 10/26/98 and a first dose of varicella virus vaccine was given on 7/20/98. Upon internal review, mercury poisoning and neurological disorder were considered to be other important medical event (OMIC). Upon request complete medical records are available. No further info is available.

VAERS ID:255949 (history)  Vaccinated:1998-04-27
Age:2.0  Onset:2005-05-10, Days after vaccination: 2570
Gender:Male  Submitted:2006-05-12, Days after onset: 367
Location:New York  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0505USA01598
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Rash vesicular, Skin ulcer, Upper respiratory tract infection, Viral infection
SMQs:, Hypersensitivity (narrow)
Write-up: Information has been received from a health professional concerning a 9 yr old male who on 27Apr98 was vaccinated with a 0.5ml dose of varicella virus vaccine live (lot 7160E). Two days ago, on 10May05, the pt experienced breakthrough chickenpox with about 50 lesions. Unspecified medical attention was sought. No product quality complaint was involved. Follow up information from a health professional indicated that on 10May05 the pt experienced mild upper respiratory infection symptoms and multiple scattered lesions in different stages of eruption over his entire body. It was reported that the pt recovered. Additional information is not expected.

VAERS ID:255975 (history)  Vaccinated:1998-04-27
Age:1.0  Onset:2005-05-17, Days after vaccination: 2577
Gender:Female  Submitted:2006-05-12, Days after onset: 360
Location:California  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl
Current Illness:
Preexisting Conditions: Drug hypersensitivity
Diagnostic Lab Data: UNK
CDC Split Type: WAES0505USA02046
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1598E1SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0053H1SC 
Administered by: Private     Purchased by: Private
Symptoms: Rash pustular, Rash vesicular, Viral infection
SMQs:, Hypersensitivity (narrow)
Write-up: Information has been received from a health professional concerning an 8 yr old female who is allergic to amoxicillin, sulfa and gentamicin sulfate (Garamycin) and has no other pertinent medical history who on 27Apr98 was vaccinated SC in the left thigh with a 0m5mL second dose of varicella virus vaccine live (lot 625131/0053H). Concomitant vaccination that day included a second dose of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar RA 27/3) (lot625231/1598E) in her right thigh. Concomitant therapy included diphenhydramine hydrochloride (Benadryl). There was no illness at the time of vaccination. There were no adverse events following prior vaccination. On 17May05 the pt developed chickenpox all over her body. It was reported that the pt had pustules, no scabs, and that she did not have a fever. Unspecified medical attention was sought. There was no treatment. At the time of the report it was not known if the pt had recovered. There was no product quality complaint involved. Additional information has been requested.

VAERS ID:110564 (history)  Vaccinated:1998-04-28
Age:26.4  Onset:1998-04-28, Days after vaccination: 0
Gender:Female  Submitted:1998-05-01, Days after onset: 3
Location:Texas  Entered:1998-05-04, 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: Orthocyclin;Vit E;calcium;multivitamin
Current Illness: NONE
Preexisting Conditions: deafood allergy;bee stings;hx of rxn to iodine
Diagnostic Lab Data: UA done-no results recv yet;
CDC Split Type:
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7F916791IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Chills, Diarrhoea, Myalgia, Neck pain, Pain, Pyrexia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: late noc 28APR98 pt c/o pain in neck & shoulder on rt side that cont radiated to lt side of body;rt arm was painful & red;pt c/o fever & chills w/inc BM''s (not diarrhea);went to hosp 30APR98 & ER dx sever tetanus rxn;pt also had pain neck

VAERS ID:110622 (history)  Vaccinated:1998-04-28
Age:1.2  Onset:1998-04-28, Days after vaccination: 0
Gender:Male  Submitted:1998-04-30, Days after onset: 2
Location:California  Entered:1998-05-05, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pediazole
Current Illness: bilateral otits media
Preexisting Conditions: congenital esotropia/hypertropia
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES4514973IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1235E1SCRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4508432PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: 5cm x 7cm hive rxn @ local site of vax, onset approx 6-8hr p/vax;

VAERS ID:110623 (history)  Vaccinated:1998-04-28
Age:66.8  Onset:1998-04-28, Days after vaccination: 0
Gender:Female  Submitted:1998-05-01, Days after onset: 3
Location:Michigan  Entered:1998-05-05, 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: Uniphyl, Ventolin, Pamelor, Miacalcin;Hovent, Moxair, Atrovent, premarin,Lasix, Synthroid
Current Illness: no acute illness
Preexisting Conditions: COPD, osteoporesis, hypothyroidism;
Diagnostic Lab Data:
CDC Split Type:
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PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4481751IMA
Administered by: Private     Purchased by: Other
Symptoms: 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: T103.2 max;pain, redness, mild edema arm; beginning 10-12hr p/vax;

VAERS ID:110698 (history)  Vaccinated:1998-04-28
Age:3.8  Onset:1998-04-29, Days after vaccination: 1
Gender:Female  Submitted:1998-05-01, Days after onset: 2
Location:New Jersey  Entered:1998-05-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0 A
Administered by: Private     Purchased by: Private
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 3 bouts of vomiting;no fever or other sx;

VAERS ID:110762 (history)  Vaccinated:1998-04-28
Age:0.4  Onset:1998-04-28, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1998-05-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CBC nl;blood cult pending;
CDC Split Type:
Vaccination
Manufacturer
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DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7L81673 IM 
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM260RJ   
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES776A   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Agitation, Crying, Diarrhoea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (narrow)
Write-up: mom states T104, vomiting & diarrhea;T102 today, extremely irritable, high pitch cry;no local rxn DTAP given in lt thigh;

