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Found 480754 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:179779 (history)  Vaccinated:2001-09-14
Age:0.8  Onset:2001-09-15, Days after vaccination: 1
Gender:Female  Submitted:2001-10-26, Days after onset: 41
Location:Oklahoma  Entered:2002-01-09, Days after submission: 75
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Bilat Otitis Media
Preexisting Conditions: Prenatal cerebral infarct, postnatal seizure, no demonstrable deficit
Diagnostic Lab Data: CT brain, blood culture and UA all negative. Sod 132; K3.6
CDC 'Split Type': OK0153
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS507A22 RL
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT127322 RL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4809002 LL
Administered by: Private     Purchased by: Public
Symptoms: Febrile convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Awoke next AM w/fever. Diffivult to arouse. On arrival in ER developed seizure activity. Given Valium, observed overnight. Temp 38.2 on arrival in ER.

VAERS ID:201049 (history)  Vaccinated:2001-09-14
Age:1.0  Onset:2001-09-18, Days after vaccination: 4
Gender:Male  Submitted:2003-04-03, Days after onset: 562
Location:Foreign  Entered:2003-04-08, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: Asthma NOS; food allergy
Diagnostic Lab Data: EEG 10/2000 "strong" EEG discharge
CDC 'Split Type': HQWYE422901APR03
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES515002IM 
MEA: MEASLES (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
RUB: RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Other     Purchased by: Other
Symptoms: Chills, Convulsion, Electroencephalogram abnormal, Grand mal convulsion, Lymphadenopathy, Pyrexia, Salivary hypersecretion
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: The pt''s experience was considered medically important (OMIC). Information has been received on 3/27/03 from the national agency for medicines concerning an infant male pt. The pt''s concurrent illnesses included bronchial asthma and multiple food allergies. The pt received his third dose of Hib-Titer vaccine on 9/14/01. Additional suspect vaccine was reported as MPR vaccine (measles virus vaccine live attenuated/pertussis vaccine/rubella virus vaccine live attenuated). Approximately four days following vaccination, the pt experienced papular rash over most of his body. The event was managed with Atarax. On 9/22/01, the pt experienced a fever and convulsions characterized by mouth snapping, shivering, and mucus bubbles coming from his mouth. The pt developed enlarged lymph nodes (lymphadenopathy) behind his ears and in his neck. The fever was managed successfully with paracetamol. The rash and lymphadenopathy persisted for approximately one month. In February 2002, the pt experienced another epileptic seizure for which an anticonvulsant medication was initiated. A diagnosis of eiplepsia partialis generalisata (grand mal convulsion) was made. Subsequently, the episodes became more frequent and an EEG obtained in October 2002 revealed "strong" EEG discharge which necessitated a change in anticonvulsant medication. Reported on 04/17/2003: "Additional information received on 04/07/2003 indicated the country of origin of this report was Finland, not Sweden. The patient''s experience was considered medically important. Information has been received on 03/27/2003 from the National Agency for Medicines in Finland concerning an infant male patient. The patien''ts concurrent illnesses included bronchial asthma and multiple food allergies. The patient received his third dose of Hib-TITER vaccine on 09/14/2001. Additional suspect vaccine was reported as M-P-R vaccine (measles virus vaccine live attenuated/pertussis vaccine/rubella virus vaccine live attenuated). Approximately 4 days following vaccination, the patient exp

VAERS ID:201464 (history)  Vaccinated:2001-09-14
Age:  Onset:2001-09-18, Days after vaccination: 4
Gender:Male  Submitted:2003-04-09, Days after onset: 568
Location:Foreign  Entered:2003-04-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pulmicort; Bricanyl
Current Illness:
Preexisting Conditions: Asthma, foodstuff allergy: pea, chocolate, strawberry, cocoa, fish and additionally one unclear foodstuff.
Diagnostic Lab Data: The clinical analysis on the 9/27/01 showed S-ParvAbG<10 EIU, S-ParvAbm negative, leukocytes was 6.9E9/l, B-Eryt 4.54 E12/L, B-HB 127g/L, B-HKR 0.37, E-MCV 82fl, E-MCH 28pg, E-MCHC 338 g/l, B-Trom 189 E9/l, S-VirLab and S-InfACF was 8 (no u
CDC 'Split Type': E200300188
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)AVENTIS PASTEUR515002IMGM
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.HL482600IMGM
Administered by: Unknown     Purchased by: Unknown
Symptoms: Depressed level of consciousness, Diarrhoea, Epilepsy, Lymphadenopathy, Pyrexia, Rash papular, Rhinitis, Tremor
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Noninfectious diarrhoea (narrow)
Write-up: It was reported that a boy was vaccinated with the 3rd dose of a Hib (Act-Hib, 51500) vaccine and the 1st dose of MMR II (batch HL48260) on 9/14/01. On 9/18/01 the pt presented with an anterior, small papule, red rash. The most of it on the thighs, legs and arms and only little on the face. 8 days after vaccination he got fever, enlarged glands behind the ears and in the neck. On the 9/24/01, he got medication Atarax and Panadol. On 10/26/01, the child was examined by the doctor. The child had slight rhinitis, been sick and has not been eaten well during couple of days. Faeces were clear looser than usual, usually has more constipation. He had the most intensive rash on the thighs, but also on the legs, on lower and upper arms, on front and back of the body. He had slight pimples on clustering and pimply, elevated on the skin, quite pale red. Palms and soles were near. There was no rash history in the family. General condition was OK, no erythema in the pharynx. Tonsils were clean. On 10/9/01, the rash was weakly visible, glands was most unvisible. The child was in a good condition all the time. The mother told that the child got an epileptic seizure while sleeping his afternoon nap on two consecutive days. About some hours after he felt asleep he "snapped" strongly with his mouth and foam-slime become out of his mouth. The child was trembling and couldn''t be waked up. In February 2002 he had a clear convulsions seizure for 10-15 min. He was hospitalized and epilepsy was diagnosed. After that left side limbs have been powerless and speech a little bit mushy for 2 days. Medication for epilepsy has started and seizures were absent until October 2002, when the medication was terminated and the amount of seizures increased again. In October 2002 a video EEG was done at first aid and a lot of outburst was detected during sleep. The medication has decided to change and after that seizure symptoms have been under control. Epileptic symptoms have been partly absence/aura symptoms and symptoms during sleep. Even after the

VAERS ID:167959 (history)  Vaccinated:2001-09-15
Age:0.5  Onset:2001-09-16, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Texas  Entered:2001-03-29
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Preterm 31 week
Diagnostic Lab Data: Full sepsis work up. CT Scan of head, EEG, comp metabolic spinal, organic / metabolic acids.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES0371AB2IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES564AA2IMLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4747232IMRL
Administered by: Private     Purchased by: Unknown
Symptoms: Infantile spasms
SMQs:, Convulsions (narrow), Neonatal disorders (narrow)
Write-up: Within 24 hours, post vax, child developed seizure-like activity later identified by Peds neurologist as infantile spasms; EEG confirmed. per doc 212684, annual follow up, patient has infantile spasms.

VAERS ID:175468 (history)  Vaccinated:2001-09-15
Age:33.0  Onset:2001-09-15, Days after vaccination: 0
Gender:Female  Submitted:2001-09-15, Days after onset: 0
Location:Texas  Entered:2001-09-18, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergies
Preexisting Conditions: Allergies
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UA444AA  LA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR0384  RA
Administered by: Military     Purchased by: Military
Symptoms: Feeling hot
SMQs:
Write-up: Right arm, neck warmness after injection of typhoid vaccine to her right upper arm. Subsided 13:30.

VAERS ID:175730 (history)  Vaccinated:2001-09-15
Age:4.0  Onset:0000-00-00
Gender:Male  Submitted:2001-09-17
Location:Pennsylvania  Entered:2001-09-26, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0515DA3IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T10982 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0252L1SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4797990IMRL
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt developed swelling and redness at the site of injection in left thigh (was treated with ibuprofen) for low-grade fever, 24 hours, post vax.

VAERS ID:182468 (history)  Vaccinated:2001-09-15
Age:11.0  Onset:2001-09-15, Days after vaccination: 0
Gender:Female  Submitted:2002-03-07, Days after onset: 173
Location:New Jersey  Entered:2002-03-14, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES01092006
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site inflammation, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a registered nurse concerning a 11 year old female who on 09/15/2001 was vaccinated with a third dose of hep b vaccine recombinant IM in the arm. On 09/15/2001, the pt experienced a localized reaction which involved a large area of the injection site and below which was quiet inflammed. The pt was treated with hiphendydramino hydrochloride and warm compresses. Additional info has been received from a registered nurse. The nurse reported that the pt had a large induration around, above and below the injection site. No further info is expected.

VAERS ID:190387 (history)  Vaccinated:2001-09-15
Age:18.0  Onset:2001-09-15, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:2002-09-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WA011799
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3384B60IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Nausea, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: 10-12 hrs after receiving immunization pt broke out in flat red rash starting at bra line progressed lower abd, thighs, and onto back no itching, no lesions, no hives, no c/o problems with breathing, no SOB no difficulty swallowing. Had nausea off and on no emesis. HA occasionally. Rash lasted 2-8 weeks. 9/19/01 MD visit to PMD and given Keflex and antihistamine.

VAERS ID:175571 (history)  Vaccinated:2001-09-17
Age:4.0  Onset:2001-09-18, Days after vaccination: 1
Gender:Female  Submitted:2001-09-19, Days after onset: 1
Location:Vermont  Entered:2001-09-21, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAMA997A24IMRA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO598AA2IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T07853IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1516K1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 6 x 9 inch irregular shaped red, swollen area right upper arm.

