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Case Details (Sorted by Vaccination Date)

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VAERS ID:168711 (history)  Vaccinated:2001-04-11
Age:1.0  Onset:2001-04-13, Days after vaccination: 2
Gender:Male  Submitted:2001-04-13, Days after onset: 0
Location:Georgia  Entered:2001-04-16, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA576AA3IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1579K0SCLA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4747320IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1603K0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt developed a reddened are 3cm in width on right upper thigh.

VAERS ID:168808 (history)  Vaccinated:2001-04-11
Age:3.0  Onset:2001-04-12, Days after vaccination: 1
Gender:Female  Submitted:2001-04-15, Days after onset: 3
Location:Florida  Entered:2001-04-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0378AA3IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt with circumferential swelling in left upper arm, around area of administration. Within 48 hours, had increase of swelling and erythema. Is recovering.

VAERS ID:168872 (history)  Vaccinated:2001-04-11
Age:5.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-04-11, Days after onset: 0
Location:Minnesota  Entered:2001-04-18, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0371AA4IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T05590SC 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0020L1SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1608K0SC 
Administered by: Private     Purchased by: Private
Symptoms: Rash morbilliform
SMQs:, Hypersensitivity (narrow)
Write-up: Pt developed polymorphic morbilliform rash on upper torso, upper back and upper extremities where vaccines were given in 5 minutes. After a dose of Benadryl, rash faded away and pt was asymptomatic.

VAERS ID:168894 (history)  Vaccinated:2001-04-11
Age:1.5  Onset:2001-04-12, Days after vaccination: 1
Gender:Male  Submitted:2001-04-13, Days after onset: 1
Location:Illinois  Entered:2001-04-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: URI, cough, runny nose, afebrile
Preexisting Conditions:
Diagnostic Lab Data: Throat culture for Strep
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0357CA3IMLA
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS520253A3IM 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4747380IM 
Administered by: Private     Purchased by: Public
Symptoms: Cough, Pyrexia, Rash papular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Developed a papular (sand paper) like rash on trunk, upper and lower extremities within 24 hours, post vax. Also had a low-grade temperature the day after vaccines. (+) cough; otherwise, normal exam.

VAERS ID:168906 (history)  Vaccinated:2001-04-11
Age:20.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Female  Submitted:2001-04-12, Days after onset: 1
Location:Virginia  Entered:2001-04-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Asthma, allergic to PCN and ASA.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1168K SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Complained of itching at and around injection site and 10 minutes, post vax, hives appeared around injection site and disappeared, 5 hours later. Benadryl was recommended but employee didn''t take any since symptoms resolved. No other symptoms occurred.

VAERS ID:168932 (history)  Vaccinated:2001-04-11
Age:1.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Female  Submitted:2001-04-12, Days after onset: 1
Location:Arizona  Entered:2001-04-20, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Slight otitis media.
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: AZ0111
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIESUO317BB3IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0825K1SCRA
MUR: MUMPS + RUBELLA (FOREIGN)MERCK & CO. INC.0298K IMRA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4725450IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0934K0SC 
Administered by: Public     Purchased by: 0
Symptoms: Coma, Convulsion, Hypoxia, Vomiting
SMQs:, Acute pancreatitis (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: This infant was unresponsive within less than 2 minutes, followed by tonic clonic seizures, vomiting. Oxygen was applied, 911 called to the ER.

VAERS ID:168937 (history)  Vaccinated:2001-04-11
Age:1.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Female  Submitted:2001-04-12, Days after onset: 1
Location:Kansas  Entered:2001-04-20, 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
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESUO320AB3 LL
Administered by: Other     Purchased by: 0
Symptoms: Injection site erythema, Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This child has a rapidly enlarging erythematous induration, tender, and firm on the left thigh, 10 x 9 cm.

VAERS ID:168946 (history)  Vaccinated:2001-04-11
Age:5.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-04-18, Days after onset: 7
Location:Maine  Entered:2001-04-20, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: ME01011
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS939A24IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T01173 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1159K1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Chest pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: The pt experienced a fever of 101, pain in rib cage and chest area.

VAERS ID:168957 (history)  Vaccinated:2001-04-11
Age:0.3  Onset:2001-04-11, Days after vaccination: 0
Gender:Female  Submitted:2001-04-14, Days after onset: 3
Location:Ohio  Entered:2001-04-23, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Viral URI
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES950A20IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS4773990IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T06970IMLL
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Screaming
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hostility/aggression (broad)
Write-up: Prolonged screaming over 4 hours. Temperature maximum of 100.9F.

VAERS ID:169080 (history)  Vaccinated:2001-04-11
Age:1.6  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-04-17, Days after onset: 6
Location:Colorado  Entered:2001-04-25, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0378AA3IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T05632SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4747211IMRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site mass, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Entire left upper thigh was red, swollen, "on fire" and red bumps on 4/12/01. On 4/17/01, has 1.5cm-2cm firm, non-tender, movable mass on left anterior lateral thigh, no femoral adenopathy. No treatment.

VAERS ID:169094 (history)  Vaccinated:2001-04-11
Age:65.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-04-12, Days after onset: 1
Location:California  Entered:2001-04-25, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucophage
Current Illness:
Preexisting Conditions: Diabetic
Diagnostic Lab Data:
CDC Split Type: CA010029
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1593K0IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.1689K0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Fatigue, Hyperglycaemia, Paraesthesia, Somnolence, Staring
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: 3 hours, post vax, pt experienced difficulty focusing eye, body tingling, fatigue and inability to stay awake. Blood sugar checked and was 130. Pt slept for 1 1/2 hours and upon awakening, felt better but not normal. Had another similar episode approx. 22 hours, post vax. Referred to PMD.

VAERS ID:169095 (history)  Vaccinated:2001-04-11
Age:10.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Female  Submitted:2001-04-11, Days after onset: 0
Location:Illinois  Entered:2001-04-25, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Sinusitis (dx''d by CT of head, post vax)
Preexisting Conditions: Allergy to penicillin; She previously had an episode involving drooping of one side of face, post vax, but had a negative CT of head. Blamed on medication reaction. Has 2 older siblings with seizure disorder.
Diagnostic Lab Data: CT Scan of head-neg
CDC Split Type: IL01009
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5176A22IMRA
Administered by: Other     Purchased by: Public
Symptoms: Anxiety, Eye movement disorder, Injury, Loss of consciousness, Musculoskeletal stiffness, Sinusitis, Skin discolouration, Somnolence, Swelling, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad)
Write-up: Syncopal attack, 2 to 3 minutes, post vax. Fell to the floor striking right temple area; approx. 6mm abrasion to right temple from eyeglasses; estimated length of time of unconsciousness, 20 seconds; transported to hospital per father and school nurse. Her anxiety level was elevated at the thought of receiving a shot. Child''s posture was rigid and eyes rolling immediately after falling. Sent home for observation with parents. Had an immediate swelling and discoloration of right temple area was evident; complained of drowsiness. Treated and released from ER. CT Scan of head-negative (except for sinusitis).

VAERS ID:169102 (history)  Vaccinated:2001-04-11
Age:12.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:2001-04-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever;DTP (unknown mfr);1;0;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5189A21IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: The evening she received the vaccine, the pt developed body aches, malaise and low-grade temperature and headaches. Symptoms were significant enough that she missed school.

VAERS ID:169113 (history)  Vaccinated:2001-04-11
Age:4.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Female  Submitted:2001-04-15, Days after onset: 4
Location:Georgia  Entered:2001-04-25, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1336K0SCRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Indurated, erythematous, slightly elevated area about 5.5cm X 4.0cm on right posterior lateral thigh. Presumed recovered.

VAERS ID:169138 (history)  Vaccinated:2001-04-11
Age:4.0  Onset:2001-04-12, Days after vaccination: 1
Gender:Female  Submitted:2001-04-14, Days after onset: 2
Location:Massachusetts  Entered:2001-04-25, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU03218A4IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T01213SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0405K1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The pt experienced swelling, warmth and erythema to the right arm around the site of vaccination.

VAERS ID:169139 (history)  Vaccinated:2001-04-11
Age:54.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Female  Submitted:2001-04-12, Days after onset: 1
Location:Texas  Entered:2001-04-25, 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: PPD
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM671A40SC 
Administered by: Other     Purchased by: Military
Symptoms: Injection site erythema, Injection site oedema, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The pt experienced a localized redness, swelling to the entire upper left arm. the pt complained of nausea and body aches.