VAERS ID:110813 (history)  Vaccinated:1998-04-28
Age:1.0  Onset:1998-05-08, Days after vaccination: 10
Gender:Male  Submitted:1998-05-08, Days after onset: 0
Location:North Carolina  Entered:1998-05-13, 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: teething synd
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0470E0SCLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0775B0PO 
Administered by: Private     Purchased by: Public
Symptoms: Febrile convulsion, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow)
Write-up: 11 days p/vax pt presented w/febrile sz w/T103 & rash on face, trunk, & legs that occurred p/rash;temp down p/motrin given;advised to take ibuprofen PRN for fever;call 911 if sz occurs again

VAERS ID:110860 (history)  Vaccinated:1998-04-28
Age:57.7  Onset:1998-05-06, Days after vaccination: 8
Gender:Female  Submitted:1998-05-08, Days after onset: 2
Location:California  Entered:1998-05-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKDA, NONE
Diagnostic Lab Data: NONE
CDC Split Type:
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TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4978225  LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Pruritus, Skin nodule
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 8 days p/vax pt devel itching @ the site of inj;on the 9th day localized redness devel @ the site of inj & pt described a knot under the skin;pt was seen by occupation med MD & was advised to apply ice packs to the site on 9th day;

VAERS ID:110924 (history)  Vaccinated:1998-04-28
Age:1.1  Onset:1998-05-08, Days after vaccination: 10
Gender:Male  Submitted:1998-05-11, Days after onset: 3
Location:Pennsylvania  Entered:1998-05-19, 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: Tine monovax by Connaught lot# M13622 given 28APR98
Current Illness: NONE
Preexisting Conditions: milk allergy;eczema;soy allergy;
Diagnostic Lab Data:
CDC Split Type:
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1107E0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Anorexia, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: exposed to chickenpox 2 days prior to vax;began 8MAY98 w/ 5-6 red marks on body;today reports 10-12 pox noted total;afeb; dec appetite;;change in disposition 2 on chin;2 on shoulder;1 on back; 1 on dorsal aspect of foot;2 on thigh;1 ankle

VAERS ID:110925 (history)  Vaccinated:1998-04-28
Age:2.8  Onset:1998-04-28, Days after vaccination: 0
Gender:Male  Submitted:1998-04-29, Days after onset: 1
Location:South Carolina  Entered:1998-05-19, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: ?PCN -amoxicillin 2-3wk ago
Diagnostic Lab Data: NONE
CDC Split Type: SC98023
Vaccination
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Lot
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Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09073803IM 
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM195RC3IM 
Administered by: Public     Purchased by: Public
Symptoms: Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: while mom & pt waiting in waiting room, pt face started to break out;immun given 12:30 broke out 12:40;hives to rt side of face by ear, hives to lt eyebrow & forehead; 2 hives under lt eye;red bumps;

VAERS ID:111022 (history)  Vaccinated:1998-04-28
Age:1.0  Onset:1998-04-29, Days after vaccination: 1
Gender:Male  Submitted:1998-05-13, Days after onset: 14
Location:Virginia  Entered:1998-05-21, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP & motrin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: VA98029
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7B918243IMRL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES09152103IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1317E0SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0769L1PO 
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: fever onset 29APR98-103PM;30APR98 PM fever inc to 104 p;/vax APAP & infant motrin;took pt to ER fever 105 treated w/suppositories & sent home w/100 temp devel fine, red rash on trunk;

VAERS ID:111145 (history)  Vaccinated:1998-04-28
Age:1.0  Onset:1998-05-07, Days after vaccination: 9
Gender:Female  Submitted:1998-05-13, Days after onset: 6
Location:Arkansas  Entered:1998-05-26, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: AR9826
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0216H3IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1306E0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0058H0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: devel rash on chest & arms & ran a fever of 103;

VAERS ID:111148 (history)  Vaccinated:1998-04-28
Age:4.8  Onset:1998-04-28, Days after vaccination: 0
Gender:Male  Submitted:1998-04-30, Days after onset: 2
Location:Arkansas  Entered:1998-05-26, Days after submission: 26
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: AR9825
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM827A24IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1245D1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4495253PO 
Administered by: Public     Purchased by: Public
Symptoms: Hypotension, Hypoventilation, Pallor, Somnolence, Stupor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax 28APR98 approx 5min later pt became very lethargic, pale, barely responsive;911 alerted, BP stable 86/50, P88, R20;became more alert, 02 & epi ready but not given;

VAERS ID:111192 (history)  Vaccinated:1998-04-28
Age:0.2  Onset:1998-04-28, Days after vaccination: 0
Gender:Male  Submitted:1998-04-29, Days after onset: 1
Location:Georgia  Entered:1998-05-27, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: 35wk gestation, peak bilirubin 16.2/0.4, ear infect 6APR98;
Diagnostic Lab Data: EEG pending-nl
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7G814910IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2512A20IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM260RJ0IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N02910SCLL
Administered by: Private     Purchased by: Private
Symptoms: Hypertonia, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: about 7-12hr p/vax pt was noted to have symmetric, rhythmic contractions of legs for about 1min followed by arm for 1/2min;the contractions didn''t extinguish when held;pt was staring ahead, not apneic;

VAERS ID:111819 (history)  Vaccinated:1998-04-28
Age:18.2  Onset:0000-00-00
Gender:Female  Submitted:1998-06-02
Location:Missouri  Entered:1998-06-12, Days after submission: 10
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: NA
CDC Split Type: MO98031
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1611E1SCA
Administered by: Public     Purchased by: Public
Symptoms: Menorrhagia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: parents reported pt was 1 day late w/period on 28APR98;has had no period since;awaiting initial appointment w/OB=gyn MD;

