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Found 500157 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:106325 (history)  Vaccinated:1998-01-09
Age:0.2  Onset:1998-01-11, Days after vaccination: 2
Gender:Female  Submitted:1998-01-12, Days after onset: 1
Location:Missouri  Entered:1998-01-12
Life Threatening? No
Died? Yes
   Date died: 1998-01-11
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7H815070IMLL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES7D917130IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.M03590IMLL
Administered by: Private     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: found dead in bed approx 06:00 11JAN98;

VAERS ID:106666 (history)  Vaccinated:1998-01-09
Age:0.2  Onset:1998-01-09, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:1998-01-20
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: NA
Diagnostic Lab Data: NA
CDC Split Type: MO98002
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7L816730IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0794E0IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.M12940SCLL
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Rash, Somnolence
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: pt slept for 4hr p/vax;mom awakened 230PM to feed baby noted to have a rash;subsequently began having uncontrollable crying;had red rash & very fussy;

VAERS ID:106708 (history)  Vaccinated:1998-01-09
Age:8.3  Onset:1998-01-09, Days after vaccination: 0
Gender:Male  Submitted:1998-01-09, Days after onset: 0
Location:Connecticut  Entered:1998-01-21, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1356D0 RA
Administered by: Private     Purchased by: Public
Symptoms: Dyspnoea, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: hives, difficulty breathing;

VAERS ID:106714 (history)  Vaccinated:1998-01-09
Age:18.0  Onset:1998-01-11, Days after vaccination: 2
Gender:Female  Submitted:1998-01-15, Days after onset: 4
Location:Virginia  Entered:1998-01-21, 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
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2424A22 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: Bell''s Palsy of face;

VAERS ID:106730 (history)  Vaccinated:1998-01-09
Age:1.1  Onset:1998-01-19, Days after vaccination: 10
Gender:Male  Submitted:1998-01-20, Days after onset: 1
Location:New Hampshire  Entered:1998-01-22, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4432653SCLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0288E0SCRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0767E2PO 
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 10days p/vax pt devel low grade fever & subsequent gen macular rash;

VAERS ID:106745 (history)  Vaccinated:1998-01-09
Age:35.0  Onset:1998-01-10, Days after vaccination: 1
Gender:Female  Submitted:1998-01-14, Days after onset: 4
Location:Wisconsin  Entered:1998-01-23, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt niece exp rxn @ 17yr old w/Engerix dose 2;
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2405A21  
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Hypertonia, Osteoarthritis, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (narrow)
Write-up: pt recv vax 8JAN98 & 10JAN97 pain, stiffness in rt shoulder, elbow & hand, used heavy doses of Ibuprofen for 4 days;better p/4 days;

VAERS ID:106988 (history)  Vaccinated:1998-01-09
Age:0.2  Onset:1998-01-11, Days after vaccination: 2
Gender:Male  Submitted:1998-01-19, Days after onset: 8
Location:California  Entered:1998-01-26, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7B918210 LL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2391A91 RL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES1177E0 LL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURERM03650 RL
Administered by: Private     Purchased by: Private
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt recv vax 9JAN98 & had a sz 11JAN97;

VAERS ID:106992 (history)  Vaccinated:1998-01-09
Age:0.3  Onset:1998-01-09, Days after vaccination: 0
Gender:Male  Submitted:1998-01-15, Days after onset: 6
Location:Iowa  Entered:1998-01-26, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: IA98002
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4477881IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0818E1IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0767C1PO 
Administered by: Public     Purchased by: Other
Symptoms: Agitation, Injection site hypersensitivity, Injection site oedema
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax approx 930AM & father reported pt had been screaming for 45min & rt thigh lateral aspect was red & swollen;pt had been given APAP 1/2hr prior to visit;pt had fallen asleep on the say MD prescribed DPH;

VAERS ID:107407 (history)  Vaccinated:1998-01-09
Age:31.3  Onset:1998-01-09, Days after vaccination: 0
Gender:Female  Submitted:1998-01-12, Days after onset: 3
Location:Michigan  Entered:1998-02-09, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: BCP on 1/35
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MI98005
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2300B60 LA
Administered by: Public     Purchased by: Unknown
Symptoms: Hypokinesia, Injection site mass, Injection site oedema, Injection site pain, Muscle spasms, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 9JAN98 knot, sl swelling, tenderness @ site;10JAN98 more severe tightness w/pain;11JAN98 severe pain-no response to pain in muscle (like spasm) shoulder to elbow-can''t move or else lt arm;

VAERS ID:107366 (history)  Vaccinated:1998-01-09
Age:31.6  Onset:1998-01-19, Days after vaccination: 10
Gender:Male  Submitted:1998-02-06, Days after onset: 18
Location:Illinois  Entered:1998-02-10, Days after submission: 4
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: HIV medication
Current Illness:
Preexisting Conditions: HIV positive
Diagnostic Lab Data: 19JAN98 BILTOT 8;hep a test positive;
CDC Split Type: 980038631
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0  
Administered by: Private     Purchased by: Private
Symptoms: Antinuclear antibody, Hepatic function abnormal, Hepatitis, Hyperbilirubinaemia, Influenza, Laboratory test abnormal, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (narrow), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax 9JAN98 & approx 10 day later 19JAN98 pt was jaundiced & had elevated liver function test, elevated prothrombin time, & elevated bilirubin of 8;pt tested positive for hep A;hosp;dx acute hep A:

VAERS ID:107838 (history)  Vaccinated:1998-01-09
Age:1.6  Onset:1998-01-17, Days after vaccination: 8
Gender:Female  Submitted:1998-01-20, Days after onset: 3
Location:Florida  Entered:1998-02-26, Days after submission: 37
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
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0109E IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES450138 PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: fever, rash;

VAERS ID:108083 (history)  Vaccinated:1998-01-09
Age:1.0  Onset:1998-01-20, Days after vaccination: 11
Gender:Male  Submitted:1998-03-02, Days after onset: 41
Location:Indiana  Entered:1998-03-09, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: IN98003
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0540E0 LA
Administered by: Public     Purchased by: Public
Symptoms: Rash, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: devel rash on rt thigh;had lesions on rt knee;no temp not ill;rash & lesion only lasted 2-3 days;

VAERS ID:108111 (history)  Vaccinated:1998-01-09
Age:1.2  Onset:1998-01-19, Days after vaccination: 10
Gender:Female  Submitted:1998-01-27, Days after onset: 8
Location:California  Entered:1998-03-09, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: BOM-conjunctivititis
Preexisting Conditions: asthma
Diagnostic Lab Data: NONE
CDC Split Type: CA980026
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0110E0SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0808E0 RA
Administered by: Other     Purchased by: Public
Symptoms: Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: blotchy red rash 10 days p/vax while on ATB for OM which was started on 9JAN98 same as vaccine;

VAERS ID:108833 (history)  Vaccinated:1998-01-09
Age:43.2  Onset:1998-01-10, Days after vaccination: 1
Gender:Female  Submitted:1998-01-13, Days after onset: 3
Location:Washington  Entered:1998-03-23, Days after submission: 69
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WA981420
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F817600IMRA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4368220IMLA
Administered by: Public     Purchased by: Private
Symptoms: Lymphadenopathy, Lymphangitis, Neck pain, Pain, Skin striae
SMQs:, Arthritis (broad)
Write-up: Friday PM painful lt shoulder;Saturday PM pain extending to lt side of neck into lt arm-Saturday PM very painful lt mid collar bone-3 red lines noted from inj site up neck over inner shoulder;dx lymphangitis;

VAERS ID:110093 (history)  Vaccinated:1998-01-09
Age:1.2  Onset:1998-01-19, Days after vaccination: 10
Gender:Male  Submitted:1998-04-15, Days after onset: 85
Location:Texas  Entered:1998-04-17, 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: Augmentin
Current Illness: serous OM
Preexisting Conditions: drug allergy
Diagnostic Lab Data:
CDC Split Type: WAES98012092
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES 3  
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS 3  
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER1010E0SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1418E0SC 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Pruritus, Pyrexia, Rash maculo-papular, Vasodilatation
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 9JAN98 & 19JAN98 pt devel a maculopapular rash consisting of approx 20-30 red papules, mainly on the trunk, & a few on extremities;pt also exp itching & T105;also devel pox lesions;