VAERS ID:169264 (history)  Vaccinated:2001-04-11
Age:0.3  Onset:2001-04-21, Days after vaccination: 10
Gender:Male  Submitted:2001-04-23, Days after onset: 2
Location:Oregon  Entered:2001-04-30, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Mild URI
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0378AA3IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA584AA3IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0016L0SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.147K0SCRL
Administered by: Private     Purchased by: Private
Symptoms: Febrile convulsion
SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Febrile grand mal seizure.

VAERS ID:169301 (history)  Vaccinated:2001-04-11
Age:0.2  Onset:2001-04-11, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:2001-05-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS975A20IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA548AA0IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T01600 LL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4747240IMRL
Administered by: Private     Purchased by: Public
Symptoms: Crying, Injection site haemorrhage, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad)
Write-up: 2 1/2 hours, post vax, pt began crying inconsolably. Mom noted swelling at right thigh administration site. She brought baby in. Swelling continued to increase. Cold compresses applied to area; 3" diameter, warm, tender and central bruising between site of 2 injections. No temperature.

VAERS ID:169304 (history)  Vaccinated:2001-04-11
Age:32.0  Onset:2001-04-12, Days after vaccination: 1
Gender:Male  Submitted:2001-04-13, Days after onset: 1
Location:Texas  Entered:2001-05-01, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: HTN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV048B6SCLA
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1IM 
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Feeling hot, Injection site erythema, Rash macular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Local reaction about 18cm erythema, warm macules.

VAERS ID:169311 (history)  Vaccinated:2001-04-11
Age:50.0  Onset:2001-04-12, Days after vaccination: 1
Gender:Female  Submitted:2001-04-17, Days after onset: 5
Location:Oregon  Entered:2001-05-01, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: HRT
Current Illness: NONE
Preexisting Conditions: possible allergy to latex
Diagnostic Lab Data:
CDC Split Type: OR200119
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1420K1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: On 4/13/01 it was reported that the left arm was red, hot, swollen and had hives. The symptoms started on 4/12/01 and started "getting worse". The pt was referred to PMD or ER for consult/evaluation. On 4/17/01 follow-up call provided that the pt was given anti-histamine and cortisone and had improved. MD states may be immune problem. Will not receive third dose.

VAERS ID:169319 (history)  Vaccinated:2001-04-11
Age:1.2  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-04-12, Days after onset: 1
Location:South Carolina  Entered:2001-05-01, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Febrile seizure on 1/01
Diagnostic Lab Data:
CDC Split Type: SC0123
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0060AA3IM 
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA533AA3IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T04842SC 
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash, Respiratory disorder, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Hypersensitivity (narrow)
Write-up: 15-20 minutes, post vax, pt broke out in a rash around mouth with progression to arms. When he awoke the next morning, rash was on legs. Rash was red, fine with itching, not hive-like. Treated by mom with Benadryl. Mom states he is unable to drink juice of any kind, has scalding in diaper area. He has a history of a seizure on 1/01 but not taking any medications. Denies change in diet, soap or detergent. Rash was gone by 4/14/01 but started having respiratory problems on Saturday and went to PMD who told mom breathing problem not related to immunizations.

VAERS ID:169326 (history)  Vaccinated:2001-04-11
Age:4.0  Onset:2001-04-12, Days after vaccination: 1
Gender:Male  Submitted:2001-04-01, Days after onset: 10
Location:California  Entered:2001-05-01, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0328BA4IMLL
HEPA: HEP A (VAQTA)MERCK & CO. INC.0254K0IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T01613SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0254K1SCLL
Administered by: Private     Purchased by: Other
Symptoms: Difficulty in walking, Injection site pain, Injection site swelling
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling at injection site within 12 hours. Painful to walk the same day.

VAERS ID:169331 (history)  Vaccinated:2001-04-11
Age:60.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-04-27, Days after onset: 16
Location:North Carolina  Entered:2001-05-01, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Sick;UNK. TYPHOID;1;.00;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI-WNL
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3375A40IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM671A40IMLA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUA287AA0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Diplopia, Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Ocular motility disorders (broad)
Write-up: Pt states had dizziness, 2 hours, post vax. He had difficulty focusing on day 2. Went to ER and was referred to a neurologist, who dx''d him with diplopia. Immune mediated event due to immunizations.

VAERS ID:169383 (history)  Vaccinated:2001-04-11
Age:14.0  Onset:2001-04-15, Days after vaccination: 4
Gender:Male  Submitted:2001-05-02, Days after onset: 17
Location:Indiana  Entered:2001-05-04, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Arnold-Chiari malformation and cerebral palsy with resultant partial paraplegia
Diagnostic Lab Data:
CDC Split Type: IN20018
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0437K0SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Cellulitis, Erythema, Pyrexia, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad)
Write-up: Admitted to the hospital on 4/23/01. Fever 102F-103F; erythema of chest; cellulitis. Spoke to mother on 5/2/01 and she reports that pt still has lesions. His mother reports that lesions were infected. Annual follow up on 11/21/2003: "Vaccine recipient recovered from the adverse events that were reported for this vaccination. Doctor reported child is fine; no residual symptoms on 07/10/2002."

VAERS ID:169409 (history)  Vaccinated:2001-04-11
Age:1.0  Onset:2001-04-18, Days after vaccination: 7
Gender:Female  Submitted:0000-00-00
Location:Kansas  Entered:2001-05-04
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 (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS956A23IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA534AA3IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1326J0SCRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4753810IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1248K0SCLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site reaction, Nausea, Pyrexia, Skin ulcer, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Fever of 102F, nausea, shaking (could be from fever). Fever duration, 48 hours. Treated with Tylenol and lots of fluids. On 4/20/01, developed lesions around the varivax injection site.

VAERS ID:169427 (history)  Vaccinated:2001-04-11
Age:61.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Female  Submitted:2001-05-01, Days after onset: 20
Location:New York  Entered:2001-05-04, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: tamoxifen
Current Illness: NONE
Preexisting Conditions: Breast cancer 1993
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0375AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: No data provided.

VAERS ID:169501 (history)  Vaccinated:2001-04-11
Age:35.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Female  Submitted:2001-05-01, Days after onset: 20
Location:Maryland  Entered:2001-05-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: HTN, Allergic rhinitis
Diagnostic Lab Data: PFT''s; BP; Pulse: Lung exam; (prior EKG and CXR)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV048B2SCRA
Administered by: Military     Purchased by: Military
Symptoms: Chest discomfort, Headache, Injection site reaction
SMQs:, Anaphylactic reaction (broad)
Write-up: Chest tightness, headache and a large local reaction at vaccine site.

VAERS ID:169525 (history)  Vaccinated:2001-04-11
Age:58.0  Onset:2001-04-14, Days after vaccination: 3
Gender:Male  Submitted:2001-04-17, Days after onset: 3
Location:North Carolina  Entered:2001-05-07, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NC01047
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3375A40IMRA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: The pt states that on 4/14/01 he developed itching, red whelps that began on torso and spread to the head, arms legs. Referred to his PMD. He was seen and given medication. The diagnosis was hives. Probably not due to vaccine.

VAERS ID:169675 (history)  Vaccinated:2001-04-11
Age:16.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-05-02, Days after onset: 21
Location:New Jersey  Entered:2001-05-10, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EKG; Blood work; CXR; Neurological exam
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5155B90IMLA
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Blood pressure decreased, Dizziness, Erythema, Eye movement disorder, Hyperhidrosis, Hypokinesia, Hypotonia, Injection site pain, Nausea, Pallor, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad)
Write-up: Burning at injection site, immediately. Itching approx. 10 minutes later, nausea approx. 15 minutes, post vax. While on way home, he said he felt funny and his head leaned to the side, his eye rolled upwards, his face got red and he had difficulty moving, sweating profusely. Went back to doctor''s office, BP was very low and he was put on oxygen. He was very pale, weak and dizzy. Went to hospital for observation.

VAERS ID:169770 (history)  Vaccinated:2001-04-11
Age:5.0  Onset:2001-04-13, Days after vaccination: 2
Gender:Female  Submitted:2001-04-20, Days after onset: 7
Location:Ohio  Entered:2001-05-11, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: OH0024
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESUO320AB4IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T05323SCRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1390K1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 2 days later, a mother called and stated her daughters arm (left arm) was swollen considerably down to her fingers. The mother was encouraged to put ice on the arm and take her to the family doctor. The doctor saw the child and confirmed reaction and placed her on Clariton.

