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Found 573164 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:133181 (history)  Vaccinated:1999-12-27
Age:38.0  Onset:1999-12-27, Days after vaccination: 0
Gender:Female  Submitted:2000-01-04, Days after onset: 8
Location:Minnesota  Entered:2000-01-11, 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:
Current Illness: NONE
Preexisting Conditions: allergy to aspirin, hypertension, and asthma
Diagnostic Lab Data: Blood Pressure 136/88, pulse 80, respirations 16, pulse oximetry on air 98%
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1084J1SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Agitation, Asthma, Chest pain, Dizziness, Dyspnoea, Nervousness
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: Pt states she felt light headed, agitated, felt beginning signs of asthma episode, tingling, tight feeling in chest and bronchioles. Pt self admin inhaler, no improvement. Treated in ER Seen in Er for Shortness of Breath, shakey, dizzy. Per follow-up: 2/11/00 - Letter and consent form returned with note that they needed dates of ER Service - Letter rewritten and consent form remailed - dates of ER Service 12/27/1999.

VAERS ID:133227 (history)  Vaccinated:1999-12-27
Age:38.0  Onset:1999-12-27, Days after vaccination: 0
Gender:Female  Submitted:2000-01-07, Days after onset: 11
Location:Minnesota  Entered:2000-01-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data
Other Medications: UNK
Current Illness:
Preexisting Conditions: Feather allergy, asthma
Diagnostic Lab Data:
CDC Split Type: WAES00010143
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1SC 
Administered by: Other     Purchased by: Other
Symptoms: Asthma, Chest pain, Condition aggravated, Dizziness
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Mins post vax, pt became lightheaded, devel asthma & exp tight feeling in chest. At ER treated & sent home. Additional info requested.

VAERS ID:133278 (history)  Vaccinated:1999-12-27
Age:12.0  Onset:1999-12-28, Days after vaccination: 1
Gender:Male  Submitted:2000-01-07, Days after onset: 10
Location:Maine  Entered:2000-01-14, 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: Received allergy shot same day.
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.4598370 LA
Administered by: Private     Purchased by: Other
Symptoms: Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: L arm soreness swelling 1 day post vax. No fever, itching, swelled from inject site to elbow.

VAERS ID:133407 (history)  Vaccinated:1999-12-27
Age:1.5  Onset:1999-12-29, Days after vaccination: 2
Gender:Female  Submitted:1999-12-29, Days after onset: 0
Location:Colorado  Entered:2000-01-20, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES46602383IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P04743SCLL
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Erythema, induration, warmth and tenderness. 8 x 9 cm area at inject site.

VAERS ID:133726 (history)  Vaccinated:1999-12-27
Age:3.0  Onset:2000-01-05, Days after vaccination: 9
Gender:Female  Submitted:2000-01-16, Days after onset: 11
Location:Michigan  Entered:2000-02-03, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MI2000001
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM912A20IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1957H0IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4618542PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1002J0SCRL
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approx 1 wk post/vax, mother noted a red raised area, approx 20mm single. Child''s scratching at area. No other sx''s at this time. Instruction to mother; prevent scratching & f/u with PMD if worsening.

VAERS ID:133735 (history)  Vaccinated:1999-12-27
Age:14.0  Onset:1999-12-30, Days after vaccination: 3
Gender:Male  Submitted:1999-12-30, Days after onset: 0
Location:Kansas  Entered:2000-02-03, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Accutane
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: KS99045
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU00100AA5IMRA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Vaccination given on 12/27/99. Dental work performed on 12/28 and 12/29 with local anesthetic. Broke out in hives on 12/29 - still some hives on the 30th.

VAERS ID:134053 (history)  Vaccinated:1999-12-27
Age:30.0  Onset:1999-12-27, Days after vaccination: 0
Gender:Male  Submitted:1999-12-30, Days after onset: 3
Location:Unknown  Entered:2000-02-15, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0445SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: 5x6" fevered hot local rxn to R arm 3 days post vax. Pt not hospitalized, no work days missed.

VAERS ID:150710 (history)  Vaccinated:1999-12-27
Age:1.0  Onset:2000-01-02, Days after vaccination: 6
Gender:Male  Submitted:2000-01-03, Days after onset: 1
Location:New Mexico  Entered:2000-03-31, Days after submission: 88
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, Blood cult, UA and Urine culture
CDC Split Type: NM00001
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4643003IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM27996A22IMRL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA461AA3IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0543J0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mom changed diaper on 1/2/00 AM at 9:00 and noticed some testicular swelling. Child had 100.2 fever. Child was taken to ER and admitted. He is on IV antibiotics.

VAERS ID:157681 (history)  Vaccinated:1999-12-27
Age:4.0  Onset:0000-00-00
Gender:Female  Submitted:2000-01-27
Location:New Jersey  Entered:2000-07-20, Days after submission: 174
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: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ0634820JAN2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4620224IM 
Administered by: Private     Purchased by: Other
Symptoms: Cough, Irritability, Myalgia, Pallor, Pharyngitis, Pollakiuria, Pyrexia, Restlessness, Rhinitis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: One day post vax the pt developed a fever of 104F. Pt experienced frequent urination, coughing, head cold symptoms, pallor, muscle pains in her thighs, irritability and restlessness. Pt was treated with Ditropan.

VAERS ID:215637 (history)  Vaccinated:1999-12-27
Age:6.0  Onset:2004-01-13, Days after vaccination: 1478
Gender:Female  Submitted:2004-01-15, Days after onset: 2
Location:California  Entered:2004-01-27, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC Split Type: CA040005
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0423J0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Varicella vaccine failure-twin sisters. Developed a light case of chickenpox on Monday 01/13/04. Approximately 50 lesions, going away 01/15/04. Exposed to 8 year old brother, who did not have vaccine. Brother developed illness 12/31/03.

VAERS ID:216612 (history)  Vaccinated:1999-12-27
Age:6.0  Onset:2004-02-10, Days after vaccination: 1506
Gender:Female  Submitted:2004-02-11, Days after onset: 1
Location:Oklahoma  Entered:2004-02-19, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC. 0  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Skin ulcer
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Varicella lesions 02/10/04 onset.

VAERS ID:329202 (history)  Vaccinated:1999-12-27
Age:36.0  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:Unknown  Entered:2008-10-20
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
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV024 SCUN
Administered by: Military     Purchased by: Military
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: SM developed generalized myalgias within 30 minutes of receiving each of his eight anthrax shots. Muscle aches lasted approximately one week. Motrin helped to keep pain tolerable. Was on quarters only once for muscle aches.

VAERS ID:379830 (history)  Vaccinated:1999-12-27
Age:1.1  Onset:0000-00-00
Gender:Male  Submitted:2010-02-05
Location:New York  Entered:2010-02-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Gait disturbance
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)
Write-up: Mother said he was unable to walk.

VAERS ID:132947 (history)  Vaccinated:1999-12-28
Age:22.4  Onset:1999-12-28, Days after vaccination: 0
Gender:Female  Submitted:1999-12-29, Days after onset: 1
Location:California  Entered:1999-12-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0781J0IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0072BA IMLA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUA116AA0SCLA
Administered by: 0     Purchased by: 0
Symptoms: Dyspnoea, Tongue oedema, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Vax at 2:00 pm. Hives at 3:20 pm. Pt at ER stated that she exp SOB and that her tongue felt as though it were swelling. .

VAERS ID:133178 (history)  Vaccinated:1999-12-28
Age:0.8  Onset:2000-01-01, Days after vaccination: 4
Gender:Male  Submitted:2000-01-03, Days after onset: 2
Location:Pennsylvania  Entered:2000-01-10, 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: Felt hot
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4623172IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.N082532IMLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site mass, Pyrexia, Rash maculo-papular, Skin nodule, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rcvd Vax 12/28/99, during visit on 1/2/00, pt developed non-erythematous papular rash covering thighs. Nodule felt at site of injection, rash surrounded area and extended up thighs to buttocks and groin area. Baby had fever.

VAERS ID:133199 (history)  Vaccinated:1999-12-28
Age:0.3  Onset:1999-12-29, Days after vaccination: 1
Gender:Female  Submitted:1999-12-30, Days after onset: 1
Location:Kansas  Entered:2000-01-11, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, Blood cult
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM916A21IMLA
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0567J1IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R00991SCRL
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Anorexia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Fever, irritability, crying constantly, not drinking well.

VAERS ID:133383 (history)  Vaccinated:1999-12-28
Age:39.4  Onset:2000-01-11, Days after vaccination: 14
Gender:Female  Submitted:2000-01-14, Days after onset: 3
Location:North Carolina  Entered:2000-01-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lopid,Anaprox,Clomid
Current Illness:
Preexisting Conditions: hay fever,sinusitis,hx of headaches
Diagnostic Lab Data: Liver profile - 0, blood sugar - 193, trigly - 704 - GBTP - 78, WBC - 12.7, HTH, 16.7, culture of pustules.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1012J1IMLA
Administered by: 0     Purchased by: 0
Symptoms: Abdominal pain, Asthma, Headache, Hyperglycaemia, Hyperlipidaemia, Laboratory test abnormal, Leukocytosis, Malaise, Rash, Sinusitis, Urticaria
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Asthma/bronchospasm (narrow), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Lipodystrophy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash on both thighs, forearms and beltline. dx in ER with hives on 1/11/00, Tx with Benedryl and Prednisone. 1/12 - seen in MD office, rash increased, some were open and bleeding apparently due to scratching. 1/13 rash worse, and some wheezing began, pt also had upper right quadrant abdominal tenderness. 1/14 pt states very ill, admitted to hospital.

