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Case Details (Sorted by Vaccination Date)

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VAERS ID:152806 (history)  Vaccinated:2000-06-02
Age:0.8  Onset:2000-06-02, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:2000-06-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:  ;UNK. DTP & HIB; ;.00;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: Heart valve blockages.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0056FA2IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES09634202 RL
Administered by: Private     Purchased by: Public
Symptoms: Anorexia, Coma, Crying, Depersonalisation, Pyrexia, Vomiting, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (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), Depression (excl suicide and self injury) (broad)
Write-up: 02/02, screaming uncontrollably, 02/02-02/03 lying in bed "comatose," 02/03-02/06, not eating and throwing up what he did, 02/02-02/05, fever of 103.5, not acting himself. Lost 3/4 lbs in 4 days.

VAERS ID:153395 (history)  Vaccinated:2000-06-02
Age:36.0  Onset:2000-06-03, Days after vaccination: 1
Gender:Male  Submitted:2000-06-05, Days after onset: 2
Location:South Carolina  Entered:2000-06-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0084SC 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR023421IM 
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Red from shoulder to the elbow, warm to the touch and itchy.

VAERS ID:153820 (history)  Vaccinated:2000-06-02
Age:4.0  Onset:2000-06-02, Days after vaccination: 0
Gender:Male  Submitted:2000-06-02, Days after onset: 0
Location:California  Entered:2000-06-09, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1958J1IMLA
Administered by: Private     Purchased by: Public
Symptoms: Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Rash all over the body and swelling given epinephrine 0.18 cc and Atarax 10 mg po Q 6 hours x 3 days.

VAERS ID:154186 (history)  Vaccinated:2000-06-02
Age:1.3  Onset:2000-06-04, Days after vaccination: 2
Gender:Male  Submitted:2000-06-04, Days after onset: 0
Location:California  Entered:2000-06-14, 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:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM919A23IMRL
Administered by: Private     Purchased by: Public
Symptoms: Hypokinesia, Infection, Injection site erythema, Injection site oedema, Injection site pain, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt experienced injection site reaction characterized by redness and swelling and was painful to move leg. Given Keflex for infected immunization site but was later reassessed as vaccine reaction.

VAERS ID:154225 (history)  Vaccinated:2000-06-02
Age:36.0  Onset:2000-06-02, Days after vaccination: 0
Gender:Male  Submitted:2000-06-04, Days after onset: 2
Location:Michigan  Entered:2000-06-14, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0080SC 
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The first day, the pt experienced localized redness and swelling, pain at the site of injection. The second day, the redness was spreading, pain and swelling approximately 6 inches in diameter. Third day, redness and back of arm pain, spreading continued on arm for 10 minutes.

VAERS ID:154554 (history)  Vaccinated:2000-06-02
Age:1.0  Onset:2000-06-11, Days after vaccination: 9
Gender:Male  Submitted:2000-06-16, Days after onset: 5
Location:Ohio  Entered:2000-06-19, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: swollen leg ;UNK. UNCLASSIFIED VACCINE; ;.00;In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R06182SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1716J0SCLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1031J0SCRL
Administered by: Public     Purchased by: Other
Symptoms: Face oedema, Oedema peripheral, Pyrexia, Rash, Rhinorrhoea
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 6/3 to 6/4/00 legs and knees swollen, 6/4 runny nose and low grade temp, 6/11 fever of 100.4 (ear), 6/12 went to MD, 6/13 rash on face and spread to trunk, 6/14 cheeks and neck swollen, 6/16 to MD, told mom he could not differentiate the rash from roseola or from the MMR vaccine.

VAERS ID:154769 (history)  Vaccinated:2000-06-02
Age:1.1  Onset:2000-06-08, Days after vaccination: 6
Gender:Male  Submitted:2000-06-12, Days after onset: 4
Location:North Carolina  Entered:2000-06-20, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: NC00038
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P123232SCLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1327J0SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0086K0SCLL
Administered by: Private     Purchased by: Public
Symptoms: Rash, Rash papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: The pt experienced a butterfly shaped rash at injection site, and a papular rash as well. Follow up: "Vaccine recipient recovered from adverse events."

VAERS ID:155779 (history)  Vaccinated:2000-06-02
Age:34.0  Onset:2000-06-03, Days after vaccination: 1
Gender:Male  Submitted:2000-06-14, Days after onset: 11
Location:California  Entered:2000-06-29, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0083SCRA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Diarrhoea, Influenza like illness, Malaise, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Complaining of flu-like symptoms, nausea, vomiting, diarrhea, chills and malaise for 1 day, post vax.

VAERS ID:155875 (history)  Vaccinated:2000-06-02
Age:0.2  Onset:2000-06-03, Days after vaccination: 1
Gender:Female  Submitted:2000-06-13, Days after onset: 10
Location:Texas  Entered:2000-06-30, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: hx of surgery
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES467674 IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0293 IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R0668 IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The pt experienced redness at the injection site with induration.

VAERS ID:156263 (history)  Vaccinated:2000-06-02
Age:1.3  Onset:0000-00-00
Gender:Male  Submitted:2000-06-08
Location:California  Entered:2000-07-11, Days after submission: 33
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: RAD, RML pneumonia and asthma
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7387BB3IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESP1290AA2IMLL
Administered by: Private     Purchased by: Public
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: A half a cm induration left thigh, not tender.

VAERS ID:156513 (history)  Vaccinated:2000-06-02
Age:1.0  Onset:2000-06-10, Days after vaccination: 8
Gender:Female  Submitted:2000-06-13, Days after onset: 3
Location:Washington  Entered:2000-07-13, Days after submission: 30
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: egg allergy, eczema
Diagnostic Lab Data: skin test at allergist - positive for eggs.
CDC Split Type: WA001667
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0108K SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1862J SC 
Administered by: Private     Purchased by: Public
Symptoms: Condition aggravated, Eczema
SMQs:, Hypersensitivity (narrow)
Write-up: Eight days post vax pt exhibited marked exacerbation of previously well controlled eczema. Onset occurred eight days post vax. Pt is afebrile, eats, plays, sleeps normally.

VAERS ID:157400 (history)  Vaccinated:2000-06-02
Age:1.1  Onset:2000-06-11, Days after vaccination: 9
Gender:Male  Submitted:2000-06-21, Days after onset: 10
Location:Colorado  Entered:2000-07-19, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl
Current Illness: mild eczema
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0290K2IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R06182IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0049K0SC 
Administered by: Private     Purchased by: Private
Symptoms: Erythema multiforme, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Nine days post vax pt began having rash on right inner arm which spread to cover her entire body by the next day. Erythematous morbilform rash looks like a rash from the measles. Pt had a temperature of 99.3. Rash covering all of her body from the top of her head down to legs.

VAERS ID:158121 (history)  Vaccinated:2000-06-02
Age:63.0  Onset:2000-06-02, Days after vaccination: 0
Gender:Female  Submitted:2000-06-14, Days after onset: 12
Location:Indiana  Entered:2000-07-28, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cardizem
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 20000176581
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY128A20IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Injection site rash
SMQs:, Hypersensitivity (narrow), Arthritis (broad)
Write-up: On 6/2/00, the pt received her 1st dose of Lymerix. Six hours later, on 6/2/00, the pt experienced generalized arthralgias and a bullseye rash at the injection site. The vaccinee had no fever, rash or pruritus. She was treated that day with NSAIDS (NOS). The most recent information, received on 6/5/00, reports the condition of the vaccinee is resolving.

VAERS ID:161400 (history)  Vaccinated:2000-06-02
Age:0.8  Onset:2000-06-02, Days after vaccination: 0
Gender:Male  Submitted:2000-09-18, Days after onset: 108
Location:North Carolina  Entered:2000-10-05, 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: NONE
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ7175712JUN2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1968J1IM 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712031IMLL
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Viral infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: A nurse reported that a 9 month old male received his 2nd dose of Prevnar and Recombivax-HB (Merck) on 6/2/00. On 6/5/00, he developed a fever of 102.1F. Additional information received on 6/26/00, indicated that the pt was seen by the physician on 6/7/00 and a dx of herpangina was made. He recovered.

