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Found 588667 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:129379 (history)  Vaccinated:1999-10-13
Age:33.6  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:1999-10-15, Days after onset: 1
Location:Illinois  Entered:1999-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: BP
Current Illness: NONE
Preexisting Conditions: HTN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0150AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site pain, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: approx x 2'' red area of lt arm;itchy, sore & feels warm;

VAERS ID:129384 (history)  Vaccinated:1999-10-13
Age:51.3  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-14, Days after onset: 1
Location:Michigan  Entered:1999-10-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS4099G0100IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chest pain, Chills, Cough, Dyspnoea, Laryngitis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt exp croupy cough w/o stridor, no wheeze;c/o chest tightness, air hunger was conscious of breathing, felt like could not fully expand chest & felt hot then cold;

VAERS ID:129473 (history)  Vaccinated:1999-10-13
Age:84.2  Onset:1999-10-13, Days after vaccination: 0
Gender:Male  Submitted:1999-10-14, Days after onset: 1
Location:Oregon  Entered:1999-10-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: ASA;Mavik;Prilosec;Norvasc;Allegra
Current Illness: NA
Preexisting Conditions: allergic rhinitis, HTn, PUD, rt knee OA, allergic to naprosyn
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982101IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: c/o lt shoulder pain that spread to lt elbow on the evening p/the vax;presented to the office next AM w/ c/o swelling & tenderness & inability to move elbow fully;tx w/decadron, DPH, APAP & ice;

VAERS ID:129498 (history)  Vaccinated:1999-10-13
Age:30.7  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-14, Days after onset: 1
Location:Texas  Entered:1999-10-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: NA
Preexisting Conditions: PCN
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS4099G0102IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: redness & swelling @ site of inj;

VAERS ID:129500 (history)  Vaccinated:1999-10-13
Age:26.3  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-14, Days after onset: 1
Location:Texas  Entered:1999-10-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: amoxycillin
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS4099G0103IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: pt got nauseated x 8hr;inj site got hard;no redness noted;

VAERS ID:129532 (history)  Vaccinated:1999-10-13
Age:15.9  Onset:1999-10-13, Days after vaccination: 0
Gender:Male  Submitted:1999-10-13, Days after onset: 0
Location:Maryland  Entered:1999-10-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp rxn @ approx age 7 w/unk vax;
Other Medications: Ritalin SR BID
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0133J1SCLA
Administered by: Other     Purchased by: Public
Symptoms: Anxiety, Conjunctivitis, Cough, Injection site oedema, Pruritus, Rhinitis
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: approx 15min p/vax pt returned w/swelling @ site of inj itching, redness of eyes, severe congestion f nose, productive cough, extreme anxiety;adrenalin & DPH given;sx subsided w/in hr;monitored during noc;no dx on 10/14/99;

VAERS ID:129548 (history)  Vaccinated:1999-10-13
Age:43.4  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:1999-10-15, Days after onset: 1
Location:Michigan  Entered:1999-10-19, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Zoloft-Estrace;Progestrine
Current Illness: NONE
Preexisting Conditions: allergic to molds;
Diagnostic Lab Data:
CDC Split Type: MI99114
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7358AB IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Lymphadenopathy, Myalgia, Nausea, Neck pain, Oedema peripheral, Pyrexia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (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), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt started having mild rt arm (site) pain 10/14/99;woke 10/15/99 a very sore, swollen, red arm & nausea, rt side of neck was also sore;t99.0 po;

VAERS ID:129593 (history)  Vaccinated:1999-10-13
Age:64.7  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-18, Days after onset: 5
Location:New York  Entered:1999-10-20, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Zesteril, Zestoretic, Norvasc, Prevolid, Serevent, asthmacort
Current Illness: NONe
Preexisting Conditions: asthma, HTN, environmental allergies;
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0127AA1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1573H0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Chest pain, Hypokinesia, Insomnia, Pain, Respiratory disorder
SMQs:, Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad)
Write-up: had very painful rt arm, unable to raise rt arm, rt arm tender to touch;was unable to sleep 10/13-10/14;c/o chest hurt-could not take a deep breath;seen by md on 10/15;started on cortisone, APAP w/codeine;

VAERS ID:129616 (history)  Vaccinated:1999-10-13
Age:83.4  Onset:1999-10-13, Days after vaccination: 0
Gender:Male  Submitted:1999-10-16, Days after onset: 3
Location:Pennsylvania  Entered:1999-10-21, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations: pt violently ill w/vomit, dizziness, weakness @ age 82 w/flu vax;
Other Medications: Lanoxin;Isoptin;Cardura;Zantac;Reglin
Current Illness: NONE
Preexisting Conditions: caines-allergies-PCN
Diagnostic Lab Data: x-ray-results unk
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Dizziness, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: 3hr post vax pt became violently ill w/vomiting, dizziness, weakness-ER by amb;

VAERS ID:129625 (history)  Vaccinated:1999-10-13
Age:42.5  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-14, Days after onset: 1
Location:Kentucky  Entered:1999-10-21, 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: anaprox allergy
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Other     Purchased by: Public
Symptoms: Asthenia, Bronchitis, Dysphonia, Dyspnoea, Pallor, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: difficulty breathing, hoarseness, paleness, weakness, fast heart beat-MD dx spasmatic bronchial bronchial tubes;given meds amoxicillin-Benzonalate;

VAERS ID:129645 (history)  Vaccinated:1999-10-13
Age:60.2  Onset:1999-10-13, Days after vaccination: 0
Gender:Male  Submitted:1999-10-15, Days after onset: 2
Location:Indiana  Entered:1999-10-21, 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: Proxnap/APAP;Anbien;Sulondac;Gemfibrozil;Neurontin;Meclizine;Estradioal;Amitriptylin;triant/HCTZ
Current Illness: NONE
Preexisting Conditions: leg prob/pain, hip pain, sinus prob;
Diagnostic Lab Data: NONE
CDC Split Type: IN99035
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Myalgia, Pruritus, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: fever, chills, itching on arms & body muscles soreness, weakness x1wk-persisting;

VAERS ID:129647 (history)  Vaccinated:1999-10-13
Age:74.0  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-15, Days after onset: 2
Location:New York  Entered:1999-10-21, 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: Navazec
Current Illness: NONE
Preexisting Conditions: high BP, dust, mold, mites
Diagnostic Lab Data: x-ray @ chiropractor negative;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Public
Symptoms: Ecchymosis, Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: site black & blue w/extreme redness & swelling;almost to elbow-hot to touch;sx persist w/continuing severity;

VAERS ID:129656 (history)  Vaccinated:1999-10-13
Age:30.5  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:1999-10-15, Days after onset: 1
Location:Texas  Entered:1999-10-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS4099G0101IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: redness & swelling of area where inj given;