VAERS ID:133417 (history)  Vaccinated:1999-12-28
Age:  Onset:1999-12-30, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:2000-01-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Exposed to Flu, no illness
Preexisting Conditions: Penicillin Allergy
Diagnostic Lab Data: CTC - WBC 10.2, HTH - WNL, Temp 99 tympanic.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49881201SCLA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt reported to er for puncture wound to foot, rcvd Td and Cipro. Two days later, pt returned to ER with swollen and painful l/deltoid. Tx with IV, Leviquin and lab work that r/o cellulitis. Sent home with cipro.

VAERS ID:133450 (history)  Vaccinated:1999-12-28
Age:1.3  Onset:1999-12-29, Days after vaccination: 1
Gender:Female  Submitted:2000-01-12, Days after onset: 14
Location:North Dakota  Entered:2000-02-01, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0008AA3IMLL
Administered by: Private     Purchased by: Public
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Localized l/tender thigh.

VAERS ID:133557 (history)  Vaccinated:1999-12-28
Age:10.0  Onset:1999-12-30, Days after vaccination: 2
Gender:Male  Submitted:2000-01-07, Days after onset: 8
Location:Illinois  Entered:2000-02-01, Days after submission: 25
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: IL20003
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2948A22IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site mass, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 12/30, evening, child showed mom his arm, at site of injection, he had a bump that protruded 1/4cm, diameter also 1/4cm. & it was pointed. It was firm, yet it could be depressed & would pop back out. On 1/1, developed hives, gone by 1/4. 60 day follow-up dated 9/26/00 provided no additional data.

VAERS ID:133568 (history)  Vaccinated:1999-12-28
Age:1.0  Onset:2000-01-08, Days after vaccination: 11
Gender:Female  Submitted:2000-01-20, Days after onset: 12
Location:Illinois  Entered:2000-02-01, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Nasal congestion
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1084J0SCL
Administered by: Private     Purchased by: Private
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Generalized papules, too numerous to count, scattered on face, trunk & extremities, appeared 10 days after vaccine administered. Papules stayed x 4 days except at injection site which stayed for 6 days.

VAERS ID:133619 (history)  Vaccinated:1999-12-28
Age:12.0  Onset:1999-12-28, Days after vaccination: 0
Gender:Female  Submitted:1999-12-30, Days after onset: 2
Location:California  Entered:2000-02-02, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD
Current Illness:
Preexisting Conditions: Morbid obesity, recurrent epistaxis
Diagnostic Lab Data:
CDC Split Type: CA990164
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3078A20IMLA
HEPA: HEP A (VAQTA)MERCK & CO. INC.1036J0IMLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0010AA4IMRA
Administered by: Other     Purchased by: Other
Symptoms: Headache, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mild urticaria, localized headache.

VAERS ID:133854 (history)  Vaccinated:1999-12-28
Age:9.8  Onset:1999-12-28, Days after vaccination: 0
Gender:Male  Submitted:2000-01-06, Days after onset: 9
Location:Massachusetts  Entered:2000-02-10, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levsin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Toxicollogy screen - negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.2979A20IMA
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Confusional state, Dry mouth, Hallucination, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)
Write-up: On day of vax and day after, pt had progressive symptoms of Anticholinergic overdose with dry mouth, elevated heart rate, significant confusion, agitation and hallucinations. Resolved spontaneously, no know ingestion.

VAERS ID:133887 (history)  Vaccinated:1999-12-28
Age:27.0  Onset:0000-00-00
Gender:Female  Submitted:2000-01-24
Location:North Carolina  Entered:2000-02-11, Days after submission: 18
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: Blood tests done for Lyme Disease & Lupus but were negative
CDC Split Type: NC00003
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3213C60IMLA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM572B60IMRA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)PFIZER/WYETH49980880SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Osteoarthritis
SMQs:, Arthritis (narrow)
Write-up: Pt reporting painful/swollen joints beginning the week of vaccine, specifically knee & ankle. Has seen DR several times & has been prescribed Naproxen, Prednisone, Hydrocodone & Ibuprofen. 1/26 pt called & said L/elbow & wrist pain & edema.

VAERS ID:134473 (history)  Vaccinated:1999-12-28
Age:3.0  Onset:1999-12-29, Days after vaccination: 1
Gender:Male  Submitted:2000-01-25, Days after onset: 27
Location:Minnesota  Entered:2000-03-01, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tegretol
Current Illness:
Preexisting Conditions: seizure disorder
Diagnostic Lab Data: Tegretol level-7.2
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0727J0SCLL
Administered by: Private     Purchased by: Unknown
Symptoms: Condition aggravated, Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Pt recv''d varicella vax and the next evening developed seizures.

VAERS ID:150408 (history)  Vaccinated:1999-12-28
Age:20.0  Onset:2000-01-28, Days after vaccination: 31
Gender:Male  Submitted:2000-03-14, Days after onset: 46
Location:Pennsylvania  Entered:2000-03-24, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Studies-Normal, Biopsy- Pending
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES6660ACV0  
Administered by: Private     Purchased by: Private
Symptoms: Vasculitis
SMQs:, Vasculitis (narrow)
Write-up: Vascultis

VAERS ID:150423 (history)  Vaccinated:1999-12-28
Age:0.3  Onset:1999-12-28, Days after vaccination: 0
Gender:Male  Submitted:2000-03-14, Days after onset: 77
Location:New Jersey  Entered:2000-03-24, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4623161IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0964J1IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURERP04631 RL
Administered by: Private     Purchased by: Other
Symptoms: Conversion disorder
SMQs:
Write-up: Pt was miserable and hysterical for hours after immunizations. (Per mom).

VAERS ID:151183 (history)  Vaccinated:1999-12-28
Age:11.0  Onset:1999-12-30, Days after vaccination: 2
Gender:Male  Submitted:2000-03-07, Days after onset: 68
Location:Pennsylvania  Entered:2000-05-02, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Head cold
Preexisting Conditions: Head cold
Diagnostic Lab Data:
CDC Split Type: WAES00010059
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Nasopharyngitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a consumer concerning his 11 year old son with a head cold who, on 12/30/99, post vax, experienced fever and arm soreness. On the morning of 12/31/99, the pt''s fever was 101.7F. The reporter noted that the pt, along with his siser are both experiencing head colds and he is unsure as to whether or not the pt''s experiences are related to the vaccine or the cold. Additional information has been requested.

VAERS ID:151812 (history)  Vaccinated:1999-12-28
Age:66.0  Onset:1999-12-28, Days after vaccination: 0
Gender:Male  Submitted:2000-04-21, Days after onset: 114
Location:Minnesota  Entered:2000-05-10, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergy to bees
Diagnostic Lab Data:
CDC Split Type: 19990536121
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY120P90IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Pain, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: On 12/28/1999, the pt received the first IM-left deltoid dose of Lymerix. One hour later on 12/28/1999, the pt experienced chills, fever, body shakes and body aches. No treatment was given. Symptoms resolved on 12/28/99. The most recent information received on 12/29/99 reports the condition of the pt is resolved.

VAERS ID:153606 (history)  Vaccinated:1999-12-28
Age:1.0  Onset:2000-04-07, Days after vaccination: 101
Gender:Male  Submitted:2000-04-14, Days after onset: 7
Location:Arkansas  Entered:2000-06-09, Days after submission: 56
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: (Varivax, Merck, 0119A, SC, RA)
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: AR0014
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES 2IMRA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0165AA1IMLA
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESP0877AP3IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0351J0SC 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0801M2PO 
Administered by: Public     Purchased by: Other
Symptoms: Cellulitis, Herpes zoster, Infection, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mother stated pt had red raised approximately 2 1/2 cm lesion top of head x 1 wk, was seen by MD. He stated that it looked like a fungus rash kept expanding to a confluent rash on right side of head with a linear line across right cheek bone. Dx as shingles.

VAERS ID:154693 (history)  Vaccinated:1999-12-28
Age:1.3  Onset:2000-01-05, Days after vaccination: 8
Gender:Female  Submitted:2000-05-24, Days after onset: 139
Location:Ohio  Entered:2000-06-19, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00010511
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approximately 8 days post vax pt experienced fever which is decreasing daily. On 1/6/00 the pt experienced a rash and an increased size of left carotid. Unspecified medical attention was sought. On an unspecified date the pt recovered. No further information is available.

VAERS ID:154956 (history)  Vaccinated:1999-12-28
Age:24.0  Onset:2000-01-05, Days after vaccination: 8
Gender:Female  Submitted:2000-01-11, Days after onset: 6
Location:Pennsylvania  Entered:2000-06-21, Days after submission: 161
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Orthotricyclen
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 20000006041
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Influenza like illness
SMQs:
Write-up: Eight days post vax pt experienced flu like symptoms.

VAERS ID:159701 (history)  Vaccinated:1999-12-28
Age:21.0  Onset:1999-12-29, Days after vaccination: 1
Gender:Female  Submitted:2000-02-02, Days after onset: 35
Location:Illinois  Entered:2000-09-08, Days after submission: 218
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: U1999011340
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.P1291511IM 
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: It was reported that a 21 year old female received a Rabies Imovax ID vaccination on 12-28-1999. Reportedly on 12/29/1999, the patient''s upper arm was red, hot, and had a swollen area the size of a baseball. The pt reportedly self treated with ibuprofen and Benadryl cream. From additional correspondence received on 1/28/2000, it was reported that the pt recovered from this experience.