VAERS ID:175672 (history)  Vaccinated:2001-09-17
Age:3.5  Onset:2001-09-18, Days after vaccination: 1
Gender:Male  Submitted:2001-09-20, Days after onset: 2
Location:Pennsylvania  Entered:2001-09-25, Days after submission: 5
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':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4815500IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This child developed erythematous area (5 cm x 7 cm) where injection was given. Afebrile, no pain.

VAERS ID:175744 (history)  Vaccinated:2001-09-17
Age:11.0  Onset:2001-09-17, Days after vaccination: 0
Gender:Female  Submitted:2001-09-21, Days after onset: 4
Location:Virginia  Entered:2001-09-26, Days after submission: 5
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: anemia
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0603L0IM 
Administered by: Public     Purchased by: Public
Symptoms: Lethargy, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: The pt experienced a fever, was lethargic, experienced vomiting and then recovered over a 4 day period beginning the day of the vax.

VAERS ID:175769 (history)  Vaccinated:2001-09-17
Age:0.3  Onset:2001-09-17, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:2001-09-27
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: Labs drawn for septic work-up - all normal.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESUO356BA0IMRL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5177A20IMLL
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES4773890IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T05950SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4797950IMLL
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Crying, Decreased appetite, Insomnia, Meningitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)
Write-up: Day 1, 09/17/01, at approximately 11:40 spiked fever of 102 - 103 at 1 pm a little fussy, decreased appetite; sites fine. Day 2, 09/18/01 - Still temp 102 - 103 for 24 hours fussy, decreased appetite. Day 3, 09/19/01, temp 102 - 103, crying non-stop, Not eating, not sleeping. Admitted to the hospital for a septic work-up. Labs normal. Crying ceased 09/20/01. Fever ceased 09/19/01 in the AM. Appetite returned 09/21/01. Discharged on 09/21/01 at 8 am. Discharge Summary Diagnosis is Fever resolved, irritability resolved, above most likely due to immunization reaction.

VAERS ID:175772 (history)  Vaccinated:2001-09-17
Age:72.0  Onset:2001-09-18, Days after vaccination: 1
Gender:Male  Submitted:2001-07-19, Days after onset: 61
Location:Iowa  Entered:2001-09-27, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Lower extremity varices
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0961K0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt''s right arm with swelling and pain, less than 24 hours, post vax. No fever or rash. Treated with Benadryl and ice prescribed.

VAERS ID:175798 (history)  Vaccinated:2001-09-17
Age:10.0  Onset:2001-09-17, Days after vaccination: 0
Gender:Male  Submitted:2001-09-18, Days after onset: 1
Location:Virginia  Entered:2001-09-28, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5225A90IMLA
Administered by: Other     Purchased by: Public
Symptoms: Chest pain, Dysphonia, Heart rate increased, Hyperhidrosis, Respiratory rate increased, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Post vax, at 13:20, the pt''s class went outside to run on track. Afterwards, he became diaphoretic, had increased heart rate (136); audible wheezing; hoarseness; rapid breathing and chest pains. Lungs were clear despite audible wheeze. He drank coke and blew into a paper bag. His heart rate eventually came down to 128, 104 and then to 82 after 20 minutes.

VAERS ID:175801 (history)  Vaccinated:2001-09-17
Age:5.0  Onset:2001-09-18, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:2001-09-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM984A24IMRA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0007L0IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0606L1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Fatigue, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt developed a fever, nausea and vomiting and fatigue.

VAERS ID:175812 (history)  Vaccinated:2001-09-17
Age:0.2  Onset:2001-09-23, Days after vaccination: 6
Gender:Female  Submitted:2001-09-25, Days after onset: 2
Location:New York  Entered:2001-09-28, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC with Differential
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM996A20IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1761K0IMRL
Administered by: Public     Purchased by: Public
Symptoms: Erythema multiforme, Vaccination complication
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: DTAP and Comvax given 9/17/01. Rash appeared on legs, arms and face on 9/23/01. Tylenol was given. Brought to office on 9/24/01 with pink, flat macules, wheal and target shaped lesions on both legs and arms; 2-3 also on face. Spoke with Infectious Disease Expert and the impression was erythema multiforme secondary to Comvax. Rx''d Tylenol and to keep a close watch. Expected to be fine.

VAERS ID:175849 (history)  Vaccinated:2001-09-17
Age:1.6  Onset:2001-09-17, Days after vaccination: 0
Gender:Male  Submitted:2001-09-21, Days after onset: 4
Location:Arkansas  Entered:2001-10-01, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: febrile seizures
Diagnostic Lab Data:
CDC 'Split Type': AR0140
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.1876K0SCLL
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Hyperaemia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: The pt experienced mild hyperemia of cheeks, and facial cheek swelling.

VAERS ID:175855 (history)  Vaccinated:2001-09-17
Age:11.0  Onset:2001-09-17, Days after vaccination: 0
Gender:Male  Submitted:2001-09-18, Days after onset: 1
Location:Michigan  Entered:2001-10-01, Days after submission: 13
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': MI2001072
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5194A20IMLA
Administered by: Public     Purchased by: Public
Symptoms: Amnesia, Anorexia, Eye disorder, Feeling abnormal, Pruritus, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (broad)
Write-up: Parent called to report, after her child had received Hep-B at 09:30. He went to school and completed a day of school but told parent he "felt weird; not like himself" all day. He complained of loss of memory, shakiness and spilling liquids while at school. By 19:30, he complained of itchy eyes and loss of appetite. He went to ER and his only treatment was to take Benadryl po.

VAERS ID:175983 (history)  Vaccinated:2001-09-17
Age:5.0  Onset:2001-09-21, Days after vaccination: 4
Gender:Female  Submitted:2001-09-21, Days after onset: 0
Location:Georga  Entered:2001-10-02, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Public     Purchased by: Other
Symptoms: Infection
SMQs:
Write-up: Pt developed chickenpox: varicella rash. Vaccine related. Unknown if any other vaccines were given.

VAERS ID:176015 (history)  Vaccinated:2001-09-17
Age:1.6  Onset:2001-09-17, Days after vaccination: 0
Gender:Male  Submitted:2001-09-20, Days after onset: 3
Location:Washington  Entered:2001-10-03, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: PE tubes
Diagnostic Lab Data:
CDC 'Split Type': WA011782
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM505A23IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA596AC3IMLL
Administered by: Public     Purchased by: 0
Symptoms: Crying, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad)
Write-up: The child experienced a swollen left thigh from knee to hip with an onset of swelling. The pt had a good range of motion. Mom reports the child cries at night due to pain and limps when walks.

VAERS ID:176034 (history)  Vaccinated:2001-09-17
Age:4.0  Onset:2001-09-19, Days after vaccination: 2
Gender:Male  Submitted:2001-09-27, Days after onset: 8
Location:Florida  Entered:2001-10-03, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Photosensitivity; Dermatitis; Allergic Rhinitis
Preexisting Conditions: Allergic Rhinitis
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM507A24IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T12733IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0379L1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site haemorrhage, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt developed swelling, slight hematoma, high fever of 102F and tenderness to right upper deltoid area at DTAP, 24 hours, post vax. Treated with Tylenol and Hydrocortisone creme. Swelling subsided a few hours afterwards. Seen on 9/19/01 and fever like-wise went down.

VAERS ID:176051 (history)  Vaccinated:2001-09-17
Age:0.3  Onset:2001-09-18, Days after vaccination: 1
Gender:Female  Submitted:2001-09-24, Days after onset: 6
Location:Indiana  Entered:2001-10-05, Days after submission: 11
Life Threatening? No
Died? Yes
   Date died: 2001-09-18
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': IN200119
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0513BA1IM 
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA612AA1IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T12731SC 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4818171IM 
Administered by: Private     Purchased by: Private
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)
Write-up: The pt died of crib death at daycare on 9/18/01. One day post vax. The cause of death was diagnosed as SIDS. Autopsy report confirms cause of death to be SIDS. Death certificate lists cause of death as SIDS also.

VAERS ID:176062 (history)  Vaccinated:2001-09-17
Age:0.4  Onset:2001-09-17, Days after vaccination: 0
Gender:Female  Submitted:2001-09-30, Days after onset: 13
Location:Vermont  Entered:2001-10-05, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Erythema and swelling;PREVNAR;1;.25;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': VT00006
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4774541IMLL
Administered by: Private     Purchased by: Other
Symptoms: Injection site haemorrhage, Injection site induration
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt''s left thigh developed slight ecchymosis and induration about quarter-sized with no erythema or cellulitis. Pt is recovering.

VAERS ID:176077 (history)  Vaccinated:2001-09-17
Age:11.0  Onset:2001-09-17, Days after vaccination: 0
Gender:Male  Submitted:2001-09-18, Days after onset: 1
Location:Massachusetts  Entered:2001-10-05, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Migraines;UNK. HEPATITIS B;1;11.00;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: Possible sensitivity to Hep B preservative. History of migraines.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD71 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Irritability
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: Mother reports child complained of a headache (severe) at approximately 8 PM along with slight irritability. Given Advil with relief of symptom approximately 915 PM. Slept through the night; woke in the AM without complaints.

VAERS ID:176094 (history)  Vaccinated:2001-09-17
Age:29.0  Onset:2001-10-01, Days after vaccination: 14
Gender:Female  Submitted:2001-10-01, Days after onset: 0
Location:Washington  Entered:2001-10-05, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Sulfa drugs
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.1874K SC 
Administered by: Private     Purchased by: Private
Symptoms: Influenza like illness, Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Received measles vaccine 09/17/2001. Noted flin like sxs one week later. Two weeks after vaccine developed low grade fever. Currently has maculopupular rash on face, neck and forearms.