VAERS ID:129681 (history)  Vaccinated:1999-10-13
Age:44.4  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-18, Days after onset: 5
Location:California  Entered:1999-10-22, Days after submission: 4
Life Threatening? Yes
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: NOEN
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982132IMRA
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3hr post vax pt devel facial swelling, total body itching-relieved w/Atarax & pred;

VAERS ID:129703 (history)  Vaccinated:1999-10-13
Age:55.0  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:1999-10-18, Days after onset: 4
Location:New York  Entered:1999-10-22, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Combivent;Cedfadroxil
Current Illness: NONE
Preexisting Conditions: asthma
Diagnostic Lab Data: NONE
CDC Split Type: NY599034
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.   RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, 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), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: severe swelling & redness from shot site;T102,arm sore, aches, pains;sought med attention

VAERS ID:129704 (history)  Vaccinated:1999-10-13
Age:1.1  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:1999-10-18, Days after onset: 4
Location:New York  Entered:1999-10-22, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC; BC
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0251J IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0691J0SCLA
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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: p/vax pt had T102 next day;pt spiked T105 & had generalized sz;seen in ER & no focal findings;

VAERS ID:129774 (history)  Vaccinated:1999-10-13
Age:5.9  Onset:1999-10-14, Days after vaccination: 1
Gender:Male  Submitted:1999-10-20, Days after onset: 6
Location:Arizona  Entered:1999-10-25, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: failure to thrive requiring enteral feedings 10-18mo old, resolved;neuro fibromatosis;
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982393IMA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: p/vax site erythema ;erythema & edema/induration;erythema 8x11cm;edema/induration 5x5cm;tx warm compresses, DPH;improved transiently w/DPH;

VAERS ID:129780 (history)  Vaccinated:1999-10-13
Age:65.8  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-14, Days after onset: 1
Location:Wyoming  Entered:1999-10-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: diabetes
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH499209 IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4578370IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site oedema, Injection site pain, Oedema peripheral, Paraesthesia
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: p/vax that evening marked swelling, pain @ site reported;reported swollen fingers of rt hand w/tingling sensation, throbbing;saw MD 10/14/99 placed on ATB;

VAERS ID:129804 (history)  Vaccinated:1999-10-13
Age:59.9  Onset:0000-00-00
Gender:Male  Submitted:1999-10-14
Location:New York  Entered:1999-10-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: NY599036
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P IMRA
Administered by: Public     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: pt recv flu vax in both arms in error;should have recv flu & pneumococcal vax;No adverse event;

VAERS ID:129810 (history)  Vaccinated:1999-10-13
Age:40.9  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:1999-10-14, Days after onset: 0
Location:California  Entered:1999-10-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: bronchitis 6/23/99;hypothyroid in past
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E24869GA0 LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1692H0 RA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Chest pain, Nausea, Syncope, Tinnitus
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: p/vax pt woke up @ 1AM w/ c/o weakness, ringing in ears, dizziness, c/o heaviness in chest;c/o nausea;no SOB; then pt fainted;still f/o weakness;

VAERS ID:129893 (history)  Vaccinated:1999-10-13
Age:44.0  Onset:1999-10-24, Days after vaccination: 11
Gender:Female  Submitted:0000-00-00
Location:Wyoming  Entered:1999-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Humolog insulin
Current Illness: NONE
Preexisting Conditions: insulin dependent diabetic, heart murmur, allergic to PCn,Dopone;
Diagnostic Lab Data: NONE
CDC Split Type: WY9911
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998209 IMRA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4598370IMLA
Administered by: Public     Purchased by: Public
Symptoms: Infection, Injection site hypersensitivity, Injection site oedema, Pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 24hr p/vax pt noted red area on inside of lt upper arm;below & medial to inj site;10/15/99 redness, swelling & extreme pain across bicep below shot site;saw MD on 101/6/99 dx w/infect & placed on cephalexin;

VAERS ID:129898 (history)  Vaccinated:1999-10-13
Age:8.8  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-14, Days after onset: 1
Location:Hawaii  Entered:1999-10-26, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Proventil;tilade
Current Illness: NONE
Preexisting Conditions: asthma
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0109BA5IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cough, Face oedema, Rash, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax mom reported pt devel a rash around mouth, swelling & welts to eyes & eyelids, sl inc in cough

VAERS ID:129899 (history)  Vaccinated:1999-10-13
Age:64.0  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:1999-10-21, Days after onset: 7
Location:Colorado  Entered:1999-10-26, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp flu-like sx @ age 63 w/influenza vax;~Influenza (no brand name)~UN~63~Patient
Other Medications: Daypro;Estrogen;Zantac;Vitamins
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P UNLA
Administered by: Public     Purchased by: Public
Symptoms: Cough, Diarrhoea, Injection site hypersensitivity, Injection site mass, Pruritus, Rhinitis
SMQs:, Anaphylactic reaction (narrow), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax exp light diarrhea, sneezing x 7 days, cough;pt also resp rash starting on arms of inj site, trunks & extremities;rash described as hard & itchy;lungs & redness @ inj site 2 1/2 inches wide;

VAERS ID:129912 (history)  Vaccinated:1999-10-13
Age:51.1  Onset:1999-10-13, Days after vaccination: 0
Gender:Male  Submitted:1999-10-19, Days after onset: 6
Location:Alabama  Entered:1999-10-26, 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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0067AA0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Cough, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: chills, fever, sore throat, cough, muscle aches since vax (6 days duration);

VAERS ID:129923 (history)  Vaccinated:1999-10-13
Age:1.3  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-21, Days after onset: 8
Location:New York  Entered:1999-10-26, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: austistic-like behavior
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA462AA3IMRA
Administered by: Private     Purchased by: Private
Symptoms: Crying, Gait disturbance, Speech disorder, Stupor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)
Write-up: extreme toe walking, periods of zoning out, loss of speech, grinding teeth, squealing, loss of eye contact, licking objects;all sx occurred w/in 48hr of vax;

VAERS ID:129973 (history)  Vaccinated:1999-10-13
Age:54.1  Onset:1999-10-16, Days after vaccination: 3
Gender:Female  Submitted:1999-10-18, Days after onset: 2
Location:Wisconsin  Entered:1999-10-26, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02089P IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1402H0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3-4 days p/vax pt c/o itchy rash covering area on 2-3inch diameter in area where shot given;denies pain swelling, or any other sx;

VAERS ID:129998 (history)  Vaccinated:1999-10-13
Age:4.1  Onset:1999-10-14, Days after vaccination: 1
Gender:Male  Submitted:1999-10-15, Days after onset: 1
Location:California  Entered:1999-10-28, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: cold
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM913A2  LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0555J  RA
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: redness to warmth @ inj site tx for early cellulitis w/augmentin;