VAERS ID:163427 (history)  Vaccinated:2000-06-02
Age:48.0  Onset:0000-00-00
Gender:Female  Submitted:2000-08-17
Location:Connecticut  Entered:2000-11-14, Days after submission: 89
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prosom; Theragran; Hematin
Current Illness:
Preexisting Conditions: brain tumor (NOS); chronic anemia; inferior vena cava ligation; thrombophlebitis
Diagnostic Lab Data: HGB - 07/2000 = 10 G/DL; Lyme disease test negative - 07/11/2000
CDC Split Type: 20000246641
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3142A20IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Fatigue, Headache, Influenza, Myalgia, Nausea, Pain, Paraesthesia, Pyrexia, Skin burning sensation, Skin exfoliation, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Two days post vax the pt experienced mild fatigue and headache and felt like she was getting the flu. She reported that she felt extremely tired as the day progressed. Around mid-day she experienced a quick onset of muscle and joint pain. Within an hour, her entire body hurt. She developed a headache across the eyes. She developed nausea that came in waves and vomited once. She became dizzy and developed a low grade fever and chills. She reported that she became so weak, she could barely walk. She developed pain in her rib cage and reported that it hurt if she took a deep breath. She reported that she was so weak, her arms and legs were shaking. This lasted for eight days and she was seen by her physician on 07/11/2000 and sent to the ER on 07/12/2000. She did not seek medical attention prior to this time as she was uninsured, but she was so sick she could not avoid it by 07/11/2000. All tests performed in the ER were negative, including a test for Lyme disease. She was started on doxycycline 100 mg bid and according the the pt, continued to receive doxycycline. After three day on doxycycline symptoms seemed to plateau. Between 07/15 and 07/20/2000, the nausea, vomiting, fever and headache resolved. On 07/20/200 she developed tingling and burning sensations and then the skin started to peel on her anterior feet and palms. The pt reported that the ER physician felt that these side effects were due to the doxycycline. As of 07/20/2000 the pt reported that she continued with generalized weakness, fatigue, muscle pain in her lower arm and thigh muscles.

VAERS ID:166446 (history)  Vaccinated:2000-06-02
Age:1.0  Onset:2000-06-05, Days after vaccination: 3
Gender:Unknown  Submitted:2001-02-16, Days after onset: 256
Location:South Carolina  Entered:2001-03-05, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00061424
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Injection site induration, Injection site warmth, Urticaria, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Reported induration at injection site, warmth at injection site, wheal at injection site. On June 5th 2000 the patient experienced a local reaction to vaccine, red welt on the arm that was warm to touch. The area was 1 1/2 x 2 1/2 cm and hard

VAERS ID:167527 (history)  Vaccinated:2000-06-02
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2001-03-07
Location:Missouri  Entered:2001-03-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00051785
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: 0     Purchased by: 0
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a health care professional concerning a 23 year old female patient who on 06/02/00 was vaccinated with one dose of Hepatitis B vaccine recombinant. Subsequently, the patient experienced a rash described as "flesh-colored bumps" on her face, sides and legs. Unspecified medical attention was sought. Additional information has been requested.

VAERS ID:169740 (history)  Vaccinated:2000-06-02
Age:18.0  Onset:2000-06-13, Days after vaccination: 11
Gender:Male  Submitted:2000-07-31, Days after onset: 48
Location:Pennsylvania  Entered:2001-05-09, Days after submission: 282
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U2000005850
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA230AA SC 
Administered by: 0     Purchased by: 0
Symptoms: Abscess
SMQs:
Write-up: It was reported that an 18 year old male pt received a Menomune A/C/Y/W-135 vaccination on 6/2/00. Reportedly, on 6/13/00, the pt developed a possible sterile abscess, no specifics provided. Further information requested.

VAERS ID:171438 (history)  Vaccinated:2000-06-02
Age:1.1  Onset:2000-06-05, Days after vaccination: 3
Gender:Male  Submitted:2001-05-15, Days after onset: 344
Location:Colorado  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00060719
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.6345120435K0SCLL
Administered by: Private     Purchased by: Private
Symptoms: Rash papular, Rash pustular, Viral infection
SMQs:, Hypersensitivity (narrow)
Write-up: On 06/05/2000 the patient started to develop a diffuse papular-pustular rash. On 06/06/2000, the patient was seen by a physician and diagnosed with chickenpox that consisted of "many lesions on his back, arms and chest with no fever. Follow up information from a physician''s office indicated that no action was taken and the patient subsequently recovered.

VAERS ID:171448 (history)  Vaccinated:2000-06-02
Age:1.3  Onset:2000-06-02, Days after vaccination: 0
Gender:Male  Submitted:2001-05-15, Days after onset: 347
Location:Washington  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: injection site erythema;MMR II;;1.25;In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Allergy, asthma, eggs allergy, wheat allergyw
Diagnostic Lab Data:
CDC Split Type: WAES00061052
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.6352030071K0SCRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: Immediately upon administering the vaccine, the patient''s arm turned quite red. Within seconds, a small one inch wheal/hive developed at the site of injection. There was no respiratory involvement or systemic reactions. The patient was observed for 20 minutes. The reaction appeared to be resolving spontaneously. Follow up information from a RN indicated that the injection site wheal "resolved spontaneously". It was noted that 5 weeks post-onset, the patient had a similar reaction to MMR.

VAERS ID:171459 (history)  Vaccinated:2000-06-02
Age:1.3  Onset:2000-08-11, Days after vaccination: 70
Gender:Male  Submitted:2001-05-15, Days after onset: 277
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00061264
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Viral infection
SMQs:
Write-up: On 06/11/2000 the patient developed chicken pox. The patient sought unspecified medical treatment. Addtional information has been requested.

VAERS ID:171807 (history)  Vaccinated:2000-06-02
Age:1.0  Onset:2000-06-23, Days after vaccination: 21
Gender:Female  Submitted:2001-05-15, Days after onset: 326
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00100754
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Rash, Viral infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Three weeks post vaccination, the patient developed chickenpox with a fever which lasted one day. It was reported that the lesions covered her body. Unspecified medical attention was sought. Additional information has been requested.

VAERS ID:175893 (history)  Vaccinated:2000-06-02
Age:9.0  Onset:2000-10-01, Days after vaccination: 121
Gender:Male  Submitted:2001-08-27, Days after onset: 330
Location:Florida  Entered:2001-10-01, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ5158324AUG2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1958J1IM 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4747240IMLA
Administered by: Private     Purchased by: Private
Symptoms: Basedow's disease, Eye disorder, Increased appetite, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Optic nerve disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hyperthyroidism (narrow)
Write-up: A mother reported that her 9 year old son received doses of Prevnar and Hep-A vaccines on 6/2/00. In 10/00, she noticed that her son was losing weight. By 1/01, her son had lost 10 lbs. He was subsequently, seen by his pediatrician. On 3/16/01, her son received a second dose of Prevnar. At that time he had developed bulging eyes, weight loss with increased appetite and had lost 14 lbs. In 5/01, her son was dx''d with Graves disease. The reporter noted that she requested the pediatrician to report this event; however, he declined since "he felt that it (Graves disease) had nothing to do with the vaccine". No further information was available at the date of the report. Follow-up info received from the child''s pediatrician on 10/08/2001 stated that on 03/16/2001, the child received prevnar and Hep a vaccines. "It is my medical opinion that his shots on 03/16/2001 did not cause or contribute to his graves disease." Follow-up info changed suspect vaccine to Pnu-Imune 23.

VAERS ID:209427 (history)  Vaccinated:2000-06-02
Age:70.0  Onset:2000-06-20, Days after vaccination: 18
Gender:Male  Submitted:2003-09-18, Days after onset: 1185
Location:Maryland  Entered:2003-09-19, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NSAID, Thyroid medication
Current Illness: Knee Pain
Preexisting Conditions: Hypothyroid, PSA elevated, allergy, arthritis, melanoma surgically removed, polyarthalgia, toe cramps, upper respiratory infection, urinary tract infection.
Diagnostic Lab Data: See attached
CDC Split Type: A0425560A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALSLY130A92IMLA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Hypoaesthesia, Muscle spasms, Myalgia, Neck pain, Paraesthesia, Sinusitis, Visual disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: This report describes the occurrence of joint pain in a 70 year old male patient who received Lyme disease vaccine recombinant OsPa (LymeRix) for prophylaxis. This report was received as part of litigation proceedings, and has not been verified by a physician or other healthcare professional. The patient submitted a report directly to VAERS. The patient''s medical history included "slightly PSA (Prostate specific antigen) (5.0), low thyroid". The patient reported that he had right knee pain at the time of immunization. Concurrent medications included "Various NSAIDS (nonsteroidal anti-inflammatory drugs), Thyroid med". An immunization record from the vaccine provider indicated that the patient received injections of LymeRix on Dec 03, 1999 (lot LY130B9). January 3, 2000 (lot LY130A9), and June 02, 2000 (lot LY130A9). The third dose of LymeRix was administered six months sooner than recommended. On a VAERS form completed by the patient, he indicated that his adverse experience began in June 2000, at an unspecified time post-immunization. For the description of the event, he wrote, "Progressive pain and disability in the following order- knee to knee to hip- fingers to shoulders to elbows to feet- earaches. Failing eyesight. Tingling on skin surface. Finger numbness, muscle pain, head neck pain." He indicated that the events were unresolved and resulted in permanent disability. On a VAERS follow up form, the patient wrote, "got very affected (sic) after third dose". He indicated that he had not recovered. He wrote, "all bones, joints, front teeth very painful- large muscle cramp and pain. Many neuropathies. Chronic sinusitis. "Under the comment section, he wrote, "This is a crippling, painful disabling at an ever increasing pace disease." He indicated that he had been evaluated by nine doctors and was receiving treatment with gammaglobulin. On September 3, 2003, the patient''s attorney alleged that the patient received injections of LymeRix "on Dec 3, 1999, Jan 3, 2000, June 2, 2000 and Aug 4, 2000 according to the