VAERS ID:176123 (history)  Vaccinated:2001-09-17
Age:4.0  Onset:2001-09-19, Days after vaccination: 2
Gender:Male  Submitted:2001-09-21, Days after onset: 2
Location:Georga  Entered:2001-10-08, Days after submission: 17
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
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM992A24IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R143723SCRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0380L1SCLA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Injection site oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Localized swelling reaction of the right arm above the elbow = soft swelling with erythematous hive.

VAERS ID:176187 (history)  Vaccinated:2001-09-17
Age:1.2  Onset:2001-09-28, Days after vaccination: 11
Gender:Female  Submitted:2001-10-10, Days after onset: 12
Location:Colorado  Entered:2001-10-10
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 (TRIPEDIA)CONNAUGHT LABORATORIES40320AA3IMRL
DTPIPV: DTP + IPV (NO BRAND NAME)CONNAUGHT LTD.T08162IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA551AA3IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.008720SCLL
Administered by: Private     Purchased by: Private
Symptoms: Blister, Pyrexia, Rhinorrhoea
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad)
Write-up: Immunization on 09/17/2001. Fever 104 09/26/2001 decrease to 102 09/28/2001, Temperature 99. Pt has 2 fluid filled vesicles on neck; shoulder, chest and back, has red dots. Cutting teeth now and has had running nose flux with yellow drainage.

VAERS ID:176201 (history)  Vaccinated:2001-09-17
Age:47.0  Onset:2001-09-19, Days after vaccination: 2
Gender:Female  Submitted:2001-09-26, Days after onset: 7
Location:Colorado  Entered:2001-10-10, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril and Synthroid
Current Illness: NONE
Preexisting Conditions: Hypertension and Hypothyroidism
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0383AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Four to five cm urticavial lesion on right deltoid two cm below injection site. Treated with ice packs and OTC Benadryl.

VAERS ID:176262 (history)  Vaccinated:2001-09-17
Age:45.0  Onset:2001-09-20, Days after vaccination: 3
Gender:Female  Submitted:2001-10-05, Days after onset: 15
Location:Unknown  Entered:2001-10-12, 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: Aspirin; gemfibrozil
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES01100025
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC. 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Agitation, Dysphagia, Nervousness, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a health professional concerning a female who on 9/17/01 was vaccinated with an adult 1.0ml 2nd dose of Hep-A virus vaccine inactivated. On 9/20/01, the pt developed an itchy scalp. On 9/21/01, the pt was awakened at 03:00 with a rash and itching on her trunk, extremities and hands. On 9/21/01, sometime in the morning, the pt took diphenhydramine hydrochloride (Benadryl) and her physician directed her to go to urgent care. The pt was placed on 30mg of prednisone and continued on Benadryl. On 9/21/01, the pt noticed that she had nervousness, agitation and difficulty swallowing. On 9/22/01, the pt returned to urgent care and her prednisone was increased to 40mg. Zyrtec was administered orally and camphor + menthol + phenol (SARNA) administered topically was added to her therapy. On 9/23/01, the pt was instructed to take 40mg of prednisone and a "tapering dose" was started. No further information was provided. Upon internal review, the pt''s difficulty swallowing was determined to be an "Other Important Medical Event". Additional information has been requested. F/U info states the DOB as 9/22/55 and the pt is 45 years old. F/U info has been received from an NP which indicated that the pt did not report any adverse events with other vaccinations; however, the pt had told her that she had seen an allergist in the past. No information was available regarding the specifics of the pt''s visits to the allergist. The reporter stated that she had spoken to the pt since the event and noted that the pt was doing "well". No further information was provided.

VAERS ID:176313 (history)  Vaccinated:2001-09-17
Age:4.0  Onset:2001-09-18, Days after vaccination: 1
Gender:Male  Submitted:2001-10-08, Days after onset: 20
Location:Connecticut  Entered:2001-10-15, 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: Claritin
Current Illness:
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM508A24IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T11463SCRA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: DTAP in left arm muscle, had swelling of entire left arm extending to anterior left chest within 24 hours of shot. Treated with Augmentin for possible cellulitis. Resolved within 5 days.

VAERS ID:176372 (history)  Vaccinated:2001-09-17
Age:4.0  Onset:2001-09-18, Days after vaccination: 1
Gender:Male  Submitted:2001-09-19, Days after onset: 1
Location:Texas  Entered:2001-10-16, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIESU0536AA IMRL
DTPIPV: DTP + IPV (NO BRAND NAME)CONNAUGHT LTD.TU28 SCRL
HEPA: HEP A (VAQTA)MERCK & CO. INC.0687L IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0734L SCLL
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt had redness, warmth and swelling at site of MMR on 09/18/2001. Child seen if office 09/19/2001. Redness, warmth, nontender area upper left thigh. Area 12 cm X 9.5 cm.

VAERS ID:176386 (history)  Vaccinated:2001-09-17
Age:36.0  Onset:2001-09-30, Days after vaccination: 13
Gender:Male  Submitted:2001-10-08, Days after onset: 8
Location:Illinois  Entered:2001-10-17, Days after submission: 9
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: GI distress, ASA allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Military     Purchased by: Private
Symptoms: Headache
SMQs:
Write-up: Pt complained of severe headache for 2 days. Seen by MD and was hospitalized.

VAERS ID:176450 (history)  Vaccinated:2001-09-17
Age:1.1  Onset:2001-09-19, Days after vaccination: 2
Gender:Male  Submitted:2001-09-19, Days after onset: 0
Location:California  Entered:2001-10-18, Days after submission: 29
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': CA010110
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAMA992923IMRA
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1670K3IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1386K0SCRA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4774533IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1899K0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Post vax the patient developed a red induration on the right arm at the deltoid muscle.

VAERS ID:176474 (history)  Vaccinated:2001-09-17
Age:1.0  Onset:2001-09-17, Days after vaccination: 0
Gender:Female  Submitted:2001-09-17, Days after onset: 0
Location:California  Entered:2001-10-18, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Propimix in formula, carnitine
Current Illness: Bone marrow suppression as of 08/19/2001
Preexisting Conditions: History of propionic acidemia/difficulty processing protein
Diagnostic Lab Data:
CDC 'Split Type': CA010109
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIESLE4705262IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.CNT050522IMLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site mass, Injection site reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Post vax, both injection sites bled, turned red and became swollen. Pressure was applied until the bleeding stopped. A small dime sized lump palpated at the DTAP site. The mother was instructed to observe the site and if later swelling, take the patient to her physician. She will see the patient''s physician tomorrow.

VAERS ID:176596 (history)  Vaccinated:2001-09-17
Age:0.3  Onset:2001-09-17, Days after vaccination: 0
Gender:Male  Submitted:2001-10-10, Days after onset: 23
Location:Kentucky  Entered:2001-10-23, Days after submission: 13
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: Urticaria
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS507AZ1IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0554U1IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T13101IMLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4815431IMLL
Administered by: Other     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Post vax, the patient developed a hive type rash, mainly on his arms and a little on his legs. The patient was treated with Benadryl.

VAERS ID:176799 (history)  Vaccinated:2001-09-17
Age:12.0  Onset:2001-09-17, Days after vaccination: 0
Gender:Male  Submitted:2001-09-20, Days after onset: 3
Location:Texas  Entered:2001-10-29, Days after submission: 39
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: Had previous allergic reaction to other "things".
Diagnostic Lab Data: UNK
CDC 'Split Type': TX01149
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0687L0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Broke out in hives in evening all over body. Given Benadryl, little relief. Seen by MD on 09/18/2001. IM Solu-medrol and no improvement. Referral to allergist. Seen 09/19/2001. Allergist prescribed Allegra and Zyrtec. Zyrtec to be used in evening if no improvement after Allegra. Rash remained on 09/20/2001. Itching somewhat better. History of allergic reaction in past to food and other allergens. Allergist desires to see child in one month and will test to see if child hypersensitive to vaccine per mother. Mother child to complete hep A series but advised her to follow advise of physician on that issue. Sent mother information on components in vaccines and study history from manufacturer. Was to call back in if rash worsened. No call received.

VAERS ID:176802 (history)  Vaccinated:2001-09-17
Age:1.0  Onset:2001-09-21, Days after vaccination: 4
Gender:Female  Submitted:2001-10-11, Days after onset: 20
Location:Texas  Entered:2001-10-29, Days after submission: 18
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: Allergic to Zithromax
Diagnostic Lab Data: NONE
CDC 'Split Type': TX01155
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS514A22 RL
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5210A22 LL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA608AA2 RL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.T05952 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0438L0 LA
Administered by: Public     Purchased by: Public
Symptoms: Skin ulcer
SMQs:
Write-up: Mom noticed a few lesions approximately 4 days after receiving varicella vaccine, now with approximately 25 lesions. Tx: Neosporin ointment.

VAERS ID:176950 (history)  Vaccinated:2001-09-17
Age:1.0  Onset:0000-00-00
Gender:Male  Submitted:2001-10-02
Location:New Jersey  Entered:2001-10-31, 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: TB Test
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, ESR, fl. culture.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1379K SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1468K SCRA
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Pt had fever 103-104 for 7 days followed by a diffuse mobilization rash. No other complication.

VAERS ID:176979 (history)  Vaccinated:2001-09-17
Age:  Onset:2001-10-02, Days after vaccination: 15
Gender:Unknown  Submitted:2001-10-24, Days after onset: 22
Location:Unknown  Entered:2001-11-01, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES01101826
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pityriasis rosea, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Information has been received from a hospital pharmacist concerning an adult hospital employee who on 9/17/01 was vaccinated with the 1st dose of Hep-B vaccine recombinant (yeast). On 10/2/01, the pt presented to the hospital with an itchy rash on the arms and trunk of the body. The pt was dx''d with pityriasis rosea. In follow up reported that it had been determined by an emergency room physician and an Infection Control Nurse that the pityrissis rosea was not associated with hepatitis B vaccine recombinant but were associated with a detergent or soap that the patient had used. Further, the patient had made a full recovery and continued with the Hepatitis B vaccine recombiant series. Upon internal review, the pityriasis rosea was considered an other important medical event. Additional information is not expected.