VAERS ID:130015 (history)  Vaccinated:1999-10-13
Age:30.6  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-20, Days after onset: 7
Location:Virginia  Entered:1999-10-28, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Flovent, Singular
Current Illness: NONE
Preexisting Conditions: claritin-rash;tetracycline-rash;contrast dye-hives;
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998284  LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1693H0 RA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Dyspnoea, Ecchymosis, Hypokinesia, Influenza, Laryngospasm, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt devel 4inch diameter bruising, couldn''t lift arm, flu sx, fever, body ache, couldn''t breath felt like throat was closing up;felt like someone had split pelvic bone;pneumonia vax given same day arm very tender, couldn''t be left;

VAERS ID:130029 (history)  Vaccinated:1999-10-13
Age:28.7  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-22, Days after onset: 9
Location:Michigan  Entered:1999-10-29, 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: Daypro;Flexeril;Darvocet;Anaprox;
Current Illness: NONE
Preexisting Conditions: lt sacroilitis;Lumbar Radiculopathy
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0066FA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Lymphadenopathy, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax that evening felt lt armpit tender & swollen;no swelling, tenderness, redness @ site;upon exam no obvious localized or mult adenopathies;c/o tenderness w/palpation & sensation of enlargement;

VAERS ID:130098 (history)  Vaccinated:1999-10-13
Age:71.9  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:1999-10-15, Days after onset: 1
Location:California  Entered:1999-11-01, 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: Synthroid
Current Illness: NONe
Preexisting Conditions: thyroid
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E30879KA  LA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES459041A0 LA
Administered by: Other     Purchased by: Other
Symptoms: Injection site abscess, Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & devel redness, swelling & heat (no drainage) below inj site;

VAERS ID:130136 (history)  Vaccinated:1999-10-13
Age:6.4  Onset:1999-10-14, Days after vaccination: 1
Gender:Male  Submitted:1999-10-25, Days after onset: 11
Location:Michigan  Entered:1999-11-02, Days after submission: 8
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: cerebral palsy, developmental delay
Preexisting Conditions: tracheo cutaneous fistula s/p tracheostomy closure
Diagnostic Lab Data: blood, CSF exam, cultures were negative;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4643003IMRL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0983290 IMRL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2944A2 IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N10620IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0920J1IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0424J IMLL
Administered by: Private     Purchased by: Unknown
Symptoms: Febrile convulsion
SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: high fever w/gen sz for approx 30min or more;this happened about 30hr p/vax;

VAERS ID:130186 (history)  Vaccinated:1999-10-13
Age:43.1  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-27, Days after onset: 14
Location:Nebraska  Entered:1999-11-02, 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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0095AA  A
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Hypotension, Nervousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: felt faint, laid down;BP 54/42, water & cookie given;watched & monitored until BP 102/76;vasovagal synd rxn;pt hungry, rushed & stressed;

VAERS ID:130312 (history)  Vaccinated:1999-10-13
Age:5.8  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:1999-11-01, Days after onset: 18
Location:Wisconsin  Entered:1999-11-04, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rxn @ 2mo w/DTP dose 1;
Other Medications: MMR by MSD lot#0124J
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WI99032
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM912A24 L
Administered by: Public     Purchased by: Public
Symptoms: Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)
Write-up: next morning couldn''t wake daughter;was breathing okay;took 5min to wake;open eyes-seemed to be okay p/mom talked loudly to child;no fever, no other sx;

VAERS ID:130575 (history)  Vaccinated:1999-10-13
Age:62.1  Onset:1999-10-21, Days after vaccination: 8
Gender:Female  Submitted:1999-10-22, Days after onset: 1
Location:Michigan  Entered:1999-11-08, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: prempro-hormone
Current Illness: NONE
Preexisting Conditions: allergic to PCN, keflex, erythromycin & codeine;
Diagnostic Lab Data:
CDC Split Type: MI99106
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02089P IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7258BA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: c/o lt arm started itching yesterday area is warm & hot to touch & swollen to size of a baseball & hard to touch;might have scratched it because of itching;

VAERS ID:130622 (history)  Vaccinated:1999-10-13
Age:33.9  Onset:1999-10-16, Days after vaccination: 3
Gender:Female  Submitted:1999-10-20, Days after onset: 4
Location:West Virginia  Entered:1999-11-09, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WV9912
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.P136911IDRA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/2nd vax severe pruritus;

VAERS ID:130670 (history)  Vaccinated:1999-10-13
Age:1.1  Onset:1999-10-20, Days after vaccination: 7
Gender:Male  Submitted:1999-10-21, Days after onset: 1
Location:Unknown  Entered:1999-11-10, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: FL99042
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESN0813AA3IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0373J0SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0699J0SCLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Infection, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt devel rash;chickenpox drying up;

VAERS ID:130704 (history)  Vaccinated:1999-10-13
Age:18.2  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-11-04, Days after onset: 22
Location:Indiana  Entered:1999-11-12, 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: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Hyperhidrosis, Injection site pain, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: p/vax pt became dizzy, hot, sweaty approx 1/2hr p/vax;c/o pain @ inj site that radiated down to inner aspect of arm;to ER;

VAERS ID:130910 (history)  Vaccinated:1999-10-13
Age:66.7  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:1999-10-19, Days after onset: 5
Location:Kentucky  Entered:1999-11-18, Days after submission: 30
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: allergic to codeine, morphine & sulfa drugs
Diagnostic Lab Data:
CDC Split Type: KY990054
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982369 LA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: rash over 75% of body (onset 10/14/99);c/o itching;seeing MD on 10/19/99;

VAERS ID:131400 (history)  Vaccinated:1999-10-13
Age:40.4  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-13, Days after onset: 0
Location:Arkansas  Entered:1999-11-26, 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: NONE
Current Illness: NONE
Preexisting Conditions: nONe
Diagnostic Lab Data: NONE
CDC Split Type: AR9942
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0946J0SCRA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Conjunctivitis, Hypotension, Injection site mass, Pain, Pruritus, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt c/o feeling feverish on rt side of face & in rt arm;c/o some itching on side of face & eyes;eyes red;denies SOB;sx of flush resolved by 11AM;now c/o pain in rt arm;50mm indurated area;T100;

VAERS ID:132247 (history)  Vaccinated:1999-10-13
Age:36.0  Onset:1999-11-07, Days after vaccination: 25
Gender:Male  Submitted:1999-11-22, Days after onset: 15
Location:Maryland  Entered:1999-12-07, 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 HLTHFAV0244SCRA
Administered by: Military     Purchased by: Military
Symptoms: Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt devel golf ball sized lymph node under rt arm;went to ER;did lab tests better w/in 3 days;

VAERS ID:132558 (history)  Vaccinated:1999-10-13
Age:41.3  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-29, Days after onset: 16
Location:Nebraska  Entered:1999-12-15, Days after submission: 47
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
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0150AA  A
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Arm red, swollen, and sore for a week; stayed red for a long time. O.K. now.