VAERS ID:223320 (history)  Vaccinated:2000-06-02
Age:1.6  Onset:2000-06-02, Days after vaccination: 0
Gender:Male  Submitted:2004-06-07, Days after onset: 1466
Location:Maryland  Entered:2004-06-24, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: IgA deficiency; Recurrent OM; Allergic Rhinitis; Recurrent yeast infections, gluten intolerance
Diagnostic Lab Data: Diagnosed with encephalopathy and regressive autism., IgA deficiency
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEUR 3IM 
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Antisocial behaviour, Autism, Encephalopathy, Laboratory test abnormal, Screaming
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hostility/aggression (narrow), Chronic kidney disease (broad)
Write-up: Persistent, inconsolable screaming and behavior occurred within 24 hours of vaccination. This was followed by loss of communication skills, social skills, ease with food and general regression in all areas. Treatment: speech, occupational and behavioral therapy. Nurse follow up on 07/21/04 states: "strabismus, developmental delays As per annual follow up report: Residual symptoms of autism, asperger continue, not withstanding extensive treatment and progress.

VAERS ID:256871 (history)  Vaccinated:2000-06-02
Age:1.2  Onset:2005-11-02, Days after vaccination: 1979
Gender:Male  Submitted:2006-05-12, Days after onset: 190
Location:New Hampshire  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0511USA00911
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Rash vesicular, Skin ulcer, Viral infection
SMQs:, Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 6 yr old male who on 02Jun00 was vaccinated with a dose of varicella virus vaccine live. There was no concomitant therapy. The physician reported that on 02Nov05, the pt developed 20-30 varicella lesions. The pt was noted to be afebrile. Unspecified medical attention was sought, but no treatment was required. At the time of this report, the pt was recovering. Additional information has been requested.

VAERS ID:152665 (history)  Vaccinated:2000-06-03
Age:43.0  Onset:0000-00-00
Gender:Female  Submitted:2000-06-04
Location:Michigan  Entered:2000-06-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0472SCLA
Administered by: Military     Purchased by: Military
Symptoms: Eye pain, Neck pain, Vision blurred, Vitreous floaters
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (narrow), Arthritis (broad)
Write-up: Eye pain in right eye, blurry vision and floaters, started a few hours, post vax. It got better and the pain in my right eye woke me up in the middle of the night. Had cloudy vision and floaters all day on Sunday. Still have neck pain.

VAERS ID:153910 (history)  Vaccinated:2000-06-03
Age:33.0  Onset:2000-06-03, Days after vaccination: 0
Gender:Female  Submitted:2000-06-05, Days after onset: 2
Location:Pennsylvania  Entered:2000-06-12, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV048B3SCLA
Administered by: Military     Purchased by: Military
Symptoms: Contusion, Dizziness, Injection site oedema, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)
Write-up: Top of upper arm swelled and in pain. Silver dollar sized bruise. Pt states prior nausea and light-headedness had elapsed Friday night. Reoccurred 12 hours, post vax. Pt claims same reaction to arm but no light-headedness with shot #3. Still occurring.

VAERS ID:154224 (history)  Vaccinated:2000-06-03
Age:52.0  Onset:2000-06-05, Days after vaccination: 2
Gender:Male  Submitted:2000-06-08, Days after onset: 3
Location:Maine  Entered:2000-06-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergy to PCN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0474SCLA
Administered by: Military     Purchased by: Military
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Left arm feels that it is asleep. Tingling feeling in elbow and fingers.

VAERS ID:154226 (history)  Vaccinated:2000-06-03
Age:41.0  Onset:2000-06-03, Days after vaccination: 0
Gender:Male  Submitted:2000-06-16, Days after onset: 13
Location:Colorado  Entered:2000-06-14, 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: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0475SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Large local reaction with redness, swelling, and pain surrounding injection site. Hand swelling one day post injection per pt - resolved now - local reaction, 95x80 mm at T+3.

VAERS ID:154538 (history)  Vaccinated:2000-06-03
Age:28.0  Onset:2000-06-03, Days after vaccination: 0
Gender:Male  Submitted:2000-06-14, Days after onset: 11
Location:Unknown  Entered:2000-06-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES7359AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction
SMQs:
Write-up: Pt experienced local reaction to Diptheria and Tetanus Toxoids and Pertussis vax. Pt received the pediatric vax instead of the adult vax.

VAERS ID:154851 (history)  Vaccinated:2000-06-03
Age:28.0  Onset:2000-06-06, Days after vaccination: 3
Gender:Male  Submitted:2000-06-14, Days after onset: 8
Location:Virginia  Entered:2000-06-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES7359AA IMRA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt reported to ER for a suture check, with an injection site reaction 4 days post vax. The site was unusually red and swollen

VAERS ID:155245 (history)  Vaccinated:2000-06-03
Age:0.6  Onset:2000-06-04, Days after vaccination: 1
Gender:Male  Submitted:2000-06-07, Days after onset: 3
Location:Pennsylvania  Entered:2000-06-22, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: WBC-$g26,000, CSF-nml
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM916A22IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R00982IMLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712080IMLL
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: 10 minute generalized seizure with fever.

VAERS ID:155450 (history)  Vaccinated:2000-06-03
Age:28.0  Onset:2000-06-03, Days after vaccination: 0
Gender:Male  Submitted:2000-06-14, Days after onset: 11
Location:Unknown  Entered:2000-06-27, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7359AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction
SMQs:
Write-up: The pt experienced a local reaction to DTaP vaccine. One of three similar reactions reported at this facility in the past two weeks. The pt received the pediatric vaccine instead of the adult vaccine.

VAERS ID:157153 (history)  Vaccinated:2000-06-03
Age:0.3  Onset:2000-06-04, Days after vaccination: 1
Gender:Female  Submitted:2000-07-07, Days after onset: 33
Location:Illinois  Entered:2000-07-18, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Blood work neg for viral infection, Low hemoglobin
CDC Split Type: IL00040
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM939A20IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1945J0IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P09050SCLA
Administered by: Public     Purchased by: Public
Symptoms: Irritability, Lethargy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: Child fussy and cried to point of lethergy for 4 days after shots. Taken to MD, mother reports child not able to hold head up. Low grade fever. Child on Tylenol, child placed on iron for low hemoglobin after visit to MD.

VAERS ID:158169 (history)  Vaccinated:2000-06-03
Age:42.0  Onset:2000-06-05, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:Michigan  Entered:2000-07-31
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: Allergies; hay fever
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0174K SC 
Administered by: Military     Purchased by: Military
Symptoms: Bacterial infection
SMQs:
Write-up: Strep throat on Monday, 6/5/00 and missed work on 6/6/00. Examined by family doctor on 6/8/00. Still recovering.

VAERS ID:158393 (history)  Vaccinated:2000-06-03
Age:48.0  Onset:2000-07-20, Days after vaccination: 47
Gender:Male  Submitted:2000-07-28, Days after onset: 8
Location:Pennsylvania  Entered:2000-08-03, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV048B2IM 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Dizziness, Headache
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: Reoccurring headaches, joint pains, and dizzy spells intermittently.

VAERS ID:159842 (history)  Vaccinated:2000-06-03
Age:55.0  Onset:2000-07-08, Days after vaccination: 35
Gender:Male  Submitted:2000-09-15, Days after onset: 69
Location:Maryland  Entered:2000-09-18, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Migraines, tonsillectomy
Diagnostic Lab Data: CRP-9.7
CDC Split Type: 20000270981
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: Five weeks post vax, the pt experienced severe joint pain in his hands, wrists, feet, knees, and shoulders. Additionally, he had a temperature of 102. He was considered by the reporter to be disabled and was admitted to the hospital. He was treated with Daypro and with prednisone on a tapering schedule.

VAERS ID:160981 (history)  Vaccinated:2000-06-03
Age:27.0  Onset:2000-06-03, Days after vaccination: 0
Gender:Male  Submitted:2000-06-04, Days after onset: 1
Location:Texas  Entered:2000-10-25, Days after submission: 143
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: INH for (+) PPD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1117J0IM 
HEPA: HEP A (VAQTA)MERCK & CO. INC.0120H1IM 
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)PFIZER/WYETH49981371SC 
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURER73437AC1SC 
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt developed dizziness, headache and muscle aches, immediately, post vax, lasting about 24 hours.