VAERS ID:110117 (history)  Vaccinated:1998-01-09
Age:  Onset:1998-01-23, Days after vaccination: 14
Gender:Female  Submitted:1998-04-15, Days after onset: 81
Location:Unknown  Entered:1998-04-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98012554
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 8JAN98 & 23JAN98 pt devel soreness approx 1 inch around inj site;pt also noted no pox & sore to touch;

VAERS ID:110175 (history)  Vaccinated:1998-01-09
Age:  Onset:1998-01-21, Days after vaccination: 12
Gender:Unknown  Submitted:1998-04-15, Days after onset: 83
Location:Minnesota  Entered:1998-04-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data
Other Medications: unknown
Current Illness:
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC Split Type: WAES98020653
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection, Pharyngitis
SMQs:, Agranulocytosis (broad), Lack of efficacy/effect (narrow), Oropharyngeal infections (narrow)
Write-up: 09Jan98 pt recv 1 dose vax. 21Jan98 pt exp upper respiratory infection. Pt presented to "Urgent Clinic" was tx w/prednisone. Few days later pt devel full blown varicella.

VAERS ID:111270 (history)  Vaccinated:1998-01-09
Age:0.4  Onset:1998-01-11, Days after vaccination: 2
Gender:Male  Submitted:1998-01-12, Days after onset: 1
Location:New York  Entered:1998-05-29, Days after submission: 136
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt prev recv tetramune & IPV on 29SEP97 w/o adverse event;
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 898015010L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4468341IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES 0PO 
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Muscle twitching
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: 2 days p/vax pt exp a sz-like event;pt was taken to the ER where 2 partial tonic-clonic sz of the upper extremities were noted;pt recovered w/o tx & was sent home;

VAERS ID:111730 (history)  Vaccinated:1998-01-09
Age:46.5  Onset:1998-01-19, Days after vaccination: 10
Gender:Female  Submitted:1998-05-29, Days after onset: 129
Location:Unknown  Entered:1998-06-02, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98011870
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Influenza, Myalgia, Pyrexia, Rash maculo-papular
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recv vax 9JAN98 & 19JAN98 pt presented to ER w/achiness & a sl fever;pt thought had the flu;tx w/biaxin;21JAN98 pt devel rash described as little red-like pimples on face, hair line,back & trunk;also c/o joint tenderness;

VAERS ID:111924 (history)  Vaccinated:1998-01-09
Age:0.6  Onset:1998-01-21, Days after vaccination: 12
Gender:Female  Submitted:1998-06-09, Days after onset: 138
Location:Washington  Entered:1998-06-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: EEG - abnormal; MRI - clear
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES6F814412 LL
HEP: HEP B (FOREIGN)MERCK & CO. INC.0457E2 RL
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIESM33OPL2 LL
Administered by: Private     Purchased by: Public
Symptoms: Convulsion, Hyperkinesia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Akathisia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Pt devel sz disorder after 6 mon DPT shot. Dx w/complex partial sz w/supplementary motor attacks. Tx w/Tegretol

VAERS ID:113948 (history)  Vaccinated:1998-01-09
Age:49.9  Onset:1998-01-23, Days after vaccination: 14
Gender:Female  Submitted:1998-04-17, Days after onset: 83
Location:Alaska  Entered:1998-09-08, Days after submission: 144
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Soma, vitamins, hormones
Current Illness: no illness/back injury
Preexisting Conditions: allergies-x-ray dye, erythromycin
Diagnostic Lab Data: post 9 wk varicella titer 2.24Hf;
CDC Split Type: AK9199801
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0638E0SCA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Headache, Herpes zoster, Infection, Lymphadenopathy, Nausea, Pain, Pruritus, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: 23JAN98 devel itching, then lesions of chickenpox nature;mild fever, h/a & nausea;lesion onforehead became infected causing some adenopathy anterior to lt ear;put on Keflex x 5 days;

VAERS ID:113920 (history)  Vaccinated:1998-01-09
Age:47.9  Onset:0000-00-00
Gender:Female  Submitted:1998-09-04
Location:West Virginia  Entered:1998-09-09, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations: pt exp mild rash on neck & back of arms w/hep b initial vax;
Other Medications:
Current Illness:
Preexisting Conditions: allergy PCN;PMH, HTN, hypothyroidism;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2506A41  
Administered by: Public     Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Dermatitis bullous, Dermatitis exfoliative, Immune system disorder, Myalgia, Nausea, Pharyngitis, Pruritus, Rash, Rash maculo-papular, Rhinitis, Similar reaction on previous exposure to drug
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt has a rash over entire body;pt sees MD for intensely pruritic rash that sporadically responses to high dose steroids;d/t worsening of skin rash, intense pruritus, n, fatigue, arthralgia & myalgia;erythematous papillar,lichenification

VAERS ID:114597 (history)  Vaccinated:1998-01-09
Age:42.2  Onset:1998-01-10, Days after vaccination: 1
Gender:Female  Submitted:1998-01-12, Days after onset: 2
Location:Pennsylvania  Entered:1998-09-30, Days after submission: 260
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Naprosyn 250mg BID; Premarin tablets .625 mg daily; Thyroid hormone 90mcg daily; Nortriptyline 10 mg at bed; Prozac 20 mg daily
Current Illness: NONE
Preexisting Conditions: Systemic lupus erythematosus, hypothyroidism, insomnia, mood swings
Diagnostic Lab Data: UNK
CDC Split Type: 898042011L
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4481910IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site pain, Pyrexia, Skin striae
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 1/9/98; on 1/10/98 pt exp fever(103F) & injection site rx of redness, pain &blistering;redness streaked into the axilla. Pt to M.D.;tx=antibiotic.

VAERS ID:114777 (history)  Vaccinated:1998-01-09
Age:35.9  Onset:1998-01-25, Days after vaccination: 16
Gender:Female  Submitted:1998-10-01, Days after onset: 248
Location:Florida  Entered:1998-10-07, 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: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2357A20 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0738E  RA
Administered by: Private     Purchased by: Private
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: migratory polyarthritis started 25JAN98 & cont for 6-8months;

VAERS ID:115803 (history)  Vaccinated:1998-01-09
Age:13.0  Onset:1998-01-09, Days after vaccination: 0
Gender:Male  Submitted:1998-10-26, Days after onset: 290
Location:Texas  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: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 19980007101
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv vax & approx a few hr later pt devel welt @ inj site;welt was reported to have lasted a few days;

VAERS ID:115822 (history)  Vaccinated:1998-01-09
Age:50.0  Onset:1998-01-10, Days after vaccination: 1
Gender:Female  Submitted:1998-10-26, Days after onset: 289
Location:Ohio  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: UNK
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: Allergic to Penicillin
Diagnostic Lab Data: UNK
CDC Split Type: 19980041351
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2427A20IMLA
Administered by: Public     Purchased by: Private
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 1/9/98; on 1/10/98 pt exp rash on chest & stomach w/pruritus x 3-4 day

VAERS ID:119860 (history)  Vaccinated:1998-01-09
Age:45.5  Onset:1998-01-14, Days after vaccination: 5
Gender:Female  Submitted:1999-03-01, Days after onset: 411
Location:Georgia  Entered:1999-03-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness:
Preexisting Conditions: Allergic to Amoxicillin, Ampicillin, Erythromycin, Gentamicin, Tetracycline; migraines, thyroid disorder
Diagnostic Lab Data: 3/4/98: HBsAb-positive antibodies
CDC Split Type: WAES98030913
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0159E3IM 
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Dyspepsia, Headache, Infection, Myasthenic syndrome, Nausea, Oedema peripheral
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Pseudomembranous colitis (broad), Malignancy related conditions (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt recv vax on 1/9/98; on 1/14/98 pt exp headache, diarrhea, nausea, dyspepsia, swollen hands &feet, muscle weakness of arms &legs; dx=cytomegalovirus