VAERS ID:111879 (history)  Vaccinated:1998-04-28
Age:5.6  Onset:1998-04-28, Days after vaccination: 0
Gender:Male  Submitted:1998-04-30, Days after onset: 2
Location:Louisiana  Entered:1998-06-15, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type: LA980603
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09157804 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1012E1 A
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0769K3PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Confusional state, Hypotonia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: 210PM pt was pushing shopping cart-became disoriented, sl tremors, hypotonia,temp nl in ER;

VAERS ID:111919 (history)  Vaccinated:1998-04-28
Age:1.2  Onset:1998-04-28, Days after vaccination: 0
Gender:Female  Submitted:1998-04-30, Days after onset: 2
Location:California  Entered:1998-06-16, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CA980059
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES7R816463IMLL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES7J916853IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1230E0SCRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0787D2PO 
Administered by: Public     Purchased by: Public
Symptoms: Febrile convulsion
SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Child woke from nap w/fever 105.8-106.Sz, CPR to ER via amb.Pediatrician exam pt & felt no permanent effects from exp.

VAERS ID:111944 (history)  Vaccinated:1998-04-28
Age:1.0  Onset:1998-05-23, Days after vaccination: 25
Gender:Female  Submitted:1998-05-28, Days after onset: 5
Location:North Carolina  Entered:1998-06-16, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: NC98022
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0470E0SCA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1581E0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt broke out in varicella rash 23MAy;pt was seen in office 24MAY w/pox, probably 20 lesions;temp @ home 104.5;

VAERS ID:112231 (history)  Vaccinated:1998-04-28
Age:12.4  Onset:1998-04-28, Days after vaccination: 0
Gender:Female  Submitted:1998-04-30, Days after onset: 2
Location:Minnesota  Entered:1998-06-29, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: unk
Diagnostic Lab Data: unk
CDC Split Type: MN98008
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0030H1SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09239101IMA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Hypertension, Injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax 28APR98 & approx 5min later fainted according to father;nurse heard a thud & ran out into hallway father reported pt fainted backwards & hit head;was assessed;BP 112/78, pulse 80, pupils equal;had h/a;

VAERS ID:112449 (history)  Vaccinated:1998-04-28
Age:3.1  Onset:1998-07-02, Days after vaccination: 65
Gender:Female  Submitted:1998-07-02, Days after onset: 0
Location:Pennsylvania  Entered:1998-07-10, 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:
Current Illness: NONE
Preexisting Conditions: allergy to amoxil hep B (hives)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0063H SCLA
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: skin-chest-abd-lower extremities bilaterally scattered-maculopapular erythematous lesions-across lower abd-some vesicular, non pruritic;

VAERS ID:113194 (history)  Vaccinated:1998-04-28
Age:  Onset:1998-04-28, Days after vaccination: 0
Gender:Unknown  Submitted:1998-07-30, Days after onset: 93
Location:Unknown  Entered:1998-08-03, Days after submission: 4
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: WAES98070835
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
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 recv vax 28APR98 & devel inj site swelling & redness;

VAERS ID:113198 (history)  Vaccinated:1998-04-28
Age:  Onset:1998-04-28, Days after vaccination: 0
Gender:Unknown  Submitted:1998-07-30, Days after onset: 93
Location:Unknown  Entered:1998-08-03, Days after submission: 4
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: WAES98070970
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
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 recv vax 28APR98 & same day pt devel inj site swelling & redness;

VAERS ID:113339 (history)  Vaccinated:1998-04-28
Age:22.0  Onset:1998-04-29, Days after vaccination: 1
Gender:Male  Submitted:1998-08-01, Days after onset: 94
Location:Unknown  Entered:1998-08-10, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0201  
Administered by: Military     Purchased by: Military
Symptoms: Headache
SMQs:
Write-up: h/a for approx 2wk p/vax;started 1 day p/vax;

VAERS ID:113369 (history)  Vaccinated:1998-04-28
Age:21.2  Onset:1998-04-29, Days after vaccination: 1
Gender:Unknown  Submitted:1998-08-01, Days after onset: 94
Location:Pennsylvania  Entered:1998-08-11, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp swelling in arm of vax w/dose 1& 2 anthrax;
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0202  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Influenza
SMQs:
Write-up: pt recv vax & devel severe cold, felt like the flu (4 days);

VAERS ID:114385 (history)  Vaccinated:1998-04-28
Age:5.1  Onset:1998-05-01, Days after vaccination: 3
Gender:Female  Submitted:1998-07-13, Days after onset: 73
Location:New Jersey  Entered:1998-09-23, Days after submission: 72
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U199800168
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7C919354IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0031M1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0786D3PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction
SMQs:
Write-up: pt recv vax 28APR98 & 1MAY98 pt exp a localized rxn;from follow-up of 26MAY98 it was reported that pt recovered from this experience;

VAERS ID:115956 (history)  Vaccinated:1998-04-28
Age:8.0  Onset:0000-00-00
Gender:Female  Submitted:1998-10-26
Location:Maryland  Entered:1998-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 19980130381
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2512A21IMLA
Administered by: Private     Purchased by: Private
Symptoms: Alopecia
SMQs:
Write-up: pt recv vax 29APR98 & exp hair loss in a circular area during APR-MAY98;the child''s hair had been coming out in patches the size of a dime;