VAERS ID:171583 (history)  Vaccinated:2000-06-03
Age:1.0  Onset:2000-06-05, Days after vaccination: 2
Gender:Male  Submitted:2001-05-15, Days after onset: 344
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00071206
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow)
Write-up: Post vax, on 06/05/2000 the patient developed a rash of vesicular lesions. On 06/06/2000 the patient was seen by a physician. The physician felt that the patient "must have been exposed to natural varicella to have developed a rash so quickly." The patient''s mother denies exposure to natural varicella. At the time of reporting the patient continued to develop 3-4 pox every day. Additionally it was noted that the patient''s mother and father also developed similar experiences. Additional information has been requested.

VAERS ID:181159 (history)  Vaccinated:2000-06-03
Age:36.0  Onset:2000-06-05, Days after vaccination: 2
Gender:Male  Submitted:2000-07-05, Days after onset: 30
Location:New Jersey  Entered:2002-02-11, Days after submission: 586
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: U200000519
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0055AA   
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUA141AA   
Administered by: 0     Purchased by: 0
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: It was reported that a 36 year old male received a YF vax and a TD adult vaccination on 3-JUN-2000. Reportedly on 5-JUN-2000, the patient developed a fine rash without urticaria on his arms, legs and trunks only, no facial involvement . The patient was evaluated and treated with Benadryl. The rash resolved and the patient recovered.

VAERS ID:220962 (history)  Vaccinated:2000-06-03
Age:38.0  Onset:2000-06-03, Days after vaccination: 0
Gender:Female  Submitted:2004-05-19, Days after onset: 1446
Location:Connecticut  Entered:2004-05-20, Days after submission: 1
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: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Private     Purchased by: Private
Symptoms: Eye disorder, Fatigue, Hypoaesthesia, Musculoskeletal stiffness, Pain, Rheumatoid arthritis
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Corneal disorders (broad), Retinal disorders (broad), Arthritis (narrow)
Write-up: Shooting pains in arms and legs, stiffness, fatigue, rheumatoid arthritis. Nurse follow up on 07/07/04 states: "Per review of medical records from vaccine provider-PCP, In 6/02, patient c/o tick bite followed by achiness (myalgia), fever (FEVER), & joint pain (ARTHRALGIA). Lyme disease was suspected, but lab tests were not done to confirm. Pt was treated with Doxycycline, but apparently did not return to the provider for follow up." As per annual follow up: rheumatoid arthritis, unusual fatigue, Numbness in left eye.

VAERS ID:234635 (history)  Vaccinated:2000-06-03
Age:53.0  Onset:0000-00-00
Gender:Male  Submitted:2000-12-09
Location:Texas  Entered:2005-03-07, Days after submission: 1549
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: Allergies
Diagnostic Lab Data: EMG of hands, Blood tests, urine heavy metals
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0314SC 
Administered by: Military     Purchased by: Military
Symptoms: Hypoaesthesia, Laboratory test abnormal, Neuropathy peripheral
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad)
Write-up: Patient went to his primary care physician. He had blood test done. He was referred to a neurologist and had an EMG completed. He was diagnosed with peripheral neuropathy. He had numbness to fingers in both hands.

VAERS ID:278202 (history)  Vaccinated:2000-06-03
Age:8.0  Onset:0000-00-00
Gender:Female  Submitted:2007-05-01
Location:Unknown  Entered:2007-05-08, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Unknown
Symptoms: Vaccination failure, Varicella
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Active case chicken pox 4/27/07 vaccine failure.

VAERS ID:345137 (history)  Vaccinated:2000-06-03
Age:53.0  Onset:2008-04-04, Days after vaccination: 2862
Gender:Male  Submitted:2009-04-28, Days after onset: 389
Location:Michigan  Entered:2009-04-29, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Myalgias; Felt nauseated; Hypotension
Diagnostic Lab Data: 03/12/2009, Absolute Lymphs, 0.59, Low; 01/23/2009, ADDS, 432, positive, greater than 200 strong positive; Alanine aminotransferase increased, 196, elevated; 03/18/2008, Alanine aminotransferase increased, 83, high; 04/23/2008, Alanine aminotransferase increased, 67, high; Alb, 2.6, low; 03/12/2009, Alb, 3.2, low; 04/23/2008, Alb/Glob, 1.12, low; 01/23/2009, Albumin %, 33.4, low; 02/19/2009, Alk Phosphatase, 135, high; 01/23/2009, Alpha-1, 0.5, high; 01/23/2009, Alpha-2, 1.0, high; Anti Smith/RNP, positive, positive; 01/23/2009, Antinuclear antibody, 1:1280, positive; 03/18/2008, Anti-SmRNP, positive, positive; 04/04/2008, Anti-SmRNP, positive, positive; 03/18/2008, Anit-SSA/Anti-RO, positive, positive; 04/04/2008, Anit-SSA/Anti-RO, positi
CDC Split Type: 09AV00058SP
Vaccination
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Lot
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0472UNUN
Administered by: Military     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio abnormal, Alpha 1 globulin increased, Alpha 2 globulin increased, Anti-SS-A antibody positive, Antineutrophil cytoplasmic antibody positive, Antinuclear antibody positive, Arthralgia, Arthritis, Aspartate aminotransferase increased, Autoimmune hepatitis, Biopsy liver abnormal, Biopsy skin abnormal, Blood albumin decreased, Blood alkaline phosphatase increased, Blood calcium normal, Blood chloride decreased, Blood cholesterol increased, Blood creatinine normal, Blood glucose increased, Blood immunoglobulin G increased, Blood sodium decreased, Blood sodium increased, Blood triglycerides increased, Blood urea increased, Brain natriuretic peptide increased, C-reactive protein increased, Chest X-ray abnormal, Colonoscopy abnormal, Computerised tomogram abnormal, Computerised tomogram thorax abnormal, DNA antibody positive, Double stranded DNA antibody, Electrophoresis protein abnormal, Eosinophil percentage increased, Gamma-glutamyltransferase increased, Haematocrit decreased, Haemoglobin decreased, Hepatic cirrhosis, High density lipoprotein decreased, Hypertension, Immunoglobulins increased, Liver function test normal, Low density lipoprotein decreased, Lymphocyte count decreased, Mean cell haemoglobin concentration decreased, Mean platelet volume decreased, Myalgia, Neutrophil percentage increased, Nuclear magnetic resonance imaging abnormal, Osteoarthritis, Pain, Platelet count normal, Protein total increased, Pulmonary function test abnormal, Red blood cell count decreased, Red blood cell sedimentation rate increased, Red cell distribution width increased, Rheumatoid factor positive, Smooth muscle antibody positive, Transferrin saturation decreased, Urobilin urine present, White blood cell count decreased, Whole body scan, X-ray abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Dyslipidaemia (narrow), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific inflammation (broad), Hyponatraemia/SIADH (narrow), Ischaemic colitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Vasculitis (broad), Lipodystrophy (broad), Skin tumours of unspecified malignancy (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Arthritis (narrow), Myelodysplastic syndrome (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad)
Write-up: Subject received BIOTHRAX in 2000. Over the last year his ankles, wrists and knees became inflamed. He was diagnosed with autoimmune hepatitis and inflammatory arthritis. He is also being treated for high blood pressure. 4/16/09 Medical Records received from Dr.''s office. See case for details. Summary of Medical Records: Subject was initially evaluated in the Rheumatology Clinic on April 4, 2008. This individual has received multiple immunizations in the past related to his military service. Subject has experienced diffuse pain, including myalgias and arthralgias, in the past 1 year with a workup revealing several positive auto-antibodies including positive ANA, homogenous pattern with titer of 1:2560, borderline elevated rheumatoid factor, positive anti-SSA/anti-RO antibody, positive anti-SmRNP antibody, positive liver smooth muscle antibody, positive P-NCA of greater than 1:320, and elevated sed rate and CRP. Laboratory tests reveal negative anti-dsDNA, negative anti-SSB/LA, negative anti-SM, negative anti-RNP, negative anti-Jo-1, negative anti-SCL70. X-rays of all affected areas showed changes consistent with inflammatory arthritis. A whole body bone scan revealed no evidence of inflammatory arthritis, however there were multiple areas of degenerative arthritis. A liver biopsy on July 22, 2008 confirmed the diagnosis of autoimmune hepatitis. A wedge resection of the liver on October 22, 2008 revealed auto-immune hepatitis-related cirrhosis. He is receiving treatment with IMURAN. The Subject''s medical record also includes a history of: AAA repair, bilateral inguinal hernia repair, smoking/COPD, lung granuloma, GERD, diverticulosis, and eczematous rash vs. primary eczema.

VAERS ID:153978 (history)  Vaccinated:2000-06-04
Age:43.0  Onset:2000-06-04, Days after vaccination: 0
Gender:Male  Submitted:2000-06-06, Days after onset: 2
Location:Virginia  Entered:2000-06-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 4SC 
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Malaise, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Post vax of 5th Anthrax on 6/4/2000, pt experienced swelling, erythema 10cm X 15cm extending from under arm to top of biceps and malaise. Pt does not have a fever or is he experiencing nausea. Treated with Benadryl, ibuprofen and Augmentin.