VAERS ID:122747 (history)  Vaccinated:1998-01-09
Age:32.9  Onset:1998-09-30, Days after vaccination: 264
Gender:Female  Submitted:1999-05-14, Days after onset: 226
Location:Massachusetts  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: 1/8/98 diagnostic lab test preg test: negative;2/5/98 diagnostic lab test preg test positive;2/28/98 lab test varicella antibodeis test (results unk);
CDC Split Type: WAES98020527
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0805E0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: pt recv vax 1/9/98 & became preg LMP 12/2797, EDC 10/3/98;2/28/98 lab test revealed pt was tested for varicella antibodies results unk;9/30/98 pt delivered nl female via c-sect;

VAERS ID:122912 (history)  Vaccinated:1998-01-09
Age:1.1  Onset:1998-03-13, Days after vaccination: 63
Gender:Female  Submitted:1999-05-14, Days after onset: 426
Location:Pennsylvania  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unknown
Current Illness:
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC Split Type: WAES98041046
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1327E0  
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: p/ pt recv vax 1/98 in 3/98 the pt exp breakthrough varicella

VAERS ID:122466 (history)  Vaccinated:1998-01-09
Age:1.9  Onset:1998-03-13, Days after vaccination: 63
Gender:Female  Submitted:1999-05-21, Days after onset: 433
Location:Pennsylvania  Entered:1999-05-24, Days after submission: 3
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:
CDC Split Type: WAES98050495
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0770E0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 1/9/98 & 3/13//98 pt exp breakthrough varicella w/a few lesions, no fever & no complications;pt recovered;

VAERS ID:157465 (history)  Vaccinated:1998-01-09
Age:1.1  Onset:1998-03-13, Days after vaccination: 63
Gender:Female  Submitted:2000-05-16, Days after onset: 794
Location:Pennsylvania  Entered:2000-07-19, Days after submission: 64
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: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99080823
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Subsequent to receiving one dose of varicella virus vaccine live the pt experienced breakthrough varicella.

VAERS ID:162951 (history)  Vaccinated:1998-01-09
Age:27.0  Onset:1998-02-03, Days after vaccination: 25
Gender:Female  Submitted:2000-11-21, Days after onset: 1022
Location:New York  Entered:2000-12-01, Days after submission: 10
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: Mumps skin test-nml; Tetanus antibody response-nml; Diphtheria antibody response-nml; IgC-nml; IgM-39.0; 43.0 (low); 2/9/98 Rubella antibodies-lack of response (0.86); 6/1/98-Rubella antibodies-negative.
CDC Split Type: WAES98042022
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC. 0IM 
Administered by: 0     Purchased by: 0
Symptoms: Immunoglobulins decreased
SMQs:
Write-up: In June, 1997, the pt was vaccinated with the 1st dose of MMR II and subsequent rubella antibodies were negative (WAES98041761). On 1/9/98, the pt was vaccinated with the 1st dose of rubella virus vaccine live (second generation). On 2/3/98, the pt sought medical attention and a lab evaluation revealed negative rubella antibodies (0.86). On 5/20/98, the pt was re-evaluated with rubella virus vaccine live (second generation). On 6/1/98, rubella antibodies were again negative. No further information is available. .

VAERS ID:171182 (history)  Vaccinated:1998-01-09
Age:3.0  Onset:2000-04-04, Days after vaccination: 816
Gender:Male  Submitted:2001-05-15, Days after onset: 406
Location:Louisiana  Entered:2001-06-01, 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: NONE
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00040318
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1102E0SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug ineffective, Infection, Skin ulcer
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Uaricella - Information has been received from a registered nurse concerning a 40 month old male who on 09 Jan 1998 was vaccinated with one dose of varicella virus vaccine live sc in the left arm. there was no concomitant medication. On 04 apr 2000 the patient experienced chickenpox with 25-30 lesions on the chest, back, and face. he was seen by a physician. he was given diphenhydramine HCL (benadryl as needed

VAERS ID:186410 (history)  Vaccinated:1998-01-09
Age:1.2  Onset:2002-01-17, Days after vaccination: 1469
Gender:Female  Submitted:2002-05-15, Days after onset: 117
Location:New Hampshire  Entered:2002-06-12, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES0201USA03131
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SCRL
Administered by: Private     Purchased by: Public
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a health professional concerning a 5 year old female who on 01/09/1998 was vaccinated SC in the right thigh with a first dose of varicella virus vaccine live. On 01/17/2002 the pt experienced chickenpox all over the body. Unspecified medical attention was sought. It was reported that the pt recovered on 01/17/2002. Additional info has been requested.

VAERS ID:256281 (history)  Vaccinated:1998-01-09
Age:  Onset:2005-05-22, Days after vaccination: 2690
Gender:Unknown  Submitted:2006-05-12, Days after onset: 355
Location:Massachusetts  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:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Body temperature-fever
CDC Split Type: WAES0506USA03800
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1327E   
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection, Pyrexia
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Info has been received from a physician concerning a white pt who on 1/9/98 was vaccinated with a dose of varicella virus vaccine live. On 5/22/05, the pt developed a rash. On 5/23/05, the pt was diagnosed with breakthrough varicella with 50-249 lesions. The pt had a fever. There were no complications. The pt''s diagnosis was not lab confirmed. The pt had no history of chickenpox. Unspecified medical attention was sought. There was no product quality complaint involved. Additional info is not expected.

VAERS ID:256282 (history)  Vaccinated:1998-01-09
Age:1.4  Onset:2005-06-10, Days after vaccination: 2709
Gender:Unknown  Submitted:2006-05-12, Days after onset: 336
Location:Massachusetts  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Body temp fever
CDC Split Type: WAES0506USA03801
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1327E  UN
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Pyrexia, Rash, Viral infection
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning an 8 year old patient who on 1/9/1998 was vaccinated with a dose of varicella virus vaccine live (lot 624724/1327B). On 6/10/2005 the patient developed a rash that was diagnosed by the LPN as breakthrough varicella with 250-500 lesions. The patient had a fever that lasted 1 day. There were no complications. The patients diagnosis was not lab confirmed. The patient had no history of chickenpox. Unspecified medical attention was sought. There was no product quality complaint involved. Additional information is not expected.

VAERS ID:257417 (history)  Vaccinated:1998-01-09
Age:1.9  Onset:2006-02-22, Days after vaccination: 2966
Gender:Male  Submitted:2006-05-12, Days after onset: 78
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:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC Split Type: WAES0603USA00177
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1101E0  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Info has been received from a woman in a pediatric office concerning a 10 year old white male student (64 lbs) with no medical history, who on 1/9/98, was vaccinated with a 1st dose of varicella virus vaccine live (lot 624068/1101E). There was no illness at the time of vaccination. On 2/22/06, the pt developed a mild case of varicella. The pt was seen in the physician''s office on 2/23/06. No treatment was reported. Subsequently, the pt recovered from varicella. No further info was available at the time of this report. Additional info is not expected.

VAERS ID:343825 (history)  Vaccinated:1998-01-09
Age:1.2  Onset:1998-01-19, Days after vaccination: 10
Gender:Female  Submitted:2009-04-09, Days after onset: 4097
Location:Indiana  Entered:2009-04-09
Life Threatening? Yes
Died? Yes
   Date died: 1998-02-18
   Days after onset: 30
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations: no~ ()~UN~0.00~Patient|no~ ()~UN~0.00~Sibling|no~ ()~UN~0.00~Sibling
Other Medications: none
Current Illness: premature, "hole" in heart that was healed
Preexisting Conditions: PMH: preemie, birth weight 2 lb 8 oz & was hospitalized x 1 mo.
Diagnostic Lab Data: Autopsy was done
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0283E0SCLL
Administered by: Public     Purchased by: Public
Symptoms: Autopsy, Cardio-respiratory arrest, Cough, Death, Dyspnoea, Heart rate increased, Nasopharyngitis, Pharyngitis, Pyrexia, Rash, Viral myocarditis, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: developed fever and rash approx. 10 to 12 days after mmr was giver on Jan. 1, 1998, after rash was gone they developed cough around Feb 11, 1998. Mother took patient to doctor on Feb 16. Dx w/ pharyngitis and told increase heart rate due to infection. Sent home w/ antibiotic. On Feb 17, patient vomiting, mother called doctor, MD orderde suppository over phone. Mother tried suppository for vomiting, did not work. Patient appeared to be getting worse. By 3:00 am Feb 18 mother took patient to ER. Patient died by 4:ooam. Autopsy ordered. 4/17/09 Autopsy report states COD as acute viral myocarditis & manner of death as natural. Report also states patient had been seen by PCP for cold symptoms on 2/16/1998, dx w/pharyngitis & tx w/antibiotics. Later that day, began vomiting, called clinic & tx w/suppositories. Coughing & vomiting continued & developed fever on 2/18. Presented to ER on 2/18/98 w/very labored respirations & fever. Shortly after arrival, went into cardiopulmonary arrest, resuscitation unsuccessful.