VAERS ID:132097 (history)  Vaccinated:1999-10-13
Age:  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-14, Days after onset: 1
Location:Texas  Entered:1999-12-28, Days after submission: 75
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: had seizure in 2nd grade
Diagnostic Lab Data: B/P-110/72, P-72, R-16
CDC Split Type: 99TX219
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1062J0 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1181H SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Gaze palsy, Hypertonia, Injury
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Ocular motility disorders (narrow)
Write-up: 5 mins after administering vax, pt fell off chair to floor, became rigid,eyes rolling to back of head lasting 30 sec.Upon regaining conciousness,pt was aware of time,date,& person.

VAERS ID:132323 (history)  Vaccinated:1999-10-13
Age:72.4  Onset:1999-10-13, Days after vaccination: 0
Gender:Male  Submitted:1999-10-14, Days after onset: 1
Location:Michigan  Entered:1999-12-28, Days after submission: 75
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin,Nitro-Bid,Prilosec,Propulsid,Multi-Vitamins
Current Illness: NONE
Preexisting Conditions: CAD
Diagnostic Lab Data: CT Scan done 10/13/99 and was negative.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1402H0IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Hypokinesia, Myasthenic syndrome
SMQs:, Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Experienced weakness of the left arm. He was unable to lift his arm. On 10/14/99, the strength in his left arm started to return.

VAERS ID:132773 (history)  Vaccinated:1999-10-13
Age:66.0  Onset:1999-10-13, Days after vaccination: 0
Gender:Male  Submitted:1999-12-14, Days after onset: 62
Location:Connecticut  Entered:1999-12-28, 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: captopril
Current Illness: NONE
Preexisting Conditions: high blood pressure
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES454979 IMRA
Administered by: Other     Purchased by: Private
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: Swelling/redness from site of injection to elbow.Tx w/ Benadryl, Tylenol, & Zithromax

VAERS ID:132790 (history)  Vaccinated:1999-10-13
Age:1.3  Onset:1999-11-09, Days after vaccination: 27
Gender:Male  Submitted:1999-11-12, Days after onset: 3
Location:Arkansas  Entered:1999-12-28, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: AR99-54
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM913A23IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0947J0SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0799M0PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1836H0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Infection, Otitis media
SMQs:
Write-up: Child was given Varivax on 10/13/99.Seen by MD on 11/9/99 & dxed w/ vaccine induced varicella & otitis media.Tx w/ Augmentin for otitis media.

VAERS ID:131772 (history)  Vaccinated:1999-10-13
Age:61.0  Onset:1999-10-19, Days after vaccination: 6
Gender:Male  Submitted:1999-11-04, Days after onset: 16
Location:Utah  Entered:1999-12-29, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: High BP
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS03279P IMLA
Administered by: Other     Purchased by: Private
Symptoms: Coordination abnormal, Diarrhoea, Dizziness, Flatulence, Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)
Write-up: 5 days after injection, I had severe light headedness & balance problems, lasting 6 hrs on 10/19. On 10/20, had light diarrhea. On 10/22, had servere gas & diarrhea; took Lomotal to stop it. On 10/23, got up, felt fine, no problems. Follow-up indicates pt had the flu for 3 weeks over Christmas and New Years. Now, still not over it, starting with sore throat and aches in my joints about 4/11/00.

VAERS ID:131773 (history)  Vaccinated:1999-10-13
Age:61.2  Onset:1999-10-15, Days after vaccination: 2
Gender:Female  Submitted:1999-11-03, Days after onset: 19
Location:Wisconsin  Entered:1999-12-29, Days after submission: 56
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Accupril
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: 2 doctor visits
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Other     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hives for 1 week.

VAERS ID:131906 (history)  Vaccinated:1999-10-13
Age:32.0  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-28, Days after onset: 15
Location:Nebraska  Entered:1999-12-29, Days after submission: 62
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications: BCP
Current Illness: NONE
Preexisting Conditions: Allergies to mold and dustmites
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0129AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest pain, Cough, Dyspnoea, Lacrimal disorder, Pruritus, Rhinitis
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Lacrimal disorders (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Watery eyes, runny nose, itchy skin, shortness of breath, cough, chest tightness. 2 hours post flu shot.

VAERS ID:131914 (history)  Vaccinated:1999-10-13
Age:1.3  Onset:1999-10-20, Days after vaccination: 7
Gender:Male  Submitted:1999-11-08, Days after onset: 19
Location:Nebraska  Entered:1999-12-29, Days after submission: 51
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4623153IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0931J0SCRL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: MMR given 10/13/99 with c/o red, blotchy rash for 1 week. Seen by Dr. on 10/27/99 and dx''d w/MMR reaction.

VAERS ID:132003 (history)  Vaccinated:1999-10-13
Age:44.0  Onset:1999-10-16, Days after vaccination: 3
Gender:Male  Submitted:1999-10-20, Days after onset: 4
Location:California  Entered:1999-12-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-Vitimans, low dose ASA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0109BA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approx. 48 hrs. after injection, pt. awakened in middle of night, itching w/masses of very small red "dots" on buttucks, mid-thigh to mid-abd., arms, hands, ankles & pronounced red-rectangular area over injection site. Lasted approx 1 week.

VAERS ID:132886 (history)  Vaccinated:1999-10-13
Age:47.0  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-12-20, Days after onset: 68
Location:Unknown  Entered:1999-12-29, Days after submission: 9
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 (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0430 RA
Administered by: Military     Purchased by: Public
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt states there is a hard nodule at inject site, no pain or redness.

VAERS ID:133005 (history)  Vaccinated:1999-10-13
Age:0.3  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-12-30, Days after onset: 78
Location:Pennsylvania  Entered:2000-01-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7387AA1IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS402203A1IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P07391SCLL
Administered by: Other     Purchased by: Other
Symptoms: Screaming
SMQs:, Hostility/aggression (broad)
Write-up: 2 mos later, grandmother states that after 10/13/99, 4 mo visit and immunizations that infant was unconsolable for 40 hrs. Probable Pertussis reaction.

VAERS ID:133142 (history)  Vaccinated:1999-10-13
Age:53.2  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:1999-11-22, Days after onset: 39
Location:Georgia  Entered:2000-01-07, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: EKG-normal sinus rhythm,WBC-12.1,hemoglobin-13.3,platlets-288,000
CDC Split Type: GA99181
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER03179P0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0042J IMLA
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Chest pain, Hypertension, Leukocytosis, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (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 (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Immunized 10/13/99, pt developed swelling of l/arm that evening. 10/14/99, pt had l/arm swelling, fever & chest pain. Went to clinic, BP 200/168, called ambulance, pt hospitalized in ICU. BP under control, swelling in arm decreased.