VAERS ID:163334 (history)  Vaccinated:1999-12-28
Age:10.0  Onset:1999-12-29, Days after vaccination: 1
Gender:Female  Submitted:2000-01-18, Days after onset: 20
Location:North Carolina  Entered:2000-11-14, Days after submission: 301
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: generalized pain; headache; lethargy;Hep B (Engerix-B);1;0;In Patient
Other Medications: Naprosyn
Current Illness:
Preexisting Conditions: Allergic to sulfa; Juvenile Rheumatoid Arthritis
Diagnostic Lab Data:
CDC Split Type: 20000012861
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3078A21IMLA
Administered by: Other     Purchased by: Other
Symptoms: Headache, Lethargy, Pain
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)
Write-up: One day post vax, the pt experienced headache, lethargy and generalized pain. These adverse events lasted a couple of weeks. One day after receiving the second dose of Engerix B the pt again experienced headache, lethargy and generalized pain. She was treated with Tylenol with uncertain effect. Engerix B is discontinued at present. The most recent information received reports the condition of the pt is ongoing.

VAERS ID:166536 (history)  Vaccinated:1999-12-28
Age:21.0  Onset:1999-12-30, Days after vaccination: 2
Gender:Female  Submitted:2000-06-27, Days after onset: 179
Location:Pennsylvania  Entered:2001-03-05, Days after submission: 251
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ0779728JAN2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (ACETONE INACTIVATED DRIED)PFIZER/WYETH49987062 SC 
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Two days post vax, she developed an injection site reaction with induration, the injection site reaction affected a 12-cm area.

VAERS ID:167670 (history)  Vaccinated:1999-12-28
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2001-03-07
Location:Arkansas  Entered:2001-03-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES00121600
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: 0     Purchased by: 0
Symptoms: Fatigue, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Physician reports post vaccine pt developed a rash on her back that recurred from time to time over the last 5 months, subsequently the pt experienced fatigue. F/U no additional info was reported.

VAERS ID:238057 (history)  Vaccinated:1999-12-28
Age:5.0  Onset:2004-04-13, Days after vaccination: 1568
Gender:Male  Submitted:2005-05-16, Days after onset: 398
Location:Unknown  Entered:2005-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0404USA02278
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Skin ulcer
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a health professional concerning a 5 year old male who on 28Dec99 was vaccinated SC with a 0.5ml dose of varicella virus vaccine live. There was no concomitant medication. On 13Apr04 the pt experienced 8-10 lesions on the trunk and was seen in the office. No treatment was required. No product quality complaint was involved. Additional information has been requested.

VAERS ID:347650 (history)  Vaccinated:1999-12-28
Age:10.0  Onset:2008-07-01, Days after vaccination: 3108
Gender:Unknown  Submitted:2009-05-15, Days after onset: 318
Location:Pennsylvania  Entered:2009-05-21, 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: Unknown
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0808USA04415
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a nurse concerning a 10 year old patient with allergy to unspecified medication who on 28-Dec-1999 was vaccinated with the first dose of VARIVAX (Oka/Merck). In July 2008, the patient had a full blown chicken pox. On an unspecified date the patient recovered from a full blown chicken pox. The patient sought medical attention and saw the physician. Additional information has been requested.

VAERS ID:152227 (history)  Vaccinated:1999-12-28
Age:60.0  Onset:0000-00-00
Gender:Male  Submitted:2000-05-19
Location:Foreign  Entered:2000-05-23, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pulmicort, Serevent, Zyrtec.
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: VR 1.0 eg, VL 0.5 eg pressure. PRL 19/25 pressure right eye. 5 days later: VR 0.8 eg, LR1 0.8. PRL 14/17.
CDC Split Type: WAES00051078
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Infection, Intraocular pressure increased, Laboratory test abnormal, Pyrexia, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (narrow), Lens disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a health authority concerning a 60 year old male, who was vaccinated on 12/28/1999 with pneumococcal vaccine 23 polyvalent. In December, 1999 the pt experienced fever and increased intraocular pressure. The increased pressure in his eyes caused blurred vision. He was seen in a dept of ophthalmology where he previously had been investigated concerning glaucoma heredity with a somewhat higher pressure in his left eye. He was hospitalized. There were some signs of eye infection. The pt recovered without sequelae. The reporter felt the fever was probably related to vaccination, however, the relationship between intraocular pressure and the vaccine was unclassifiable. No further information is available.

VAERS ID:133024 (history)  Vaccinated:1999-12-29
Age:1.7  Onset:1999-12-29, Days after vaccination: 0
Gender:Male  Submitted:1999-12-29, Days after onset: 0
Location:Wyoming  Entered:2000-01-05, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4643062IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES099258302IMLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.N04912SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0548J0SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1359J0IMLL
Administered by: Public     Purchased by: Other
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Notified by ER nurse, child had seizure after vaccination.

VAERS ID:133247 (history)  Vaccinated:1999-12-29
Age:36.0  Onset:1999-12-30, Days after vaccination: 1
Gender:Female  Submitted:2000-01-03, Days after onset: 4
Location:California  Entered:2000-01-12, Days after submission: 9
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: No allergies. Obese
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES466550 IMLA
Administered by: Public     Purchased by: Unknown
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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: TD given 12/29. Pt noted swelling, redness, tenderness at site of inject. L upper arm mild itching. Inflamation inc in size 15x12 cm on 4th day.

VAERS ID:133316 (history)  Vaccinated:1999-12-29
Age:1.0  Onset:1999-12-29, Days after vaccination: 0
Gender:Unknown  Submitted:2000-01-03, Days after onset: 5
Location:Massachusetts  Entered:2000-01-20, Days after submission: 17
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: Multiple food allergies
Diagnostic Lab Data: HR-155, RR-36, O2 Sat-99%/RA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0008BA3IMLA
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS441008A3IMRL
Administered by: Private     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Returned within 30 min, mother stated "she is breaking out all over". Pt had servere hives all over torso and spreading up to neck & ears. Tx''d w/Epinephrine. Mother stated that she had already given Benadryl in the car. Excellent results.

VAERS ID:133393 (history)  Vaccinated:1999-12-29
Age:44.0  Onset:2000-01-08, Days after vaccination: 10
Gender:Female  Submitted:2000-01-10, Days after onset: 2
Location:Connecticut  Entered:2000-01-20, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Negative for rubella, titer 11/30/99
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1258J0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Lymphadenopathy, Pharyngitis, Pyrexia, Rash maculo-papular, Rhinitis
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: Fever, swollen tonsills, submandibular and post occiptal glands. Sore throat, nasal congestion, rash-papular face, chest hands, and arms.

VAERS ID:133443 (history)  Vaccinated:1999-12-29
Age:50.0  Onset:1999-12-31, Days after vaccination: 2
Gender:Female  Submitted:2000-01-10, Days after onset: 10
Location:Colorado  Entered:2000-02-01, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Serevent, Azmacort, Accolate, flexoril, Balan, Lipitor
Current Illness: NA
Preexisting Conditions: All: ASA, NSAIDS, Marcrolydes, Dx Asthma, palpatations, fibromyalgia, Episodic HTN, Inc lipids.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1077J0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Hypokinesia, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Muscle pain in affected arm. Pain inc with weight bearing, extension, pushing, pulling. Pain onset began with injection.

VAERS ID:133660 (history)  Vaccinated:1999-12-29
Age:0.5  Onset:1999-12-30, Days after vaccination: 1
Gender:Male  Submitted:2000-01-14, Days after onset: 15
Location:Texas  Entered:2000-02-03, Days after submission: 20
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: EEG within normal limits
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES9296002IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0994J2IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESN1195AA2IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0805A2PO 
Administered by: Private     Purchased by: Public
Symptoms: Convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Temperature of 100 and tonic-clonic seizure.

VAERS ID:133719 (history)  Vaccinated:1999-12-29
Age:15.0  Onset:1999-12-29, Days after vaccination: 0
Gender:Male  Submitted:2000-01-05, Days after onset: 7
Location:Kansas  Entered:2000-02-03, Days after submission: 29
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: Asthma
Diagnostic Lab Data: Blood work, no results yet
CDC Split Type: KS200001
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1795H1SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES40010AA4IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Face oedema, Hypertension, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Difficulty breathing, referred to ER. Mother reported in ER that pt broke out in hives and face is swelling. Mother thought pts blood pressure was elevated, but not sure. Tx was 2 shots, mother said pt felt better. 1

VAERS ID:133795 (history)  Vaccinated:1999-12-29
Age:1.4  Onset:2000-01-06, Days after vaccination: 8
Gender:Female  Submitted:2000-01-26, Days after onset: 20
Location:Hawaii  Entered:2000-02-08, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zantac,Beclonase, Atrovent, Albuterol, O2, Vitamin E
Current Illness: NONE
Preexisting Conditions: Bilateral Pulmonary Dysplasia, Short Gut Syndrome, Enterocollitis
Diagnostic Lab Data: X-rays, Blood cultures, CBC''s
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pharyngitis, Pneumonia, Pyrexia
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt had URI symptoms & fever 105 (ax). Tx''d w/Nebs, A Vent, Atrovent, O2, CPT, Tylenol, Rocephin inj. 2nd vax 12/29/99, had resp. sx''s, 1/6/00, resulted in Viral Pnuemonia, requiring hospital stay.