VAERS ID:116446 (history)  Vaccinated:1998-04-28
Age:  Onset:1998-04-28, Days after vaccination: 0
Gender:Female  Submitted:1998-04-29, Days after onset: 1
Location:Oregon  Entered:1998-11-13, Days after submission: 198
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: UNK
Diagnostic Lab Data: UNK
CDC Split Type: 898120008A
Vaccination
Manufacturer
Lot
Dose
Route
Site
CHOL: CHOLERA (USP)PFIZER/WYETH4978054   
Administered by: Public     Purchased by: Other
Symptoms: Diarrhoea, Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt recv vax on 4/28/98; 30 min post vax pt exp fever, diarrhea, vomiting & headache

VAERS ID:119913 (history)  Vaccinated:1998-04-28
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:1999-03-01
Location:Virginia  Entered:1999-03-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Monospot & Lyme titer- neg, Renal function study & CBC- normal, Epstein-Barr virus antibody- neg
CDC Split Type: WAES98060020
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Infection, Sinusitis, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Pt recv vax on 4/28/98; in 4/98 post vax pt exp sinus infection, lethargy, bilateral knee arthralgias

VAERS ID:123037 (history)  Vaccinated:1998-04-28
Age:46.2  Onset:1998-04-30, Days after vaccination: 2
Gender:Female  Submitted:1999-05-14, Days after onset: 379
Location:Louisiana  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data;
Other Medications: Proventil;Atrovent;Axid;Calan
Current Illness:
Preexisting Conditions: allergy;asthma;
Diagnostic Lab Data:
CDC Split Type: WAES98050037
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0081E0SC 
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & exp soreness @ the site of inj, erythema, swelling;area was size of a half dollar & noted area was warm to touch;

VAERS ID:123100 (history)  Vaccinated:1998-04-28
Age:27.1  Onset:1998-05-01, Days after vaccination: 3
Gender:Female  Submitted:1999-05-14, Days after onset: 378
Location:Wisconsin  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: 5/20/98 ultrasound positive for preg;4/22/98 serum varicella zoster negative;5/12/98 urine beta human chorion positive;
CDC Split Type: WAES98050775
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1569E0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Laryngitis, Pharyngitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow)
Write-up: pt recv vax & urine HCG test was positive 5/12/98;an ultrasound on 5/20/98 was positive as well;LMP 3/26/98;expected date of delivery 1/1/99;pt exp croup, URI then another URI;

VAERS ID:123579 (history)  Vaccinated:1998-04-28
Age:32.2  Onset:1998-05-10, Days after vaccination: 12
Gender:Female  Submitted:1999-05-14, Days after onset: 369
Location:California  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: dx test: negative for HSV
CDC Split Type: WAES98062072
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: p/ pt recv vax approx 12 days later pt devel localized vesicular rash at inject site.

VAERS ID:124375 (history)  Vaccinated:1998-04-28
Age:3.5  Onset:1998-11-16, Days after vaccination: 202
Gender:Female  Submitted:1999-05-14, Days after onset: 178
Location:Virginia  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98121665
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0546E0SCL
Administered by: Private     Purchased by: Public
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: approx 7mos p/vax pt exp varicella w/blisters. treated w/acyclovir & benadryl

VAERS ID:123416 (history)  Vaccinated:1998-04-28
Age:32.3  Onset:1998-04-28, Days after vaccination: 0
Gender:Female  Submitted:1999-05-14, Days after onset: 381
Location:Washington  Entered:1999-05-24, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: flovent, inamin
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98051841
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1326E0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: p/ pt recv vax, same day devel 1.5'''' red, round, hot & swollen area at the inject site lasting 5 days

VAERS ID:156842 (history)  Vaccinated:1998-04-28
Age:4.0  Onset:2000-05-04, Days after vaccination: 737
Gender:Male  Submitted:2000-05-05, Days after onset: 1
Location:New Mexico  Entered:2000-07-17, Days after submission: 73
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: NM050003
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1326E0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Drug ineffective, Infection, Pyrexia
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Subsequent to receiving varicella vaccine on 4/28/98 and exposure in May, 2000, pt had breakthrough infection on 5/4/00. Pt had 40 lesions on day 2 and a low grade fever.

VAERS ID:171938 (history)  Vaccinated:1998-04-28
Age:8.0  Onset:2000-12-12, Days after vaccination: 959
Gender:Female  Submitted:2001-05-15, Days after onset: 153
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ;VARIVAX;2;.00;In Sibling
Other Medications: Ritalin
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00121276
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.6253740059H0SC 
Administered by: Private     Purchased by: Private
Symptoms: Viral infection
SMQs:
Write-up: Post vax, the medical assistant reported that on 12/12/2000, the patient "broke out with chicken pox". Unspecified medical attention was sought. In follow up the physician reported that the patient recovered. The patient''s siblings had a similar experience following exposure to varicella virus vaccine live. No further information is available.

VAERS ID:186419 (history)  Vaccinated:1998-04-28
Age:6.0  Onset:2002-01-11, Days after vaccination: 1354
Gender:Male  Submitted:2002-05-15, Days after onset: 123
Location:Massachusetts  Entered:2002-06-12, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WAES0202USA00168
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0056H0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Drug ineffective, Infection, Pruritus
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Hypersensitivity (broad)
Write-up: Information has been received from a registered nurse concerning a 10 year old male with no past medical history and no allergies who on 04/28/1998 was vaccinated with the first dose of varicella virus vaccine in the left arm SC. There was no concomitant medication or illness at the time of vaccination. On 01/11/2002, the pt developed a mild case of chickenpox. The pt was prescribed Benadryl for the itch. Follow-up info reported no other adverse events. No further info is available.