VAERS ID:150548 (history)  Vaccinated:1999-10-13
Age:25.0  Onset:1999-10-30, Days after vaccination: 17
Gender:Female  Submitted:2000-03-15, Days after onset: 137
Location:Unknown  Entered:2000-03-29, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: electrolytes-nml, pap smear-nml
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0374SC 
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES0994660 SC 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESP09102 IM 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Hypoaesthesia, Joint stiffness, Menorrhagia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Starting approximately on 10/30/99, the pt developed menstrual bleeding which increased to 3-4 per week. In approximately early 12/99, bleeding became almost constant, with maybe 1 or 2 clear days per month. Intensity also increased from light bleeding to bleeding similar to my period. Bleeding was not related to intercourse. This continued until 3/6/00 when the bleeding stopped following my regular monthly period. In approximately 11/99, I noticed that in the mornings my knees were very stiff and sore. In 1/00, I increased my running and since then the problem has subsided. Also in early 12/99, the pt noticed that she had a small rash or dry looking skin patch. Starting in 1/00, the pt applied Bacitracin once a day, every day for a month. The area did not clear up and is actually still there. In late 10/99/early 11/99, I began to notice that my hands, arms, and feet were falling asleep when I laid down and when I slept. This occurred in any position, on both sides of body, typically once or twice per night and almost every night. One night, she woke up and the right side of her face was asleep. The numbness usually takes 1-5 minutes to subside. The pt saw a physician but all lab work was normal.

VAERS ID:152710 (history)  Vaccinated:1999-10-13
Age:47.0  Onset:1999-10-25, Days after vaccination: 12
Gender:Female  Submitted:1999-11-09, Days after onset: 15
Location:New Jersey  Entered:2000-06-07, Days after submission: 210
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: hypertension, mitral valve prolapse
Diagnostic Lab Data: UNK
CDC Split Type: FLU12321199
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS01889P0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Fatigue, Influenza like illness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Reported low grade fever, aching fingers, aching neck and hands (unable to make fist), extreme fatigue. Complained flu-like symptoms.

VAERS ID:153362 (history)  Vaccinated:1999-10-13
Age:19.0  Onset:1999-10-15, Days after vaccination: 2
Gender:Male  Submitted:2000-03-03, Days after onset: 140
Location:California  Entered:2000-06-09, Days after submission: 97
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pemoline, Talnaftate, benzoyl peroxide
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982550IMRA
Administered by: Other     Purchased by: Public
Symptoms: Pyrexia, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt reportedly developed a rash and fever of 100.4 approximately 40 hours following vax. The rash was red and raised on inner aspects of wrists, forearms and both feet. Macular rash on upper and lower legs, chest and abdomen. The pt was treated with diphenhydramine and acetaminophen. Rash disappeared on 10/16/1999.

VAERS ID:154057 (history)  Vaccinated:1999-10-13
Age:35.0  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:2000-01-17, Days after onset: 95
Location:Maryland  Entered:2000-06-13, Days after submission: 147
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ2572414OCT1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982741IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Within 24 hours post vax, the pt developed an injection site reaction characterized by swelling, redness, and induration. This is one of two pts from this facility who developed an injection site reaction following receipt of vax.

VAERS ID:154075 (history)  Vaccinated:1999-10-13
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:1999-11-16
Location:Kansas  Entered:2000-06-13, 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: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ2794119OCT1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998277 IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site mass, Injection site oedema, Pruritus, Pyrexia
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 (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A nurse reported that a 45 year old female received the Flu Shield on 10/13/99 and subsequently developed a low grade fever and an injection site reaction characterized by swelling, redness and itching. On 10/15/99, the pt was seen by the physician. Additional information received 11/11/99 from the physician indicated that as of 11/5/99, the pt''s symptoms resolved, however, she subsequently developed a lump the size of a pea at the injection site.

VAERS ID:155517 (history)  Vaccinated:1999-10-13
Age:  Onset:1999-10-14, Days after vaccination: 1
Gender:Unknown  Submitted:1999-11-24, Days after onset: 41
Location:New York  Entered:2000-06-27, Days after submission: 215
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ2622818OCT1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998271 IM 
Administered by: Public     Purchased by: Other
Symptoms: Influenza like illness
SMQs:
Write-up: Post vax, this pt developed flu-like symptoms.

VAERS ID:155518 (history)  Vaccinated:1999-10-13
Age:61.0  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:2000-01-19, Days after onset: 97
Location:Pennsylvania  Entered:2000-06-27, Days after submission: 159
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin 250mg 3x per 1 day
Current Illness: Sinusitis
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ2646118OCT1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH    
Administered by: Other     Purchased by: Other
Symptoms: Condition aggravated, Sinusitis
SMQs:
Write-up: While administering vax to pt, the syringe disconnect and the vaccine squirted in the nurse''s mouth and nostrils. At the time, she was being treated for a sinus infection with Amoxicillin. The infection worsened within 2 days of exposure to fax and the nurse''s physician increased antibiotic dosage. Physician does not correlate worsening of infection to the vax exposure.

VAERS ID:129467 (history)  Vaccinated:1999-10-14
Age:74.1  Onset:1999-10-14, Days after vaccination: 0
Gender:Male  Submitted:1999-10-14, Days after onset: 0
Location:Maryland  Entered:1999-10-18, 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: Cardarone;ASA;Flovent
Current Illness: NONE
Preexisting Conditions: hx A-fib;prostate CA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P   
Administered by: Other     Purchased by: Unknown
Symptoms: Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad)
Write-up: pt w/sudden onset of jerky movements-involuntary @ trunk area & arms;

VAERS ID:129468 (history)  Vaccinated:1999-10-14
Age:39.6  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:1999-10-15, Days after onset: 1
Location:Kansas  Entered:1999-10-18, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp inj site redness @ age 38 w/flu vax;
Other Medications: Celebrex;Accolate;Bumex;Proventil inhaler;Asthmacort Inhaler;
Current Illness: hx of asthma-no symptoms @ time of vax;
Preexisting Conditions: Keflex, Vancomycin, codeine & related drugs, tetracycline, OTC vitamins, Theodur
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0104AA3IMLA
Administered by: Public     Purchased by: Private
Symptoms: Asthma, Chest pain, Dyspnoea, Injection site hypersensitivity, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: 10min p/vax pt exp chest tightness & SOB;wheezing occurred;p/albuterol nebulizer tx w/o improvement;to ER w/inc wheezing & SOB;given epi, DPH, Tagamet & micronephrine nebulizer tx w/slow improvement;3.5x4cm reddened area @ inj site;

VAERS ID:129690 (history)  Vaccinated:1999-10-14
Age:37.2  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:1999-10-17, Days after onset: 3
Location:Ohio  Entered:1999-10-22, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0433SC 
Administered by: Military     Purchased by: Military
Symptoms: Injection site reaction
SMQs:
Write-up: $g6cm reaction 2 inj site;