VAERS ID:109028 (history)  Vaccinated:1998-01-09
Age:59.0  Onset:1998-02-03, Days after vaccination: 25
Gender:Female  Submitted:1998-03-17, Days after onset: 42
Location:Foreign  Entered:1998-04-01, 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: Prempak-C (norgestrel, Levonorgestrel, Oestraone;
Current Illness:
Preexisting Conditions: menopause
Diagnostic Lab Data:
CDC Split Type: 19980078531
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2289A6 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Coombs direct test positive, Haemolytic anaemia
SMQs:, Haemolytic disorders (narrow), Systemic lupus erythematosus (broad)
Write-up: pt recv vax 9JAN98 & 25 days p/vax 3FEB97 pt devel coombs positive hemolytic anemia;pt was not hosp for the event;

VAERS ID:109992 (history)  Vaccinated:1998-01-09
Age:1.0  Onset:1998-03-26, Days after vaccination: 76
Gender:Female  Submitted:1998-04-16, Days after onset: 20
Location:Foreign  Entered:1998-04-22, Days after submission: 6
Life Threatening? No
Died? Yes
   Date died: 1998-03-26
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U1998001420
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESM10922  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dehydration, Diarrhoea, Pneumonia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 9JAN98 & 23MAR98 pt was hosp w/a dx of diarrhea & dehydration;26MAR98 pt died w/COD listed as pneumonia;

VAERS ID:106375 (history)  Vaccinated:1998-01-10
Age:21.8  Onset:1998-01-10, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:Massachusetts  Entered:1998-01-13
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1595D   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypertonia, Hypotonia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), 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: pt had tonic clonic muscular activity for approx 45sec;no hx of neuro problems in past;pt & MD question rxn to MMR;

VAERS ID:107424 (history)  Vaccinated:1998-01-10
Age:1.3  Onset:1998-01-10, Days after vaccination: 0
Gender:Male  Submitted:1998-01-27, Days after onset: 17
Location:Missouri  Entered:1998-02-10, 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: Augmentin x 5 days;APAP
Current Illness: mild skin eczema on thighs
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7H815073 RA
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS165RH3 LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: marked redness & swelling to muscle w/pain-itching @ inj site;ice applied & temp-golf ball size to grape size resolved completely in 4 days only in rt deltoid;

VAERS ID:110646 (history)  Vaccinated:1998-01-10
Age:48.5  Onset:1998-01-13, Days after vaccination: 3
Gender:Female  Submitted:1998-01-30, Days after onset: 17
Location:Colorado  Entered:1998-05-05, Days after submission: 94
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: corizide;Corgaard
Current Illness: thiazide indeced dermatitis;
Preexisting Conditions: HTN, recurrent sinusitis
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F818980IMLA
Administered by: Private     Purchased by: Private
Symptoms: Muscle twitching, Myoclonus
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad)
Write-up: muscle twitching & jerking occurring primarily during sleep;seen by neurologist who dx myoclonus;

VAERS ID:114615 (history)  Vaccinated:1998-01-10
Age:83.0  Onset:0000-00-00
Gender:Female  Submitted:1998-02-18
Location:Texas  Entered:1998-09-30, Days after submission: 223
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: 898084024L
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4481920IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 1/10/98; subsequently pt exp a rash. On 1/12/98 pt exp injection site rxn of pain &swelling.

VAERS ID:122914 (history)  Vaccinated:1998-01-10
Age:0.1  Onset:0000-00-00
Gender:Female  Submitted:1999-05-14
Location:Virginia  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: none
Current Illness:
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type: WAES98041063
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: pt recv varicella vax 1/98 & subsequently exp an unspecified event

VAERS ID:107778 (history)  Vaccinated:1998-01-11
Age:48.0  Onset:1998-01-13, Days after vaccination: 2
Gender:Female  Submitted:1998-02-16, Days after onset: 34
Location:Minnesota  Entered:1998-02-20, 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: Zestrol
Current Illness: NONE
Preexisting Conditions: high BP on med (Zestrol)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4978073  LA
Administered by: Other     Purchased by: Other
Symptoms: Infection, Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 11JAN98 & exp localized rxn on 13JAN98;area was reported to be the size of a fist @ the site of vax;instructed on care & if sx worsened med attention needed;w/in 2 days reduced in size & redness subsided;dx infect under skin

VAERS ID:114014 (history)  Vaccinated:1998-01-11
Age:57.5  Onset:1998-01-15, Days after vaccination: 4
Gender:Male  Submitted:1998-09-01, Days after onset: 228
Location:New Jersey  Entered:1998-09-10, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: 16JAN98 atypical lymphocyte 5.4;atypical lymphocyte 5%;basophil count 1.0;lymphocyte count 1.0;lymphocyte count 62.7;21JAN98 lymph count 67;monocyte count 6.7;neutrophil count 22.3;WBC count 17.6;16JAN98 neutrophil count 26.5;27FEB98 UA;
CDC Split Type: WAES98011856
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1033E0  
Administered by: Other     Purchased by: Other
Symptoms: Haematuria, Laboratory test abnormal, Leukaemia, Leukocytosis, Urine analysis abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Malignant tumours (narrow), Tubulointerstitial diseases (broad)
Write-up: 15JAN98 during pre operative screening pt noted to have sl elevated WBC count;9 days post vax WBC count was 5% higher;WBC count on 16JAN98 was 13.46 & on 21JAN98 it had inc to 17.6;16JAN98 neutrophils 26.5;dx chronic lymphocytic leukemia;

VAERS ID:106721 (history)  Vaccinated:1998-01-12
Age:66.2  Onset:1998-01-15, Days after vaccination: 3
Gender:Male  Submitted:1998-01-16, Days after onset: 1
Location:Ohio  Entered:1998-01-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness:
Preexisting Conditions: recurrent bronchitic infect;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1452E0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Cough, Myalgia, Productive cough, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: T99, body aches, productive sputum (clear) w/cough;

VAERS ID:106740 (history)  Vaccinated:1998-01-12
Age:38.4  Onset:1998-01-13, Days after vaccination: 1
Gender:Female  Submitted:1998-01-16, Days after onset: 3
Location:New Hampshire  Entered:1998-01-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma;eczema;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7H918391IMRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Rash maculo-papular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: swelling @ inj site;hives 4cm in size @ inj site;fine maculopapular rash on forearms;

VAERS ID:106750 (history)  Vaccinated:1998-01-12
Age:1.5  Onset:0000-00-00
Gender:Male  Submitted:1998-01-12
Location:Massachusetts  Entered:1998-01-23, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications:
Current Illness: mild cough for 3 days
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)PFIZER/WYETHM305PN3UNLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0993D UNRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.141991UNLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood culture negative, CSF cell count normal, CSF culture negative, Full blood count normal, Grand mal convulsion, Pyrexia, Unevaluable event
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt had one dose of vax 17JUL97& got another un-necessary varivax on 12JAN97;pt did not devel any side effect so far;

VAERS ID:106940 (history)  Vaccinated:1998-01-12
Age:1.3  Onset:1998-01-14, Days after vaccination: 2
Gender:Female  Submitted:1998-01-20, Days after onset: 6
Location:California  Entered:1998-01-26, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: MA
Other Medications: NONE
Current Illness: URI
Preexisting Conditions: NONE
Diagnostic Lab Data: CXR-blood test per mom;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES7K816463IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES7K916873IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1104E0 RA
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Febrile convulsion, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), 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: pt recv vax 12JAN98 & around 3PM that evening & the next day pt woke up Wednesday 14JAN97 w/fever & irritability;had fever all day 100-101;that evening @ 6PM had T101 & had sz;pt drowsy prior to sz;911 was called & pt taken to hosp;