VAERS ID:177409 (history)  Vaccinated:2001-09-17
Age:5.0  Onset:2001-09-18, Days after vaccination: 1
Gender:Male  Submitted:2001-10-02, Days after onset: 14
Location:Georga  Entered:2001-11-08, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': GA01088
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS514A24IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.M021L1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Aunt here today. States child broke out in rash day after shots on 09/17/2001. Rash covered neck and back. No fever. Did not see doctor or ER. No breathing difficulty Rash still there.

VAERS ID:177423 (history)  Vaccinated:2001-09-17
Age:3.0  Onset:2001-09-18, Days after vaccination: 1
Gender:Female  Submitted:2001-09-19, Days after onset: 1
Location:Georga  Entered:2001-11-08, Days after submission: 50
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fifth''s disease with no fever.
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': GA01085
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS513AZ3IMRA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5184A93IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: 09/18/2001, 8:30 PM fever last night gave Tylenal, 09/19/2001, 12:00 noon reticad redness, swelling, warmth to RDT, No check out pain from child, 09/19/2001, 13:15 PM, temp 98.4, gave Benadryl 12.5 mg. By mouth and Tylenol 1 tsp by mouth per Dr. Cold compress applied.

VAERS ID:177510 (history)  Vaccinated:2001-09-17
Age:3.0  Onset:2001-09-18, Days after vaccination: 1
Gender:Male  Submitted:2001-10-25, Days after onset: 37
Location:Florida  Entered:2001-11-09, Days after submission: 15
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: Pneumonia in 7/00
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES481550 IM 
Administered by: Private     Purchased by: Private
Symptoms: Bacterial infection, Lymphadenopathy
SMQs:
Write-up: Twenty four hours after the shot was administered pt experienced severe swelling at the neck especially his left lymph node. He was hospitalized for strep-pneumonia in July of 2000 and wondered if there was a connection. I wanted to communicate this info so it could be tracked and help other children and physicians. Noticed when he woke up from his nap. I was told he had a bacteria.

VAERS ID:177664 (history)  Vaccinated:2001-09-17
Age:1.0  Onset:2001-09-18, Days after vaccination: 1
Gender:Male  Submitted:2001-09-21, Days after onset: 3
Location:Tennessee  Entered:2001-11-12, Days after submission: 52
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: NKA
Diagnostic Lab Data: NONE
CDC 'Split Type': TN01052
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM508A23IMRA
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1823K2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Feeling hot, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Child has redness and warmth to right upper arm 09/18/2001. Saw MD 09/20/2001, fever 100, redness and warmth to right arm from shoulder to elbow and extending onto chest. Given Benadryl by MD to return to MD for recheck.

VAERS ID:177967 (history)  Vaccinated:2001-09-17
Age:13.0  Onset:2001-09-17, Days after vaccination: 0
Gender:Female  Submitted:2001-11-16, Days after onset: 60
Location:California  Entered:2001-11-20, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Pathological exam-acute appendicitis; Temperature measurement-101F
CDC 'Split Type': WAES01092009
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0687L0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Abdominal pain, Gastrointestinal disorder, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Information has been received from a consumer concerning his 13 year old daughter who on 9/17/01 at 14:30 (also reported as 15:30) was vaccinated with a 1st dose (lot 639764/0587L) IM in the left arm of hepatitis A virus vaccine inactivated. On 9/17/01, at 22:30, the pt was taken to the hospital with a fever of 101F and stomach cramps (it was also reported that the abdominal pain began in the morning of 9/18/01). Follow-up information received from a physician indicated that the pt underwent an appendectomy on 9/18/01 and symptoms resolved. It was noted that the pt''s abdominal pain was secondary to the appendicitis. A pathological exam on 9/19/01 dx''d the pt with an "acute appendicitis with early fibrinopurulent periappendicitis" that was "negative for malignancy". The pt was hospitalized for 6 days. The physician felt that the abdominal pain and the appendicitis were not related to the therapy with hepatitis A virus vaccine inactivated. No further info is available.

VAERS ID:179897 (history)  Vaccinated:2001-09-17
Age:6.0  Onset:2001-09-18, Days after vaccination: 1
Gender:Female  Submitted:2001-11-29, Days after onset: 72
Location:Maryland  Entered:2002-01-14, Days after submission: 46
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: UNK
Diagnostic Lab Data: No tests performed
CDC 'Split Type': 6382625
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES481556 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Headache, Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: A physician reported via a company representative that a 6-year-old female received an inrjection of Prevnar on 09/17/2001. On 09/18/2001, the child developed a fever, a headache, and an injection site reaction characterized by swelling and warmth. Follow-up information received from the physician on 11/12/2001 indicated that the child recovered.

VAERS ID:179910 (history)  Vaccinated:2001-09-17
Age:0.2  Onset:2001-09-18, Days after vaccination: 1
Gender:Female  Submitted:2002-03-26, Days after onset: 189
Location:New York  Entered:2002-01-14, Days after submission: 71
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: UNK
CDC 'Split Type': HQ6308724SEP2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4815460IMLL
Administered by: Private     Purchased by: Other
Symptoms: Irritability, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: A pediatricians office assistant reported that an infant rec''d her first dose of Prevnar and a dose of hepatitis B (manufacturer unknown) vaccine on 9/17/01. the following evening, the infant developed a fever of 100.8F (axillary temperature) and experienced irritability. She was treated with tylenol (paracetamol) and seemed better the next morning. On 09/19/01, she developed slight swelling at the injection site. On 09/20/02, her temperature was 100.2 F

VAERS ID:180441 (history)  Vaccinated:2001-09-17
Age:73.0  Onset:2001-09-26, Days after vaccination: 9
Gender:Female  Submitted:2001-09-28, Days after onset: 2
Location:Texas  Entered:2002-01-24, Days after submission: 118
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: Hepatitis B Surface Antigen-(+)
CDC 'Split Type': 20010230881
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3376A41IM 
Administered by: Other     Purchased by: Other
Symptoms: Hepatitis
SMQs:, Hepatitis, non-infectious (narrow)
Write-up: On 8/25/01, the pt received her 1st 40mcg IM dose of Engerix-B (lot ENG3203A4). The expiration date for that lot number was 4/23/01. On 9/17/01, the pt received her 2nd 40mcg IM dose of Engerix-B. On 9/26/01, she was found to be hepatitis B surface antigen positive. As of 9/26/01, the pt was feeling "fine". The pt''s blood was re-tested and results are not yet available.

VAERS ID:183002 (history)  Vaccinated:2001-09-17
Age:3.0  Onset:2002-02-13, Days after vaccination: 149
Gender:Female  Submitted:2002-03-20, Days after onset: 35
Location:California  Entered:2002-04-01, Days after submission: 12
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: Acute lymphocytic leukaemia NOS
Diagnostic Lab Data: Blod culture-strep pneumoniae recovered(2/13/02)
CDC 'Split Type': HQ0825321FEB2002
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4815460IM 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Sepsis
SMQs:, Agranulocytosis (broad), Lack of efficacy/effect (narrow)
Write-up: A pediatrician reported that a 3 year old female received an injection of Prevnar. A few months later, in Feb. 2002, the child developed invasive pneumococcal disease. Invasive pneumococcal disease is considered medically important. No further info was available at the date of this report. The follow up info was received from the physician on 3/14/02. The child, who had a medical history of acute lymphocytic leukemia, received her first dose of Prevnar on 9/17/02. On 2/13/02, a blood culture was collected; Strep pneumoniae was isolated. A diagnosis of pneumococcal bacteremia without focus was made; she was hospitalized that day. She was discharged from the hospital on 2/16/02.

VAERS ID:185328 (history)  Vaccinated:2001-09-17
Age:0.2  Onset:0000-00-00
Gender:Male  Submitted:2002-05-17
Location:Massachusetts  Entered:2002-05-24, 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: NONE
Current Illness: NONE
Preexisting Conditions: Allergic to eggs
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURU0514AA0 LL
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES4783920 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0584K0 RL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4797970 RL
Administered by: Private     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up:

VAERS ID:186590 (history)  Vaccinated:2001-09-17
Age:65.0  Onset:2001-09-17, Days after vaccination: 0
Gender:Male  Submitted:2002-06-12, Days after onset: 268
Location:Massachusetts  Entered:2002-06-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURERTD74  LA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site atrophy, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Received Td 09/17/01 left deltoid c/o deep pain since. Exam shows mild atrophy. No response to NSAIDs, Cox-2 inhib

VAERS ID:187466 (history)  Vaccinated:2001-09-17
Age:1.3  Onset:2001-09-27, Days after vaccination: 10
Gender:Male  Submitted:2002-05-30, Days after onset: 245
Location:Ohio  Entered:2002-07-12, 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:
Current Illness:
Preexisting Conditions: Rash NOS; Urticaria NOS; Milk allergy
Diagnostic Lab Data: Diagnostic microbiology - strep test negative; Temp Measurement - elevated temp.
CDC 'Split Type': WAES01100262
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0902L0SC 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES 3IM 
Administered by: Private     Purchased by: Other
Symptoms: Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 15 month old white male with a history of no known drug allergies, possible allergy to milk, and a prior history of having a rash and urticaria for more than a month (cause unspecified) who on 17 SEP 2001 was vaccinated SC (SQ) in his left arm with his first dose of MMR. Concomitant therapy included a fourth dose of streptococcus pneumoniae vaccine which was administered IM in his left leg. On 27 SEP 2001, 10 days after his vaccination, the patient developed a temperature of 99.8 degrees F to 102.6 degrees F. After ibuprofen, his temperature was 99.8 degrees F in the physician''s office. In addition, the patient had developed a maculopapular rash/sandpaper rash on his extremities, axilla, abdomen and back. Lab evaluation revealed streptococcus test negative. The patient was diagnosed with rash from the vaccine. Treat prescribed was ibuprofen as necessary. On 29 SEP 2001 after 48 hours, the patient recovered from his fever and maculopapular rash. No further information is available.