VAERS ID:129721 (history)  Vaccinated:1999-10-14
Age:65.8  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:1999-10-19, Days after onset: 5
Location:Tennessee  Entered:1999-10-22, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp fl x 3 days at age 55 w/flu vax
Other Medications: Norvasc;Cumudin;Estrodom;Rhinotan;Captopril;liptor;Rnetedin;chlorton;chloraden;
Current Illness: NONE
Preexisting Conditions: allergies, stomach ulcer, high BP, cholesterol, neuropathy
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: excessive chills, temp 103 x 6hr, body aches, h/a, dizzy, nausea;

VAERS ID:129771 (history)  Vaccinated:1999-10-14
Age:34.8  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:1999-10-21, Days after onset: 7
Location:Illinois  Entered:1999-10-25, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to PCn & codeine
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982790IMLA
Administered by: Military     Purchased by: Unknown
Symptoms: Dyspnoea, Face oedema, Hypertension, Rash maculo-papular
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: devel red blotchy rash & lip swelling, heavy breathing;inc BP;had EKG done;02 sat & put on pred x 5 days & DPH;

VAERS ID:129794 (history)  Vaccinated:1999-10-14
Age:45.1  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:1999-10-18, Days after onset: 4
Location:Ohio  Entered:1999-10-25, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: OH99071
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0136AA0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Chills, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt became cold & achy, progressed to fever of 102.5 w/chills & severe h/a;pt called ER @ hosp & was told to take APAP for h/a;pt states still has h/a & receives moderate relief w/APAP;

VAERS ID:129811 (history)  Vaccinated:1999-10-14
Age:27.7  Onset:1999-10-15, Days after vaccination: 1
Gender:Female  Submitted:1999-10-15, Days after onset: 0
Location:California  Entered:1999-10-25, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Verapamil;Imitrex;Ambien;Belladonna
Current Illness: NONE
Preexisting Conditions: migraine h/a, endometriosis;
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU010913A0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Influenza, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 17hr p/vax pt devel flu like sx;fever 99.3, sore muscles, h/a;

VAERS ID:129841 (history)  Vaccinated:1999-10-14
Age:51.0  Onset:1999-10-15, Days after vaccination: 1
Gender:Male  Submitted:1999-10-25, Days after onset: 10
Location:Pennsylvania  Entered:1999-10-26, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lasix, Coumadin, KDur, Prilosec, Clorzoxasone, Albuterol MDI, Prednisone, Accolate, Serevent MDI
Current Illness: NO
Preexisting Conditions: asthma/reactive airway; polymyalgia rheumatica; s/p phlebitis & recurrent PE; multiple allergies: PCN, Cipro, Keflex, ASA, Sulfa, Polysporin-Neosporin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4898226 IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4590381IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anaemia, Injection site oedema
SMQs:, Haematopoietic erythropenia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: swelling @ inj site on both arms;

VAERS ID:129862 (history)  Vaccinated:1999-10-14
Age:29.4  Onset:1999-10-14, Days after vaccination: 0
Gender:Male  Submitted:1999-10-20, Days after onset: 6
Location:Wisconsin  Entered:1999-10-26, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0096EA3IMLA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2994D61IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1291H0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Cyanosis, Dehydration, Insomnia, Leukocytosis, Myalgia, Oedema, Pain, Peripheral vascular disorder, Pyrexia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt had pain in my rt shoulder, armpit & elbow;whole arm felt like the circulation & low;cold & finger were sl blue probably d/t swelling;T99.7;could not sleep;sore all over;T101.5;high fever d/t dehydration;cellulitis;redness;

VAERS ID:129917 (history)  Vaccinated:1999-10-14
Age:73.8  Onset:1999-10-15, Days after vaccination: 1
Gender:Female  Submitted:1999-10-21, Days after onset: 6
Location:Virginia  Entered:1999-10-26, 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: Atenolol;Synthroid
Current Illness:
Preexisting Conditions: NKA, Eczema, hypothyroidsim
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Unknown
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: rash-presented to office on 10/16-no distress;

VAERS ID:129935 (history)  Vaccinated:1999-10-14
Age:0.5  Onset:1999-10-15, Days after vaccination: 1
Gender:Male  Submitted:1999-10-15, Days after onset: 0
Location:Washington  Entered:1999-10-26, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7172BA2IMRL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 2IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESN1142AA2IMLL
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: urticaria not at immunization site;

VAERS ID:129946 (history)  Vaccinated:1999-10-14
Age:5.0  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:1999-10-14, Days after onset: 0
Location:Florida  Entered:1999-10-26, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7316BA4IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0530J1SCRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES802H44PO 
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Gaze palsy, Hypertonia, Opisthotonus, Pollakiuria
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad)
Write-up: p/vax mom report pt became stiff arched back, eyes rolled, pale, no T-C action, +loss of urine lasted 3-5seconds;pt awoke cried;

VAERS ID:129977 (history)  Vaccinated:1999-10-14
Age:27.9  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:1999-10-21, Days after onset: 7
Location:Wisconsin  Entered:1999-10-27, 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: Orthotricyclene BCP
Current Illness: NONE
Preexisting Conditions: PCN allergy
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982290IMLA
Administered by: Private     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: diffuse, urticaria epi, DPH, pred, fluids given;

VAERS ID:129999 (history)  Vaccinated:1999-10-14
Age:11.4  Onset:1999-10-14, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:South Carolina  Entered:1999-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: SC99063
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3093090IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0011AA5IMLA
Administered by: Public     Purchased by: Other
Symptoms: Convulsion, Hyperventilation, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: p/vax pt passed out & had sz;this is according to teacher;child was taken to MD;had an episode of hyperventilation;

VAERS ID:130008 (history)  Vaccinated:1999-10-14
Age:79.6  Onset:1999-10-16, Days after vaccination: 2
Gender:Female  Submitted:1999-10-21, Days after onset: 5
Location:Minnesota  Entered:1999-10-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Premarin;Lopressor;Hydrochloret
Current Illness: HTN & osteoarthritis
Preexisting Conditions: deodarant, bath powder & bactrum
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4653120IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt came in 6 days p/vax w/entire upper arm red, hot & swollen;pt said very itchy;area were shot given beginning to clear up;about size of fifty cent piece not as red as rest of arm;

VAERS ID:130283 (history)  Vaccinated:1999-10-14
Age:34.9  Onset:1999-10-15, Days after vaccination: 1
Gender:Male  Submitted:1999-10-20, Days after onset: 5
Location:Virginia  Entered:1999-11-04, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: pt states was feeling like having cold
Preexisting Conditions: allergic to chicken embryos (as a child)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0374SC 
HEPA: HEP A (VAQTA)MERCK & CO. INC.0569H0IM 
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Diarrhoea, Dizziness, Headache, Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Laryngospasm, Paraesthesia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: p/vax pt c/o vomiting, diarrhea, h/a & abd cramping;also having sl tightness in throat;dizzy spells x 1wk;+lump, swelling, redness on inj area;lump larger than quarter;tender by touch;general tricep area, numbness, tingling on hands;