VAERS ID:133925 (history)  Vaccinated:1999-12-29
Age:0.4  Onset:1999-12-30, Days after vaccination: 1
Gender:Female  Submitted:2000-01-03, Days after onset: 4
Location:Idaho  Entered:2000-02-15, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UA, CBC-both nml and WBC-4.2
CDC Split Type: ID00001
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4643021IMRL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3024A21IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISS20313A1IMLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P016721 LL
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever at home 103(R), in office 101.4(R), rash all over body, noticed by mom in AM of 12/30/99. Called office in afternoon & child brought in by mom.

VAERS ID:133442 (history)  Vaccinated:1999-12-29
Age:  Onset:1999-12-29, Days after vaccination: 0
Gender:Female  Submitted:1999-12-29, Days after onset: 0
Location:Illinois  Entered:2000-02-22, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TB skin test
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4546150IM 
Administered by: Private     Purchased by: Unknown
Symptoms: Hypokinesia, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: C/o left hand swelling and pain and unable to use L arm since injection.

VAERS ID:134384 (history)  Vaccinated:1999-12-29
Age:22.0  Onset:1999-12-29, Days after vaccination: 0
Gender:Female  Submitted:2000-02-15, Days after onset: 48
Location:Iowa  Entered:2000-02-29, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM596C60IM 
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU20010AA0IM 
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUA088AA0SC 
Administered by: Other     Purchased by: Other
Symptoms: Anxiety, Asthma, Dyspnoea, Infection
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: 8 hrs post/vaxs, pt had an

VAERS ID:154741 (history)  Vaccinated:1999-12-29
Age:1.5  Onset:1999-12-29, Days after vaccination: 0
Gender:Male  Submitted:2000-05-16, Days after onset: 138
Location:West Virginia  Entered:2000-06-19, 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: UNK
Current Illness: nasal discharge
Preexisting Conditions: Amoxicillin allergy
Diagnostic Lab Data:
CDC Split Type: WAES00010139
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1353J0SC 
Administered by: Private     Purchased by: Private
Symptoms: Infection
SMQs:
Write-up: Pt developed a few pox; a total of 12 lesions, but did not blister and scab. The pt sought unspecified medical attention. Follow-up information from a LPN indicated that the pt fully recovered.

VAERS ID:162369 (history)  Vaccinated:1999-12-29
Age:18.0  Onset:1999-12-29, Days after vaccination: 0
Gender:Male  Submitted:2000-01-24, Days after onset: 26
Location:Ohio  Entered:2000-10-13, Days after submission: 262
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD/Tubersol 5 TU/Aventis Pasteur Ltd/250211
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U1999011360
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0160AA IM 
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Dizziness, Dysphonia
SMQs:, Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: It was reported that an 18 year old male received a Fluzone SV ''99-''00 vaccination as well as a PPD-Tubersol skin test on 12/29/99. Approx. 5 hours, post vax, the pt developed dizziness. In the morning of 12/30/99, the pt developed heaviness in chest and a hoarse voice. Pt denies any difficulty breathing. From correspondence received on 1/17/00, additional pt and responsible physician information was provided.

VAERS ID:163346 (history)  Vaccinated:1999-12-29
Age:29.0  Onset:1999-12-29, Days after vaccination: 0
Gender:Male  Submitted:2000-02-15, Days after onset: 48
Location:Iowa  Entered:2000-11-14, Days after submission: 273
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bactrim (Sulfamethoxazole / Trimethop) 12/31/1999
Current Illness:
Preexisting Conditions: Dysuria
Diagnostic Lab Data:
CDC Split Type: 20000041401
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2958A20IM 
Administered by: Other     Purchased by: Other
Symptoms: Dysuria, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case reference number 2000004140-1, is a spontaneous report from a physician referring to a 29 year old male. Allergies are unspecified. The patient has dysuria and received Bactrim starting on 12/31/99. On 12/29/99, the patient, received his first IM dose of Engerix-B for Prophylaxis of Hepatitis B. Post vaccination, on 12/29/99, the patient experienced urticaria. He was seen in the ER twice over a three day period. Then the patient was treated with Benadryl and IM Depo-Medrol 80 mg. Engerix-B was discontinued. Symptoms resolved over "several" days. The most recent information, received on 2/8/00, reports the condition of the patient as resolved.

VAERS ID:166132 (history)  Vaccinated:1999-12-29
Age:  Onset:0000-00-00
Gender:Male  Submitted:2000-07-20
Location:Maryland  Entered:2001-02-22, Days after submission: 217
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: Skin disorder NOS
Diagnostic Lab Data: UNK
CDC Split Type: HQ1730722MAR2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A nurse reported that an adult male received an injection of Tetanus Toxoid Adsorbed, Ultrafined on 12/29/99. The pt subsequently, developed welts with itching on his chest and his hands extending to his elbows. He was treated with prednisone and diphenhydramine. The welts and itching persisted as of 3/13/00.

VAERS ID:166535 (history)  Vaccinated:1999-12-29
Age:  Onset:0000-00-00
Gender:Female  Submitted:2000-07-14
Location:Iowa  Entered:2001-03-05, Days after submission: 234
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ0564518JAN2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM541A60IMRA
TTOX: TETANUS TOXOID (NO BRAND NAME)LEDERLE LABORATORIES4586020IMLA
TYP: TYPHOID VI POLYSACCHARIDE (ACETONE INACTIVATED DRIED)PFIZER/WYETH 0SCLA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUA065AA0SCRA
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The pt developed pain in her left deltoid.

VAERS ID:197039 (history)  Vaccinated:1999-12-29
Age:41.0  Onset:1999-12-29, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Kansas  Entered:2003-01-31
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pain left hip and leg
Preexisting Conditions: Depression, left hip and leg pains S/P pain shot 9/99
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0241 RA
Administered by: Military     Purchased by: Military
Symptoms: Balance disorder, Erythema, Insomnia, Joint stiffness, Oedema peripheral, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Stiffness in joints, knees, ankles, wrists swelling especially right wrist. Back swelling and insomnia. Migratory swelling, redness. Pt also experience loss of balance. Annual follow up on 03/08/04: "Pt has not recovered from adverse events. Pain and swelling both knees, right wrist surgery, pain migratory swelling and redness, fingers, toes, ankles. Insomnia left hip pain, trocurtric bursitis, stomach ulcers, skin rashes, migraines. My whole life has been turned upside down. I''m going through a medical board to be discharged from my work I need to be compensated for my pain and suffering. 4/19/03: I just had an episode here is the report. I sent 5 envelopes of documented medical problems stemming from the shot.

VAERS ID:221783 (history)  Vaccinated:1999-12-29
Age:4.0  Onset:2003-12-18, Days after vaccination: 1450
Gender:Male  Submitted:2004-05-14, Days after onset: 147
Location:Connecticut  Entered:2004-05-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Concurrent conditions: Developmental delay.
Diagnostic Lab Data:
CDC Split Type: WAES0401USA01395
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.631772/1031J0SC 
Administered by: Private     Purchased by: Public
Symptoms: Drug ineffective, Infection, Pruritus, Pyrexia, Rash vesicular, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a licensed practical nurse concerning a 4 year old male with developmental delay and no known allergies who on 29-Dec-1999 was vaccinated with a first dose of varicella virus vaccine live (lt #631772/1031K), subcutaneously in the left arm. There was no concomitant medication or illness at the time of vaccination. On 19-Dec-2003 the patient was seen after developing less than 50 lesions on his trunk the day before, on 18-Dec-2003, with itching and a fever. It was also reported that on 18-Dec-2003 the patient developed a "spare papular vesicular rash on trunk, itchy." The patient reportedly had breakthrough chicken pox. The patient was prescribed acetaminophen (Tylenol) or oatmeal baths as needed. Subsequently, the patient recovered from breakthrough chicken pox. There were no relevant diagnostic or laboratory tests. There was no product quality complaint involved. No further information is expected.

VAERS ID:274419 (history)  Vaccinated:1999-12-29
Age:0.2  Onset:1999-12-29, Days after vaccination: 0
Gender:Male  Submitted:2007-03-20, Days after onset: 2637
Location:Texas  Entered:2007-03-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: inflamed red, hot leg~DTaP+IPV+HepB+Hib (Hexavax)~~0~In Patient
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: Patient is now 7 and is facing a myriad of challenges. He developed language late and we sought speech therapy to bring that along. His muscle tone and coordination are low. He has been diagnosed with ADHD- Inattentive type, dysgraphia,
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURERU0A15CA  UN
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER1523J  UN
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURERUA486AA  UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURERP0823  UN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Attention deficit/hyperactivity disorder, Autism spectrum disorder, Coordination abnormal, Crying, Dysgraphia, Dyslexia, Fatigue, Hypotonia, Injection site erythema, Injection site inflammation, Injection site reaction, Speech disorder developmental
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: The night that patient received his first round of vaccinations he screamed for 4 hours straight- inconsolable. I called the emergency room that evening and they told me that if he continued to cry for more than 4 hours to bring him in. He stopped at 4 hours- exhausted. During his next round of shots (4 months)his leg became so red and inflamed that we took him to the emergency room. We were told this was a site reaction. Patient is now 7 and is facing a myriad of challenges. He developed language late and we sought speech therapy to bring that along. His muscle tone and coordination are low. He has been diagnosed with ADHD- Inattentive type, dysgraphia, dyslexia and PDD NOS (autistic spectrum).