VAERS ID:187587 (history)  Vaccinated:2001-09-17
Age:1.0  Onset:2001-09-22, Days after vaccination: 5
Gender:Unknown  Submitted:2002-05-30, Days after onset: 250
Location:Unknown  Entered:2002-07-15, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES01093184
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)
Write-up: Information has been received from an LPN concerning a 12 month old pt who on 9/17/01 was vaccinated with a dose of MMRII. Five or six days, post vax, on approx. 9/22/01, the pt broke out in spots. The LPN reported that she does not know if rash was all over the body but reported that the spots/rash was starting to spread to the child''s face. Unspecified medical attention was sought. Additional information has been requested.

VAERS ID:189496 (history)  Vaccinated:2001-09-17
Age:72.0  Onset:2001-09-17, Days after vaccination: 0
Gender:Female  Submitted:2001-09-24, Days after onset: 7
Location:Pennsylvania  Entered:2002-08-28, Days after submission: 338
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dyazide, Mysoline, Neurontin, Potassium, Procardia XL, Vioxx
Current Illness: UNK
Preexisting Conditions: NKA
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ6188520SEP2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.4735560IMRA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: A nurse reported that a 72 year old female received an injection of Pnu-Imune 23 on 09/17/01. That same day, the patient developed right shoulder pain. She also developed an injection site reaction characterized by swelling and redness. This is 1 of 2 patient from this facility who had an adverse experience following reipt of Pnu-imune 23 (lot 473-556) See MCN HQ6179720SEP2001

VAERS ID:190345 (history)  Vaccinated:2001-09-17
Age:1.0  Onset:2001-09-17, Days after vaccination: 0
Gender:Male  Submitted:2002-09-13, Days after onset: 361
Location:California  Entered:2002-09-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: Sleep EEG evaluations
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5338A22 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0740L0 RL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0782L0 RL
Administered by: Private     Purchased by: Private
Symptoms: Antisocial behaviour, Autism, Cognitive disorder
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (narrow)
Write-up: Autism (lack of verbal, social skills) starting therapy (occupational, behavioral). As per 60 day follow up: Pt has not recovered from adverse events. Pt still shows symptoms of autism. Letter states; We have not sent the access authorization for our sons medical recodres. However, please feel free to request whatever you need through us. Did you see the Nov/Dec issue of Mothering magazine. Follow up on 10/29/2003: "Vaccine recipient did not recover from the adverse event. Autism."

VAERS ID:191425 (history)  Vaccinated:2001-09-17
Age:1.6  Onset:2002-06-16, Days after vaccination: 272
Gender:Female  Submitted:2002-10-15, Days after onset: 121
Location:Pennsylvania  Entered:2002-10-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4797873IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1607K0SCRL
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Pt received Varivax 09/17/2001, but was seen at hospital on 06/16/2002, Dx: Chicken pox

VAERS ID:196354 (history)  Vaccinated:2001-09-17
Age:21.0  Onset:2001-09-17, Days after vaccination: 0
Gender:Female  Submitted:2003-01-09, Days after onset: 479
Location:Wisconsin  Entered:2003-01-17, 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: Oral contraceptive
Current Illness: UNK
Preexisting Conditions: Allergy to PCN
Diagnostic Lab Data: UNK
CDC 'Split Type': A0361113A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5208A21IM 
Administered by: Private     Purchased by: Private
Symptoms: Pigmentation disorder
SMQs:
Write-up: On 9/17/01, the vaccinee received her 2nd injection of Engerix-B. On the day of the injection, the vaccinee experienced a change in the skin pigment at the injection site described as a ring "about the size of a quarter" that was lighter than the rest of her skin color. The vaccinee was seen by a physician. The most recent information received on 2/26/02, reported the event as unresolved.

VAERS ID:198870 (history)  Vaccinated:2001-09-17
Age:20.0  Onset:2001-09-17, Days after vaccination: 0
Gender:Female  Submitted:2002-02-06, Days after onset: 142
Location:Indiana  Entered:2003-03-05, Days after submission: 392
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sumycin, Retina
Current Illness: NONE
Preexisting Conditions: Acne
Diagnostic Lab Data:
CDC 'Split Type': U200200065
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURUA444AA SCLA
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: It was reported that a 20 y.o. female PT received a Menomune A/C/Y/W-135 vax, administered SC in her left arm on 9/17/01 at 7 p.m. At 8:45 p.m. that same evening the PT started itching w/hives on right hand, wrist, neck itching. Benadryl 50 mg per oral was given at 9:05 p.m. Reportedly the PT recovered from this experience.

VAERS ID:176109 (history)  Vaccinated:2001-09-17
Age:0.3  Onset:2001-09-18, Days after vaccination: 1
Gender:Male  Submitted:2001-10-04, Days after onset: 16
Location:Foreign  Entered:2001-10-08, Days after submission: 4
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Temperature (38C) on 9/18/01
CDC 'Split Type': 20010232492
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM(A) IM 
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3146A2 IM 
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER(C) IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER(B) IM 
Administered by: 0     Purchased by: 0
Symptoms: Crying, Cyanosis, Hypotonia, Loss of consciousness, Pallor, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (narrow)
Write-up: On 9/17/01, a dose of Engerix-B (lot 3146A2, IM) and a dose of Infanrix-Polio-Hib (see case 20010232491) were given. On 9/18/01, 1 day post vax, this 3 month old boy experienced a loss of consciousness and developed persistent crying, cyanosis of fingernails and lips, muscular hypotonia, pallor and fever (38C). On a date as yet unknown, he had completely recovered. On 9/20/01, he had recovered from the fever. The reporting physician considered the events to be life-threatening and almost certainly related to Engerix-B and/or to the concomitant Infanrix-Polio-Hib. Additional information has been requested.

VAERS ID:184902 (history)  Vaccinated:2001-09-17
Age:1.3  Onset:2001-10-01, Days after vaccination: 14
Gender:Male  Submitted:2002-05-14, Days after onset: 225
Location:Foreign  Entered:2002-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Cephalhematoma; URI NOS
Diagnostic Lab Data: Temperature on 10/1/01-40C; 11/18/01CRP test (61); sedimentation rate test (37); 12/3/01 Hemoglobin-9.3; WBC-7.9; tanned red cells (trc) on 12/3/01-329; Sed rate-21; CRP-10; differential u.a. free thyroxine-23.1; TSH-1.29; IgA-0.7; IgM-1.1;
CDC 'Split Type': WAES0205USA00623
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1052K SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Blood thyroid stimulating hormone decreased, Gait disturbance, Haemoglobin decreased, Joint stiffness, Joint swelling, Laboratory test abnormal, Pyrexia, Red blood cell sedimentation rate increased, Rheumatoid arthritis, Synovitis
SMQs:, Haematopoietic erythropenia (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypothyroidism (broad), Hyperthyroidism (broad), Arthritis (narrow)
Write-up: Information has been received from a health authority concerning a 15 month old, otherwise previously healthy, male pt with a history of congenital cephalhematoma and and some upper respiratory infections in childhood who on 9/17/01 was vaccinated with a dose (batch number HM36330) (dose series unknown) of MMRII. There was no concomitant medication. Approx. 2 weeks after vaccination, the pt developed a fever up to 40C for 2 days. It was reported that he recovered, but had recurrent episodes of fever. From 10/6/01, the pt developed a limp, swelling of the right ankle and stiffness for the first 5-10 minutes in the morning, which gradually extended to an hour. The pain increased and he developed swelling of the left knee and was hospitalized on 11/18/01. He was dx''d with juvenile rheumatoid arthritis. It was noted that there was possible synovitis of the left wrist, but no signs of uveitis. The pt was discharged on 11/27/01 but re-admitted for samples on 12/3/01. The pt was seen again on 1/15/02 and it was reported that he had developed symptoms in his right knee, in spite of treatment. Otherwise, he responded well to the treatment. It was noted that there was no family history of arthritis. The pt''s juvenile rheumatoid arthritis persisted. Addition information is expected.

VAERS ID:187236 (history)  Vaccinated:2001-09-17
Age:0.3  Onset:2001-09-18, Days after vaccination: 1
Gender:Male  Submitted:2002-07-19, Days after onset: 304
Location:Foreign  Entered:2002-07-05, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0206USA02078
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC. 0  
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Apnoea, Breath holding, Crying
SMQs:, Acute central respiratory depression (narrow), Depression (excl suicide and self injury) (broad)
Write-up: Information has been received from a health authorities concerning a 12 week old male who on 09/17/2001 was vaccinated with the first dose of Haemophilus B conjugate vaccine/hepatitie B vaccine recombinant. Concomitant therapy included the first dose of diphtheria toxoid/pertussis vaccine/poli (Tetravac). On 09/18/2001 the pt experienced prolonged, unconsolable crying and apnea and was hospitalized. He recovered without sequelae. On 11/14/2001, the pt was vaccinated with the second dose of Haemophilus B conjugate vaccine/hep B vaccine recombinant and diphtheria toxoid/pertussis vaccine/poli. On 11/16/2001 the pt experienced unconsolable crying and apnea and was hospitalized. Subsequently, the pt recovered from unconsolable crying and apnea. It was reported since the pt presented with unconsolable crying associated with apnea that the pt may have suffered from a breathholding spell.