VAERS ID:154219 (history)  Vaccinated:2000-06-04
Age:38.0  Onset:2000-06-05, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:New Mexico  Entered:2000-06-14
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
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV048B5SC 
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Itching, swelling, no fever.

VAERS ID:155430 (history)  Vaccinated:2000-06-04
Age:41.0  Onset:2000-06-04, Days after vaccination: 0
Gender:Male  Submitted:2000-06-12, Days after onset: 8
Location:Unknown  Entered:2000-06-27, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: tinitus
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV068B SC 
Administered by: Military     Purchased by: Unknown
Symptoms: Arthropathy, Asthenia, Ciliary muscle spasm, Dizziness, Fatigue, Hypoacusis, Tinnitus, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (narrow), Vestibular disorders (broad), Arthritis (broad)
Write-up: Pt experienced hearing loss and increased ringing, dizziness (when bending), weakness in joints, tiredness, muscle spasms / tremors in legs and arm.

VAERS ID:156059 (history)  Vaccinated:2000-06-04
Age:36.0  Onset:2000-06-06, Days after vaccination: 2
Gender:Male  Submitted:2000-06-17, Days after onset: 11
Location:Oregon  Entered:2000-07-05, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Recent tooth extraction
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0081SCLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Hypoaesthesia, Joint stiffness, Nausea, Oedema, Pain, Pruritus, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: 2 days post vax, the pt experienced redness and swelling to the left elbow, and forearm. Fingers were numb and tingly. Shoulders stiff and upper arm painful to touch or move. Itching at site. On 6/7/00, the swelling progressed past elbow. Saw an MD and was prescribed Claritin. After 1st shot had nausea and vomiting. For 1 day, no treatment. Both conditions now resolved.

VAERS ID:158977 (history)  Vaccinated:2000-06-04
Age:40.0  Onset:2000-06-05, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:2000-08-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0084SCRA
Administered by: Military     Purchased by: Military
Symptoms: Feeling hot, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Red, raised welt area that increased over 24 hour perior to the size of 5" X 8". The diameter of her arm increased by 4". Area was hot to touch and temperature strip to area was 103F. Oral temperature was 98.6. Also, had itching.

VAERS ID:153813 (history)  Vaccinated:2000-06-05
Age:2.3  Onset:2000-06-07, Days after vaccination: 2
Gender:Male  Submitted:2000-06-08, Days after onset: 1
Location:Illinois  Entered:2000-06-09, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD/Connaught/251811/RFA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4643003IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1363H0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site nodule, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Tuesday mom noticed a little lump. Child complained of ouwee. No redbess. Wednesday, babysitter called mom because she had noticed redness on left leg. Mom called health dept, they said if swelling and redness increased to go to ER, told to give Tylenol and cool compresses. Mom came in Thursday morning with child''s left leg 3" X 3" redness and 1" X 1" induration. Child playing, eating, walking, is active and alert. Taking Tylenol. No other symptoms. Told that if symptoms increase to see MD. Child playing, eating, walking. Pt is active and alert. Taking Tylenol, no other symptoms per mom told if symptoms increased to take to doctor.

VAERS ID:153853 (history)  Vaccinated:2000-06-05
Age:16.0  Onset:2000-06-05, Days after vaccination: 0
Gender:Female  Submitted:2000-06-05, Days after onset: 0
Location:New York  Entered:2000-06-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mantoux/Pasteur-Merieux/C0016AA/SC/LFA/1 previously
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1982H1IMLA
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49980914IMRA
Administered by: Private     Purchased by: Private
Symptoms: Coma, Convulsion, Muscle rigidity
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Petite mal seizure after vax. Rigid body, moaning, unresponsive total time 4 min from unresponsive to full alertness. Transfer to ER.

VAERS ID:153918 (history)  Vaccinated:2000-06-05
Age:0.9  Onset:2000-06-06, Days after vaccination: 1
Gender:Female  Submitted:2000-06-08, Days after onset: 2
Location:Missouri  Entered:2000-06-12, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712161IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site swelling, Pyrexia, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Post vax, had a rash the next day. Increased in severity over 48 hour period. Papular, red, confluent, raised patch at site of injection, on all extremities, face, macular feet and hands. Low-grade fever noted on date of exam, 6/8/2000.

VAERS ID:153934 (history)  Vaccinated:2000-06-05
Age:3.0  Onset:2000-06-05, Days after vaccination: 0
Gender:Male  Submitted:2000-06-09, Days after onset: 4
Location:Arkansas  Entered:2000-06-12, 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 & blood culture.
CDC Split Type:
Vaccination
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DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER  SCRA
Administered by: Public     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema, Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Right upper arm very red to elbow 9-10 cm slightly indurated and swollen. Dx''d with cellulitis. Treatment Rocephin.

VAERS ID:153944 (history)  Vaccinated:2000-06-05
Age:1.7  Onset:2000-06-07, Days after vaccination: 2
Gender:Male  Submitted:2000-06-07, Days after onset: 0
Location:New Mexico  Entered:2000-06-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ;DTP + Hib (unknown mfr);2;0;In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM922A23IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P047422 RL
Administered by: Private     Purchased by: Public
Symptoms: Feeling hot, Injection site oedema, Injection site vesicles
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Blistering, redness, swelling, warmth to site. Augmentin.

VAERS ID:153963 (history)  Vaccinated:2000-06-05
Age:14.0  Onset:2000-06-07, Days after vaccination: 2
Gender:Male  Submitted:2000-06-08, Days after onset: 1
Location:Kentucky  Entered:2000-06-13, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: KY2000018
Vaccination
Manufacturer
Lot
Dose
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Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0003BA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Injection site reaction, Lymphadenopathy, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt presented on 6/7/00 with local reaction. No redness at injection site, however, swelling noted in axillary area also painful with movement, afebrile.

VAERS ID:154192 (history)  Vaccinated:2000-06-05
Age:4.0  Onset:2000-06-07, Days after vaccination: 2
Gender:Male  Submitted:2000-06-09, Days after onset: 2
Location:Massachusetts  Entered:2000-06-14, 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: Amoxicillin
Current Illness: otitis media
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0037CA4IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P00403 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0347J1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site mass, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt experienced swelling and induration at injection site 9 X 6 cm.

VAERS ID:154194 (history)  Vaccinated:2000-06-05
Age:0.3  Onset:2000-06-05, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:2000-06-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EEG-normal; MRI- normal; all labs normal
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM922A21IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1968J1IMRL
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES570403A1IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P138121IMRL
Administered by: Private     Purchased by: Public
Symptoms: Convulsion, Eye movement disorder
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow)
Write-up: Pt received vaccines during the day, that night pt had a seizure, clawing movement of extremities and rolling of eyes, peri-oral cyanosis; taken to emergency room.

VAERS ID:154199 (history)  Vaccinated:2000-06-05
Age:0.5  Onset:2000-06-06, Days after vaccination: 1
Gender:Female  Submitted:2000-06-07, Days after onset: 1
Location:Virginia  Entered:2000-06-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0056AA2IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0052K1IMRL
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt. developed redness and swelling on right thigh at injection site. Warm compresses and Advil were prescribed.

VAERS ID:154251 (history)  Vaccinated:2000-06-05
Age:36.0  Onset:0000-00-00
Gender:Male  Submitted:2000-06-08
Location:South Carolina  Entered:2000-06-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0085SCLA
Administered by: Military     Purchased by: Unknown
Symptoms: Arthralgia, Joint swelling, Oedema peripheral, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Swelling in lower arm and elbow. Itching in lower arm and pain in the elbow joint.

VAERS ID:154472 (history)  Vaccinated:2000-06-05
Age:1.4  Onset:2000-06-06, Days after vaccination: 1
Gender:Male  Submitted:2000-06-08, Days after onset: 2
Location:Alaska  Entered:2000-06-16, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4669253IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG320419211IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R023522SCLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.128050SCRL
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Skin nodule
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Pt developed erythema on left thigh, with induration that lasted 36 hours.

VAERS ID:154774 (history)  Vaccinated:2000-06-05
Age:2.0  Onset:2000-06-05, Days after vaccination: 0
Gender:Male  Submitted:2000-06-09, Days after onset: 4
Location:California  Entered:2000-06-20, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0137BA0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 4 hours post vax, pts right deltoid swollen and erythematous. Treated with warm compresses.