VAERS ID:347648 (history)  Vaccinated:1999-12-29
Age:14.0  Onset:2008-06-18, Days after vaccination: 3094
Gender:Unknown  Submitted:2009-05-15, Days after onset: 331
Location:Pennsylvania  Entered:2009-05-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0808USA04413
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a nurse concerning a 14 year old patient with allergy to unspecified medication who on 12-DEC-1999 was vaccinated with the first dose of VARIVAX (Oka/Merck). On 18-JUN-2008( also reported on 18-AUG-2008) the patient had a full blown chicken pox. On an unspecified date the patient recovered from a full blown chicken pox. The patient sought medical attention and saw the physician. Additional information has been requested.

VAERS ID:133198 (history)  Vaccinated:1999-12-30
Age:10.0  Onset:1999-12-30, Days after vaccination: 0
Gender:Female  Submitted:1999-12-30, Days after onset: 0
Location:Mississippi  Entered:2000-01-11, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NOINE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MS99053
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1023J0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0718J0SCLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5 minutes post vax, c/o itching at inject site, redness noted surrounding site, involved 3/4 of area of upper arm. Raised area at inject site.

VAERS ID:133229 (history)  Vaccinated:1999-12-30
Age:  Onset:2000-01-01, Days after vaccination: 2
Gender:Male  Submitted:2000-01-07, Days after onset: 6
Location:New York  Entered:2000-01-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: amoxicillin
Current Illness: otic infection
Preexisting Conditions: Otic infection
Diagnostic Lab Data: cultures negative for meningococcemia;lymphocytes-69; hemoglobin-13.6; RBC-4.92; platelet-438
CDC Split Type: WAES00010104
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Ecchymosis, Haemolysis, Lymphocytosis, Otitis media, Petechiae, Purpura, Red blood cell abnormality, Thrombocythaemia, Vasodilatation
SMQs:, Haemolytic disorders (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 12/30/99:Pt recv''d MMR vax.On 1/1/00:Pt developed facial flushing,petechia & purpura on the face,chest,neck,& upper arms.Pt was hospitalized & tx w/ IV antibiotics.It was noted that the purpura started to fade & areas looked bruised. 60 day follow-up received on 10/25/00 states the pt has recovered.

VAERS ID:133503 (history)  Vaccinated:1999-12-30
Age:48.0  Onset:0000-00-00
Gender:Female  Submitted:2000-01-04
Location:California  Entered:2000-02-01, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESV0061AA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: L upper arm w/ lg area erythema and discomfort. Episode of fever at home.

VAERS ID:133811 (history)  Vaccinated:1999-12-30
Age:3.3  Onset:2000-01-01, Days after vaccination: 2
Gender:Female  Submitted:2000-01-06, Days after onset: 5
Location:Iowa  Entered:2000-02-08, Days after submission: 33
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: NONE
CDC Split Type: IA00004
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU00465C3IM 
Administered by: Private     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Child developed a rash on hands & face on 1/1/00. Per call to ER, she was advised to give Benadryl & rash disappeared but was visable again on 1/3, this time more noticable. Mom called child''s MD, told to give Benadryl; no more problems.

VAERS ID:133880 (history)  Vaccinated:1999-12-30
Age:1.4  Onset:2000-01-02, Days after vaccination: 3
Gender:Male  Submitted:2000-02-06, Days after onset: 35
Location:Pennsylvania  Entered:2000-02-11, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hx of recurrent otitis media and slightly dilated kidney at birth.
Diagnostic Lab Data: MRI, Labs involving specimen of L/thigh revealed mononucleic cells
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 2IM 
HIBV: HIB (HIBTITER)PFIZER/WYETH530453A2IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1087J0SCLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abscess, Agitation, Cellulitis, Debridement, Hypokinesia, Laboratory test, Nuclear magnetic resonance imaging, Oedema peripheral, Pyrexia, Weight bearing difficulty
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Unable to move or use left leg for 1 month. Swollen L/thigh/leg. Unable to move or bear weight for some time. Pt developed fever and was agitated. Pt taken to ER and admitted for 1 week had 2 surgeries for extensive thigh abscess, still unable to bear wt on leg. Follow-up: 02/11/00 1320 - 1st attempt to reach reporter - Message left on answering machine requesting call back. 2/14/00 910- Spoke to reporter who had sent a signed consent form with VAERS report. Letter and consent form sent to hospital. Diagnosis according to reporter was cellulitis - debrided x 2. Child admitted to hospital 1/9/00 and treated with antibiotics - He is still unable to bear weight on L leg - will be having physical therapy start after F/u MRI. Other missing info (13) - MMR #1 Merck 1087J - L thigh. HIB #3 - Lederle - 530453A L thigh - Child did not receive Hep B #3 according to nurse in DR office where vaccines were administered. (14) - No other vaccines given within 4 weeks prior.

VAERS ID:133920 (history)  Vaccinated:1999-12-30
Age:1.3  Onset:1999-12-31, Days after vaccination: 1
Gender:Male  Submitted:2000-01-04, Days after onset: 4
Location:Georgia  Entered:2000-02-15, Days after submission: 42
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: GA00001
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAMA910A23IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1617H2IMLL
Administered by: Public     Purchased by: Public
Symptoms: Oedema peripheral, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling from hip to knee. Red also. Resolved w/in 48 hrs.

VAERS ID:133439 (history)  Vaccinated:1999-12-30
Age:7.0  Onset:2000-01-07, Days after vaccination: 8
Gender:Male  Submitted:2000-01-13, Days after onset: 6
Location:Michigan  Entered:2000-02-29, Days after submission: 47
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
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1017J0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Infection, Pyrexia, Skin ulcer
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 12/30/99 Pt rcv''d varivax 1 day post borhter presented w/ varicella lesions. 1/7/00 Pt exp varicella leisons (approx 500), temp of 102. Lesions remained until 1/12/00.

VAERS ID:150009 (history)  Vaccinated:1999-12-30
Age:38.0  Onset:2000-02-10, Days after vaccination: 42
Gender:Male  Submitted:2000-02-25, Days after onset: 15
Location:Massachusetts  Entered:2000-03-13, Days after submission: 17
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: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0373SCLA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Arthropathy, Oedema, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Approximately 5 weeks post vax, left thumb began to "pop" when bending at middle joint. Approximately 1 week later the sensation of swelling was felt (not at site) in thumb and fingers. This sensation is mild during the morning, but worsens as the day progresses. Within several days, the pt began experiencing aches in left elbow with shoulder joint 2 days later. Pt has experienced pain in right foot, mainly in joints of 1st two toes beginning with big toe. All symptoms remain today. No treatment received.

VAERS ID:150070 (history)  Vaccinated:1999-12-30
Age:0.2  Onset:1999-12-30, Days after vaccination: 0
Gender:Female  Submitted:2000-03-02, Days after onset: 63
Location:Montana  Entered:2000-03-14, 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:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4643020IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0827J0IMLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.N082620SCLL
Administered by: Public     Purchased by: Public
Symptoms: Decreased appetite, Erythema, Pain, Screaming, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3 hours post vax, pt developed swelling in both legs, soreness and redness especially in left thigh. Infant cried and screamed, fell asleep for brief periods of time but essentially inconsolable, and pt also experienced decrease in appetite. No fever was noted but pt was taking Tylenol.

VAERS ID:151816 (history)  Vaccinated:1999-12-30
Age:56.0  Onset:1999-12-30, Days after vaccination: 0
Gender:Male  Submitted:2000-04-21, Days after onset: 112
Location:Virginia  Entered:2000-05-10, Days after submission: 19
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: 20000001161
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: On 12/30/99, the pt received his first IM-left deltoid dose of Lymerix. A few hours later on 12/30/99, the pt experienced injection site soreness and a tingling prickly sensation on his whole body. An MD visit was required and anti-inflammatories were prescribed. The symptoms lasted a few days and then subsided. However they reoccurred and persist. The most information received on 1/5/00 report the condition of the pt is ongoing.

VAERS ID:154760 (history)  Vaccinated:1999-12-30
Age:10.0  Onset:2000-01-03, Days after vaccination: 4
Gender:Male  Submitted:2000-05-16, Days after onset: 133
Location:Florida  Entered:2000-06-19, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: asthma; varicella exposure
Diagnostic Lab Data: specimen for a papular lesion was inadequate
CDC Split Type: WAES00010425
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1017J0SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection, Laboratory test abnormal, Pyrexia, Skin ulcer
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt developed generalized lesions with increased clusters at the site of vaccination and a fever. Pt was diagnosed with chickenpox. Pt was hospitalized for 7 days for IV acyclovir therapy.

VAERS ID:155666 (history)  Vaccinated:1999-12-30
Age:35.0  Onset:1999-12-30, Days after vaccination: 0
Gender:Female  Submitted:2000-02-02, Days after onset: 34
Location:Virginia  Entered:2000-06-28, Days after submission: 146
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zomig PRN, Bactrin PRN
Current Illness: NONE
Preexisting Conditions: Menstrual migraines, recurrent cystitis, anemia, history of fainting with injections.
Diagnostic Lab Data: CT head - nml, CXR - nml, OBC - nothing overly concerning, CH7 - nml.
CDC Split Type: U2000000020
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0012AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Muscle rigidity, Tetany
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow)
Write-up: The same day post vax, this pt experienced acute tetany, and her whole body went ridged. The pt was sent to the ER. As of 01/31/00, the pt had recovered.