VAERS ID:169777 (history)  Vaccinated:2001-04-11
Age:0.8  Onset:2001-04-17, Days after vaccination: 6
Gender:Male  Submitted:2001-04-17, Days after onset: 0
Location:Ohio  Entered:2001-05-11, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: OH0023
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS975A22IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0788K0IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T02832SCRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4747321IMLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: The pt experienced a red, raised bump slightly larger than a quarter on the left leg with leg pain, that is getting worse in past 24 hours on day 7 post vax. Instructed to be evaluated by pediatrician. Pediatrician described a normal mild reaction. No treatment required.

VAERS ID:169865 (history)  Vaccinated:2001-04-11
Age:20.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-04-13, Days after onset: 2
Location:Michigan  Entered:2001-05-15, Days after submission: 32
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UA365A80SCLA
Administered by: Private     Purchased by: Private
Symptoms: Pain, Rash pustular
SMQs:, Hypersensitivity (narrow)
Write-up: 2 hours after receiving Menincoccal mening vaccine patient experienced pain in the left axilla. A few hours later a few bumps noted. The next day bumps were pustules. A Z-pak was given, avoid deodorant, use antibacterial soap

VAERS ID:169999 (history)  Vaccinated:2001-04-11
Age:16.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-04-12, Days after onset: 1
Location:Pennsylvania  Entered:2001-05-18, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD, lot # CO521AA, 04/11/01. Allegra, Nasocort AQ.
Current Illness: NONE
Preexisting Conditions: Asthma.
Diagnostic Lab Data: NONE
CDC Split Type: PA0136
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1448K0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthma, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Pneumovax recommended by MD at school physical exam. History of asthma. PPD also administered a the same time, approximately 3 PM on 04/11/01. By the evening the patient developed generalized itching, and hives, covering most of his body. Physician unavailable that evening. The patient was seen at neighboring clinic, where he was given Benadryl IM, then oral Benadryl every 4 - 6 hours. The hives were present on 04/12/01 in the AM,but reportedly resolving.

VAERS ID:170007 (history)  Vaccinated:2001-04-11
Age:45.0  Onset:2001-04-21, Days after vaccination: 10
Gender:Female  Submitted:2001-05-03, Days after onset: 12
Location:California  Entered:2001-05-18, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: CA010047
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1284K0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Erythema, Lacrimation increased, Pyrexia, Rash maculo-papular, Rhinorrhoea, Skin nodule
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: The pt contacted the health department to report the following: The pt developed a fever 10 days post vax varying in range from 99-102. Followed by a red maculo-papular rash all over with olive sized nodules behind ears, watery eyes, nose and joint pain.

VAERS ID:170042 (history)  Vaccinated:2001-04-11
Age:1.6  Onset:2001-04-17, Days after vaccination: 6
Gender:Male  Submitted:2001-05-15, Days after onset: 28
Location:Illinois  Entered:2001-05-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ? ear infection/ear pain
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0378AA3IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T07852IMRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site urticaria, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Developed generalized urticaria, 6 days, post vax. Large urticarial wheal over left thigh injection site with central clearing. Resolved with Benadryl. Incidentally has been complaining of ear pain prior to reaction.

VAERS ID:170078 (history)  Vaccinated:2001-04-11
Age:4.0  Onset:2001-04-12, Days after vaccination: 1
Gender:Male  Submitted:2001-04-13, Days after onset: 1
Location:Michigan  Entered:2001-05-22, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: MI2001033
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM975A24IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T04723SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1386K1SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4774490IM 
Administered by: Public     Purchased by: Public
Symptoms: Abasia, Agitation, Pain
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: On 04/12/01, 8 1/2 hours post-immunization the patient awoke complaining of both of his thighs. The mother stayed home from work to observe. Motrin every 6 - 8 hrs, warm moist compresses to legs. The child approximately 35 lbs and very thin. Complains of inability to walk, refused to stand upright, crawling and crying. By 4PM he began using his legs. On 04/19/01, per the mother the patient is totally recovered. No more sickness.

VAERS ID:170079 (history)  Vaccinated:2001-04-11
Age:4.0  Onset:2001-04-12, Days after vaccination: 1
Gender:Male  Submitted:2001-04-13, Days after onset: 1
Location:Michigan  Entered:2001-05-22, Days after submission: 39
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: Has a twin brother
Diagnostic Lab Data:
CDC Split Type: MI2001034
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM975A24IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T04723SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1386K1SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4774490IMLL
Administered by: Public     Purchased by: Public
Symptoms: Abasia, Crying, Feeling hot, Injection site pain
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (broad)
Write-up: On 4/12/01, 8 hours, post vax, pt complained of pain in both legs in thigh areas. Mom stayed home from work. Gave Motrin every 6-8 hours and applied moist compresses to legs. Child weighs about 35 lbs, very thin legs. Complained of inability to walk and refused to stand up and walk. Was crawling and crying. By 16:00, began using legs. Felt feverish to mom. On 4/19/01, per mom, pt is totally recovered and no more symptoms.

VAERS ID:170314 (history)  Vaccinated:2001-04-11
Age:14.0  Onset:2001-04-15, Days after vaccination: 4
Gender:Male  Submitted:2001-06-05, Days after onset: 51
Location:Indiana  Entered:2001-05-29, Days after submission: 7
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: UNK
Current Illness:
Preexisting Conditions: Cerebral Palsy; immunosuppression
Diagnostic Lab Data: UNK
CDC Split Type: WAES01051150
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.6348250437K0SC 
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Pyrexia, Skin disorder, Viral infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Information has been received from a physician concerning an immunocompromised patient with cerebral palsy who on 04/11/01, was vaccinated with Varicella virus vaccine live. On 04/15/01, the patient developed a severe case of chicken pox. On the same date, the patient was hospitalized for a skin infection which was considered possibly due to the chicken pox. The physician reported that the patient had no prior exposure to wild type varicella and that he did not know the nature of the skin infection. In follow-up, the physician reported that he did not have much additional information to report but was in the process of trying to gather additional information. In addition, the physician stated that he believed that the patient had not had a recent varicella exposure, was not immunocompromised and had recovered but will attempt to confirm this information. Additional information has been requested. Follow up information has been received from a physician who reports the patient was diagnosed with cellulitis and secondary infected chicken pox and had subsequently recovered as of 04/30/2001. It was reported that the child had a persistent fever with his chicken pox. When admitted to the hospital he was treated with Kefzol. At the time of discharge the pt did have some active pox, but he was afebrile and his appetite had returned. He was given Duricef at discharge to continue for 1 week. No further information is expected.

VAERS ID:171108 (history)  Vaccinated:2001-04-11
Age:44.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-06-06, Days after onset: 56
Location:Kentucky  Entered:2001-06-12, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: KY2001041
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3384B60IM 
Administered by: Public     Purchased by: Private
Symptoms: Asthenia
SMQs:, Guillain-Barre syndrome (broad)
Write-up: Pt reports he became extremely weak/fatigued evening of vaccine being administered, lasted 12-18 hours. No treatment needed.

VAERS ID:171114 (history)  Vaccinated:2001-04-11
Age:3.0  Onset:2001-04-12, Days after vaccination: 1
Gender:Female  Submitted:2001-04-12, Days after onset: 0
Location:Georgia  Entered:2001-06-12, Days after submission: 61
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diuril; bacitracin
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: GA01040
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM973A24IMLA
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1288K3IMRA
Administered by: Public     Purchased by: Public
Symptoms: Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: On 4/12/01, around noon today, observed right more than left upper arms and when dressing, mother noticed a pink, raised area on back. No treatment by mother. Brought to HD and saw RNC who said it was a topical immunization reaction. Mother said she had Caladryl at home to apply. Call Pediatrician if changes or any worse.

VAERS ID:171115 (history)  Vaccinated:2001-04-11
Age:3.4  Onset:2001-04-12, Days after vaccination: 1
Gender:Male  Submitted:2001-04-12, Days after onset: 0
Location:Georgia  Entered:2001-06-12, Days after submission: 61
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: GA01041
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS973A24IMLA
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1288K3IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The pt experienced upper arm redness and warmth to the touch at the site of injection. No discoloration or irritability. Brought to health department.

VAERS ID:172694 (history)  Vaccinated:2001-04-11
Age:2.5  Onset:2001-04-13, Days after vaccination: 2
Gender:Female  Submitted:2001-05-09, Days after onset: 26
Location:California  Entered:2001-07-02, Days after submission: 54
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ9762217APR2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES474720 IMRL
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Two days post vax, pt developed an injection site reaction measuring 7cm by 7cm and characterized by induration and erythema.

VAERS ID:172770 (history)  Vaccinated:2001-04-11
Age:0.3  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-04-18, Days after onset: 7
Location:Texas  Entered:2001-07-03, Days after submission: 76
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: TX01053
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESUO161CA0IMLL
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5184B91IMRL
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES560753A0IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P047420SCLA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4637270IMRL
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Irritability, Pyrexia, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: One hour after immunizations pt developed increased temp and fussiness. Pt also developed redness, swelling and rash to left half of head. Mother advised to take pt directly to ER. All attempts to follow up with parent failed.