VAERS ID:175578 (history)  Vaccinated:2001-09-18
Age:4.0  Onset:0000-00-00
Gender:Male  Submitted:2001-09-20
Location:Florida  Entered:2001-09-21, 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:
Current Illness: NONE
Preexisting Conditions: Short stature
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM996A22IM 
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Edema, erythema 6 cm x 6 cm, tender left mid thigh.

VAERS ID:175637 (history)  Vaccinated:2001-09-18
Age:0.5  Onset:2001-09-18, Days after vaccination: 0
Gender:Male  Submitted:2001-09-21, Days after onset: 3
Location:Connecticut  Entered:2001-09-24, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': CT200106
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM508A22IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS4773952IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T11862IMRL
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Crying, Dysphonia
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)
Write-up: The pt experienced high pitched crying for 5 hours and was inconsolable. No fever was present. The following day, he was irritable and hoarse. An exam revealed no other source.

VAERS ID:175686 (history)  Vaccinated:2001-09-18
Age:51.0  Onset:2001-09-20, Days after vaccination: 2
Gender:Female  Submitted:2001-09-20, Days after onset: 0
Location:Indiana  Entered:2001-09-25, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Wood sliver under finger nail.
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESVO463AA  RA
Administered by: Public     Purchased by: 0
Symptoms: Injection site erythema, Injection site mass, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Knot in injection site, red swelling the size of a silver dollar. The knot has a travel tale moving down the arm. If you touch it, it sends off an itching sensation. Injection was given on 09/18/01 about 10:00 AM.

VAERS ID:175733 (history)  Vaccinated:2001-09-18
Age:1.5  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-09-20, Days after onset: 2
Location:Tennessee  Entered:2001-09-26, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4783280IMLL
Administered by: Private     Purchased by: Public
Symptoms: Injection site reaction, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt''s left thigh swollen and warm. No blisters or joint swelling.

VAERS ID:175747 (history)  Vaccinated:2001-09-18
Age:1.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-09-18, Days after onset: 0
Location:Oregon  Entered:2001-09-26, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA612AA3IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.074470SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0790L0SCLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Rash macular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt developed a small, red, blotchy rash on her face and a 1cm to 2cm local reaction at the injection site (LL).

VAERS ID:175843 (history)  Vaccinated:2001-09-18
Age:4.4  Onset:2001-09-20, Days after vaccination: 2
Gender:Male  Submitted:2001-09-24, Days after onset: 4
Location:Washington  Entered:2001-10-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Mild URI
Preexisting Conditions: OM and RAD with URI''s
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM507A24IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T05633SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1484E1SCLL
Administered by: Private     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt developed generalized urticaria, about 30 hours, post vax, which lasted 48 hours.

VAERS ID:175970 (history)  Vaccinated:2001-09-18
Age:1.6  Onset:2001-09-19, Days after vaccination: 1
Gender:Male  Submitted:2001-09-20, Days after onset: 1
Location:Ohio  Entered:2001-10-02, 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:
CDC 'Split Type': OH0052
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA523AA3IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1389K0SCLL
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: On 9/19/01, mother called office with a complaint of rash on both legs of pt and on abdomen. He was afebrile and not acting ill. He was seen at doctor''s office by NP and was told it was a reaction to MMR. On 9/20/01, phone call to mother and she said that rash was gone.

VAERS ID:176021 (history)  Vaccinated:2001-09-18
Age:39.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-09-24, Days after onset: 6
Location:Indiana  Entered:2001-10-03, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Kava-Kava; pseudoephedrine
Current Illness:
Preexisting Conditions: Tolectin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0817L IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt received Hep-B vaccine on 9/18/01 at 12:30. Pt reported approx. 1 hour later, that she developed a rash on right arm with itching. That evening, she noticed rash on right trunk but it was gone the next day. No other symptoms. Reported on 9/21/01. Reported that she went to donate blood and couldn''t because ESR was low.

VAERS ID:176046 (history)  Vaccinated:2001-09-18
Age:1.0  Onset:2001-09-20, Days after vaccination: 2
Gender:Male  Submitted:2001-09-25, Days after onset: 5
Location:Texas  Entered:2001-10-04, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0733L0SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1134K0SC 
Administered by: Private     Purchased by: Private
Symptoms: Gait disturbance, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad)
Write-up: Wobbly gait and walking toward his right. This started 2 days, post vax. Also with fever of 101F to 105F.

VAERS ID:176093 (history)  Vaccinated:2001-09-18
Age:21.0  Onset:2001-09-19, Days after vaccination: 1
Gender:Female  Submitted:2001-10-02, Days after onset: 13
Location:New Jersey  Entered:2001-10-05, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0360L1IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Upper arm became swollen, red and hot, rash around injection site. Pt refused to see physician, ice applied.

VAERS ID:176191 (history)  Vaccinated:2001-09-18
Age:54.0  Onset:2001-09-20, Days after vaccination: 2
Gender:Male  Submitted:2001-09-25, Days after onset: 5
Location:California  Entered:2001-10-10, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': CA010104
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0761L0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Two days post vax pt developed diarrhea and vomiting all night. He was better for a few hours. Noon the next day he developed diarrhea and vomiting again that lasted several hours.

VAERS ID:176196 (history)  Vaccinated:2001-09-18
Age:20.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Male  Submitted:2001-09-25, Days after onset: 7
Location:Massachusetts  Entered:2001-10-10, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0672L0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: There is no description of adverse reaction listed.

VAERS ID:176306 (history)  Vaccinated:2001-09-18
Age:2.4  Onset:2001-09-20, Days after vaccination: 2
Gender:Male  Submitted:2001-09-21, Days after onset: 1
Location:Tennessee  Entered:2001-10-15, Days after submission: 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Chest x-ray and CBC done with increased CBC. JMGGH FB 09/20/01
CDC 'Split Type': TN01048
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM514A23IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: On 09/20/01 HD MD -Left upper arm swollen almost to 2 X normal size from elbow to shoulder with some swelling above shoulder. In the area of the injection there is increased erythema and multiple tiny vesicles. Instructed to go to PCP today. Mother states they went to ER and 3 different doctors looked at child without knowing the problem. Chest x-ray and CBC done. Pt prescribed oral antibiotics and topical ointment for arm.

VAERS ID:176307 (history)  Vaccinated:2001-09-18
Age:4.0  Onset:2001-09-20, Days after vaccination: 2
Gender:Female  Submitted:2001-09-21, Days after onset: 1
Location:Tennessee  Entered:2001-10-15, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': TN01049
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM506A23IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Mother states Kolbie''s arm (site) swelled to the size of the palm of a hand. MD looked at child''s arm in ER while brother being seen. Mother says MD stated it was swelled larger than usual but ok. No meds prescribed.

VAERS ID:176375 (history)  Vaccinated:2001-09-18
Age:1.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-09-21, Days after onset: 3
Location:Texas  Entered:2001-10-16, 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: Poly D Elixer 1/2 tsp BID
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': TX01141
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS984A23IMRL
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES4773893IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0014L0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0780L0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Within 10 minutes, post vax, pt developed an irregular border 50mm to 60mm circular, pale redness noted around the injection site on right and left arms. Redness continued to intensify. At 16:50, they were 50 cent-sized. Bright red area to definite border, 10-15mm wheal at both injection sites. At 16:55, gave 4.5ml Benadryl po and at 17:10 the redness and wheal had decreased slightly. At 17:40, only slight redness remained on each arm, wheal had disappeared. Discussed danger signs, swelling of lips or face, difficulty breathing and instructed to call 911 if occured. Benadryl sent home with mom. Instructed to observe arms closely, give 1/2 to 1 tsp if needed in 4-6 hours.

VAERS ID:176405 (history)  Vaccinated:2001-09-18
Age:  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-10-04, Days after onset: 16
Location:Unknown  Entered:2001-10-17, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0166L SC 
Administered by: 0     Purchased by: 0
Symptoms: Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: On 09/27/2001 it was reported that on 09/18/2001 the patient experienced a severe headache, nausea and vomiting. On 09/19 the nausea and vomiting subsided but the headache remained. No medical care as symptoms slowly resolved over 72 hours.

VAERS ID:176620 (history)  Vaccinated:2001-09-18
Age:10.0  Onset:2001-10-05, Days after vaccination: 17
Gender:Female  Submitted:2001-10-15, Days after onset: 10
Location:Pennsylvania  Entered:2001-10-23, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ;UNK. MEASLES, MUMPS & RUBELLA VIRUS LIVE;1;1.50;In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Elevated sed rate
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5205A21IM 
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Fatigue, Gait disturbance, Joint swelling, Red blood cell sedimentation rate increased
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Pt began having aching joints in fingers. To date, this has progressed to knees, ankles, wrists, and 1 shoulder with some swelling in the joints. She also has fatigue. Pt has been limping for 9 days. Pt''s MD does not know enough about her symptoms and referred pt to a rheumatologist. Pt takes ibuprofen daily.

VAERS ID:176770 (history)  Vaccinated:2001-09-18
Age:20.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Male  Submitted:2001-10-22, Days after onset: 34
Location:Minnesota  Entered:2001-10-26, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0382AA1IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt c/o LD pain started on 9/18/01 after vaccine. Pt has had temperature, soreness and swelling to LD since 9/18/01 and has been taking Tylenol but ineffective. this sx continue from 9/18/01 to now.