VAERS ID:106948 (history)  Vaccinated:1998-01-12
Age:0.3  Onset:1998-01-12, Days after vaccination: 0
Gender:Male  Submitted:1998-01-14, Days after onset: 2
Location:Utah  Entered:1998-01-26, Days after submission: 12
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:
CDC Split Type: UT980403
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4477880IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0928F0IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4484990PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Diarrhoea, Insomnia, Pyrexia
SMQs:, 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), Noninfectious diarrhoea (narrow)
Write-up: mom reports excess crying, not sleeping, T103.8, diarrhea;breast feeding constantly is the only thing that calms pt;saw MD on Tuesday, illness r/o;mom called hlth dept Wednesday to report cont s/s;controlling w/APPA & motrin;

VAERS ID:107061 (history)  Vaccinated:1998-01-12
Age:11.8  Onset:1998-01-16, Days after vaccination: 4
Gender:Female  Submitted:1998-01-20, Days after onset: 4
Location:Texas  Entered:1998-01-29, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type: TX98010
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0465E0 LA
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER    
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7F916790 RA
Administered by: Private     Purchased by: Public
Symptoms: Neck pain, Pain
SMQs:, Arthritis (broad)
Write-up: pt recv vax 12JAN98 & on 16JAN97 pt started having neck pain then should discomfort (bilat) & now arm discomfort (bilat);

VAERS ID:107187 (history)  Vaccinated:1998-01-12
Age:35.1  Onset:1998-01-24, Days after vaccination: 12
Gender:Male  Submitted:1998-01-26, Days after onset: 2
Location:Virginia  Entered:1998-02-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0704E0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Lymphadenopathy, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recv vax & devel rash, gen adenopathy;arthralgia/arthritis;

VAERS ID:107192 (history)  Vaccinated:1998-01-12
Age:1.0  Onset:1998-01-18, Days after vaccination: 6
Gender:Male  Submitted:1998-01-19, Days after onset: 1
Location:Nebraska  Entered:1998-02-02, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Rondec DM
Current Illness: NONE
Preexisting Conditions: arrested hydrocephalous
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0811E0SCRL
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Dermatitis bullous, Pyrexia, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 12JAN98 & by 18JAN98 pt devel a few scattered pustules-papules on shoulder, abd, very high fever;fussy;pt mom called ER for advice;

VAERS ID:107400 (history)  Vaccinated:1998-01-12
Age:36.4  Onset:1998-01-12, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1998-02-09
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: smoker-began Zban 16DEC97 then to inc to 150mg;hx 1992 inc chol, migraines since DEC92;JAN95 rt neck torticollis dx w/botox inj, badden, phenergan, toradol, solumedrol, xanax;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Infection, Injection site hypersensitivity, Injection site oedema, Pruritus, Pyrexia, Rash, Skin ulcer, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 12AJAN98 & 26JAN97 reported rxn red raised spot on forehead;mult spots on back;inj site red & swollen;also w/red spots, temp 101, itching all over including vaginal area;pt saw MD 27JAN98;pt to avoid immun & non immun people;

VAERS ID:107723 (history)  Vaccinated:1998-01-12
Age:36.3  Onset:1998-01-14, Days after vaccination: 2
Gender:Female  Submitted:1998-01-20, Days after onset: 6
Location:Texas  Entered:1998-02-12, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: denies
Other Medications: OTC sinus/allergy tablets
Current Illness: allergy-sinus problems
Preexisting Conditions: environmental allergies
Diagnostic Lab Data: NA
CDC Split Type: TX98012
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7E916573IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Skin striae, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt reported to clinic clerk that lt arm became very swollen, reddened, w/heat & sore approx 2 days p/vax;pt also reports red streaks radiating from inj site to mid elbow;tenderness lasted approx 1wk;pt did not seek eval from PMD:

VAERS ID:107744 (history)  Vaccinated:1998-01-12
Age:0.4  Onset:1998-01-14, Days after vaccination: 2
Gender:Male  Submitted:1998-02-13, Days after onset: 30
Location:Pennsylvania  Entered:1998-02-18, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: viral mengitis 5NOV97-7NOV97 hosp
Diagnostic Lab Data: EEG nl;CBC-diffirential/chem 7/glucose
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4490981IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.M10701 RL
Administered by: Private     Purchased by: Unknown
Symptoms: Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: shaking of head & hands lasting under 15sec;

VAERS ID:107769 (history)  Vaccinated:1998-01-12
Age:0.4  Onset:1998-01-13, Days after vaccination: 1
Gender:Male  Submitted:1998-02-16, Days after onset: 34
Location:Ohio  Entered:1998-02-20, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: anoxic brain injury @ birth-MD from birth hosp expected severe neuro problems;+ primary care MD not convinced sz from immun although positive temperal relationship;
Diagnostic Lab Data: glucose 88;all cult negative;CSF cell cult negative; EEG focal changes;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4386211IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.M08431IM 
Administered by: Private     Purchased by: Other
Symptoms: Convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt had a tonic clonic sz which lasted 1hr 15min & treated w/meds;pt also had a temp of 104 prior to transport;sz started 4AM 1 day p/vax;

VAERS ID:108082 (history)  Vaccinated:1998-01-12
Age:1.3  Onset:1998-01-21, Days after vaccination: 9
Gender:Male  Submitted:1998-03-02, Days after onset: 40
Location:Indiana  Entered:1998-03-09, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: IN98002
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7H815143 LL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES7H915683 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0769E0 RL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1325E0 LA
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: 21JAN98 rash resembling chickenpox 10 on face & 30 abd & 15-20 back;T99;gone w/in 2 days;

VAERS ID:108194 (history)  Vaccinated:1998-01-12
Age:13.2  Onset:1998-01-14, Days after vaccination: 2
Gender:Male  Submitted:1998-01-28, Days after onset: 14
Location:Georgia  Entered:1998-03-13, Days after submission: 44
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Intal;Eyantab, Albuterol inhaler;Slobid, allergy inj
Current Illness: asthmatic
Preexisting Conditions: asthma, allergies, sinusitis (chronic) hayfever
Diagnostic Lab Data: CXR, PE, strep cult negative
CDC Split Type: GA98008
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E20037KB7IMLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Asthenia, Asthma, Condition aggravated, Dyspnoea, Nausea, Pneumonia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: 14JAN98 feeling tired, cold pale;15JAN98 fever 103.6 not controlled by APAP;tired, dyspnea, sore throat, stomachache, fatigue;taken to ER dx w/walking pneumonia, loss of appetite;later cough & wheezing;

VAERS ID:108832 (history)  Vaccinated:1998-01-12
Age:67.7  Onset:1998-01-12, Days after vaccination: 0
Gender:Female  Submitted:1998-01-15, Days after onset: 3
Location:Washington  Entered:1998-03-23, Days after submission: 67
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: WA981423
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4978146 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0950D0SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7J91913 IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: redness, itching on day of inj area is red, raised, & warm to touch;

VAERS ID:108944 (history)  Vaccinated:1998-01-12
Age:10.6  Onset:1998-01-30, Days after vaccination: 18
Gender:Male  Submitted:1998-02-13, Days after onset: 14
Location:Pennsylvania  Entered:1998-03-30, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: URI
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: PA9813
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2356A20IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0423E0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Skin ulcer
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: 30JAN98 lesions of various sizes on face, neck, arms & legs;temp 102.4-fever lasted 4 days;lesions lasted 1wk;Ibuprofen for fever;still has scars from lesions;

VAERS ID:110057 (history)  Vaccinated:1998-01-12
Age:16.2  Onset:1998-01-13, Days after vaccination: 1
Gender:Male  Submitted:1998-04-15, Days after onset: 91
Location:California  Entered:1998-04-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data
Other Medications: Thorazine, Decadrol
Current Illness:
Preexisting Conditions: Benadryl allergy
Diagnostic Lab Data:
CDC Split Type: WAES98011565
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 10Dec97 & 12Jan98 Pt recv 1 & 2nd dose vax. Concomitant meds: Decadrol & Thorazine. 13Jan98 Pt devel itchy generalized lesions, 10-20 scattered over body. Reporter noted lesions not "true vesicles".