VAERS ID:173076 (history)  Vaccinated:2001-04-11
Age:1.8  Onset:2001-04-12, Days after vaccination: 1
Gender:Male  Submitted:2001-06-26, Days after onset: 75
Location:Illinois  Entered:2001-07-10, Days after submission: 14
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EEG, CT, MRI
CDC Split Type: IL01025
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS970A23IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESP0852AA2IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P12322SCLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1657J0SCRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4747260IMRL
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Musculoskeletal stiffness, Pyrexia, Staring
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad)
Write-up: Pt developed elevated temperature of 104, fixed eyes, stiffness and unresponsiveness. He was taken to ER and diagnosed with seizure.

VAERS ID:173521 (history)  Vaccinated:2001-04-11
Age:0.3  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-07-18, Days after onset: 98
Location:Massachusetts  Entered:2001-07-24, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: rash;UNCLASSIFIED/UNSPECIFIED VACCINE;;.20;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESUO321BA1IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS611053A1IMLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4747361IMRL
Administered by: Private     Purchased by: 0
Symptoms: Irritability, Pruritus, Rash maculo-papular, Similar reaction on previous exposure to drug
SMQs:, Anaphylactic reaction (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: Pt developed mac-pap rash on both thighs the day immunizations given. He was very fussy and scratching legs. He had similar rash 1-2 days after 2 month immunizations.

VAERS ID:180397 (history)  Vaccinated:2001-04-11
Age:30.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-05-16, Days after onset: 35
Location:Kentucky  Entered:2002-01-24, Days after submission: 253
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: 20010119521
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0  
Administered by: Other     Purchased by: Other
Symptoms: Asthenia
SMQs:, Guillain-Barre syndrome (broad)
Write-up: Report 20010119521 described weakness in a 30 year old male who received hep B vaccine (Engerix-B). The vaccinee''s allergies, medical history, and concomitant medications wer enot specified. On 04/11/2001, the vaccinee received his first "adult" dose of Engerix-B. Three to four hours post vaccination, he experienced weakness, which resolved within 24 hours. As of 05/14/2001, the event resolved.

VAERS ID:180411 (history)  Vaccinated:2001-04-11
Age:44.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-06-15, Days after onset: 65
Location:Kentucky  Entered:2002-01-24, Days after submission: 223
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: 20010144801
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3384B60IM 
Administered by: Public     Purchased by: Private
Symptoms: Asthenia
SMQs:, Guillain-Barre syndrome (broad)
Write-up: On 4/11/01, the pt received his 1st IM dose of Engerix-B. Post vax, on 4/11/01, the pt experienced weakness and fatigue. The reporter stated that these adverse events were moderate in severity and possibly related to Engerix-B. No drugs were used to treat the adverse events. They resolved on 4/12/01. Engerix-B was stopped. As of 6/12/01, the adverse events had resolved.

VAERS ID:180757 (history)  Vaccinated:2001-04-11
Age:23.0  Onset:2001-05-14, Days after vaccination: 33
Gender:Male  Submitted:2002-01-22, Days after onset: 253
Location:Texas  Entered:2002-01-31, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Smoke 1 pack every 2 to 3 days past 2 years.
Diagnostic Lab Data: I have copies of all medical reports and decumentations. I am gladly able to send off on demand. Microscopic hematuria
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER 0IM 
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER    
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUA361AB   
Administered by: Military     Purchased by: Military
Symptoms: Bacterial infection, Immune system disorder, Reiter's syndrome, Skin disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (narrow)
Write-up: Prior to being deployed overseas, I received an Anthrax vaccination. I have had problems in the past with the pneumonia vaccine. I had sudden vomiting and was required to use an inhaler and also developed skin problems. While overseas, I contracted Salmonella, which led to the Reiter''s Syndrome in which now I am in the process of a Medical Evaluation Board. I''m currently under Chemotherapy, monitoring and under going a lot of pharmaceutical treatment. While in a discussion of the events with a Major during my part 2 physical, we came to a relative conclusion that the vaccine lowers my immune system, making me susceptible to sickness. And also, the fact that 20 plus soldiers all got sick but I was the only 1 that came out with Salmonella and which lead to Reiter''s Syndrome. It''s beyond me. Follow up: Additional diagnosis noted on discharge summaries: Dehydration, reactive arthritis, plantar fasciitis.

VAERS ID:182197 (history)  Vaccinated:2001-04-11
Age:54.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Female  Submitted:2001-04-16, Days after onset: 5
Location:Texas  Entered:2002-03-11, Days after submission: 329
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: 20010095001
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Injection site oedema, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Report described swelling at the injection site in a 54 year old female who received hep A vaccine. This report was received from a corpsman and has not been verified by a physician or other healthcare professional. Allergies, medical history, and concomitant medications were unknown. On 04/11/2001, the vaccinee received her first SQ dose of Havrix. Post vaccination, she reported swelling from shoulder to elbow of the injection arm. The arm circumference was not measured. The reporter stated that the pt''s arm was blowing up like a balloon. The pt had self-treated with ice on 04/11/2001. At the time of the report, the pt was being seen by a physician, who probably was going to give her a steroid injection for the swelling. As of 04/12/2001, the outcome of the event was unknown.

VAERS ID:184828 (history)  Vaccinated:2001-04-11
Age:1.3  Onset:2001-04-20, Days after vaccination: 9
Gender:Male  Submitted:2002-05-15, Days after onset: 390
Location:Michigan  Entered:2002-05-20, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES01042416
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1341K0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pyrexia, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a licensed practical nurse concerning a 15 month old male with an amoxicillin allergy who on 04/11/2001 was vaccinated with a first dose of varicella vaccine, SC in left deltoid. On 04/20/2001, the pt developed a temp of 102.3 F and a rash on the body, few dots on chest. On 04/21/2001, the pt developed red dots over the body. In follow-up, the licensed practical nurse stated that the pt "was covered with finish dots all over body." On 04/22/2001, the pt developed three chicken pox like vesicles. In follow-up, the licensed practical nurse stated that the pt had three chickenpox vesicles on the face. On 04/23/2001, the "dots were very faint in color." On 04/24/2001, the licensed practical nurse reported that the areas were fading in color and the child was feeling better. She reported that no treatment or medications were ordered. In follow-up, the licensed practical nurse reported that the pt recovered from his experiences. Unspecified medica attention was sought. No further info is available.

VAERS ID:185120 (history)  Vaccinated:2001-04-11
Age:18.0  Onset:2001-04-14, Days after vaccination: 3
Gender:Female  Submitted:2002-05-15, Days after onset: 396
Location:Unknown  Entered:2002-05-22, 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:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WAES01061887
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Lethargy, Rash vesicular
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning an 18 year old female who on 04/11/2001 was vaccinated with the first dose of the varicella vaccine. There was no concomitant medication. A few days after vaccination, the pt developed five to 10 lesions and lethargy. Unspecified medical attention was sought. The lesions scabbed and crusted and her symptoms subsided. Additional info has been requested.

VAERS ID:185854 (history)  Vaccinated:2001-04-11
Age:0.2  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2002-05-16, Days after onset: 400
Location:Tennessee  Entered:2002-05-31, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: A0346109A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAMA981A20IMLL
Administered by: Private     Purchased by: Private
Symptoms: Lethargy, Pallor
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Report 20010092611 described lethargy and pallor in a two month old male who adsorbed (Infanrix) for prophylaxis of diphtheria, tetanus and pertussis. Reportedly, the vaccinee had no allergies or medical history. Reportedly, he took no concomitant medications. On 04/11/2001 11:00, the pt received his first 0.5 ml left thigh dose of Infanrix. "Within minutes" post-vaccination, the vaccinee became lethargic and very pale. There was no loss of consciousness. Within 15 minutes, the vaccinee''s color had had returned. After an additional fifteen minutes, the vaccinee was mroe alert and took some of his bottle. The vaccinee stayed in the physician''s office for "a while" to be observed. As of 04/11/2001, the adverse events were resolving.