VAERS ID:187992 (history)  Vaccinated:1998-04-28
Age:5.0  Onset:2002-07-17, Days after vaccination: 1541
Gender:Female  Submitted:2002-07-19, Days after onset: 2
Location:Florida  Entered:2002-07-24, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1611E0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1424E0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Broke out with chickenpox.

VAERS ID:191041 (history)  Vaccinated:1998-04-28
Age:5.0  Onset:2002-10-01, Days after vaccination: 1617
Gender:Male  Submitted:2002-10-01, Days after onset: 0
Location:New Jersey  Entered:2002-10-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0055H   
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash both ankles and legs.

VAERS ID:210405 (history)  Vaccinated:1998-04-28
Age:1.1  Onset:2003-10-04, Days after vaccination: 1985
Gender:Female  Submitted:2003-10-08, Days after onset: 4
Location:Pennsylvania  Entered:2003-10-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tine
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1669E0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Erythema, Pruritus, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Temp 102 degrees oral 10/4/03-normal at present. Red, raised pruritic spots on trunk, face, extremities. Exposed to c. pox 1 wk ago, few vesicles.

VAERS ID:238184 (history)  Vaccinated:1998-04-28
Age:1.3  Onset:2004-04-28, Days after vaccination: 2192
Gender:Male  Submitted:2005-05-16, Days after onset: 383
Location:Indiana  Entered:2005-05-26, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Body height: 43 inches; Body weight 43.5 lbs.
CDC Split Type: WAES0405USA01947
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1581E0SC 
Administered by: Other     Purchased by: Other
Symptoms: Blister, Rash, Viral infection
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 7 year old male who on 4/28/98 was vaccinated SC in the left arm with a 0.5cc first dose of varicella virus vaccine live (lot # 625127/1581E). The patient was not ill at the time of vaccination. On 4/28/04 the patient started breaking out with blister-like spots on red base over torso, face, and neck. The patient was seen in the physician office on 5/3/04 and varicella was confirmed. The patient recovered from varicella on an unknown date. No additional information is expected.

VAERS ID:256303 (history)  Vaccinated:1998-04-28
Age:1.4  Onset:2005-05-26, Days after vaccination: 2585
Gender:Female  Submitted:2006-05-12, Days after onset: 351
Location:Ohio  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: herpes zoster~Varicella (Varivax)~~10~In Sibling|varicella~Varicella (Varivax)~~2~In Sibling
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0507USA00240
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1564E0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Skin ulcer, Viral infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a health professional concerning an 5 year old white female who in the am of 4/28/1998 was vaccianted SC wit a 0.5ml first does of varicella virus vaccine live experienced breakthrough varicella. It was noted that she had over 150 lesions. Unspecified medical attention was sought. Subsequently, the patient recovered. A product quality complaint was not involved. No further information is expected. The patients 10 year old brother (WAES0505USA00241) developed varicella after vaccination.

VAERS ID:280153 (history)  Vaccinated:1998-04-28
Age:1.3  Onset:2006-03-13, Days after vaccination: 2876
Gender:Female  Submitted:2007-05-16, Days after onset: 428
Location:California  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: none
Diagnostic Lab Data: body tem 3/13/06 102.1
CDC Split Type: WAES0604USA01790
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1320E UNUN
Administered by: Other     Purchased by: Other
Symptoms: Body temperature increased, Pyrexia, Rash, Skin lesion, Varicella, Varicella post vaccine
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a certified medical assistant concerning a 9 year old female with no allergies or medical history who on 28 Apr 1998 was vaccinated in the right anterior thigh with a dose of Varivax (lot# 624655/1320E). There was no concomitant medication. On 13 Mar 2006, the patient was diagnosed chickenpox. The patient was seen by the physician and had a fever of 102.1 and a rash on her face, torso, arms, legs. She had one lesions on her hypopharynx. The physician placed her on acyclovir. No diagnostic laboratory tests were performed. Subsequently, the patient recovered from chickenpox and was described as fine. A product quality complaint was not involved. Chickenpox was determined to be an other important medical event by the reporter. Additional information has been requested.

VAERS ID:112296 (history)  Vaccinated:1998-04-28
Age:50.9  Onset:1998-05-13, Days after vaccination: 15
Gender:Female  Submitted:1998-06-13, Days after onset: 31
Location:Foreign  Entered:1998-07-02, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Zona
Diagnostic Lab Data: 18MAY98 erythrocyte sed rate-1 HR 60;GGT 191; SGOT 75;SGPT 187;total bilirubin 13;toxoplasma positive;
CDC Split Type: 19980147771
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM  IM 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIES    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Anorexia, Diarrhoea, Hepatic function abnormal, Hepatitis, Infection, Nausea, Pyrexia, Red blood cell sedimentation rate increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 28APR98 & 15 days p/vax pt exp nausea, epigastric & rt hypochondrium pain then fever 39.5 during 8 days & anorexia w/a weight loss of approx 5kg;19MAY98 pt devel liquid stools;dx biologic hepatitis;

VAERS ID:305360 (history)  Vaccinated:1998-04-28
Age:  Onset:1999-10-01, Days after vaccination: 521
Gender:Female  Submitted:2008-02-21, Days after onset: 3065
Location:Foreign  Entered:2008-02-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: D0056156A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Cystitis, Dyspnoea, Facial paresis, Feeling cold, Paresis
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: This case was reported by a physician and described the occurrence of facial paresis in an adult female subject of unspecified age who was vaccinated with Engerix-B adult for prophylaxis. The subject was working as paediatric nurse. Previous vaccinations included the first two doses of Engerix-B adult, given on 15 April 1997 and 13 May 1997. On 28 April 1998 the subject received the third dose of Engerix-B adult (1 ml, unknown). Approximately 18 months post vaccination with Engerix-B adult, on an unknown date in October 1999, the subject experienced urocystitis. One month later, approximately 19 months post vaccination with Engerix-B adult, on unknown dates in November 1999, the subject experienced facial paresis, cold feeling, various paresis and breathing problems. The subject was hospitalised for an unknown period of time. The outcome of the events was unspecified. Follow-up information has been requested.