VAERS ID:154782 (history)  Vaccinated:2000-06-05
Age:53.0  Onset:2000-06-06, Days after vaccination: 1
Gender:Female  Submitted:2000-06-14, Days after onset: 8
Location:Maryland  Entered:2000-06-20, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zestril, Medroxyprogesterone
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4999101 IMLA
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Injection site mass, Injection site oedema, Injection site vesicles, Injection site warmth, Malaise, 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 had what looked like cellulitis; fever; chills; malaise; area above needle mark got very hot and hard; blistering. The swelling spread and pt was treated with Dicloxacillin.

VAERS ID:154838 (history)  Vaccinated:2000-06-05
Age:4.0  Onset:2000-06-05, Days after vaccination: 0
Gender:Male  Submitted:2000-06-07, Days after onset: 2
Location:California  Entered:2000-06-21, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0137BA4IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.1750J0IMLA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R050623SCRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0167K1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt developed a fine red rash all over entire body.

VAERS ID:154854 (history)  Vaccinated:2000-06-05
Age:11.0  Onset:2000-06-07, Days after vaccination: 2
Gender:Male  Submitted:2000-06-15, Days after onset: 8
Location:Utah  Entered:2000-06-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LTD.U0061AA0IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.0435K0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain, Lymph node pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Two days post vax, the pt developed an erythemic upper arm; surrounding tissue was tender and right axillary lymph node was tender. On 6/8/00, the pt''s uppper arm was still erythemic with induration. Tender axillary lymph node. Treated with ibuprofen, ice, and Benadryl.

VAERS ID:154948 (history)  Vaccinated:2000-06-05
Age:1.5  Onset:2000-06-06, Days after vaccination: 1
Gender:Female  Submitted:2000-06-14, Days after onset: 8
Location:Arizona  Entered:2000-06-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4646920IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: One day, post vax, pt developed erythematous maculopapular rash that started on trunk and spread to extremities, sparing palms and soles. Did not seem to be pruritic. No other associated symptoms. Treated with Benadryl. Rash resolved within 4 days of onset.

VAERS ID:155478 (history)  Vaccinated:2000-06-05
Age:17.0  Onset:2000-06-06, Days after vaccination: 1
Gender:Female  Submitted:2000-06-15, Days after onset: 9
Location:Massachusetts  Entered:2000-06-27, 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: NONE
Current Illness: NONE
Preexisting Conditions: GERD
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0150K2IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1276J1SCLA
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURERTD66 IMRA
Administered by: Private     Purchased by: Public
Symptoms: Arthralgia, Injection site oedema, Joint range of motion decreased, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt developed aching muscles, shoulder joint pain, decreased range of motion of shoulders, swelling at injection site, and fever 24 hours post vax.

VAERS ID:155608 (history)  Vaccinated:2000-06-05
Age:1.8  Onset:2000-06-06, Days after vaccination: 1
Gender:Female  Submitted:2000-06-09, Days after onset: 3
Location:North Carolina  Entered:2000-06-28, Days after submission: 19
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
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0040BA3IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0953J2IMLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The pt received the vaccines on 6/5/00. The Father called the health department on 6/6/00 to report notable swelling of right leg where vax was given. The RN requested that the child be seen by a pediatrician. The MD diagnoses a "local reaction", swelling reported as heavy to calf and mid thigh of right leg. The RN contacted the mother on 6/8/00. The child''s leg still described as swollen but decreasing in size. No other symptoms or complications at report date.

VAERS ID:155617 (history)  Vaccinated:2000-06-05
Age:48.0  Onset:2000-06-10, Days after vaccination: 5
Gender:Female  Submitted:2000-06-12, Days after onset: 2
Location:California  Entered:2000-06-28, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lotinsin
Current Illness: NONE
Preexisting Conditions: hypertension, allergy to PCN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49881483IMLA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: The pt experienced swelling, heat, redness and pain on 6/10/00. Seen in ER on 6/12/00. Treated with Keflex. On 6/13/00, the pt had a marked improvement.

VAERS ID:156035 (history)  Vaccinated:2000-06-05
Age:1.0  Onset:2000-06-15, Days after vaccination: 10
Gender:Female  Submitted:2000-06-21, Days after onset: 6
Location:Oklahoma  Entered:2000-07-05, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: OK0025
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R039723SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1080J0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0701J0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Cough, Pyrexia, Rash, Rhinorrhoea, Skin ulcer
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Pt suffered rash, cough, runny nose, fever, et pox lesions.

VAERS ID:156265 (history)  Vaccinated:2000-06-05
Age:0.1  Onset:2000-06-07, Days after vaccination: 2
Gender:Male  Submitted:2000-06-09, Days after onset: 2
Location:California  Entered:2000-07-11, Days after submission: 32
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 done.
CDC Split Type: CA000065
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0173CA0IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0837J0IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P12310 LA
Administered by: Public     Purchased by: Public
Symptoms: Apnoea, Crying, Eructation, Hypotonia
SMQs:, Peripheral neuropathy (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (narrow)
Write-up: Two days post vax pt started crying as if he had colic. Pt was burped and suddenly eyes closed and body went limp. Pt stopped breathing and was taken to the ER.

VAERS ID:156318 (history)  Vaccinated:2000-06-05
Age:0.3  Onset:2000-06-05, Days after vaccination: 0
Gender:Female  Submitted:2000-06-06, Days after onset: 1
Location:Idaho  Entered:2000-07-11, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cardec DM
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Chemistry and Metabolic Panel, BAS, Hematology and CBC
CDC Split Type: ID00025
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4669251IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS591313A1IMLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P0303A1IMLL
Administered by: Private     Purchased by: Public
Symptoms: Anorexia, Coma, Irritability, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad)
Write-up: Post vax, pt became irritable, fussy and began vomiting. Pt would not take solids or liquid food. Pt fell asleep and would not awaken or arouse. Pt seen in ER that evening. Pt seen at physicians office the following day and was sleepy but awake and playful.

VAERS ID:156522 (history)  Vaccinated:2000-06-05
Age:45.0  Onset:2000-06-06, Days after vaccination: 1
Gender:Female  Submitted:2000-06-08, Days after onset: 2
Location:Idaho  Entered:2000-07-13, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrogen; Effexor
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: ID00032
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3203B40IMLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Fatigue, Influenza like illness, Injection site pain, Myalgia, Nausea, Oedema, Pruritus, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt experienced flu like symptoms 24 hours post vax. Pt had fatigue, muscle ache, nausea and fever. Pt also experienced pain at injection site, swelling, redness and itching.

VAERS ID:157387 (history)  Vaccinated:2000-06-05
Age:1.6  Onset:2000-06-06, Days after vaccination: 1
Gender:Male  Submitted:2000-06-07, Days after onset: 1
Location:Colorado  Entered:2000-07-19, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Right acute otitis media
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM941A20IMLL
Administered by: Other     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: No text provided.

VAERS ID:157969 (history)  Vaccinated:2000-06-05
Age:21.0  Onset:2000-06-06, Days after vaccination: 1
Gender:Female  Submitted:2000-06-09, Days after onset: 3
Location:Unknown  Entered:2000-07-26, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0484SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Post vax, the pt noted local erythema and swelling. It progressed in size and severity to 12 x 14 cm when pt saw the physician. Pt was treated with Motrin and ice packs.

VAERS ID:158240 (history)  Vaccinated:2000-06-05
Age:2.0  Onset:2000-06-05, Days after vaccination: 0
Gender:Female  Submitted:2000-06-07, Days after onset: 2
Location:Texas  Entered:2000-08-01, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergy to milk
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0159J0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Wheezing

VAERS ID:158936 (history)  Vaccinated:2000-06-05
Age:  Onset:2000-06-05, Days after vaccination: 0
Gender:Female  Submitted:2000-08-08, Days after onset: 64
Location:Ohio  Entered:2000-08-16, 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: NONE
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: EM20000238
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Post vax, the pt developed hives on the arm at the injection site.

VAERS ID:159025 (history)  Vaccinated:2000-06-05
Age:39.0  Onset:2000-06-06, Days after vaccination: 1
Gender:Male  Submitted:2000-08-17, Days after onset: 72
Location:Delaware  Entered:2000-08-22, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0083SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site pain, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt states after receiving 4th shot, he experienced constant pain starting from injection site all the way to the end of the hand. He stated to be experiencing tingling feeling in hand and fingers.

VAERS ID:161405 (history)  Vaccinated:2000-06-05
Age:1.5  Onset:2000-06-06, Days after vaccination: 1
Gender:Female  Submitted:2000-09-15, Days after onset: 101
Location:New York  Entered:2000-10-05, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cortaid as needed; Topical; Tuberculin/PPD
Current Illness: NONE
Preexisting Conditions: Eczema NOS
Diagnostic Lab Data: NONE
CDC Split Type: HQ7791123JUN2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0291K2IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R051922IM 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712020IM 
Administered by: Private     Purchased by: Other
Symptoms: Rash papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: A physician reported that an 18 month old female received Prevnar, Comvax (Merck) and IPV (Aventis Pasteur SA) vaccines on 6/5/00. On 6/6/00, she developed a rash. The pt was examined by a dermatologist, who described the rash as a "fine papular rash with areas or lesions of urticaria". She recovered.