VAERS ID:186070 (history)  Vaccinated:2001-04-11
Age:  Onset:0000-00-00
Gender:Female  Submitted:2002-05-28
Location:Unknown  Entered:2002-06-05, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Pregnancy (LMP-02/21/01)
Diagnostic Lab Data: UNK
CDC Split Type: WAES01041965
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Dry mouth
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Information has been received from a female with no known allergies who on approximately 04/11/2001 was vaccinated with Hep A vaccine. There was no concomitant medication. In April 2001, the pt experienced dry mouth and other symptoms which she attributed to morning sickness. At the time of this report on 04/19/2001, the pt was 8 weeks pregnant (estimated LMP 02/21/2001, estimated due date 11/28/2001). Unspecified medical attention was sought. Additional info has been requested.

VAERS ID:189844 (history)  Vaccinated:2001-04-11
Age:2.5  Onset:2002-08-11, Days after vaccination: 487
Gender:Male  Submitted:2002-08-26, Days after onset: 15
Location:Unknown  Entered:2002-09-09, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURUO357AA3 RL
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: On 08/11/02, client developed "chicken pox" like rash which progressed in ''crops". Client also experienced fever up to 100.2 F. Sys resolved bhy Aug 19th.

VAERS ID:202609 (history)  Vaccinated:2001-04-11
Age:0.1  Onset:2001-09-11, Days after vaccination: 153
Gender:Male  Submitted:2003-04-23, Days after onset: 589
Location:South Carolina  Entered:2003-05-06, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Complete eval reveals autism by age 18 months.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1698K0IM 
Administered by: Private     Purchased by: Other
Symptoms: Autism
SMQs:
Write-up: Developed signs of autism by 5 months of age. Unknown if newborn dose of Hep B contained Thimersol. A 60-day follow up report received 7/29/2003 adds: Not recovered. Has autism. The medical record received on 1/6/04 confirms the diagnosis of autism.

VAERS ID:217545 (history)  Vaccinated:2001-04-11
Age:0.0  Onset:2001-04-12, Days after vaccination: 1
Gender:Female  Submitted:2004-03-08, Days after onset: 1061
Location:Pennsylvania  Entered:2004-03-08
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: MILD ASTHMA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)AVENTIS PASTEURUA487AB3IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0406K0IMLA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES474733   
Administered by: Private     Purchased by: Private
Symptoms: Abasia, Coma, Oral intake reduced, Pyrexia, Speech disorder
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Patient developed a high fever of 104 14 hours post vaccination .Was in low responsive state .Would not walk talk or eat for several hours.

VAERS ID:235119 (history)  Vaccinated:2001-04-11
Age:1.1  Onset:2005-03-11, Days after vaccination: 1430
Gender:Male  Submitted:2005-03-14, Days after onset: 3
Location:West Virginia  Entered:2005-03-17, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES1152K   
Administered by: Private     Purchased by: Other
Symptoms: Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: red bumps, rash

VAERS ID:252776 (history)  Vaccinated:2001-04-11
Age:1.3  Onset:2006-03-01, Days after vaccination: 1785
Gender:Female  Submitted:2006-03-09, Days after onset: 8
Location:New Mexico  Entered:2006-03-14, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS955A22 RL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.14081C1 LL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T04842 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0584K1 RA
PNC: PNEUMO (PREVNAR)PFIZER/WYETH4149510 RL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.11501C0 RA
Administered by: Public     Purchased by: Public
Symptoms: Drug ineffective, Viral infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt diagnosed with chickenpox 1 hour office on 3-8-2006. Pt received varicella vaccine through Public Health Dept on 4-11-2001. Started breaking out one week ago-too late to prescribe antiviral.

VAERS ID:168778 (history)  Vaccinated:2001-04-12
Age:9.0  Onset:2001-04-12, Days after vaccination: 0
Gender:Female  Submitted:2001-04-12, Days after onset: 0
Location:California  Entered:2001-04-17, 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: History of febrile seizures at a younger age.
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM678A20IMLA
Administered by: Private     Purchased by: Public
Symptoms: Eye movement disorder, Fall
SMQs:, Accidents and injuries (narrow), Ocular motility disorders (narrow)
Write-up: About a half hour after the vaccine, the patient fell to the floor, eyes rolled back, lasted a few seconds. The mother claims she had a similar reaction after Hep B vaccine in March of 1999.

VAERS ID:168866 (history)  Vaccinated:2001-04-12
Age:27.0  Onset:2001-04-12, Days after vaccination: 0
Gender:Male  Submitted:2001-04-13, Days after onset: 1
Location:Florida  Entered:2001-04-18, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: On 4/13/01, BP-151/89; P-85; R-16; T-98.6F
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0580K2SCRA
Administered by: Other     Purchased by: 0
Symptoms: Dysphagia, Hypertension, Hypoventilation, Musculoskeletal stiffness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Arthritis (broad)
Write-up: On 4/12/01, stiff neck, trouble swallowing and trouble moving neck. No medication. Referred to PMD.

VAERS ID:168867 (history)  Vaccinated:2001-04-12
Age:1.3  Onset:2001-04-12, Days after vaccination: 0
Gender:Male  Submitted:2001-04-13, Days after onset: 1
Location:Washington  Entered:2001-04-18, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Mild pulmonary valve stenosis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS975A23IMRL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA563AA3IMLL
Administered by: Private     Purchased by: Public
Symptoms: Abasia, Injection site pain, Irritability, Musculoskeletal stiffness
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Arthritis (broad)
Write-up: Approx. 4 hours, post vax, mom noticed increased fussiness, complaining of leg pain and stiffness, non-weight bearing. Mom took child to ER with a questionable dx at the hospital. Today, he is moving better but slower than normal.

VAERS ID:168898 (history)  Vaccinated:2001-04-12
Age:18.0  Onset:2001-04-12, Days after vaccination: 0
Gender:Female  Submitted:2001-04-12, Days after onset: 0
Location:Minnesota  Entered:2001-04-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: History of fainting reported.
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5203A91IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Hypotension, Loss of consciousness, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Expressed dizziness following shot. Nurse assisted her to lower head. Brief loss of consciousness (30-45 seconds) and awakened and color pale. BP 90/50-deep breathing done. Remained with head down 3-4 minutes. Felt less dizzy; took water and BP 104/58 and ambulated to waiting area. Supervised by parent. Dismissed 4:05 PM.

VAERS ID:168908 (history)  Vaccinated:2001-04-12
Age:80.0  Onset:2001-04-12, Days after vaccination: 0
Gender:Female  Submitted:2001-04-13, Days after onset: 1
Location:Arizona  Entered:2001-04-19, 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: Claritin Reditabs
Current Illness:
Preexisting Conditions: Osteoporosis; Labile BP; Hyperglycemia; Diverticulosis; Thyroid replacement therapy history; Degenerative arthritis; Prostatic right hip
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0820K1IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt reported reaction at approx. 16:00 on 4/12/01. She had pain, edema, erythema and itching at left deltoid injection site. Area of edema measured and area of erythema measured. Benadryl 25mg given at 16:30 and 10 capsules of same for home administration.

VAERS ID:168938 (history)  Vaccinated:2001-04-12
Age:2.0  Onset:0000-00-00
Gender:Male  Submitted:2001-04-12
Location:California  Entered:2001-04-20, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1701K2IMRL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS4773872IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T07603SCLA
Administered by: Private     Purchased by: 0
Symptoms: Unevaluable event
SMQs:
Write-up: No data

VAERS ID:168942 (history)  Vaccinated:2001-04-12
Age:11.0  Onset:2001-04-13, Days after vaccination: 1
Gender:Female  Submitted:2001-04-14, Days after onset: 1
Location:D.C.  Entered:2001-04-20, 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: HbSS (Sickle Cell Anemia).
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Public
Symptoms: Cellulitis, Injection site erythema, Injection site oedema, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: HBV & VZV given at 2 PM on 04/12/2001. In the AM of 04/13/01, the patient had swelling, erythema, and bullae noted on the right triceps, site of VZV vaccine. Area appears cellulitis.

VAERS ID:169047 (history)  Vaccinated:2001-04-12
Age:4.0  Onset:2001-04-15, Days after vaccination: 3
Gender:Female  Submitted:2001-04-19, Days after onset: 4
Location:California  Entered:2001-04-25, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI of the Head - Neg. EEG with right sided focal abnormality.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1161K1SCRL
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Electroencephalogram abnormal
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: This patient had an onset of prolonged left sided focal seizure. requiring IV Valium in the ER to stop her seizure. No reoccurrence to date.

VAERS ID:169066 (history)  Vaccinated:2001-04-12
Age:1.3  Onset:2001-04-13, Days after vaccination: 1
Gender:Male  Submitted:2001-04-13, Days after onset: 0
Location:Tennessee  Entered:2001-04-25, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS968A23IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R06912SCRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4753802IMLL
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Right thigh with 10cm X 8cm induration and erythema seen around site of DTAP injection. Non-tender.