VAERS ID:176821 (history)  Vaccinated:2001-09-18
Age:56.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-09-21, Days after onset: 3
Location:Utah  Entered:2001-10-29, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Meds for Diabetes
Current Illness: NONE
Preexisting Conditions: Diabetes
Diagnostic Lab Data:
CDC 'Split Type': UT012216
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0243L0 LA
Administered by: Public     Purchased by: Other
Symptoms: Diarrhoea, Dyspnoea, Fatigue, Malaise, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)
Write-up: Pt reports "feeling yucky" 3 hours after hep A shot. Pt complained of diarrhea, nausea, mild breathing problems and fever that went from 99-102.5 that night. Fever on Wed night was higher possibly 105.3, but pt isn''t sure she read thermometer right. Fever on Thurs (09/20/2001) was 99. Pt better today, just complained of "low energy".

VAERS ID:176992 (history)  Vaccinated:2001-09-18
Age:23.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-10-24, Days after onset: 36
Location:California  Entered:2001-11-01, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUA422AA0SCRA
Administered by: Military     Purchased by: Military
Symptoms: Blood pressure increased, Cough, Dyspnoea, Hot flush, Tongue oedema, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Pt received vaccine at 13:45 and 20-30 minutes later, experienced hot flush, wheezing, cough, dyspnea, tongue swelling and shortness of breath. Pt returned to BAS. Vital signs at 14:20; BP-143/72; Pulse-72; Respirations-20 and temperature was 97.9F. She was administered 1.0cc Epi and 25mg Benadryl and O2 therapy. Pt''s breathing improved and she was sent to NHCP for further treatment.

VAERS ID:177092 (history)  Vaccinated:2001-09-18
Age:3.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-10-18, Days after onset: 30
Location:Indiana  Entered:2001-11-01, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES968A2 IMGM
JEV: JAPANESE ENCEPHALITIS (JE-VAX)AVENTIS PASTEUR92030 IMGM
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The patient''s left buttock was red and swollen from 09/18 thru 09/20. The patient was treated with Augmentin, Benadryl and ice compresses. The patient was completely recovered by 09/24/2001.

VAERS ID:177150 (history)  Vaccinated:2001-09-18
Age:39.0  Onset:2001-10-17, Days after vaccination: 29
Gender:Female  Submitted:2001-10-26, Days after onset: 9
Location:Indiana  Entered:2001-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: All follow-up labs-nml
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM704A40IM 
Administered by: Private     Purchased by: Private
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased
SMQs:, Liver related investigations, signs and symptoms (narrow)
Write-up: One month following vax, pt''s ALT (SGPT) was 169 and AST (SGOT) was 70. Pt had no symptoms. The abnormal labs were noted through routine bloodwork.

VAERS ID:177384 (history)  Vaccinated:2001-09-18
Age:0.6  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-09-20, Days after onset: 2
Location:Georga  Entered:2001-11-08, Days after submission: 49
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: Child was tested by allergist on 2/28/02 and on 3/6/02 with the same vaccines and found to have an allergic response to the Prevnar vaccine which resembled the AE reported.
CDC 'Split Type': GA01086
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM508A21IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0954J1IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T079021SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4815441IMRL
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Feeling hot, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Pt came back, 30 minutes, post vax, with erythema (generalized) on chest and abdomen, thighs, legs, pelvic area and back. It was hot to touch. Pt was admitted to the hospital on 9/18/01 and came home on 9/19/01. Wheezing was stabilized with 1 nebulizer treatment at 17:00 on 9/18/01. Subsequently diagnosed by allergist with an allergic response to Prevnar at 1:10 dilution.

VAERS ID:177650 (history)  Vaccinated:2001-09-18
Age:4.0  Onset:2001-09-21, Days after vaccination: 3
Gender:Male  Submitted:0000-00-00
Location:Michigan  Entered:2001-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURU0321BA4IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT05052  LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0596L1SCRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt has swelling and redness locally left upper arm.

VAERS ID:177663 (history)  Vaccinated:2001-09-18
Age:41.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-10-12, Days after onset: 24
Location:Tennessee  Entered:2001-11-12, Days after submission: 31
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: Allergic to Amoxocillin.
Diagnostic Lab Data: UNK
CDC 'Split Type': TN01053
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0998K SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: 09/18/2001 Itching, went to MD. He gave medication for itching. 09/19/2001 having trouble breathing. MD gave her inhaler. 09/21/2001 still itching a little, no rash, continue to have trouble breathing. 09/24/2001 did not return call.

VAERS ID:179606 (history)  Vaccinated:2001-09-18
Age:29.0  Onset:2001-11-23, Days after vaccination: 66
Gender:Female  Submitted:2001-12-26, Days after onset: 33
Location:Unknown  Entered:2002-01-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Pregnancy (LMP-8/4/01)
Preexisting Conditions:
Diagnostic Lab Data: Ultrasound 10/15/01-Pregnancy confirmed; Ultrasound 10/31/01-Viable 8 week pregnancy
CDC 'Split Type': WAES01100288
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Abortion spontaneous, Laboratory test abnormal
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: Information has been received from an NP concerning a 29 year old female pt who on an unspecified date was vaccinated with varicella virus vaccine live. The NP indicated that the pt was 2 weeks pregnant when she received the vaccination. No adverse experiences were reported. The pt sought unspecified medical attention. Follow-up information was received from a physician''s assistant who indicated that the pt (gravida 4, para 3) was vaccinated on 9/18/01 with a 1st dose of varicella virus vaccine live for immigration purposes. The pt has a miscarriage on 11/23/01 (12 weeks from LMP). There were no birth defects. No further information is available.

VAERS ID:181382 (history)  Vaccinated:2001-09-18
Age:6.0  Onset:2001-10-16, Days after vaccination: 28
Gender:Male  Submitted:2002-02-04, Days after onset: 111
Location:Illinois  Entered:2002-02-13, 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:
Current Illness: NONE
Preexisting Conditions: hypoglycemia
Diagnostic Lab Data: MRI of right shoulder Microscopic diagnosis: biopsy of muscle, right shoulder-Normal tissue; Remarks: No inflammatory infiltrates are seen. no neoplastic changes
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURU0317BB1 LA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1656K1 RA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T04851 LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt developed a mass in right upper arm-was in to see the doctor on 10-16-01. had a MRI & was scheduled with orthopedic . He did a biopsy. Mom feels all related to immunization. Parents refused immunizations as infant for no reason.

VAERS ID:181600 (history)  Vaccinated:2001-09-18
Age:33.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-10-16, Days after onset: 28
Location:Ohio  Entered:2002-02-21, Days after submission: 128
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Alesse Birthcontrol pills, Celexa, Advair
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEUR0463AA  LA
Administered by: Private     Purchased by: Private
Symptoms: Hypoaesthesia, Inflammation, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Within seconds both arms, hands, fingers went completely numb. After injection had achy severe pain with burning from her shoulder down to her fingers. She have been diagnosed with RSD due to this injury (vaccine) and take nuerontin for nueropathic pain, receive stelute gangalion nerve blocks and now is in physical therapy. Her treatment started early but no one knows it has now almost been 5 month since the vaccine.

VAERS ID:182297 (history)  Vaccinated:2001-09-18
Age:9.0  Onset:2001-10-07, Days after vaccination: 19
Gender:Female  Submitted:2002-03-08, Days after onset: 152
Location:Texas  Entered:2002-03-13, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: allergy medication, Zyrtec-Flonase (recently)
Current Illness: NONE
Preexisting Conditions: environmental allergies
Diagnostic Lab Data: antibodies for Pneumonia and breathing treatments.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1611K0SCRA
Administered by: Public     Purchased by: 0
Symptoms: Pneumonia, Pruritus, Pyrexia, Scar, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Pneumonia-first part of October, Fever. Also had a few lesions and a few lesions in mid-February Itching scattered. Left a scar (not indented)

VAERS ID:182470 (history)  Vaccinated:2001-09-18
Age:  Onset:2001-09-20, Days after vaccination: 2
Gender:Female  Submitted:2002-03-07, Days after onset: 168
Location:Unknown  Entered:2002-03-14, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: plasma aspartate-70
CDC 'Split Type': WAES01092531
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Liver function test abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow)
Write-up: Information has been received from a pharmacist concerning a female who on 09/18/2001 was vaccinated with a dose of hep b vaccine recombinant. On 09/20/2001, labs were drawn and an elevated liver function test was observed. No other info was available. Unspecified medical attention was sought. Additional info has been requested. Follow up info received from the pharmacist indicated that she was stopped in the hallway by a physician who asked her if she was aware of the hep B vaccine causing an elevation in AST liver function tests. The pharmacist indicated that she did not know which brand of hep B vaccine was administered to the pt. No further info is available.

VAERS ID:183698 (history)  Vaccinated:2001-09-18
Age:18.0  Onset:2001-09-19, Days after vaccination: 1
Gender:Female  Submitted:2002-03-26, Days after onset: 188
Location:Illinois  Entered:2002-04-19, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone
Current Illness: NONE
Preexisting Conditions: Allergies
Diagnostic Lab Data:
CDC 'Split Type': IL02014
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5202A21IMRA
Administered by: Public     Purchased by: Public
Symptoms: Thrombocytopenic purpura
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: Received phone call from client. States she developed ITP (idiopathic thrombocytopenic purpura). MD stated it may be due to the heb B vaccine. He would check into it more. Client told not to get the third hep B vaccination.