VAERS ID:110112 (history)  Vaccinated:1998-01-12
Age:31.4  Onset:1998-01-24, Days after vaccination: 12
Gender:Male  Submitted:1998-04-15, Days after onset: 80
Location:Unknown  Entered:1998-04-17, 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: cephalosporin allergy;PCN allergy
Diagnostic Lab Data:
CDC Split Type: WAES98012547
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Headache, Nausea, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 12JAN98 & 24JAN98 pt devel less than 15 chickenpox lesions on arms, face & neck;the lesions were vesicular, red & itchy;

VAERS ID:110249 (history)  Vaccinated:1998-01-12
Age:32.0  Onset:1998-02-12, Days after vaccination: 31
Gender:Female  Submitted:1998-04-15, Days after onset: 61
Location:New York  Entered:1998-04-17, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: lab test 2/12/98 negative VZV IgG
CDC Split Type: WAES98021641
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: 12Dec97 & 12Jan98 pt recv 1 & 2nd dose of vax. 12Feb98 lab eval revealed neg varicella IgG failure to seroconvert.

VAERS ID:110485 (history)  Vaccinated:1998-01-12
Age:1.9  Onset:1998-03-24, Days after vaccination: 71
Gender:Male  Submitted:0000-00-00
Location:Arizona  Entered:1998-04-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol syrup;Chericals w/codeine
Current Illness: UPI
Preexisting Conditions: NA
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1322E IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax 12JAN98 & devel varicella on 24MAR98;

VAERS ID:111272 (history)  Vaccinated:1998-01-12
Age:1.3  Onset:1998-01-12, Days after vaccination: 0
Gender:Female  Submitted:1998-02-09, Days after onset: 28
Location:New York  Entered:1998-05-29, Days after submission: 108
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 898049003L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4432632IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0072E2IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4400692PO 
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: MOC reported w/in 40min of vax pt devel a sl rash;4hr later devel gen urticaria & swollen ears;tx w/DPH & recovered;

VAERS ID:111850 (history)  Vaccinated:1998-01-12
Age:59.1  Onset:0000-00-00
Gender:Male  Submitted:1998-06-08
Location:Michigan  Entered:1998-06-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp pain w/dose 1 hep B vax & swelling in arm w/flu vax;
Other Medications: Motrin-PRN
Current Illness: Denies
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: MI98059B
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2300B61IMLA
Administered by: Public     Purchased by: Public
Symptoms: Condition aggravated
SMQs:
Write-up: c/o pain 4-6wk p/2nd dose vax;pain never ceased but became more intense p/2nd dose;c/o wrist pain bilat & rt shoulder pain for past 4wk;pt saw chiropractor x 3-no relief;

VAERS ID:111852 (history)  Vaccinated:1998-01-12
Age:62.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Michigan  Entered:1998-06-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp pain in rt shoulder, neck, & arm w/dose 1 hep b vax;
Other Medications: Synthroid
Current Illness: denies
Preexisting Conditions: pt was told had lupus dermatitis 1990;current states no lupus;sensitive to hismanal & horse serum;
Diagnostic Lab Data: FEB98 MRI;Scan of T1 & T2 WNL
CDC Split Type: MI98058B
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2300B61IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Neck pain, Pain, Similar reaction on previous exposure to drug
SMQs:, Arthritis (broad)
Write-up: pt exp rt shoulder, neck & arm pain p/dose 2;

VAERS ID:111867 (history)  Vaccinated:1998-01-12
Age:10.2  Onset:1998-01-13, Days after vaccination: 1
Gender:Female  Submitted:1998-01-15, Days after onset: 2
Location:Wisconsin  Entered:1998-06-15, Days after submission: 150
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: WI98003
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0928E2IMA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: c/o local soreness immed p/vax;redness noted @ inj site 13JAN98 PM;14JAN98 redness spread w/swelling occurring @ inj site;15JAN98 AM rt arm edematous w/redness & warmth from deltoid to elbow;

VAERS ID:113143 (history)  Vaccinated:1998-01-12
Age:8.0  Onset:1998-02-24, Days after vaccination: 43
Gender:Male  Submitted:1998-07-30, Days after onset: 155
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:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: ASTHMA, OTITIS MEDIA
Diagnostic Lab Data: 2/24/98 Diagnostic lab test-lack of seroconversion
CDC Split Type: WAES98032052
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt recv vax on 1/12/98; on 2/24/98 pts lab results indicated a lack of response.

VAERS ID:114780 (history)  Vaccinated:1998-01-12
Age:0.0  Onset:1998-01-12, Days after vaccination: 0
Gender:Female  Submitted:1998-09-26, Days after onset: 256
Location:Connecticut  Entered:1998-10-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2368A20 RL
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Agitation, Asthenia, Insomnia
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad)
Write-up: pt clearly tired yet was inconsolable;shortly thereafter had pain & cramps in abd;was irritable, clearly agitated & suffered from insomnia;cont for 12hr straight;abd pain & cramps cont & is believed to contributed to colic;

VAERS ID:115417 (history)  Vaccinated:1998-01-12
Age:1.2  Onset:1998-01-13, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Arizona  Entered:1998-10-28
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: PCN milk products, only allergy hx
Diagnostic Lab Data: glucose 124;creat 0.4;bili-IND 0.1;LDH 226;CHOL 131;BUN/Creat 30;osmo (calc) 286;RBC 4.85;MCV 79.9;MCH 26.0;MCHC 32.6;MPV 7.1;segs 65.0;mono 3.0;segs 8.4;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4477872IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4490952PO 
Administered by: Private     Purchased by: Private
Symptoms: Apnoea, Cyanosis, Febrile convulsion, Hyperchloraemia, Hypernatraemia, Otitis media, Pneumonia, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Tubulointerstitial diseases (broad)
Write-up: pt in ER last noc pt stopped breathing for no apparent reason, & sz @ daycare;T107 @ ER;febrile sz;OM, pneumonia;turned blue & passed out;skin flushed;dry, cranky;rapid resp;lethargic, crying;nasal mucosa;

VAERS ID:115811 (history)  Vaccinated:1998-01-12
Age:0.1  Onset:1998-01-21, Days after vaccination: 9
Gender:Male  Submitted:1998-10-26, Days after onset: 278
Location:Pennsylvania  Entered:1998-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: neonatal hosp course uneventful;pt was switched from Enfamil to Prosobee formula dEC97;
Diagnostic Lab Data:
CDC Split Type: 19980024491
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2391A91IML
Administered by: Private     Purchased by: Private
Symptoms: Erythema multiforme, Oral candidiasis, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 12JAN98 & 21JAN98 9 days p/vax devel a typical erythema mult rash;fever 100.5 & oral candidiasis;

VAERS ID:117190 (history)  Vaccinated:1998-01-12
Age:38.2  Onset:0000-00-00
Gender:Female  Submitted:1998-12-02
Location:Colorado  Entered:1998-12-08, 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: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: 27MAY98 diagnostic procedure polymerase chain rxn-inadequate specimen;
CDC Split Type: WAES98020676
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Abortion
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: pt recv vax & became pregnant (LMP 26DEC98);pt had a spontaneous abortion which required a D&C the eleventh week mark;

VAERS ID:119826 (history)  Vaccinated:1998-01-12
Age:0.3  Onset:1998-01-18, Days after vaccination: 6
Gender:Male  Submitted:1999-03-01, Days after onset: 407
Location:Ohio  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: No relevant data;
Other Medications:
Current Illness:
Preexisting Conditions: varicella exposure
Diagnostic Lab Data:
CDC Split Type: WAES98020565
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER    
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 12JAN98 & 19JAN98 pt exp varicella like rash;