VAERS ID:169075 (history)  Vaccinated:2001-04-12
Age:0.3  Onset:2001-04-12, Days after vaccination: 0
Gender:Male  Submitted:2001-04-18, Days after onset: 6
Location:New York  Entered:2001-04-25, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM981A21IMLA
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.5817BA1IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T07601 RA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4747501IMLL
Administered by: Private     Purchased by: Private
Symptoms: Hypotonia, Shock
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)
Write-up: Hypotonia and shock-like.

VAERS ID:169077 (history)  Vaccinated:2001-04-12
Age:0.5  Onset:2001-04-15, Days after vaccination: 3
Gender:Female  Submitted:2001-04-16, Days after onset: 1
Location:New York  Entered:2001-04-25, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Jaundice at birth
Diagnostic Lab Data: CBC-fairly normal; Spinal Tap-nml
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0313BA3IMRL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2726A20IMLL
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES4730073IMRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4753830IMLL
Administered by: Private     Purchased by: Public
Symptoms: Agitation, Crying, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)
Write-up: Pt developed fever of 103F, inconsolable crying $g 3 hours, vomited X 1. Went to ER for full work-up, blood work and lumbar puncture.

VAERS ID:169116 (history)  Vaccinated:2001-04-12
Age:1.0  Onset:2001-04-13, Days after vaccination: 1
Gender:Female  Submitted:2001-04-17, Days after onset: 4
Location:Illinois  Entered:2001-04-25, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1034K2IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T04852SCLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0827K0SCRL
Administered by: Other     Purchased by: Other
Symptoms: Furuncle, Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Mother called to report large "boil" on thigh where HIB/HEP administered. Area with increased redness. Rx''d Augmentin and Benadryl per MD.

VAERS ID:169151 (history)  Vaccinated:2001-04-12
Age:0.2  Onset:2001-04-12, Days after vaccination: 0
Gender:Male  Submitted:2001-04-19, Days after onset: 7
Location:Mississippi  Entered:2001-04-27, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MS01012
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESVO357CA0IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1797K0IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T03950SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4747340IMRL
Administered by: Public     Purchased by: Public
Symptoms: Oedema, Screaming
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: On 04/13/01, this patient''s mother called at 12:30 stating the infant hadn''t stopped crying since he was given the immunization 04/12/01. No fever or rash, gave the infant Tylenol. She couldn''t see what was causing him to cry, no transportation to bring him to the MD. The mother promised to carry him to the PMD. The grandmother noted his left thigh was swollen and the infant''s thigh was rubbed with alcohol and he stopped crying. The infant was not carried to the PMD and as of 04/19/01, no other problems.

VAERS ID:169266 (history)  Vaccinated:2001-04-12
Age:66.0  Onset:2001-04-12, Days after vaccination: 0
Gender:Female  Submitted:2001-04-17, Days after onset: 5
Location:D.C.  Entered:2001-04-30, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0959K1SCLA
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Fatigue, Injection site erythema, Injection site pain, Pain, Rash maculo-papular, Vertigo
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (narrow), Hypersensitivity (narrow)
Write-up: Given pneumovax only with no problems within 30 minutes. 1 1/2 hours, later, upper left arm with increased aching, fatigue, red and splotchy rash around shot site and itching. At home she took aspirin. Next AM she was still sore and under arm pit, had dizziness and trouble with vertigo, laying down. Slightly improved that day.

VAERS ID:169287 (history)  Vaccinated:2001-04-12
Age:0.5  Onset:2001-04-13, Days after vaccination: 1
Gender:Male  Submitted:2001-04-19, Days after onset: 6
Location:South Carolina  Entered:2001-05-01, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Teething but no temperature
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: SC0124
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS984A22IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T05612SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4733371IMRL
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site erythema, Injection site swelling, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (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)
Write-up: Client started spiking elevated temperature of 103F and would not keep medication down; vomited on every attempt to keep Tylenol down, approx. 10-15 times. Leg started swelling and redness occurred on 4/13/01, approx. 2 1/2"; then mother took infant to ER, after calling PMD. Client''s mother states that the ER physician dx''d cellulitis and administered medications for signs and symptoms; Tylenol and an antibiotic in ER.

VAERS ID:169310 (history)  Vaccinated:2001-04-12
Age:1.0  Onset:2001-04-22, Days after vaccination: 10
Gender:Male  Submitted:2001-04-27, Days after onset: 5
Location:Minnesota  Entered:2001-05-01, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CXR, Blood and Urine for meningitis or pneumonia, bladder infection or other bacterial infection but all were negative.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER  SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1471K0SCRL
Administered by: Private     Purchased by: 0
Symptoms: Infection, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: On 4/22/01, temperature was 103.2F; on 4/23/01, temperature was 105.6F; on 4/24/01, temperature was 105.2F. He had over 40 chickenpox. Recovering but still a few chickenpox.

VAERS ID:169338 (history)  Vaccinated:2001-04-12
Age:29.0  Onset:2001-04-21, Days after vaccination: 9
Gender:Female  Submitted:2001-04-25, Days after onset: 4
Location:Washington  Entered:2001-05-01, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1710J SCLA
Administered by: Private     Purchased by: Private
Symptoms: Infection, Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: The pt experienced a maculo-papular rash and then vaccine related measles developed 9 days post vax.

VAERS ID:169342 (history)  Vaccinated:2001-04-12
Age:9.0  Onset:2001-04-12, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Indiana  Entered:2001-05-01
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: pertussis allergy and orange dye
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1652K0IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1389K1SCRL
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0298AA0IMLL
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Flushing, Rhinorrhoea, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Approximately 15 minutes post vax, the pt was brought back into clinic with difficulty breathing, running nose and flushing. Found to have wheezes throughout lung fields. Given albuterol nebulizer treatment twice, chlorpheniramine and transported to ER via ambulance. Pt was given steroids and observed.

VAERS ID:169520 (history)  Vaccinated:2001-04-12
Age:1.0  Onset:2001-04-20, Days after vaccination: 8
Gender:Male  Submitted:2001-04-27, Days after onset: 7
Location:Texas  Entered:2001-05-07, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1335K0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: The pt experienced a chicken pox like rash at the site of the varicella vaccination. Reassurance given at the office visit.

VAERS ID:169568 (history)  Vaccinated:2001-04-12
Age:1.3  Onset:2001-04-23, Days after vaccination: 11
Gender:Male  Submitted:2001-04-30, Days after onset: 7
Location:Ohio  Entered:2001-05-08, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0155L0SCLA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4733313IMLL
Administered by: Private     Purchased by: Private
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: Maculo papular rash on trunk, proximal extremities.

VAERS ID:169605 (history)  Vaccinated:2001-04-12
Age:12.0  Onset:2001-04-12, Days after vaccination: 0
Gender:Female  Submitted:2001-04-22, Days after onset: 10
Location:Massachusetts  Entered:2001-05-08, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol inhaler
Current Illness: NONE
Preexisting Conditions: mild intermittent asthma
Diagnostic Lab Data: EKG - results pending
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1265K0IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0405K1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Fall, Hypotension, Loss of consciousness, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Following vaccination, the pt fell off the exam table hitting head on floor and arms, legs and stomach were shaking (seizure) with LOC, lasting approximately 5 seconds. BP 100/70, HR 80. Ice applied, had normal neurological exam after incident, normal cardiac exam. Ice applied to face.

VAERS ID:169623 (history)  Vaccinated:2001-04-12
Age:0.2  Onset:2001-04-12, Days after vaccination: 0
Gender:Female  Submitted:2001-04-19, Days after onset: 7
Location:Tennessee  Entered:2001-05-09, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Mother (+) syphillis. Prophylactically antibiotics 10 days after birth.
Diagnostic Lab Data:
CDC Split Type: TN01015
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS988A20IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1822K0IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T06970SCRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4747310IMLL
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: This infant received shots on 04/12/01. She had a fever of 102.7 2 - 3 days fluctuating degrees, with Tylenol. A rash was noted (hives) "all over her entire body". She received children''s Benadryl on 04/14/10 through 04/15/01. The hives started to disappear on Sunday and the hives were completely gone by Monday 04/16/01. The infant is to see a doctor today in the AM on 04/19/01. No problems noted instructed per doctor to inform us of a reaction. The mother was instructed to have doctor write orders for DT next time.