VAERS ID:187584 (history)  Vaccinated:2001-09-18
Age:1.0  Onset:2001-09-19, Days after vaccination: 1
Gender:Male  Submitted:2002-05-30, Days after onset: 253
Location:Florida  Entered:2002-07-15, Days after submission: 46
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': WAES01092549
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0483L2IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1391K0SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0225L0SCLL
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from an LPN concerning a 12 month old male with no known drug allergies or past medical history who on 9/18/01 (PM) was vaccinated with the 1st dose of MMRII (634429/1391K) SC in the right thigh. Concomitant therapy that same day included the 3rd dose of HIB-Hep-B vaccine (lot 639442/0483L) IM in the left thigh and the 1st dose of varicella vaccine (lot 638252/0225L) SC in the left thigh. It was reported that the vaccinations were administered at different sites. There were no other concomitant medications. There was no illness at the time of vaccination. On 9/19/01, the pt had a rash/bumps on the face, neck and chest. There was no fever or scratching. On 9/20/01, the pt was seen in the physician''s office with an itchy, red rash/bumps over the entire body. The pt had scratching but was afebrile. The pt received treatment with Benadryl 1 teaspoon every 6 hours. There were no other symptoms noted. On an unknown date, the pt recovered. No further information is available.

VAERS ID:190382 (history)  Vaccinated:2001-09-18
Age:0.2  Onset:2001-09-18, Days after vaccination: 0
Gender:Male  Submitted:2001-09-25, Days after onset: 7
Location:Washington  Entered:2002-09-19, Days after submission: 359
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: NKA
Diagnostic Lab Data: NONE
CDC 'Split Type': WA011793
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM525A20 RL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1967J1 LA
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA573AA0 LL
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURT07860 RL
Administered by: Private     Purchased by: Public
Symptoms: Crying, Dyspnoea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad)
Write-up: Went to medical facility later in evening with SOB, screaming, grunting, T 99.2 Rectal, D/c with no sub, Color good, WNL

VAERS ID:190655 (history)  Vaccinated:2001-09-18
Age:47.0  Onset:2001-10-16, Days after vaccination: 28
Gender:Female  Submitted:2002-10-10, Days after onset: 359
Location:Maryland  Entered:2002-09-26, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: The subject was in "excellent health" prior to Sept. 01.
Diagnostic Lab Data: Adolase--normal; Antinuclear antibody--normal; Complete metabolic panel--normal; Creatine Phosphokinase, Serum--normal; Erythrocyte Sedimentation Rate--normal; Folate--normal; Full blood count--normal; Glucose, Blood--normal; Potassium--nor
CDC 'Split Type': A0381235A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS144B72IMLA
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Hypoaesthesia, Myalgia, Polyneuropathy
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: A physician reported the occurrence of sensory polyneuropathy in a 47 year old female who was vaccinated with Lyme disease vaccine recombinant OspA (LYMErix) for prophylaxis. The subject was in "excellent health" prior to September 2001. The subject received no concurrent medications. *The subject experienced no adverse events following previous vax''s. On 8/8/00, 11/3/00, and 9/18/01, the subject received her 1st, 2nd, and third LYMErix injections, respectively. 28 days following the 3rd LYMErix injection, on 10/14/01,* she experienced "extreme" fatigue, muscle pain, (mostly in her trunk which varied in intensity), and sensory polyneuropathy characterized by burning and numbness in *her arms, trunk, and legs.* These events occurred sometimes at the same time. The physician stated that the subject''s laboratory studies and magnetic resonance imaging (MRI) of the brain and the spinal cord were all normal. Lyme titer was positive. A Western blot was sent by the local hospital to a tertiary hospital, which returned the Western blot saying that "it was unable to interpret the results due to Lyme vaccine." The subject has reportedly been seen by a neurologist, a rheumatologist, a "spinal specialist", and two rehabilitation specialists who have referred the subject back to the vaccine provider. The events have gotten progressively worse and has resulted in disability. As of 9/18/02, the subject was unable to work due to extreme fatigue and muscle pain and was unable to drive or to get out of bed without help. *As of 10/1/02, the MD reported the events of sensory poolyneuropathy and paresthesia, fatigue, and muscle pain persisted. The reporting MD stated that the events were possibly related to LYMErix administration.*

VAERS ID:196374 (history)  Vaccinated:2001-09-18
Age:26.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Male  Submitted:2003-01-09, Days after onset: 478
Location:Ohio  Entered:2003-01-17, 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: Lansoprazole (Prevacid)
Current Illness: UNK
Preexisting Conditions: Acid Reflux
Diagnostic Lab Data: UNK
CDC 'Split Type': A0365510A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Hypoventilation, Tremor, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad)
Write-up: On 9/18/01, the vaccinee received his 1st injection of Engerix-B. Thirty minutes later, he had problems focusing, shallow breathing and shakiness. The events lasted 30 minutes. On 10/19/01, the vaccinee received his 2nd injection of Engerix-B (lot ENG5255B6). No adverse events were reported at that time. On 3/21/02, the vaccinee was seen in the office to receive his 3rd injection of Engerix-B. At that time, he reported that 30 minutes after receiving his 2nd injection of Engerix-B, on 10/19/01, he experienced nausea, vomiting, tingling sensation in his right hand, blurred vision, shakiness, weakness and anxiety. The nausea resolved on 10/19/01. As of 3/21/02, the outcome of the vomiting, tingling sensation in his right hand, blurred vision, shakiness, weakness and anxiety were unknown. The 3rd injection of Engerix-B was not administered.

VAERS ID:215007 (history)  Vaccinated:2001-09-18
Age:30.0  Onset:0000-00-00
Gender:Female  Submitted:2004-01-09
Location:Alabama  Entered:2004-01-16, 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: UNK
Preexisting Conditions: Medical history, concurrent conditions and concurrent medications were not specified.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0357451A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSENG5186C60IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis
SMQs:, Hypersensitivity (narrow)
Write-up: Report 2002000935-1 describes dermatitis around the injection site in an approx 30-year-old female pt who received hepatitis B vaccine recombinant (Engerix-B). Medical history, concurrent conditions and concurrent medications were not specified. On 09/18/2001, the pt received her 1st injection of Engerix-B (lot ENG5186C6). Subsequently, she had a "dermatitis reaction" around the area of the vaccination. The pt was seen by a dermatologist, who reportedly made a diagnosis of dermatitis related to the hepatitis B vaccination. As of 01/11/2001, the outcome of the event was unknown.

VAERS ID:251410 (history)  Vaccinated:2001-09-18
Age:1.0  Onset:2006-02-10, Days after vaccination: 1606
Gender:Male  Submitted:2006-02-10, Days after onset: 0
Location:Arizona  Entered:2006-02-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: unknownnon
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash, Viral infection
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Mom phoned office, has two red bumps- one behind ear and one on waist. Was exposed to varicella two weeks ago. Afebrile.

VAERS ID:251608 (history)  Vaccinated:2001-09-18
Age:1.1  Onset:2005-09-26, Days after vaccination: 1469
Gender:Female  Submitted:2006-02-07, Days after onset: 134
Location:Pennsylvania  Entered:2006-02-17, 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: Asthma, anemia
Diagnostic Lab Data: CHOP urology VZV by DFA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1905U0 RL
Administered by: Public     Purchased by: Public
Symptoms: Back pain, Herpes zoster, Pyrexia, Rash vesicular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow)
Write-up: L thigh and vaginal area vesicular rash as with fever and back pain. Zoster, Rx-Tylenol

VAERS ID:176907 (history)  Vaccinated:2001-09-18
Age:22.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-10-24, Days after onset: 36
Location:Foreign  Entered:2001-10-31, 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: levothyroxine 0.1mg continuing (since 1/1/01)
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CRP was 5 and her prothrombin level decreased to 51%.
CDC 'Split Type': BERNA20010093
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD 1PO 
Administered by: 0     Purchased by: 0
Symptoms: Diarrhoea haemorrhagic, Laboratory test abnormal, Prothrombin level decreased, Vomiting
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)
Write-up: Three hours after ingestion of the Vivotif capsule on 9/8/01, this 22 year old female experienced severe nausea. The 2nd dose was taken on 9/18/01, and again, 3 hours after ingestion, the pt developed severe nausea, followed by vomiting and partial hemorrhagic diarrhea. The pt was hospitalized. The pt was treated with 0.9% NaCI infusion and vitamin K1. The pt recovered without sequelae. (ICH) "Medically Important".

VAERS ID:234048 (history)  Vaccinated:2001-09-18
Age:49.0  Onset:0000-00-00
Gender:Female  Submitted:2005-02-18
Location:Foreign  Entered:2005-02-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data: Antinuclear antibody positive; CSF test abnormal; MRI brain abnormal
CDC 'Split Type': B0362633A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Other     Purchased by: Other
Symptoms: Antinuclear antibody positive, CSF test abnormal, Hypoaesthesia, Immune system disorder, Multiple sclerosis, Nausea, Neuropathy, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Systemic lupus erythematosus (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Demyelination (narrow)
Write-up: This case was reported by a physician via an insurance company and described the occurrence of multiple sclerosis in a 49 year old female subject who had received Hepatitis B vaccine injection for prophylaxis. The subject was taking no concomitant medication and was previously healthy except for proctitis that she was having for years. On 9/26/00, the first dose of Engerix B was given. On 9/18/01, the patient received the second dose of Hepatitis B vaccine at 20mcg. In September or October 2001, she developed the first symptoms of multiple sclerosis with paresthesia and numbness of hands. On 11/19/01, she was seen by a physician who judged the event as an adverse reaction to the vaccine, possibly a neuropathy. Since then no further attacks occurred. On 4/18/03, she developed a suspected winter vomiting disease, but as the nausea persisted, she was admitted to hospital from 5/6/03 until 5/26/03. Liquor investigation showed a picture of immunopathy. An MRI of the brain showed high signal changes periventricular and one in C2 area, consistent with an immunopathy. No information regarding the activity was provided. Lab tests proved also positive antinuclear antibodies. The outcome of the events is unknown.

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