VAERS ID:119835 (history)  Vaccinated:1998-01-12
Age:35.0  Onset:1998-01-22, Days after vaccination: 10
Gender:Male  Submitted:1999-03-01, Days after onset: 403
Location:Tennessee  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: No relevant data;
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: serum hepatitis A antibody IgM negative;serum hepatitis B core antibody IgM positive;serum hepatitis B surface antigen=positive;
CDC Split Type: WAES98021155
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Chills, Infection, Jaundice, Pyrexia, Vomiting
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax 12JAN98 & 22JAN98 pt exp jaundice, n/v, fever & chills;on 22JAN98 to MD office;lab eval revealed serum hepatitis A antibody test = IgM negative;serum hep b core antibody test = IgM positive;serum hep B surface antigen=positive;

VAERS ID:121074 (history)  Vaccinated:1998-01-12
Age:7.9  Onset:1999-03-29, Days after vaccination: 441
Gender:Female  Submitted:1999-04-07, Days after onset: 8
Location:New York  Entered:1999-04-09, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1183E80SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Pyrexia, Rhinitis
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Pt recv vax on 1/12/98; on 3/29/99 pt exp chicken pox, fever (x2 day), runny nose

VAERS ID:124633 (history)  Vaccinated:1998-01-12
Age:3.0  Onset:1999-03-02, Days after vaccination: 414
Gender:Female  Submitted:1999-05-14, Days after onset: 72
Location:Massachusetts  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: WAES99030721
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0423E0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Pharyngitis, Pyrexia, Rhinitis
SMQs:, Severe cutaneous adverse reactions (narrow), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt exp fever & cold sx;pt devel chickenpox w/approx 21 lesions all over body;

VAERS ID:124634 (history)  Vaccinated:1998-01-12
Age:1.0  Onset:1999-02-24, Days after vaccination: 408
Gender:Male  Submitted:1999-05-14, Days after onset: 78
Location:Texas  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: pt sibling devel varicella @ age 6yr w/varivax dose 1;
Other Medications:
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES99030725
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: pt exposed to sibling & devel chickenpox consisting of about 40 pox;pt seen by MD tx w/acyclovir;

VAERS ID:127124 (history)  Vaccinated:1998-01-12
Age:59.0  Onset:1998-01-27, Days after vaccination: 15
Gender:Female  Submitted:1999-07-10, Days after onset: 528
Location:California  Entered:1999-08-11, Days after submission: 32
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none
Other Medications: premarin, provera
Current Illness: none
Preexisting Conditions: penicillan; erythromycin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.2357A21  
Administered by: Private     Purchased by: Private
Symptoms: Hyperthyroidism, Hypokinesia, Myasthenic syndrome, Myopathy, Pain
SMQs:, Rhabdomyolysis/myopathy (narrow), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hyperthyroidism (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: 15 days p/vax pt exp severe lower limb myopathy w/extreme pain; inability to walk; bedridden; muscles deteriorated; dx of Graves Disease

VAERS ID:130110 (history)  Vaccinated:1998-01-12
Age:1.0  Onset:1999-10-24, Days after vaccination: 650
Gender:Female  Submitted:1999-10-25, Days after onset: 1
Location:Georgia  Entered:1999-11-01, 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: 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.1230E0SCLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1102E SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: devel chickenpox despite receiving vax;

VAERS ID:157268 (history)  Vaccinated:1998-01-12
Age:1.1  Onset:1999-07-19, Days after vaccination: 553
Gender:Male  Submitted:2000-05-16, Days after onset: 302
Location:Virginia  Entered:2000-07-19, Days after submission: 64
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: sulfonamide allergy
Diagnostic Lab Data:
CDC Split Type: WAES99071262
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1327E0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Subsequent to receiving one dose of varicella virus vaccine live the pt developed a unknown number of lesions and was diagnosed with a mild case of varicella.

VAERS ID:170610 (history)  Vaccinated:1998-01-12
Age:4.0  Onset:2001-06-01, Days after vaccination: 1236
Gender:Female  Submitted:2001-06-01, Days after onset: 0
Location:New Jersey  Entered:2001-06-05, 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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1327E0SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: The pt developed chicken pox. The pt had the vax on 1/12/1998.

VAERS ID:212525 (history)  Vaccinated:1998-01-12
Age:1.3  Onset:2003-11-12, Days after vaccination: 2130
Gender:Female  Submitted:2003-11-12, Days after onset: 0
Location:North Carolina  Entered:2003-11-18, 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:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0689E0 RA
Administered by: Private     Purchased by: Other
Symptoms: Blister, Infection, Pruritus, Rash erythematous
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 11/12/2003 red spots with vesicles, itch over face, trunk and extremities. Dx varicella.

VAERS ID:313746 (history)  Vaccinated:1998-01-12
Age:11.0  Onset:2007-11-27, Days after vaccination: 3606
Gender:Female  Submitted:2008-05-16, Days after onset: 170
Location:Texas  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0711USA06634
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0806E UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a physician concerning a 11-year-old female who on 12-JAN-1998 was vaccinated with a 0.5 mL dose of varicella virus vaccine live (Oka/Merck) (lot # 623654/0806E). On 27-NOV-2007, the patient developed more than 50 chicken pox lesions on her body even after being vaccinated. The patient sought unspecified medical attention. At the time of the report the patient''s status was unknown. At the time of the report the patients status was unknown. A product quality complaint was not involved. Additional information has been requested.

VAERS ID:336797 (history)  Vaccinated:1998-01-12
Age:1.3  Onset:2008-11-26, Days after vaccination: 3971
Gender:Female  Submitted:2009-01-06, Days after onset: 41
Location:Unknown  Entered:2009-01-08, Days after submission: 2
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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.UN0IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest pain, Herpes zoster, Rash vesicular
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Patient received VARIVAX on 1/12/98 at another facility. Site of immunization is not recorded in records. She came to our facility on 11/26/99 with a diagnosis of shingles. Described in medical record as "rash developed on left chest 4-5 days ago - very painful. Small cluster - vesicular rash left chest lateral."

VAERS ID:339541 (history)  Vaccinated:1998-01-12
Age:1.0  Onset:2009-02-10, Days after vaccination: 4047
Gender:Male  Submitted:2009-02-11, Days after onset: 1
Location:Missouri  Entered:2009-02-12, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)PFIZER/WYETH4406323IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0735E0SCRL
Administered by: Private     Purchased by: Private
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash on chest, back, face, scalp, arms - few on legs

VAERS ID:108073 (history)  Vaccinated:1998-01-12
Age:29.2  Onset:1998-01-13, Days after vaccination: 1
Gender:Female  Submitted:1998-03-05, Days after onset: 51
Location:Foreign  Entered:1998-03-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt aunt devel giant vulvar herpes w/DT/polio
Other Medications: Miniphase contraception;
Current Illness:
Preexisting Conditions: pt aunt in 1997 devel giant vulvar herpes p/DT polio vax;
Diagnostic Lab Data:
CDC Split Type: 19980034151
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2152B6 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Herpes simplex, Oedema, Pain, Skin disorder, Vulvovaginal disorder
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: pt recv vax 12JAN98 & 13JAN98 pt exp incapacitating (w/stop smoking about 10 days) giant vulvar herpes w/edema, pain & asthenia;med given 20JAN98;26FEB98 pt not yet recovered asthenia & 2 disappearing red wounds;

VAERS ID:107757 (history)  Vaccinated:1998-01-13
Age:27.6  Onset:1998-01-14, Days after vaccination: 1
Gender:Female  Submitted:1998-01-16, Days after onset: 2
Location:Massachusetts  Entered:1998-02-19, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Chlonorin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MA9802
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1011E SCRA
Administered by: Public     Purchased by: Public
Symptoms: Back pain, Chills, Headache, Myalgia, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: pt reported 14JAN c/o pain in back & neck;no rash but sore arm;pt recv vax 13JAN98;c/o chills no fever;sx lasting 2-3 days;As of 16JAN neck & back still sore, h/a also;went to hosp ER 14JAN98

VAERS ID:110050 (history)  Vaccinated:1998-01-13
Age:24.5  Onset:1998-01-19, Days after vaccination: 6
Gender:Female  Submitted:1998-04-15, Days after onset: 85
Location:Pennsylvania  Entered:1998-04-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES98011475
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Malaise, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 13Jan98 Pt recv 1 dose vax. 19Jan98 Pt devel approx 50 lesions, malaise & low grade fever.