VAERS ID:169795 (history)  Vaccinated:2001-04-12
Age:4.0  Onset:2001-04-13, Days after vaccination: 1
Gender:Female  Submitted:2001-05-03, Days after onset: 20
Location:Ohio  Entered:2001-05-14, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hx of pneumonia
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS995A24IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site oedema, Injection site pain, Injection site warmth, Skin discolouration
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: The pt experiences left arm redness and swelling. Seen in the ER on 4/15/01. The left upper arm had a circular, reddened area surrounding vax site. Minimally tender to the touch, slightly warm, slightly indurated suggesting a local reaction to vax. The pt was released home in good condition. No meds given until 4/16/01. Augmentin was given per moms request. Arm was discolored for 2 weeks.

VAERS ID:170104 (history)  Vaccinated:2001-04-12
Age:47.0  Onset:2001-04-16, Days after vaccination: 4
Gender:Male  Submitted:2001-05-15, Days after onset: 29
Location:California  Entered:2001-05-22, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0377AA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left arm red, swollen, painful and numb. Symptoms began 4 days, post vax. Seen in ER. Treated with Cephalexin 500mg X 5 days and Prednisone 10mg 2 BID X 3 days.

VAERS ID:170177 (history)  Vaccinated:2001-04-12
Age:4.0  Onset:2001-04-13, Days after vaccination: 1
Gender:Female  Submitted:2001-04-16, Days after onset: 3
Location:Michigan  Entered:2001-05-23, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MI2001035
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0276CA4IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T0472 SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1386K1SCLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1333K0SCLL
Administered by: Public     Purchased by: 0
Symptoms: Feeling hot, Irritability, Rash maculo-papular
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: Child became irritable on 4/13/01 and 4/14/01. On 4/15/01, she developed maculopapular "bumps" in front of left and right axilla, 1 on abdomen, 1 on back of arm and 1 on back of leg. Slight itching. States daughter feels a little warm but did not measure temperature with thermometer. Mom advised to have evaluated by physician. On 4/15/01, telephone call from pt''s mom. Did not see physician. Had 2 more bumps on abdomen today, 1 on back of leg and 2 near feet. Macularpapular (not becoming smaller in size). On 4/26/01, a few bumps faded away and the rest scabbed over and cleared up. She is feeling well.

VAERS ID:171079 (history)  Vaccinated:2001-04-12
Age:51.0  Onset:2001-04-15, Days after vaccination: 3
Gender:Female  Submitted:2001-05-20, Days after onset: 35
Location:Georgia  Entered:2001-06-11, Days after submission: 22
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: Hypertension
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0376AA IMRA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Hypoaesthesia, Injection site anaesthesia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Deep muscle pain in arm, neck, back and numbness at injection site. Treated with prednisone, Motrin and Tagamet. Seen in ER on 4/15/01 for same and chest pain.

VAERS ID:171049 (history)  Vaccinated:2001-04-12
Age:1.0  Onset:2001-04-22, Days after vaccination: 10
Gender:Female  Submitted:2001-04-24, Days after onset: 2
Location:Minnesota  Entered:2001-06-12, Days after submission: 49
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1387K0SC 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4738763IM 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1604K0SC 
Administered by: Private     Purchased by: 0
Symptoms: Acne, Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Noticed pimple rash on L arm at injection site. Small cluster few red pimple areas on face and stomach and back couple on legs.

VAERS ID:173309 (history)  Vaccinated:2001-04-12
Age:37.0  Onset:2001-04-12, Days after vaccination: 0
Gender:Male  Submitted:2001-06-27, Days after onset: 76
Location:Unknown  Entered:2001-07-17, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Numerous blood tests
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Difficulty in walking, Influenza like illness, Joint stiffness
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: On 4/12/01, I received the 3rd in a series of 3 Lymerix vaccinations. 2 1/2 days, post vax, I had flu-like symptoms. One week later, I had extensive pain in my left foot, ankle and bottom of foot. The joints stiffened up in my feet, wrists, fingers and knees. Since 4/12/01, I have been to 7 doctors with no direct answer to my condition. I am still in pain and I can barely walk some days. I am presently taking 3200mg of ibuprofen and using doxycycline.

VAERS ID:173516 (history)  Vaccinated:2001-04-12
Age:1.3  Onset:2001-04-21, Days after vaccination: 9
Gender:Male  Submitted:2001-07-16, Days after onset: 86
Location:Wisconsin  Entered:2001-07-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: ibuprofen, Vantin oral suspension rx''d on 4/12/01 X 10 days.
Current Illness: UTI with cough, rhinorrhea and left left otitis media but no fever.
Preexisting Conditions: NONE
Diagnostic Lab Data: Head CT-showed possible ventricular dilation but otherwise normal; EEG; CXR-right upper lobe atelectasis, left lower lobe with mild haziness; Lumbar Puncture; Blood, Urine and CSF cultures
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1390K0SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4725543IMLL
Administered by: Private     Purchased by: Private
Symptoms: Atelectasis, Febrile convulsion, Hypoxia, Laboratory test abnormal, Musculoskeletal stiffness, Pneumonia aspiration, Postictal state, Respiratory disorder, Respiratory failure
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Convulsions (narrow), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: On 04/22/2001 the pt presented to the ER with a temperature of 104.9F and seizing. Seizure lasted 45 minutes. He was riding in the back seat of the family car when his father noticed stiffening of his limbs and an irregular breathing pattern. Did have 2 to 3 days of intermittent nasal congestion, rhinorrhea and cough. Intubated for subsequent respiratory failure using vecuronium and thiopental for 12 hours. Transported by EMS to PICU for stay overnight. Discharge dx: Status epilepticus, mechanical ventilation for less than 12 hours and probable complex febrile seizures. Treatment: IV antibiotics (lorazepam and fosphenytoin) and Neurology consult. Because of findings on the CXR, there were concerns about a possible aspiration pneumonia. The only neurologic finding was some wobbliness with walking consistent with postictal ataxia versus medication intoxication. Plan is to continue on Dilantin until follow-up with Neurology, 1 month post discharge. The Dilantin was discontinued about 1 week after discharge, with rapid resumption of his normal gait, mental status, and coordination. The patient developed another fever 2 weeks after discharge with the temperature ranging from 100F to 102F. This persisted for 3 days and was treated with alternating Tylenol and ibuprofen.

VAERS ID:173923 (history)  Vaccinated:2001-04-12
Age:2.0  Onset:2001-04-14, Days after vaccination: 2
Gender:Male  Submitted:2001-04-16, Days after onset: 2
Location:Illinois  Entered:2001-08-06, Days after submission: 112
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: IL01026
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0278CA2IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P0997  LL
Administered by: Private     Purchased by: Public
Symptoms: Injection site swelling, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt had swelling of thigh with slight erythematous rash.

VAERS ID:174308 (history)  Vaccinated:2001-04-12
Age:  Onset:2001-04-19, Days after vaccination: 7
Gender:Male  Submitted:2001-08-07, Days after onset: 110
Location:Pennsylvania  Entered:2001-08-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: History of bronchiolitis and asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Cerebellar ataxia, Dizziness, Encephalitis, Infection, Nystagmus, Oral intake reduced, Skin ulcer, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow)
Write-up: 8 year old male develops varicella encephalitis/cerebral ataxia and chickenpox which was seen after receiving chickenpox vaccine. Pt had decreased appetite, dizziness, somnolence, mild nystagmus, persistent vomiting and covered with chickenpox lesions. Treated with antiemetics, Tan and IV acyclovir with good results.

VAERS ID:174577 (history)  Vaccinated:2001-04-12
Age:4.0  Onset:2001-04-19, Days after vaccination: 7
Gender:Female  Submitted:2001-08-14, Days after onset: 117
Location:Washington  Entered:2001-08-22, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM99731924IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T05050SC 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1390K1SC 
Administered by: Private     Purchased by: Public
Symptoms: Joint swelling, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Pt developed a urticarial rash with itching of lips and perioral area. She had joint swelling and pain. She was treated with Benadryl. Urticarial rash resolved over 24 hours. Joint pain and swelling resolved over 4 days.

VAERS ID:178512 (history)  Vaccinated:2001-04-12
Age:1.5  Onset:2001-04-19, Days after vaccination: 7
Gender:Female  Submitted:2001-11-28, Days after onset: 223
Location:Unknown  Entered:2001-12-03, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WAES01042655
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Information has been received from the mother of an 18 month old female with no known allergies and no past medical history who on 4/12/01 was vaccinated with rubella virus vaccine live (second generation). There was no concomitant medication. On approx. 4/19/01, the pt developed a fever for 2 days. On 4/22/01, the pt developed a rash. The pt''s rash persisted as of 4/26/01. Unspecified medical attention was sought. No further details were provided. Additional information has been requested.