VAERS ID:110524 (history)  Vaccinated:1998-04-29
Age:5.1  Onset:1998-04-29, Days after vaccination: 0
Gender:Female  Submitted:1998-04-29, Days after onset: 0
Location:Illinois  Entered:1998-04-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0992E1IMRA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM839A21IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1235E0IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES201ND101PO 
Administered by: Private     Purchased by: Public
Symptoms: Face oedema, Hypothermia, Hypoventilation, Rhinitis, Tachycardia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Accidents and injuries (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & T97.1, P88, R22, Ht 44;1110AM parent reported edema to face & eyes along congestion, P146, R16;epi given;P146, R16;

VAERS ID:110644 (history)  Vaccinated:1998-04-29
Age:21.1  Onset:1998-04-29, Days after vaccination: 0
Gender:Female  Submitted:1998-04-29, Days after onset: 0
Location:Virginia  Entered:1998-05-05, 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: BCP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESM10810IM 
Administered by: Other     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: entire arm sore & painful, unable to raise arm;

VAERS ID:110689 (history)  Vaccinated:1998-04-29
Age:5.0  Onset:1998-05-01, Days after vaccination: 2
Gender:Male  Submitted:1998-05-05, Days after onset: 4
Location:Colorado  Entered:1998-05-07, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rxn to mosquito bites-tx DPH by MD-no other
Diagnostic Lab Data: NONE
CDC Split Type: CO98032
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7C919354IMA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2333A21IMA
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Hypertonia, Injection site hypersensitivity, Injection site mass, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt began feeling bad late Friday then on Saturday sx peaked: spasm to arms & legs w/shooting pains to hands & legs as described by parent;loss of appetite;fever of 103.5 by noon;baseball size reddened raised area to rt arm below site inj;

VAERS ID:110797 (history)  Vaccinated:1998-04-29
Age:1.1  Onset:1998-04-29, Days after vaccination: 0
Gender:Male  Submitted:1998-05-07, Days after onset: 8
Location:Texas  Entered:1998-05-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: ear infect
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0220B0 L
Administered by: Private     Purchased by: Other
Symptoms: Agitation, Convulsion, Febrile convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: temp elevated to 104-105 x 3 days, sz (possibly 2), irritable for several days;inconsolable consulted MD sz related to temp;mom feels poss life threatening if vax again w/vax;

VAERS ID:110873 (history)  Vaccinated:1998-04-29
Age:1.5  Onset:1998-04-29, Days after vaccination: 0
Gender:Male  Submitted:1998-04-30, Days after onset: 1
Location:Virginia  Entered:1998-05-15, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type: VA98027
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7J815353IMRA
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM195RF3IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0990E0SCLA
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 arm red swollen & warm to touch over deltoid area;mom reports swelling inc since yesterday;denies any diff breathing or scratching of area;MD assessed, no tx;

VAERS ID:110890 (history)  Vaccinated:1998-04-29
Age:77.0  Onset:1998-04-30, Days after vaccination: 1
Gender:Female  Submitted:1998-05-06, Days after onset: 6
Location:Missouri  Entered:1998-05-18, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Covera HS;Paxil;hep a by SKB lot# VHA579A4 given 1MAY98
Current Illness: fatigue & residual cough following flu-like URI
Preexisting Conditions: NONE other than allergic to PCN
Diagnostic Lab Data: NONE
CDC Split Type: MO98020
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7F91700 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Hypertonia, Injection site hypersensitivity, Injection site mass, Pruritus
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: itching & erythema w/knot @ inj site began AM p/vax;the next day exp stiffness & aching joint in lt jaw;did not feel ill @ anytime & had not fever;sx began improving 4MAY98;

VAERS ID:110893 (history)  Vaccinated:1998-04-29
Age:1.0  Onset:1998-05-07, Days after vaccination: 8
Gender:Male  Submitted:1998-05-08, Days after onset: 1
Location:Massachusetts  Entered:1998-05-18, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: URI (stuffy nose)
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.1011E0IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES776A52PO 
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: 8MAY98 pt w/fever 7-8 days p/vax up to 102, irritable, cranky, otherwise no other sx;9MAY98 no fever today, up few times in noc;no rash;

VAERS ID:110922 (history)  Vaccinated:1998-04-29
Age:5.3  Onset:1998-04-30, Days after vaccination: 1
Gender:Male  Submitted:1998-05-13, Days after onset: 13
Location:Georgia  Entered:1998-05-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: GA98040
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESA826A21IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0289E1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0775L3PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 29APR98 in lt arm; mom noticed lt arm swelling later 30APR98 firm top of shoulder to elbow & also hot to touch;was seen by MD 1MAY98 & given ATB;BY 6MAY98 swelling disappeared;