VAERS ID:168449 (history)  Vaccinated:1999-12-30
Age:1.3  Onset:1999-12-30, Days after vaccination: 0
Gender:Male  Submitted:2001-02-21, Days after onset: 419
Location:Oklahoma  Entered:2001-04-10, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: OK0110
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESP0971A4 (A)3IMLA
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESP0971A4 (B)3IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0541J0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Cyanosis, Dyspnoea, Hypersensitivity, Hypoxia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mom noted whelps, 10 minutes, post vax, and went to the hospital where Grandma worked. When he arrived at hospital his lips were blue and SA O2 reading was 89%. Grandma took him to the clinic immediately, where the pt began to experience SOB. Epinephrine was given in doctor''s office and child was admitted to the hospital for 24 hours and Benadryl for the next week. Diagnosed with allergic reaction to MMR Vaccine

VAERS ID:184571 (history)  Vaccinated:1999-12-30
Age:1.3  Onset:1999-12-30, Days after vaccination: 0
Gender:Male  Submitted:2002-05-06, Days after onset: 857
Location:Oregon  Entered:2002-05-15, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cold
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURU0056FA3IMLA
HIBV: HIB (ACTHIB)AVENTIS PASTEURUA470AB3IMLA
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURP04242SCRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1084S0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1352T0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Abnormal behaviour, Aggression, Aphasia, Autism, Emotional disorder, Neurodevelopmental disorder, Pyrexia, Screaming
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever after vaccinations; up screaming all night. Stopped talking and became mute was speaking at least 20 words and lost all of them. He started biting his hands and banging his head, spinning and wanting to be by himself. Autism was also dx''d with pervasive developmental disorder.

VAERS ID:238335 (history)  Vaccinated:1999-12-30
Age:1.1  Onset:2004-06-23, Days after vaccination: 1637
Gender:Female  Submitted:2005-05-16, Days after onset: 327
Location:Massachusetts  Entered:2005-05-27, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES 0406USA02213
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0444J SC 
Administered by: Private     Purchased by: Public
Symptoms: Drug ineffective, Viral infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from an RN concerning a 5 year old female with no pre existing allergies, birth defects, or medical conditions who on 12/30/99 was vaccinated SQ with a 1st dose of varicella virus vaccine live. At the time of vaccination the pt has resolving OM and was being treated with amoxicillin. On 06/23/2004, the pt was brought to the physicians office with a rash that had developed that morning. Upon exam, the physician believed the rash to be caused by varicella. There were 13 lesions located about the groin, back, and trunk and a few more may be developing. No evidence of URI, cough or fever was present. No specific Tx was indicated. No product quality complaint was involved. There were no adverse events following prior vacciantions of the pt or siblings. Follow up information received from a RN indicated that on 06/23/2004. the child was seen in the office with scattered lesions appearing over the course of the morning. There was no evidence of an URI, fever or cough. Tx included symptomatic relief and standard varicella precautions. The outcome was reported as recovered. No additonal information is expected.

VAERS ID:315547 (history)  Vaccinated:1999-12-30
Age:1.3  Onset:2007-04-15, Days after vaccination: 2663
Gender:Male  Submitted:2008-05-16, Days after onset: 397
Location:Ohio  Entered:2008-05-23, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA03490
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Private     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a physician concerning an 8 year old male who on 30-DEC-1999, when he was 15 months old was vaccinated with a dose of varicella virus vaccine live (Oka/Merck). "Recently," in April 2007 the patient developed a breakthrough of chickenpox with approximately 25 lesions. Unspecified medical attention was sought. A product quality complaint was not involved. Additional information has been received from a physician who reported that on 15-APR-2007 the patient was seen in the physician''s office and had developed a breakthrough of chickenpox. The patient had recovered from chickenpox after 1 week. No further information is expected.

VAERS ID:476832 (history)  Vaccinated:1999-12-30
Age:1.1  Onset:0000-00-00
Gender:Female  Submitted:2012-10-30
Location:New York  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data: 2010, Varicella virus test, equivocal
CDC Split Type: WAES1210USA009265
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0UNUN
Administered by: Private     Purchased by: Other
Symptoms: Antibody test negative, Herpes zoster, Scab, Varicella virus test
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 8 years old female patient with seasonal asthma. The patient was vaccinated with the first dose of (Merck) VARIVAX (lot# unspecified) on 30-DEC-1999 with no concomitant medications. No other co-suspects were reported. On 08-AUG-2007 the patient was diagnosed with shingles. It was noted by physician that the patient had a patch on the forehead. There is no documented culture that was done to confirm the diagnosis of shingles. The patient was treated with acyclovir (800 mg, 4 times a day for 5 days). The patient had a follow up office visit to physician on 10-AUG-2007 and the notes stated the patch was drying up and scabbing, improving and the patient was to be using NEOSPORIN. In approximately 2010, the patient had a titer done at age 12 and the results were equivocal. The outcome of the events was reported as recovered. No lab test was performed. Additional information has been requested.

VAERS ID:134581 (history)  Vaccinated:1999-12-30
Age:0.5  Onset:1999-12-30, Days after vaccination: 0
Gender:Male  Submitted:2000-03-02, Days after onset: 63
Location:Foreign  Entered:2000-03-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No relevant medical history.
Diagnostic Lab Data:
CDC Split Type: 20000055792
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (NO BRAND NAME)UNKNOWN MANUFACTURER 1IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER  SC 
Administered by: Other     Purchased by: Other
Symptoms: Agitation, Cough, Crying, Dermatitis bullous, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Same day post vax, pt devel vesicular rash, cough, pyrexia and was screaming. Hospitalized overnight for events. All vax rcv''d are suspect.

VAERS ID:158996 (history)  Vaccinated:1999-12-30
Age:  Onset:2000-01-16, Days after vaccination: 17
Gender:Unknown  Submitted:2000-08-17, Days after onset: 213
Location:Foreign  Entered:2000-08-21, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 20000242041
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER  SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Meningitis
SMQs:, Lack of efficacy/effect (narrow), Noninfectious meningitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 17 days post vax, the vaccinee experienced a vaccine failure and developed group C meningococcal meningitis.

VAERS ID:154792 (history)  Vaccinated:1999-12-31
Age:38.0  Onset:2000-01-03, Days after vaccination: 3
Gender:Female  Submitted:2000-05-16, Days after onset: 133
Location:New Jersey  Entered:2000-06-20, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: ache; low grade fever
Preexisting Conditions: Septra allergy, ampicillin allergy, sulfa allergy
Diagnostic Lab Data:
CDC Split Type: WAES00010913
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0728J0SC 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Infection, Paraesthesia, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Three days post vax, pt started to break out in chickenpox. The pt was covered with itchy, pus filled chickenpox on her whole torso, shoulders, face, scalp; she had a tingling, prickly sensation. Information from the physician indicated that the pt developed a widespread pruritic vesicular rash.

VAERS ID:165175 (history)  Vaccinated:1999-12-31
Age:  Onset:2000-03-01, Days after vaccination: 61
Gender:Male  Submitted:2001-01-17, Days after onset: 322
Location:New York  Entered:2001-01-24, 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: NONE
Preexisting Conditions: joint pain in right shoulder
Diagnostic Lab Data: ANA - pos, rheumatoid factor - neg
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Chest pain, Dyspnoea, Fatigue, Joint swelling, Neck pain, Ocular hyperaemia, Oedema peripheral, Pain in extremity, Pharyngeal oedema, Pleurisy, Tremor
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: The pt experienced fatigue swollen hands, wrist and feet pain, low grade fever, night sweats, difficulty breathing, neck pain, hand tremor, bloodshot eyes, pleuritis, Treated with Doxycycline for 10 days prednisone, Prevacid, Voltaren and Ultram). the pt also experienced chest pain, and a restrictive feeling in throat.

VAERS ID:133435 (history)  Vaccinated:2000-01-01
Age:54.0  Onset:2000-01-01, Days after vaccination: 0
Gender:Male  Submitted:2000-01-11, Days after onset: 10
Location:Michigan  Entered:2000-02-01, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: glucophage
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0310  
Administered by: Military     Purchased by: Unknown
Symptoms: Pain
SMQs:
Write-up: Shortly after vaccination, entire arm was very sore. Soreness ended, however the arm is very sensative to any pressure and has been for 3+ days. If you roll on it sleeping, it will wake you up.