VAERS ID:181417 (history)  Vaccinated:2001-04-12
Age:  Onset:2001-04-12, Days after vaccination: 0
Gender:Female  Submitted:2002-02-05, Days after onset: 299
Location:Oklahoma  Entered:2002-02-15, Days after submission: 10
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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5179A60IMLA
Administered by: Other     Purchased by: Private
Symptoms: Headache, Hypoaesthesia, Injection site pain, Injection site swelling, Pain, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Arm swelled to 2x normal within an hour; pain at injection site with numbness/tingling to fingertips; headache; body aches; temp 103.5 deg. F.; lumph nodes swollen to point of airway blockage. Admitte to hospital.

VAERS ID:196373 (history)  Vaccinated:2001-04-12
Age:1.0  Onset:2002-03-12, Days after vaccination: 334
Gender:Male  Submitted:2003-01-09, Days after onset: 303
Location:Texas  Entered:2003-01-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The pt''s mother was a Hep-B carrier.
Diagnostic Lab Data: UNK
CDC Split Type: A0365449A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS  IM 
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5166A21IM 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES  IM 
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Laboratory test abnormal
SMQs:, Lack of efficacy/effect (narrow)
Write-up: In 3/01, (when the pt was a neonate in the hospital), the vaccinee received his 1st injection of Hep-B vaccine (mfr unk). On 4/12/01, the vaccinee received his 2nd injection of Hep-B vaccine (Engerix-B, lot ENG5166A2). On 9/12/01, the vaccinee received his 3rd injection of Hep-B vaccine (Recombivax-HB, lot 0318K). On 3/12/02, the pt was found to be a non-responder. As of 3/19/02, the outcome of the event was unknown.

VAERS ID:233710 (history)  Vaccinated:2001-04-12
Age:34.0  Onset:2001-04-14, Days after vaccination: 2
Gender:Female  Submitted:2001-11-19, Days after onset: 219
Location:Michigan  Entered:2005-02-11, Days after submission: 1180
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Paxil, Ortho-Tricyclen
Current Illness: NONE
Preexisting Conditions: Epidermoid Tumor of the brain
Diagnostic Lab Data: NONE
CDC Split Type: BIT010002
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV048B1SCLA
Administered by: Other     Purchased by: Private
Symptoms: Ecchymosis, Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: A 33 year old female, with a medical history of an epidermoid tumor of the brain, received the 2nd dose of Anthrax vaccine (lot # FAV048B) pm 04/12/01. No other vaccines were given at that time. The patient received the 1st dose of Anthrax vaccine on 03/27/01 with no reaction. Concomitant medications reported were Paxil and Ortho-Tricyclen. On 04/14/01, the patient experienced induration (150mm x 150MM), edema, pruritus, erythema and heat at the injection site (left deltoid). On 04/14/01, the patient noted redness, itching, swelling and heat at the injection site. By 04/18/01, the area of induration reached 150mm x 150mm with an area (60mm x 60mm) of purple discoloration surrounding the center of the injection site. At this time, the patient began applying ice to the area four times a day for fifteen minutes. On 04/19/01, the patient was seen by medical personnel and was treated with Benadryl, po, and instructed to continue to apply ice to the area as stated above. This treatment regimen continued through 04/22/01, with symptoms steadily improving. Marked improvement was seen by the medical personnel when the patient was seen again on 04/24/01 as noted by decreasing redness, size, itching and heat. On 04/25/01, the area was nearly invisible and by 05/01/01, all symptoms had resolved.

VAERS ID:251966 (history)  Vaccinated:2001-04-12
Age:1.1  Onset:2006-02-06, Days after vaccination: 1761
Gender:Male  Submitted:2006-02-07, Days after onset: 1
Location:Oregon  Entered:2006-02-24, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES474-7201IMRL
Administered by: Other     Purchased by: Other
Symptoms: Viral infection
SMQs:
Write-up: Pt diagnosed with mile varicella 2/7/06 (was previously vaccinated).

VAERS ID:310590 (history)  Vaccinated:2001-04-12
Age:70.0  Onset:2007-11-01, Days after vaccination: 2394
Gender:Male  Submitted:2008-04-22, Days after onset: 173
Location:Maine  Entered:2008-04-22
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroxine sodium
Current Illness: Unknown
Preexisting Conditions: Thyroidectomy - The subject has no history of adverse events following previous vaccinations.
Diagnostic Lab Data: UNK
CDC Split Type: A0723911A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 2UNRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Joint effusion, Lyme disease, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: This case was reported by a consumer and described the occurrence of right knee pain in a 70-year-old male subject who was vaccinated with LYMERIX, GlaxoSmithKline. A physician or other health care professional has not verified this report. The subject''s medical history included thyroidectomy. Concurrent medications included Thyroxine sodium (Synthroid). On 12 April 2001, 1 May 2000 and 29 March 2000 the subject received 3rd dose, 2nd dose and 1st dose of LYMERIX (all injections in the right arm). In November 2007, a little over 6 years after the 3rd vaccination with LYMERIX, the subject experienced right knee pain with fluid on the right knee. This was considered to be a systemic reaction. The events were considered to be disabling. At the time of reporting, the subject was being tested for Lyme disease. Developing Lyme disease following vaccination series with LYMERIX is considered to be a vaccination failure. At the time of reporting, the knee pain was unresolved. The outcome of the other events was not known.

VAERS ID:169115 (history)  Vaccinated:2001-04-13
Age:42.0  Onset:2001-04-13, Days after vaccination: 0
Gender:Female  Submitted:2001-04-14, Days after onset: 1
Location:Alaska  Entered:2001-04-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES471038 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Local reaction with swelling, redness and warmth, 48 hours, post vax. Treated with ibuprofen and Benadryl.

VAERS ID:179558 (history)  Vaccinated:2001-04-13
Age:  Onset:2001-04-13, Days after vaccination: 0
Gender:Female  Submitted:2001-12-03, Days after onset: 234
Location:Texas  Entered:2001-12-28, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: contact with or exposure to rabies
Diagnostic Lab Data: A female patient( age unknown) experienced nausea, vomiting, chest pain, fever and hypertension on 04/14/2001 following treatment with RabAvert for postexposure prophylaxis. the patient was bitten by a raccoon on 04/09/2001 and began postex
CDC Split Type: EM20010564
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Agitation, Chest pain, Hypertension, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypertension (narrow), Cardiomyopathy (broad)
Write-up: A female patient (age unknown) experienced nausea, vomiting, chest pain, fever, and hypertension on 4/14/01 following treatment with RabAvert for postexposure prophylaxis. The patient was bitten by a raccoon on 4/9/01 and began postexposure vaccination on 4/13/01. On 4/13/01 she received human rabies immune globulin into an around the site of the wound, and RabAvert was given IM in her arm. Approximately 2 hours later, the patient began to feel edgy, hot and sick to her stomach. The next day, she presented to the emergency room with nausea, vomiting, chest pain, fever, and hypertension. She was treated with IV fluids and sent home. On 4/16/01, the patient returned to the emergency room for her second dose of RabAvert. She did not develop any adverse experiences following the second dose of RabAvert. The patient missed her third and fourth doses of RabAvert. She was due into the clinic on 4/30/01 for her third dose of postexposure RabAvert and would then try to complete the postexposure schedule per the approved regimen. The Drug Safety physician assessed that human rabies immune globulin as a secondary suspect product. Follow up information has been requested.

VAERS ID:197206 (history)  Vaccinated:2001-04-13
Age:54.0  Onset:2001-04-14, Days after vaccination: 1
Gender:Female  Submitted:2001-07-24, Days after onset: 101
Location:New Jersey  Entered:2003-02-04, Days after submission: 560
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: U200100673
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0368AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: It was reported that a pt rec''d a TD adult vaccine on 4/13/01. Reportedly the next day after the injection the pt developed itching at the site. The pt recovered from the experience. This case is closed.

VAERS ID:281318 (history)  Vaccinated:2001-04-13
Age:6.0  Onset:2006-08-27, Days after vaccination: 1962
Gender:Female  Submitted:2007-05-16, Days after onset: 262
Location:Washington  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0609USA01580
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1133K UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella
SMQs:
Write-up: Information has been received fro a consumer concerning her 6 year old female daughter who on 13-APR-2001 was vaccinated with a dose of Varivax (lot # 635192/1133K). About eleven days ago, on approximately 27-AUG-2006 the patient developed chickenpox. About 9 days after the first lesions developed, all of the lesions seemed to clear. Eleven days from when the rash first started, more lesions seemed to form. The lesions were found on her face, back and stomach. No other symptoms were noted. Medical attention was sought. At the time of the report the patient was recovering. There was no product quality complaint involved. Additional information has been requested.

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