VAERS ID:130350 (history)  Vaccinated:1999-10-14
Age:1.6  Onset:1999-10-25, Days after vaccination: 11
Gender:Male  Submitted:1999-10-27, Days after onset: 2
Location:D.C.  Entered:1999-11-05, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atrovent;Casapride;Zantac;aldactazide;
Current Illness:
Preexisting Conditions: BPD, tracheo malecia, hypospadias, GER
Diagnostic Lab Data: DFA cult to r/o Vzoster positive x 2;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4560583IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N095722SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1340H0SC 
Administered by: Private     Purchased by: Other
Symptoms: Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pinpoint macular lesions appeared on10/25, fever;pt placed in negative air pressure room & contact & airborne isolation;

VAERS ID:130352 (history)  Vaccinated:1999-10-14
Age:46.0  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:1999-11-05
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: cortisone
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998233 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain, Oedema peripheral, Pain, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt had severe hot pains down lt arm & across top of breast, to neck to back;called MD;pt not seen;c/o temp during noc but didn''t take temp had red raised hard area @ inj site;sore to touch;hand sl edema;

VAERS ID:130796 (history)  Vaccinated:1999-10-14
Age:59.3  Onset:1999-10-18, Days after vaccination: 4
Gender:Female  Submitted:1999-10-18, Days after onset: 0
Location:Georgia  Entered:1999-11-15, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tomoxil;Glucocol;
Current Illness: NA
Preexisting Conditions: astham;breast surgery 3yr ago;
Diagnostic Lab Data: NA
CDC Split Type: GA99125
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU011AA0IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4557540IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax now exp tightness in chest;no s/o chest pain;c/o T100;;

VAERS ID:130981 (history)  Vaccinated:1999-10-14
Age:25.9  Onset:1999-10-18, Days after vaccination: 4
Gender:Female  Submitted:1999-11-15, Days after onset: 28
Location:New York  Entered:1999-11-22, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: FLU2151199
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS0297P0 LA
Administered by: Private     Purchased by: Other
Symptoms: Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: p/vax lt arm was edematous from upper shoulder to elbow;

VAERS ID:130982 (history)  Vaccinated:1999-10-14
Age:  Onset:1999-10-18, Days after vaccination: 4
Gender:Female  Submitted:1999-11-16, Days after onset: 29
Location:New York  Entered:1999-11-22, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: FLU2161199
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P0 LA
Administered by: Private     Purchased by: Other
Symptoms: Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: p/vax pt exp edematous from upper shoulder to elbow;

VAERS ID:131001 (history)  Vaccinated:1999-10-14
Age:38.0  Onset:1999-10-15, Days after vaccination: 1
Gender:Female  Submitted:1999-11-01, Days after onset: 17
Location:South Dakota  Entered:1999-11-22, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Started O''s alesse 10/25;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: SD99038
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypokinesia, Injection site pain, Muscle twitching, Myalgia, Neck pain, Neuralgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: p/vax pt devel some soreness in lt arm;arm remained sore but pain started on 5th day in muscle above bicep;pain progressed to whole arm & into neck in back of neck;pain head & wrist & muscle jerking;poss nerve was hit by needle per MD;

VAERS ID:131072 (history)  Vaccinated:1999-10-14
Age:5.0  Onset:1999-10-15, Days after vaccination: 1
Gender:Male  Submitted:1999-10-19, Days after onset: 4
Location:Massachusetts  Entered:1999-11-23, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7390AA4IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0131J1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: arm reddened w/inj site;no fever;

VAERS ID:131581 (history)  Vaccinated:1999-10-14
Age:50.0  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:1999-10-15, Days after onset: 1
Location:Utah  Entered:1999-11-30, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt devel sore arm;~ ()~ ~~In patient
Other Medications: premarin;advil
Current Illness: NONE
Preexisting Conditions: foot surgery-July 9still uses advil);
Diagnostic Lab Data: NONe
CDC Split Type: UT990638
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P10 RA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES73608A10 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Diarrhoea, Myalgia, Nausea, Pyrexia, Rhinitis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax s/s runny nose/congestion 1:30PM;nauset @ 3:00;fatigue 7 weakness 5:00;body aches 6:45;diarrhea, fever overall;ill feeling all noc next day;

VAERS ID:131725 (history)  Vaccinated:1999-10-14
Age:7.2  Onset:1999-10-15, Days after vaccination: 1
Gender:Male  Submitted:1999-10-18, Days after onset: 3
Location:Minnesota  Entered:1999-12-29, Days after submission: 72
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Premature birth - mild cp - mild intermittent RAD
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02879P0IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Large local reaction - hive from tip of shoulder to elbow.

VAERS ID:131727 (history)  Vaccinated:1999-10-14
Age:1.5  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Colorado  Entered:1999-12-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: N/A
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHIB: DTP + HIB (TETRAMUNE)LEDERLE LABORATORIES4560602IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0797L2PO 
Administered by: Military     Purchased by: Military
Symptoms: Febrile convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever to 104 and generalized febrile seizure approx 4 hrs following tetramune. No sequelae seen. Rx with Tylenol.

VAERS ID:131809 (history)  Vaccinated:1999-10-14
Age:1.2  Onset:1999-10-21, Days after vaccination: 7
Gender:Male  Submitted:1999-11-04, Days after onset: 14
Location:North Carolina  Entered:1999-12-29, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cold
Preexisting Conditions: Otitis media
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER 2IML
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 0SCL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Febrile convulsion, Hypotonia, Somnolence
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Febrile seizure lasting approximately one minute involving all four extremities, followed by about two hours of lethargy and low muscle tone.

VAERS ID:132995 (history)  Vaccinated:1999-10-14
Age:66.6  Onset:1999-10-31, Days after vaccination: 17
Gender:Male  Submitted:1999-11-10, Days after onset: 10
Location:North Dakota  Entered:2000-01-05, Days after submission: 56
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: opthalmic lubricant, Erythromycin
Current Illness:
Preexisting Conditions: PCN allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E29179HA IMLA
Administered by: Other     Purchased by: Public
Symptoms: Dyspnoea, Guillain-Barre syndrome, Myasthenic syndrome
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Cardiomyopathy (broad), Demyelination (narrow)
Write-up: Extreme muscle weakness; required help to move. Noted to be using ancillary muscles for breathing at urgent care. Pt was hospitalized and transferred to Minneapolis.Dx of GBS.

VAERS ID:132459 (history)  Vaccinated:1999-10-14
Age:37.0  Onset:1999-10-15, Days after vaccination: 1
Gender:Female  Submitted:1999-10-20, Days after onset: 5
Location:Georgia  Entered:2000-01-06, Days after submission: 78
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: GA99150
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS03279P1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1402H0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Injection site hypersensitivity, Injection site oedema, 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), Hypersensitivity (narrow)
Write-up: On 10/15/99, L/arm was very swollen, tender & warm to touch and large area of redness. "Can''t lift arm high enough to open car door". Pt returned on 10/18/99, but wasn''t able to wait. Messages returned from pt, states "much better".