VAERS ID:164501 (history)  Vaccinated:1998-01-13
Age:1.3  Onset:1998-01-13, Days after vaccination: 0
Gender:Male  Submitted:2000-12-15, Days after onset: 1067
Location:California  Entered:2001-01-09, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol/children''s
Current Illness: Flu
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES08515003IMRL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES08515003IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0767E0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0963E0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Abasia, Cognitive disorder, Dementia, Immune system disorder, Injection site erythema, Injection site oedema, Irritability, Pyrexia, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (narrow), Dystonia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (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)
Write-up: Immediately following vaccination, the pt slept and when he woke up he had a fever and was given Tylenol. We had a hard time keeping the fever down. He was very irritable (crying) his right leg where the vax was given was very red, swollen and he couldn''t walk on it. 60 day follow-up states the pt also experienced a decreased blood flow in the brain, experienced regression in speech, language, congnition development, has a sensitivity to foods with casein gluten, corn and soy and a weekened immune system.

VAERS ID:197701 (history)  Vaccinated:1998-01-13
Age:0.3  Onset:1998-01-13, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Unknown  Entered:2003-02-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness:
Preexisting Conditions: Medical history: Hospitalization, pneumonia NOS, Synovitis; Concurrent conditions: Egg allergy, hypersensitivity NOS
Diagnostic Lab Data: Temp measurement 01/13/1998 - 101
CDC Split Type: WAES01112562
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEUR    
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.6249241112E   
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEUR    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Neurodevelopmental disorder, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Info. has been received from a registered nurse concerning a 4 mt old male w/a "casien" allergy, eggs allergy and gluten allergy and a history of transient synovitis in March 01, and hospitalization for pneumonia in April 01. On 11/7/97 and on 1/13/98 the PT was vaccinated with the first (lot #623260/0445E) and 2nd (lot # 624924/1112E) dose of HIB conjugate vaccine (MSD) (lot #623260/0445E). Concomitant therapy on 1/13/98 included alum, potassium (+) diphtheria toxoid (+) pertussis vaccine (+) tetanus toxoid (TRIPEDIA) and poliovirus vaccine inactivated (IPOL). Other concomitant therapy included cetirizine hydrochloride (ZYRTEC) prn. Subsequent to the vaccinations on 1/13/98 the mother reported that the PT developed a rash and fever (101 F). It was also reported that on 10/8/97 and on 3/13/98 the PT received a first (lot #624497/0923E) and 2nd dose (lot #625399/1447E) of Hep B vaccine recombinant (yeast). Concomitant therapy on 3/13/98 included a dose of alum, potassium (+) diphtheria toxoid (+) pertussis vaccine (+) tetanus toxoid (TRIPEDIA). Subsequent to the vaccinations on 3/13/98 the PT developed a rash, 13 days duration. The registered nurse reported that both fever and rash were thought to be related to a probable reaction to therapy with alum, potassium (+) diphtheria toxoid (+) pertussis vaccine (+) tetanus toxoid. On 10/8/98 the PT was vaccinated with varicella virus vaccine live (lot #628027/1257H). It was also reported that on 12/18/98 the PT was vaccinated with measles virus vaccine live (+) mumps virus vaccine live (_) rubella virus vaccine live (2nd generation) (MSD) (lot #628905/1362H) (diluent # 629037/1521H). In June 99, the PT was diagnosed with pervasive developmental disorder, autism (WAES #01110497). The PT was being followed by an MD at the time of this report. Add''l info. has been requested.

VAERS ID:207964 (history)  Vaccinated:1998-01-13
Age:1.0  Onset:2003-07-31, Days after vaccination: 2025
Gender:Female  Submitted:2003-08-07, Days after onset: 7
Location:Florida  Entered:2003-08-18, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0688E0 LL
Administered by: Private     Purchased by: Private
Symptoms: Infection
SMQs:
Write-up: Mild case of varicella 8/4/03.

VAERS ID:107250 (history)  Vaccinated:1998-01-13
Age:1.0  Onset:0000-00-00
Gender:Unknown  Submitted:1998-02-03
Location:Foreign  Entered:1998-02-06, Days after submission: 3
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: unk
Current Illness:
Preexisting Conditions: exposure varicella
Diagnostic Lab Data: unk
CDC Split Type: WAES98017943
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Apnoea, Convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt recv vax 13JAN98 & 6 days p/vax pt exp fever, convuls & resp arrest & was hosp from the 21 to the 26JAN98 @ hosp;nurse reported pt has been in contact w/chickenpox before vax;

VAERS ID:107362 (history)  Vaccinated:1998-01-13
Age:0.4  Onset:1998-01-13, Days after vaccination: 0
Gender:Female  Submitted:1998-02-05, Days after onset: 23
Location:Foreign  Entered:1998-02-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO7842
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES    
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES31042121IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cyanosis, Hypotonia, Pallor, Peripheral vascular disorder, Respiratory disorder, Shock, Somnolence, Stupor
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Dementia (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 13JAN98 & 2hr p/vax increasing somnolence;devel of typical signs of shock;

VAERS ID:113257 (history)  Vaccinated:1998-01-13
Age:0.5  Onset:1998-01-22, Days after vaccination: 9
Gender:Female  Submitted:1998-08-03, Days after onset: 192
Location:Foreign  Entered:1998-08-06, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 19980195281
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM 1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Haemolysis, Haemolytic anaemia, Pallor, Rhinitis
SMQs:, Haemolytic disorders (narrow), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax 1/13/98, five days later experienced hemoglobulinuria and was sent to the hospital on 1/18/98 where autoimmune hemolytic anemia was established.tx w/meds (not specified);steroid tx stopped APR98;

VAERS ID:114768 (history)  Vaccinated:1998-01-13
Age:41.8  Onset:1998-01-13, Days after vaccination: 0
Gender:Female  Submitted:1998-10-02, Days after onset: 261
Location:Foreign  Entered:1998-10-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 19980110391
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM216A4A0IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Speech disorder, Thinking abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: pt recv vax 13JAN98 & 1/2hr p/later unable to concentrate @ work;pt returned home;husband noticed that had devel slurred speech which lasted a few hr;

VAERS ID:157865 (history)  Vaccinated:1998-01-13
Age:2.0  Onset:1998-01-13, Days after vaccination: 0
Gender:Female  Submitted:2000-07-24, Days after onset: 922
Location:Foreign  Entered:2000-07-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations: ;MMR II;1;2.00;In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Allergy to cats and cow milk
Diagnostic Lab Data: EEG-abn, lab tests-nml
CDC Split Type: WAES00071726
Vaccination
Manufacturer
Lot
Dose
Route
Site
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER 1PO 
Administered by: Other     Purchased by: Other
Symptoms: Aphasia, Diarrhoea, Difficulty in walking, Dizziness, Electroencephalogram abnormal, Epilepsy, Hemiplegia, Nervous system disorder, Neurodevelopmental disorder, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Noninfectious diarrhoea (narrow)
Write-up: In 01/12/1999, at approximately 4 years of age this child was not recovered from previous reactions to first MMR and first OPV, but was much better with improved right sided paresis, when she received her second OPV. Post second OPV the previous adverse event reoccurred. The previous symptoms began with fever and diarrhea. Also her development had stopped and slowly deteriorated. She stopped talking, became unable to feed herself and developed right sided paresis and dizziness disabling her to get up and walk. She was hospitalized and an EEG was performed and she was diagnosed with Landau Kleffner epilepsy with brain damage. 10/1999, she was somewhat better. Additionally it was noted that as of 12/1999, her condition had not changed. The information regarding the gait disturbance following MMR vax was reported by the parents. The development of the child was otherwise normal until 2-years-old: she began to speak and helping herself eat. Those abilities were reported to have disappeared post first OPV vax. It is also noted that the pt''s IgE level was normal at birth and that her father has allergies. The reporter indicated a possible relationship between the adverse event and the vaxs.

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