VAERS ID:161489 (history)  Vaccinated:2000-06-05
Age:0.8  Onset:2000-06-07, Days after vaccination: 2
Gender:Female  Submitted:2000-08-08, Days after onset: 62
Location:California  Entered:2000-10-05, Days after submission: 58
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: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ8176106JUL2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 2IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD. 1  
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES471211 IMRL
Administered by: Private     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: A physician reported that a 9 month old female received Prevnar, IPV (Aventis Pasteur SA), and Hep-B vaccines on 6/5/00. Two days, post vax, the infant''s parents noticed a "very slight" rash. The rash persisted, and the infant was seen by the physician on 6/21/00. The infant recovered. This is 1 of 2 pts from this facility who developed a rash following receipt of Prevnar or the concomitantly administered vaccines.

VAERS ID:160566 (history)  Vaccinated:2000-06-05
Age:5.0  Onset:2000-06-07, Days after vaccination: 2
Gender:Female  Submitted:2000-09-26, Days after onset: 111
Location:North Carolina  Entered:2000-10-16, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
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 received vaccination shots 2 days ago; now complaining of redness and swelling around site of shots. Reddened area about 7" in diameter. No fevers or difficulty breathing.

VAERS ID:162900 (history)  Vaccinated:2000-06-05
Age:44.0  Onset:2000-06-19, Days after vaccination: 14
Gender:Female  Submitted:2000-09-13, Days after onset: 86
Location:Pennsylvania  Entered:2000-10-26, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin; calcium; iron; Claritin
Current Illness:
Preexisting Conditions: Pt has hay fever and allergic rhinitis. Pt is allergic to amoxicillin, dust and pollen.
Diagnostic Lab Data:
CDC Split Type: 20000210361
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY144B90IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)
Write-up: 14 days post vax the pt reported that she developed a metallic taste in her mouth which did not affect the taste of food. No treatment was given. Physician was uncertain as to the onset date of the adverse event. Approximately 2 weeks later the pt received the second dose of Lymerix. The most recent information reports the outcome of the event as uncertain per the physician.

VAERS ID:163414 (history)  Vaccinated:2000-06-05
Age:12.0  Onset:2000-06-05, Days after vaccination: 0
Gender:Male  Submitted:2000-07-18, Days after onset: 43
Location:New York  Entered:2000-11-14, Days after submission: 119
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: 20000214991
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3094821IM 
Administered by: Other     Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Subsequent to receiving the second dose of Engerix B the pt fainted. An ER or doctor visit was required and unspecified treatment was given. The most recent information received reports the outcome of the event as resolved.

VAERS ID:167361 (history)  Vaccinated:2000-06-05
Age:1.6  Onset:2000-06-05, Days after vaccination: 0
Gender:Male  Submitted:2000-08-17, Days after onset: 73
Location:New York  Entered:2001-03-14, Days after submission: 209
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: U2000004690
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0039CA3IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R0506022IMRA
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Approximately 30 minutes post vax, the pt developed hives, a rash over the entire body and swelling of upper lip. The pt was treated with Solu-Medrol, Benadryl. the pt reportedly recovered from this experience. No additional information was provided. No further information is anticipated for this report.

VAERS ID:174002 (history)  Vaccinated:2000-06-05
Age:76.0  Onset:2000-06-06, Days after vaccination: 1
Gender:Female  Submitted:2001-07-30, Days after onset: 419
Location:Wisconsin  Entered:2001-08-07, 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: WAES00071280
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1216J1IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: One day post vaccination the pt developed an area of induration and erythema which measured approximately 8 X6 cm. There was some slight overlying warmness and no associated adenopathy. The pt sought medical attention. The reporting physician noted that he thought this represents a lical reaction. I do not thing there is anything here at this point to suggest cellulitis. i recommend some cool packs for 15-20 minutes at a time, for 2 or 3 times a day. On an unspecified date, the pt recovered. No further information is available.

VAERS ID:189825 (history)  Vaccinated:2000-06-05
Age:3.0  Onset:2000-06-05, Days after vaccination: 0
Gender:Male  Submitted:2002-08-26, Days after onset: 812
Location:Kentucky  Entered:2002-09-06, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.012230 LA
Administered by: Private     Purchased by: Unknown
Symptoms: Aphasia
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Complete loss of speech language (had been cooing, babbling, talking- had been saying "ma & hi") Only grunted until 27 mos old and then started talking again with severe articulation problems

VAERS ID:190551 (history)  Vaccinated:2000-06-05
Age:1.0  Onset:2002-09-15, Days after vaccination: 832
Gender:Male  Submitted:2002-09-16, Days after onset: 1
Location:Alabama  Entered:2002-09-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type: AL0221
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1685J0SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: In today 9/16/02 with twenty vesicular lesions-generalized. Rash began yesterday. Received Varivax given on 6/5/02.

VAERS ID:192115 (history)  Vaccinated:2000-06-05
Age:38.0  Onset:2000-06-05, Days after vaccination: 0
Gender:Male  Submitted:2002-10-10, Days after onset: 857
Location:Massachusetts  Entered:2002-10-29, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Colitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY130A92IMLA
Administered by: Private     Purchased by: Private
Symptoms: Influenza like illness, Malaise, Musculoskeletal stiffness, Pain
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Shortly after first vaccine, developed stiffness in upper torso as well as general aches and pains, malaise. These continued and after second vaccine, back stiffness increased and I had a period of flu-like symptoms. I have also been diagnosed with a retinal problem; they are calling it presumed occular histoplasmosis.

VAERS ID:197680 (history)  Vaccinated:2000-06-05
Age:1.0  Onset:2003-02-04, Days after vaccination: 974
Gender:Male  Submitted:2003-02-05, Days after onset: 1
Location:New York  Entered:2003-02-12, 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: N/A
Current Illness: NONE
Preexisting Conditions: N/A
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0903J0 RA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0302U0 LA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Chicken pox rash started 2/4/03 - woke up with them all over body. Benadryl prn

VAERS ID:202475 (history)  Vaccinated:2000-06-05
Age:0.3  Onset:0000-00-00
Gender:Male  Submitted:2003-04-16
Location:Ohio  Entered:2003-05-02, Days after submission: 16
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: NONE
Diagnostic Lab Data: Sleep deprived EEG normal; Brain scan normal; Testing for Autism; MRDD; LEP; Developed mentally delayed
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Dyspnoea, Mental retardation severity unspecified, Pyrexia, Screaming, Sleep disorder, Vomiting
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), Hostility/aggression (broad), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)
Write-up: Screamed, couldn''t sleep, vomited, couldn''t breath at times, diarrhea, fever.

VAERS ID:216703 (history)  Vaccinated:2000-06-05
Age:1.0  Onset:2004-02-17, Days after vaccination: 1352
Gender:Female  Submitted:2004-02-19, Days after onset: 2
Location:Texas  Entered:2004-02-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1717J0SCUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1862J0SCUN
Administered by: Private     Purchased by: Unknown
Symptoms: Dermatitis bullous, Drug ineffective
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: This child received the varicella vaccine on June 5, 2000. She was reported by the daycare as having Chicken Pox.

VAERS ID:226834 (history)  Vaccinated:2000-06-05
Age:5.0  Onset:0000-00-00
Gender:Female  Submitted:2004-08-02
Location:Florida  Entered:2004-09-21, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0101T0 LL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1863J0 RL
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: Rash on trunk consistent with chicken pox.

VAERS ID:273603 (history)  Vaccinated:2000-06-05
Age:  Onset:2007-02-27, Days after vaccination: 2458
Gender:Male  Submitted:2007-03-01, Days after onset: 2
Location:Texas  Entered:2007-03-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Skin lesion, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Vaccine failure - developed mild type Varicella with $g 100 lesions.

VAERS ID:280128 (history)  Vaccinated:2000-06-05
Age:1.4  Onset:2006-04-02, Days after vaccination: 2127
Gender:Female  Submitted:2007-05-16, Days after onset: 408
Location:Unknown  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity, allergic reaction to antibiotics
Preexisting Conditions:
Diagnostic Lab Data: Body temp, 04/02/06, 99.7 F.
CDC Split Type: WAES0604USA00559
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1867J SC 
Administered by: Other     Purchased by: Other
Symptoms: Body temperature increased, Pyrexia, Rash, Rash papular, Rash vesicular, Varicella
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse practitioner concerning a 7-year-old white female with drug reactions or allergies to AUGMENTIN, codeine, and KEFLEX and no other pertinent medical history who on 05-JUN-2000 was vaccinated with a subcutaneous 0.5 mL dose in the left arm of Varivax (lot # 634842/1867J). Concomitant therapy that day included a dose of MMR II. There was no other concomitant medication. On 02-APR-2006 the patient developed chickenpox breakthrough rash. The rash was seen on her arms, legs, back, and chin. The lesions were papular-vesicular. The child had a fever to 99.7. Unspecified medical attention was sought and she was treated with BENADRYL as needed and monitoring. As of 04-APR-2006 the patient was recovering. A product quality complaint was not involved. Additional information has been received from a medical assistant who reported that on 03-APR-2006 the patient had eight scattered papular-vesicular lesions. BENADRYL was given on her extremities and face. It was noted that she was exposed to chickenpox at school. The patient recovered on 08-APR-2006. Additional information is not expected.