VAERS ID:110992 (history)  Vaccinated:1998-04-29
Age:18.0  Onset:1998-05-05, Days after vaccination: 6
Gender:Male  Submitted:1998-05-07, Days after onset: 2
Location:New York  Entered:1998-05-20, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: heart murmur;ATV accident 11JUN94 w/hepatic laceration & spleenectomy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0100E1SCLA
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Arthropathy
SMQs:, Arthritis (broad)
Write-up: @ approx 9PM on 5MAY98 pt c/o pain & stiffness of lt elbow joint;pt was unable to fully extend forearm;no redness or swelling present;

VAERS ID:111292 (history)  Vaccinated:1998-04-29
Age:1.6  Onset:1998-04-29, Days after vaccination: 0
Gender:Male  Submitted:1998-05-27, Days after onset: 28
Location:Illinois  Entered:1998-06-02, Days after submission: 6
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: mild URI
Preexisting Conditions: eczema
Diagnostic Lab Data: EEG done WNL 9d p/sz
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4504973 RL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2508A22 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4525902  
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Cyanosis, Hypertonia, Pyrexia, Salivary hypersecretion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt recv vax 29APR98 10AM;awoke 5PM tactile fever, w/in 5min found to be bluish, foaming @ mouth & stiff;lasted 3-5min dx in ER w/sz;

VAERS ID:111417 (history)  Vaccinated:1998-04-29
Age:0.2  Onset:1998-04-29, Days after vaccination: 0
Gender:Male  Submitted:1998-04-29, Days after onset: 0
Location:California  Entered:1998-06-04, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES08743500IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0158E1IMLL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES08743500IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0787D0PO 
Administered by: Public     Purchased by: Other
Symptoms: Agitation, Cyanosis, Pallor
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax 29APR98 approx 10AM & approx 230PM pt had an episode of turning pale while crying w/cyanotic lips;p/being picked up & held pallor subsided p/10min;

VAERS ID:111677 (history)  Vaccinated:1998-04-29
Age:1.3  Onset:1998-04-30, Days after vaccination: 1
Gender:Female  Submitted:1998-05-05, Days after onset: 5
Location:Washington  Entered:1998-06-10, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WA981450
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7G814893IMLL
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous, Infection, Rash, Stomatitis
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: rash: other than @ inj site;rash devel coincidentally to episode of hand-foot-mouth disease;

VAERS ID:112155 (history)  Vaccinated:1998-04-29
Age:24.0  Onset:1998-04-29, Days after vaccination: 0
Gender:Male  Submitted:1998-05-06, Days after onset: 7
Location:Idaho  Entered:1998-06-24, Days after submission: 49
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp psddrf ouy, vertigo, dizziness w/dose 1 anthrax vax;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: ABG-nl to r/ anxiety;LFT & serum lytes nl;hyperventilation
CDC Split Type: ID98022
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0201SC 
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Diarrhoea, Diplopia, Dizziness, Nausea, Similar reaction on previous exposure to drug
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Ocular motility disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: double vision;dizziness;nausea;fatigue;diarrhea;tx w/rest/phenergan/antivert;

VAERS ID:112182 (history)  Vaccinated:1998-04-29
Age:2.1  Onset:1998-04-30, Days after vaccination: 1
Gender:Male  Submitted:1998-06-17, Days after onset: 48
Location:North Dakota  Entered:1998-06-25, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: ND9815
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0061H0IMA
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: broke out w/chickenpox from the vaccine;

VAERS ID:112188 (history)  Vaccinated:1998-04-29
Age:  Onset:1998-05-04, Days after vaccination: 5
Gender:Unknown  Submitted:1998-06-12, Days after onset: 39
Location:New York  Entered:1998-06-25, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: no hx of allergies;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4978099 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Face oedema, Injection site hypersensitivity, Injection site mass, Injection site oedema, Oedema, Pain, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: palpable nodule;swelling & redness @ site extending into shoulder;pain;swelling under lt eye;

VAERS ID:112340 (history)  Vaccinated:1998-04-29
Age:41.0  Onset:1998-05-13, Days after vaccination: 14
Gender:Male  Submitted:1998-06-30, Days after onset: 48
Location:Texas  Entered:1998-07-06, 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:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.1714E  LA
Administered by: Unknown     Purchased by: Public
Symptoms: Lymphadenopathy, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 29APR98 & broke out in a rash all over body w/sl fever & lymph node enlargement 2wk p/vax;pt went to PMD & told this was the 1st case had seen a rxn from rubella in an adult;pt stayed off work 1wk because of appearance;

VAERS ID:112495 (history)  Vaccinated:1998-04-29
Age:  Onset:1998-05-11, Days after vaccination: 12
Gender:Female  Submitted:1998-06-08, Days after onset: 28
Location:Virginia  Entered:1998-07-13, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1017E1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: none @ time of inj;reported fine rash x 1wk following vax;

VAERS ID:112976 (history)  Vaccinated:1998-04-29
Age:1.4  Onset:1998-04-30, Days after vaccination: 1
Gender:Male  Submitted:1998-05-04, Days after onset: 4
Location:Iowa  Entered:1998-07-31, Days after submission: 88
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: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES09023803 LA
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0077H3 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0464E0 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0771D0PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1610E0 LL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Oedema peripheral, Rash, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: mom called & stated next AM p/vax pt arm @ DTAP site was fiery red & swollen & had a rash;mom did not notify MD @ that time;later reported to PHN as pt allergic to tetanus;