VAERS ID:150374 (history)  Vaccinated:2000-01-01
Age:46.0  Onset:2000-01-01, Days after vaccination: 0
Gender:Male  Submitted:2000-03-23, Days after onset: 82
Location:New York  Entered:2000-03-24, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:  Approximately 12/03/1999;LYMERIX;1;46.00;In Patient
Other Medications:
Current Illness: None reported
Preexisting Conditions:
Diagnostic Lab Data: EMG of wrists.
CDC Split Type: 20000078081
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Carpal tunnel syndrome, Cough, Ear disorder, Hypoacusis, Hypoaesthesia, Influenza like illness, Injection site oedema, Pyrexia, Sinusitis, Vision blurred
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Within hours post 2nd vax, pt developed bloody drainage out of Left ear and clear/yellow fluid from right ear. He lost hearing in his left ear one day post vax which lasted approximately 1 month. It began to improve in February but has not returned to normal as of 03/16/00. Pt has been seen by ENT, neurologist, primary physician, and neurosurgeon. Has been treated with Augmentin, ciprofloxacin and another unspecified antibiotic. Has symptoms of carpal tunnel syndrome in wrists. Had reported intermittent blurry vision lasting 2-3 minutes affecting primarily close vision starting in approximately late February, 2000 and is ongoing. Has received steroid injections in wrists as of March. Took ibuprofen 1200 mg/day when symptoms were very bad. This report is considered to be medically serious. Medical confirmation is being sought. Most recent information received 03/16 reports that pt still had cough, sinus problems, wrist pain and decreased hearing in left ear. It is still unknown if he still has pain in hands, fingers, or numbness in his hands and fingers. Flu-like symptoms, fever and swelling at injection site resolved. Blurry vision is ongoing. Follow-up information received on 8/7/00 states that the pt had right ear cerumen, left ear otitis media and slightly decreased hearing, left hand severe pain and numbness, righ thand minimal pain, toes occasional numbness, and some orthostatic symptoms.

VAERS ID:151898 (history)  Vaccinated:2000-01-01
Age:43.0  Onset:2000-02-01, Days after vaccination: 31
Gender:Male  Submitted:2000-04-21, Days after onset: 79
Location:Ohio  Entered:2000-05-12, Days after submission: 21
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: 20000060811
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0  
Administered by: Other     Purchased by: Other
Symptoms: Myalgia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: In 1/00, the pt received his second dose of Lymerix. One month later, in 2/00, the pt experienced myalgias and rash. He was treated with pain medication. The most recent information received on 3/1/00 reports the condition of the pt as ongoing.

VAERS ID:154706 (history)  Vaccinated:2000-01-01
Age:24.0  Onset:2000-02-02, Days after vaccination: 32
Gender:Female  Submitted:2000-05-24, Days after onset: 111
Location:California  Entered:2000-06-19, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00020610
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approximately one month post vax, pt experienced a fine rash on face and buttocks. .

VAERS ID:154708 (history)  Vaccinated:2000-01-01
Age:1.3  Onset:2000-02-02, Days after vaccination: 32
Gender:Male  Submitted:2000-05-24, Days after onset: 111
Location:California  Entered:2000-06-19, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00020956
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approximately one month post vax the pt experienced a fine rash on face and buttocks.

VAERS ID:155730 (history)  Vaccinated:2000-01-01
Age:1.0  Onset:2000-02-08, Days after vaccination: 38
Gender:Female  Submitted:2000-05-16, Days after onset: 97
Location:Indiana  Entered:2000-06-29, Days after submission: 44
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: WAES00020697
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a consumer concerning her 1 year old daughter who in 1/2000 was vaccinated with 1 dose of varicella vaccine. On about 2/8/00, 2 weeks, post vax, the pt developed 20 to 30 pox on her belly. She sought unspecified medical attention. No further information is available.

VAERS ID:162048 (history)  Vaccinated:2000-01-01
Age:  Onset:2000-01-01, Days after vaccination: 0
Gender:Unknown  Submitted:2000-06-21, Days after onset: 171
Location:Indiana  Entered:2000-10-06, Days after submission: 107
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ7534220JUN2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES458582 IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: The pt developed an injection site reactions characterized by redness, swelling and muscle pain radiating down the arm.

VAERS ID:166056 (history)  Vaccinated:2000-01-01
Age:13.0  Onset:2000-04-01, Days after vaccination: 91
Gender:Male  Submitted:2000-04-25, Days after onset: 23
Location:Unknown  Entered:2001-02-21, Days after submission: 302
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ4154122APR2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)LEDERLE LABORATORIES  IM 
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: A pharmacist reported that a 13 year old male received an injection of Tetanus Toxoid Adsorbed, Purogenated. Approximately 6 days post immunization presented to emergency room with a 4cm by 7cm area of redness at the injection site with "central clearing in the middle. On 4/19/2000, the reporter indicated that the redness was resolving.

VAERS ID:172216 (history)  Vaccinated:2000-01-01
Age:33.0  Onset:0000-00-00
Gender:Female  Submitted:2001-05-15
Location:Florida  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Drug abuse
Diagnostic Lab Data: Serum varicella zoster: negative prior to vaccine
CDC Split Type: WAES01030119
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Public     Purchased by: Public
Symptoms: Lymphocytic leukaemia
SMQs:, Malignant tumours (narrow)
Write-up: Information has been received from a physician concerning a patient who in approximately 2000 was vaccinated. According to the physician, "a month or two later" she developed acute lymphocytic leukemia. Additional information has been requested.The physician questioned as to if there was a relationship between varicella virus vaccine live and acute lymphocytic leukemia. The physician also believed that the pt''s experience was disabling. Additional info has been requested.

VAERS ID:221788 (history)  Vaccinated:2000-01-01
Age:  Onset:0000-00-00
Gender:Female  Submitted:2004-05-14
Location:Indiana  Entered:2004-05-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Varicella (Varivax);;;0;In Sibling;;Varicella (Varivax);;;0;In Sibling
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0401USA01511
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Infection
SMQs:
Write-up: Information has been received from a physician concerning her daughter who in January 2000, was vaccinated with a 0.5 mL dose of varicella virus vaccine live. There was no concomitant therapy. The physician reported that her daughter subsequently developed full blown breakthrough varicella. It was unknown if medical attention was sought, but no prescription drug treatment was required. Subsequently, the physician''s daughter recovered. The physician also reported that two of her other children developed mild breakthrough varicella after being vaccinated with varicella virus vaccine live. Additional information has been requested.

VAERS ID:281874 (history)  Vaccinated:2000-01-01
Age:7.0  Onset:2006-12-01, Days after vaccination: 2526
Gender:Male  Submitted:2007-05-16, Days after onset: 165
Location:Unknown  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0701USA01934
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Varicella
SMQs:
Write-up: Information has been received from a physician concerning a 7 year old male who, in 2000, at one year of age, was vaccinated with Varivax. In December of 2006 the patient experienced "breakthrough". The number of lesions was not specified. Unspecified medical attention was sought. There was no product quality complaint. Additional information has been requested.

VAERS ID:282068 (history)  Vaccinated:2000-01-01
Age:10.0  Onset:2007-02-20, Days after vaccination: 2607
Gender:Female  Submitted:2007-05-16, Days after onset: 84
Location:Unknown  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Varicella post vaccine~Varicella (Varivax)~~13~In Sibling|Varicell post vaccine~Varicella (Varivax)~~0~In Sibling
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: temperature measurement 09/??/2006 - low grade fever
CDC Split Type: WAES0703USA00659
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Varicella, Varicella post vaccine
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a registered nurse concerning her 10 year old daughter who in approximately 2000, at three years of age, was vaccinated with varicella virus live (Oka/Merck). On 20-February-2007, the patient developed a mild case of chickenpox, with less than 50 lesions and no fever at that time. Unspecified medical attention was sought. The nurse reported that chicken pox was going around at the local school. There was no product quality complaint. It was also noted that the patient''s two sisters developed an adverse event after vaccination with varicella virus vaccine live (Oka/Merck) (WAES#0702USA04089 and WAES#0703USA06659). Additional information has been requested.

VAERS ID:282500 (history)  Vaccinated:2000-01-01
Age:  Onset:2006-01-01, Days after vaccination: 2192
Gender:Male  Submitted:2007-05-16, Days after onset: 499
Location:Unknown  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: The subject''s medical history, concurrent conditions, and concurrent medications were not reported.
Diagnostic Lab Data: The mother of the subject reported on 06 October 2006 that she was, "awaiting verification of lab results."
CDC Split Type: A0622802A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSSKB917A2 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Laboratory test, Pertussis
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This case was reported by an consumer and described the occurrence of possible pertussis in a male child who was vaccinated with diphtheria and tetanus toxoids and acellular pertussis vaccine adsorbed (Infanrix, GlaxoSmithKline for prophylaxis. The reported is the mother of the subject. A physician or other health care professional has not verified this report. On an unspecified date in 2000 the subject received a dose of Infanrix (dose number not reported). On an unspecified date in 2006 on or before 06 October 2006, 6 years after vaccination with Infanrix, the subject experienced a possible pertussis infection and lack of effect. The subject was seen at a physician''s office. The mother of the subject reported on 06 October 2006 that she was, "awaiting verification of lab results." The outcome of the event was not reported. Follow-up will not be available.