VAERS ID:281071 (history)  Vaccinated:2000-06-05
Age:1.0  Onset:2000-06-05, Days after vaccination: 0
Gender:Male  Submitted:2007-06-10, Days after onset: 2561
Location:Maryland  Entered:2007-06-10
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hydrocele
Diagnostic Lab Data: Labs and Diagnostics: EEG 6/202-normal. Amino Acid tests( 6/2002) (-) for inheirited metabolic defect. Fragile X (-). Peripheral blood karytyping: Normal 46 XY. Organic Acid testing (-) for inheirited metabolic disorder
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.VAC-0174K/DIL 00IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.VAC-1854J/DIL 00IMLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Autism spectrum disorder, Blood amino acid level normal, Convulsion, DNA test for fragile X, Developmental delay, Electroencephalogram normal, Febrile convulsion, Karyotype analysis normal, Laboratory test, Mixed receptive-expressive language disorder, Speech disorder developmental, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Within 5-10 minutes (actual time not recorded) after receiving MMR and VARIVAX, 12 month old patient exhibited a severe shaking, convulsion-like reaction to immunizations. Full body convulsions lated approximately 30 seconds. Physician was not in room at the time of incident but was called back into the room immediately during episode. Physician did not see reaction however both parents were present at the time and noted reaction to the physician. Physician did not record episode in his notes and did not file a VAERS. TC with Mom who states child has regressive autism. 06/18/2007 Comprehensive MR received from PCP beginning age 2 months (8/3/1999) to present. Initial visit shows a healthy 2 mon. old with hydrocele. After 4 mon. vax (10/7/1999) child had a brief shaking episode in the office (see VAERS 281070). Again-healthy 4 mon old with hydrocele. Multiple sick visits. 6 and 9 mon vax given w/o incident. First developmental issues noted at 12 mon WCC-not saying 3 words or cruising. No mention of any rxn to vax. "Good development" noted at 15 mon WCC, only exception not saying "mama/dada", however noted to be vocalizing alot. Speech delay noted at 18 months. Febrile seizure noted 3/28/2001. Multiple sick visits. At 2.5 yr visit-variable receptive language skills noted, hearing tested ok. Developmental delays noted. Refered to specialty facility-DX: PDD. Question of absence seizures noted at 3 yr WCC. Autism Spectrum Disorder noted at 4 yr WCC. Progress noted in speech. 1/11/2010 Autism is still present. Seizure disorder still present.

VAERS ID:313602 (history)  Vaccinated:2000-06-05
Age:1.1  Onset:2008-01-01, Days after vaccination: 2766
Gender:Unknown  Submitted:2008-05-16, Days after onset: 135
Location:Unknown  Entered:2008-05-23, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0803USA01693
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Varicella post vaccine
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Information has been received from a registered nurse concerning an approximate 8-year-old patient who on 05-JUN-2000 was vaccinated with a dose of varicella virus vaccine live (Oka/Merck). In January 2008, the patient developed chickenpox and presented with a low grade fever. The rash was mild, lasting for 3-4 days. No lab work was available. A product quality complaint was not involved. this is one of several reports received from the same source. Additional information has been requested.

VAERS ID:246718 (history)  Vaccinated:2000-06-05
Age:0.3  Onset:2000-06-19, Days after vaccination: 14
Gender:Male  Submitted:2005-11-03, Days after onset: 1963
Location:Foreign  Entered:2005-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Breast feeding, Skin blemishes
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: D0047666A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS200073VH IMGM
HIBV: HIB (HIBERIX)GLAXOSMITHKLINE BIOLOGICALS200073VH IMGM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER200073VH IMGM
Administered by: Other     Purchased by: Other
Symptoms: Dry skin, Eczema, Rash, Seborrhoea, Skin disorder
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This case was initially reported b a consumer and described the occurrence of seborrheic eczema in her 4 month old son who was vaccinated with combined diphtheria, tetanus, acellular pertussis,inactivated poliomyelitis and haemophilus influenza b vaccine (Infanrix-IPV+Hib) injection for prophylaxis. On follow up received on Oct 28 2005, the treating physician confirmed the report. the subjects medical history was unknown. Concurrent medical conditions included tendency to skin blemishes. Concomitant medications were not reported. the subject was breast fed. Both parents suffer from non treatment requiring allergy. On June 5 2000 the subject received first dose of Infanrix IPV Hib intramuscularly into right gluteal. Approximately one week after vaccination with Infanrix IPV Hib, the subject developed clearly defined exanthema on cheeks with scaling and weeping skin and scab formation. On June 19 2000, after examination by pediatrician, the subject received topical treatment with zinc ointment and Eucerin 12% Omega cream. On July 5 2000, after examination by dermatologist, the subject was treated topically with zinc oil. According to the reporter, topical treatment led to initial improvement of symptoms, but only for a short period of time. On July 10 2000 the subject received second dose of Infanrix IPV Hib intramuscularly into right gluteal. On July 17 2000 the subject was examined by dermatologic specialist at hospital and received topical treatment with 4% zinc in Alphason basic cream ointment. Approximately on July 22 2000, approximately on month after onset of the events, topical treatment was discontinued and the subject was treated homeopathically with globules (saccharose balls) with sodium chloride preparation. Weeping of exanthema resolved now, after approximately two months, but the other symptoms continued. On Aug 8 2000, the subject received third dose of Infanrix IPV Hib intramuscularly into right gluteal, so basic immunization was completed. Exanthema continued until the end of 2000, and was complet

VAERS ID:364316 (history)  Vaccinated:2000-06-05
Age:26.0  Onset:2000-06-05, Days after vaccination: 0
Gender:Male  Submitted:2009-10-30, Days after onset: 3434
Location:Foreign  Entered:2009-11-02, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0910USA03335
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTIPV: DT + IPV (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site urticaria, Laryngeal disorder, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 26 year old male patient with asthma progressing to asthma on effort who on 05-JUN-2000 at 5:25 PM was vaccinated intramuscularly in the left deltoid with MMR II (lot number not reported) and a dose of DT POLIO via intramuscular route in the right deltoid. On 05-JUN-2000 at 5:30 PM, after 5 minutes the patient experienced an urticarian reaction (Urticaria) on the whole vaccinated arm with laryngeal disorders. Nevertheless, pulse and blood pressure were stable. Improvement was observed further to the injection of SOLUDECADRON. The patient recovered on an unspecified date. Urticaria and laryngeal disorders were considered to be other important medical events by the reporter. Other business partner number included E2009-09954. No further information is available.

VAERS ID:280327 (history)  Vaccinated:2000-06-06
Age:1.6  Onset:2006-03-14, Days after vaccination: 2107
Gender:Female  Submitted:2007-05-16, Days after onset: 427
Location:Kentucky  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Chickenpox~Varicella (Varivax)~~6~In Sibling
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0604USA02512
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella
SMQs:
Write-up: Information has been received from a medical center concerning a 7 year old female who on 06-JUN-2000 was vaccinated with Varivax. On 14-MAR-2006 the patient experienced chickenpox. She was diagnosed on 15-MAR-2006. No additional information was provided. The patient''s sibling (WAES 0604USA02514) had a similar experience after vaccination with Varivax. Additional information has been requested.

VAERS ID:348907 (history)  Vaccinated:2000-06-06
Age:25.0  Onset:2001-11-01, Days after vaccination: 513
Gender:Female  Submitted:2009-06-11, Days after onset: 2778
Location:Unknown  Entered:2009-06-11
Life Threatening? No
Died? Yes
   Date died: 2001-11-04
   Days after onset: 3
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None (in infant)
Diagnostic Lab Data: Blood cultures, #1 Enterobacter cloacae, MND; #2 Klebsiella pneumoniae, MND; #3, Bacillus species, MND (not B. Anthracis); #4, Strep viridians, CWM
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Secondary transmission
SMQs:
Write-up: NOTE: Reported Adverse Event is death of vaccinee''s male infant/NOT VACCINEE. Infant male pronounced dead on 11/04/01 at age 2 months. (Born on 7 Sept 2001.) Autopsy opinion: Cause of death was interstitial pneumonitis and adrenal hemorrhage. Pathological findings include interstitial pneumonitis with intraalveolar extension. Adrenal hemorrhage was noted as well.

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