VAERS ID:113201 (history)  Vaccinated:1998-04-29
Age:13.0  Onset:1998-04-29, Days after vaccination: 0
Gender:Male  Submitted:1998-07-29, Days after onset: 91
Location:Maryland  Entered:1998-08-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: pt has medical history of lyme disease since age 11;
Diagnostic Lab Data: 5-21-98: Anti-nuclear antibody-neg; C-reactive protein-normal; Erythrocyte sedrate-normal
CDC Split Type: 19980195411
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2492A21IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Back pain, Hypertonia, Nuchal rigidity, Pain, Rheumatoid arthritis
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (narrow)
Write-up: pt recv vax & exp joint pain;pt dx w/ankylosing spondylitis;

VAERS ID:115187 (history)  Vaccinated:1998-04-29
Age:2.8  Onset:1998-07-17, Days after vaccination: 79
Gender:Female  Submitted:1998-10-20, Days after onset: 95
Location:Michigan  Entered:1998-10-23, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? Yes
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: WAES98101210
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1567E0SC 
Administered by: Private     Purchased by: Other
Symptoms: Agitation, Arthralgia, Hypotonia, Oedema, Osteoarthritis, Pyrexia, Rheumatoid arthritis
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (narrow)
Write-up: pt recv vax 29APR98 & 29JUN98 pt was fussy & exp pain & swelling of joints;13JUL98 pt exp swelling & was limp & had a fever off & one;AUG98 pt hosp & dx w/juvenile rheumatoid arthritis;

VAERS ID:117628 (history)  Vaccinated:1998-04-29
Age:13.2  Onset:1998-06-15, Days after vaccination: 47
Gender:Male  Submitted:1998-12-14, Days after onset: 182
Location:Maryland  Entered:1998-12-22, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: lyme disease 9SEp96 rx pred & amoxicillin; Bell''s Palsy pleocytosis of LP rx IV;
Diagnostic Lab Data: CBC OK, ESR 6, ANA negative;latex fix c- react prot 0.33 (0-1) ua NWL;SOGT 22, PT 14, creat 0.6;IgG 799, IgA 86, IgM 115, C3 94, C14 18;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2492A21IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthropathy, Rheumatoid arthritis
SMQs:, Arthritis (narrow)
Write-up: pt recv vax 29APR98 & 15JUN98 dx juvenile ankylosing spondylitis;

VAERS ID:119898 (history)  Vaccinated:1998-04-29
Age:26.4  Onset:1998-04-30, Days after vaccination: 1
Gender:Female  Submitted:1999-03-01, Days after onset: 305
Location:Louisiana  Entered:1999-03-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98050088
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1283D1  
Administered by: Other     Purchased by: Public
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv vax 29APR98 & 30APR98 pt devel 3"x4" wheal @ the inj site; 2 days later pt recovered;

VAERS ID:120157 (history)  Vaccinated:1998-04-29
Age:25.0  Onset:1998-06-10, Days after vaccination: 42
Gender:Female  Submitted:1999-03-05, Days after onset: 268
Location:Maryland  Entered:1999-03-11, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Demulen;Imitrex;Ultram;pt recv anthrax vax 2JUN98;
Current Illness: migraine h/a
Preexisting Conditions: migraine h/a assoc w/nausea, photophobia, phonophobia; allergy percocet gets rash; s/p bone graft & rt leg rod placement for FX tib fib from MVA 2 1/2 years ago
Diagnostic Lab Data: lumbar spinal fluid dx CSF: no malignant cell seen mild lymphocytosis;pupils 3mm & weakly reactive;discs appear sharp bilat;CSF myelin basic protein 2.0;C3 131;alpha 2 globulin 1.07;TSH 8.2;albumin/T.P 68;17JUN glucose 114;bilirubin 1.2;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0160SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blindness, Coordination abnormal, Dizziness, Multiple sclerosis, Nausea, Neuropathy, Vertigo
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Retinal disorders (broad), Vestibular disorders (narrow)
Write-up: pt exp loss of coordination & balance of both upper & lower extremities, vertigo, n, loss of vision in rt eye on or about 10JUN98;pt noted persistent n, dizziness during month of MAY98;pt exp poss CNS disease-?MS; exp loss of taste;h/a;

VAERS ID:123038 (history)  Vaccinated:1998-04-29
Age:6.0  Onset:0000-00-00
Gender:Male  Submitted:1999-05-14
Location:Arizona  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data~~ ~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98050044
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Neck pain, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recv vax & exp burning & itching of neck & also a rash on neck;

VAERS ID:123093 (history)  Vaccinated:1998-04-29
Age:1.5  Onset:1998-05-08, Days after vaccination: 9
Gender:Unknown  Submitted:1999-05-14, Days after onset: 371
Location:California  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: WAES98050692
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & devel a bump behind ear & on arm & a fever;

VAERS ID:123379 (history)  Vaccinated:1998-04-29
Age:4.8  Onset:1998-05-15, Days after vaccination: 16
Gender:Female  Submitted:1999-05-14, Days after onset: 364
Location:Pennsylvania  Entered:1999-05-24, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications:
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98051459
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1610E0SC 
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: MD rpt pt recv vax 4/29/98 & 5/15 pt exp 18-20 lesions w/mild temp 101f for 1day, & desquamation.

VAERS ID:156913 (history)  Vaccinated:1998-04-29
Age:6.0  Onset:1999-04-01, Days after vaccination: 337
Gender:Male  Submitted:2000-05-16, Days after onset: 410
Location:New York  Entered:2000-07-17, Days after submission: 62
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99042022
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Subsequent to receiving varicella virus vaccine live the pt developed approximately 20 varicella like lesions. The pt had a fever for 1 day then afebrile. After the 20 lesions crusted over, one additional lesion appeared.

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