VAERS ID:338457 (history)  Vaccinated:2000-01-01
Age:48.0  Onset:0000-00-00
Gender:Female  Submitted:2009-01-28
Location:Pennsylvania  Entered:2009-01-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafaxine hydrochloride; Alprazolam; Clonazepam
Current Illness: Unknown
Preexisting Conditions: Anxiety; Automobile accident; Depression; Whiplash injury. The subject''s medical history, concurrent conditions and concurrent medications were not reported.
Diagnostic Lab Data: 13 October 2000: Brain MRI ATTN IAC''s with and without contrast: Revealed no gross abnormality within the IAC/CPA regions; Also no abnormality of the remainder of the brain parenchyma. 16 July 2003: Lyme IgG Blot was negative. 18 August 200
CDC Split Type: A0599585A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain lower, Activities of daily living impaired, Anxiety, Arthralgia, Borrelia burgdorferi serology positive, Condition aggravated, Coordination abnormal, Deafness, Dizziness, Fatigue, Gastrooesophageal reflux disease, Headache, Immunology test, Influenza like illness, Joint swelling, Nerve injury, Nuclear magnetic resonance imaging brain normal, Pain, Paraesthesia, Swelling, Vertigo
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow), Vestibular disorders (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: This case was reported by a lawyer and described the occurrence of joint pain in a female subject of unspecified age who was vaccinated with LYMERIX. A physician or other health care professional has not verified this report. On an unspecified date the subject received unspecified dose of LYMERIX (unknown). At an unspecified time after vaccination with LYMERIX, the subject experienced joint pain, and swelling, particularly in her hands, knees, elbows, shoulders, and hips, flu-like symptoms, fatigue, possible neurological injuries, possible autoimmune disease, decreased activities of daily life, tingling in her extremities, shooting pains in her arms, vertigo, headaches, and possible memory loss. At the time of reporting the outcome of the events was unspecified. This information was received via a Statement of Injuries. Follow up information was received on 19 December 2008 via an interview between the subject and attorney(s). The subject was vaccinated with LYMERIX in February 1999, March 1999 and January 2000. Within one month of the third LYMERIX vaccination, the subject developed painful swollen joints. In 2000 she developed dizziness/lightheadedness and headaches. In 2001 or 2002 she developed fatigue. Treatment included ADVIL, ALEVE, AMOXICILLIN, unspecified medication for vertigo, and antibiotic. She developed aggravation of acid reflux, which she attributed to ALEVE and ADVIL taken for joint pain. The events were unresolved at the time of this report. Follow-up information in the form of medical records was received on 16 January 2009. On 26 July 2000, the subject was evaluated for her anxiety which had been a problem recently. She was started on EFFEXOR for treatment. An exam dated 21 August 2000 indicated that the subjects anxiety and depression were stable and she continued treatment with EFFEXOR. On 11 October 2000 the subject was complaining of questionable ear problems and dizziness. The problems had been ongoing for a while and has been taking EFFEXOR. As a result of these conditions the subjects c

VAERS ID:429619 (history)  Vaccinated:2000-01-01
Age:43.0  Onset:2000-04-01, Days after vaccination: 91
Gender:Male  Submitted:2011-08-13, Days after onset: 4150
Location:Connecticut  Entered:2011-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Well controlled HTN
Diagnostic Lab Data: ECG with LBBB. Normal ETT/echo.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Private     Purchased by: Private
Symptoms: Bundle branch block left, Echocardiogram normal, Electrocardiogram abnormal, Exercise test normal, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Cardiomyopathy (broad)
Write-up: Palpitations, developed LBBB. Occurred shortly after vaccination.

VAERS ID:228089 (history)  Vaccinated:2000-01-01
Age:22.0  Onset:2001-10-23, Days after vaccination: 661
Gender:Female  Submitted:2004-10-21, Days after onset: 1094
Location:Foreign  Entered:2004-10-22, 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:
Preexisting Conditions: Chronic diarrhea; Crohn''s Disease; Fatigue
Diagnostic Lab Data: Lymphocyte count: 10/23/01 186/mm3, 3/9/02 213/mm3, 11/27/02 353/mm3, 3/27/03 132/mm3, 7/21/03 250/mm3; WBC: 10/23/01 6190/mm3, 3/9/02 7900/mm3, 11/27/02 5700/mm3, 3/27/03 4900/mm3.
CDC Split Type: B0297047B
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Condition aggravated, Fatigue, Lymphopenia, Weight decreased
SMQs:, Haematopoietic leukopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A physician reported the occurrence of lymphopenia in a 24 year old female subject who was vaccinated with hepatitis B vaccine for prophylaxis. The subject''s medical history included Crohn''s disease with chronic diarrhea since 8/4/97 and fatigue since 12/97. Co-suspect medication included azathioprine for Crohn''s disease since July 1999. Concurrent medication included levenorgestrel + ethinylestradiol for contraception since 1996. In July 1999, the subject started taking azethioprine at a daily dose of two tablets. In 2000, the subject received an injection of hepatitis B vaccine. Several months later, on 10/23/01, blood cell count evidenced lymphopenia with lymphocyte count at 186 cells/mm3 (normal range between 1000 and 4000) without clinical symptoms. On 11/27/02, this count was at 353 cells/mm3. On 3/27/03, lymphocyte count was at 132 cells/mm3 and on 7/21/03, at 250 cells/mm3. At an unspecified date, she experienced aggravation of fatigue and decreased weight. At an unspecified date, the daily dose of Imurel was increased to 2.5 tablets per day. According to the reporter, the events were clinically significant (OMIC). On 10/11/04, lymphopenia and aggravation of fatigue were not resolved and outcome of decreased weight was unknown. The reporter considered lymphopenia and aggravation of fatigue as probably and almost certainly related to Imurel, respectively. Causality relationship was not specified for hepatitis B vaccine.

VAERS ID:282607 (history)  Vaccinated:2000-01-01
Age:  Onset:0000-00-00
Gender:Unknown  Submitted:2007-06-21
Location:Foreign  Entered:2007-06-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ECZEMA, HAY FEVER
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: B0475528A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (DITANRIX)GLAXOSMITHKLINE BIOLOGICALSAC12B01DG IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site inflammation, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This case was reported by a regulatory authority and describe the occurrence of injection site inflammation in a subject of unspecified age and gender who was vaccinated with Ditanrix adult, GlaxoSmithKline. This case is one out of 4 patients (out of 29 vaccinated subjects) who developed a similar reaction. On 25 April 2007 the subject received unspecified dose of Ditanrix adult (intramuscular, unknown). At an unspecified time after vaccination with Ditanrix adult, the subject experienced injection site inflammation with pain, redness and oedema (10 cm of diameter). The regulatory authority reported that the events were clinically significant (or requiring intervention). At the time of reporting, the outcome of the events was unknown. Additional information has been requested.

VAERS ID:295496 (history)  Vaccinated:2000-01-01
Age:81.0  Onset:2007-10-09, Days after vaccination: 2838
Gender:Female  Submitted:2007-11-02, Days after onset: 24
Location:Foreign  Entered:2007-11-05, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0710USA05082
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, General physical health deterioration, Hypoaesthesia, Hypotension, Injected limb mobility decreased, Mobility decreased, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Initial and follow up information has been received from a health professional concerning an 81 year old female patient who was vaccinated on 09-OCT-2007 IM in to left deltoid with a second dose of Pneumovax 23. About 12 hours post vaccination she developed large swelling and pain of the whole vaccinated arm accompanied by numbness and decreased mobility of this arm. She additionally developed asthenia and hypotension. General condition was reduced. The reporter mentioned that a previous dose of Pneumovax 23 had been given in 2000 and was well tolerated. She recovered completely after 2 days. The reaction was considered to be serious (especially reaction to the vaccinated arm) by the reporter. Other business partner numbers included: E2007-07302 Additional information is not expected.

VAERS ID:316347 (history)  Vaccinated:2000-01-01
Age:  Onset:0000-00-00
Gender:Female  Submitted:2008-06-16
Location:Foreign  Entered:2008-06-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: D0057657A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Transaminases increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case was reported by a physician, via a sales representative, and described the occurrence of increased transaminases in a female subject of unspecified age who was vaccinated with TWINRIX adult (GlaxoSmithKline). On an unspecified date, approximately 8 years before the initial report the subject received 2nd dose of TWINRIX adult (unknown route and application site). At an unspecified time after vaccination with TWINRIX adult, a test showed increased transaminases. This case was assessed as medically serious by GSK. At the time of reporting the outcome of the event was unspecified. Follow-up information has been requested.

VAERS ID:413251 (history)  Vaccinated:2000-01-01
Age:  Onset:0000-00-00
Gender:Unknown  Submitted:2010-12-20
Location:Foreign  Entered:2010-12-20
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: D0069688A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (FOREIGN)GLAXOSMITHKLINE BIOLOGICALS200084VH UNUN
Administered by: Other     Purchased by: Other
Symptoms: Developmental delay, Gastrostomy tube insertion, Hypotonic-hyporesponsive episode, Mental retardation
SMQs:, Hypotonic-hyporesponsive episode (narrow)
Write-up: This case was reported by a physician and described the occurrence of mental and physical retardation in an infant subject of unspecified age who was vaccinated with INFANRIX-IPV+HIB (GlaxoSmithKline). On an unknown date in 2000 the subject received a dose of INFANRIX-IPV+HIB (0.5 ml, unknown). For a follow-up vaccination the subject received a dose of PENTAVAC (Sanofi Pasteur MSD) (0.5 ml, unknown). At an unspecified time post vaccination with INFANRIX-IPV+HIB, on an unknown date, the subject experienced mental and physical retardation. The subject depends on gastrointestinal tube insertion/percutaneous endoscopic gastrostomy (PEG) for feeding. The physician considered the events were disabling. At the time of reporting, on 10 December 2010, the events were unresolved. Follow-up information was received on 13 December 2010 from the reporting physician. The reporting physician asked whether chronic hypotonic-hyporesponsive episode (HHE) had been reported in association with vaccination with INFANRIX-IPV+HIB. Follow-up information has been requested.

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