VAERS ID:133061 (history)  Vaccinated:1999-10-14
Age:14.0  Onset:0000-00-00
Gender:Female  Submitted:1999-11-16
Location:California  Entered:2000-01-06, Days after submission: 51
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: CA990150
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7258BA IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: Pt recv''d her immunizations on 10/14/99.On 11/15/1999, pt returned to have her 2nd dose of Varivax;at that time she admitted she was pregnant but the nurse gave her the vax in error. Later she came back and stated that she had been pregnant

VAERS ID:133396 (history)  Vaccinated:1999-10-14
Age:71.0  Onset:1999-10-21, Days after vaccination: 7
Gender:Female  Submitted:2000-01-13, Days after onset: 84
Location:Iowa  Entered:2000-01-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lotensin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4998283 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Raised red hives on l/shoulder extending across the back of shoulders and to the posterior neck. Described as very painful. No a true dermatoform distribution. Started one week after flu shot (10/28/99).

VAERS ID:133505 (history)  Vaccinated:1999-10-14
Age:4.6  Onset:2000-01-12, Days after vaccination: 90
Gender:Male  Submitted:2000-01-18, Days after onset: 6
Location:West Virginia  Entered:2000-02-01, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Arnold-Chiari malformation, V-P Shunt Hydrocephalus, sulfa allergy.
Diagnostic Lab Data: Nasal viral panel for influenza A&B
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998240 IM 
Administered by: Private     Purchased by: Private
Symptoms: Cough, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Cough, congestion, fever.

VAERS ID:134160 (history)  Vaccinated:1999-10-14
Age:21.0  Onset:1999-10-15, Days after vaccination: 1
Gender:Female  Submitted:1999-10-21, Days after onset: 6
Location:Michigan  Entered:2000-02-17, Days after submission: 119
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
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU01516AA1IMA
Administered by: Public     Purchased by: Private
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Awakened with nausea - vomited.

VAERS ID:134504 (history)  Vaccinated:1999-10-14
Age:38.9  Onset:1999-10-15, Days after vaccination: 1
Gender:Female  Submitted:2000-02-18, Days after onset: 126
Location:Unknown  Entered:2000-03-03, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tenormin, Birth Control
Current Illness:
Preexisting Conditions: NKA, irregular heart beat
Diagnostic Lab Data: BP - 105/49, T - 99.1, P - 61, R - 16
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypotension, Hypoventilation, Oedema, Pharyngitis, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Agranulocytosis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt received vaccination and on same day noticed swelling, raised soft non-tender areas, bilaterally above clavicles. Denies other sx''s, mild sore throat on following morning. Given Benadryl and motrin, pt discharged.

VAERS ID:134601 (history)  Vaccinated:1999-10-14
Age:63.0  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:2000-03-02, Days after onset: 140
Location:Ohio  Entered:2000-03-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Severe muscle aches and pains for 2 weeks post vax in 1998. ;UNK. INFLUENZA VACC
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0144AA2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Malaise, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: For 2 weeks post vax, had severe aches and pains. Had no local reaction. Twelve to fifteen times since then, pt has had a ''hurting'' in her arm lasting 5-10 minutes in the same area shot was administered. After each ''hurting'' episode, she stated that she generally does not feel well for the next couple of days. Pt has not been to the doctor.

VAERS ID:152420 (history)  Vaccinated:1999-10-14
Age:66.0  Onset:1999-10-14, Days after vaccination: 0
Gender:Male  Submitted:2000-05-11, Days after onset: 210
Location:West Virginia  Entered:2000-05-26, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 49 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH499827 IM 
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES456690 IM 
Administered by: 0     Purchased by: 0
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)
Write-up: On 10/14/99, the pt received a flu vaccine and a pneumococcal vaccine and 4 - 5 minutes post vax, the pt suffered a bleeding stroke and was sent to the hospital. The pt remained in the hospital for 7 weeks and is still in rehabilitation. The pt was told that he was the fourth pt admitted to the hospital with a stroke after receiving the flu vaccine. There was a recall of three county areas (outdated) while the pt was in the hospital. "Additional information per call to reporter 5/10/2000. At the time of the incident the reporter was 66 years old and in good health. He received a flu vaccine and a pneumococcal vaccine. he contacted the facility where he received to get the manufacturers names and was told that the manufacturers vary; he was given a lot number of 456690, but does not know which product it is for.

VAERS ID:155531 (history)  Vaccinated:1999-10-14
Age:40.0  Onset:1999-10-18, Days after vaccination: 4
Gender:Female  Submitted:2000-01-27, Days after onset: 101
Location:Utah  Entered:2000-06-27, Days after submission: 151
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ3270522OCT1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982300IMLA
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Injection site pain, Muscular weakness, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Fours days post vax, this pt experienced pain at the injection site which radiated to her shoulder, back, and neck. She also experienced weakness and heaviness in her arm, causing difficulty lifting or using the arm. She recovered in 2 days without treatment.

VAERS ID:155532 (history)  Vaccinated:1999-10-14
Age:50.0  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:2000-01-26, Days after onset: 104
Location:Alabama  Entered:2000-06-27, Days after submission: 152
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ3340322OCT1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982873IMLA
Administered by: Private     Purchased by: Private
Symptoms: Influenza like illness, Injection site hypersensitivity, Injection site oedema, Injection site pain, Pain, Pharyngolaryngeal pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This pt experienced burning at the injection site during administration. Within 30 minutes, she experienced itching at the injection site, and then developed redness, swelling also but which comes and goes. She was prescribed Augmentin. Achiness at injection site ensued and radiated down her arm and up into her shoulders and neck. On 10/20, she developed "flu-like" symptoms of sore throat and achiness. She recovered.

VAERS ID:156552 (history)  Vaccinated:1999-10-14
Age:4.0  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:2000-05-16, Days after onset: 215
Location:Florida  Entered:2000-07-13, Days after submission: 58
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99101287
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Following the vax, the pt experienced a fever of 101F which subsided the following day. One day, post vax, the pt experienced vomiting. Additional information has been requested.

VAERS ID:156561 (history)  Vaccinated:1999-10-14
Age:11.0  Onset:1999-10-15, Days after vaccination: 1
Gender:Male  Submitted:2000-05-16, Days after onset: 214
Location:Alabama  Entered:2000-07-13, Days after submission: 58
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99101547
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: One day post vax the pt experienced a rash from the shoulder to the elbow of the arm where he received the injection. The pt''s rash persisted at the time of the report. The reporter was "not sure if it was a hypersensitivity reaction".

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