MedAlerts Home
  Read the MedAlerts Blog Subscribe to the MedAlerts Blog 

Found 466004 cases in entire database

Case Details (Sorted by Vaccination Date)

This is page 1766 out of 4661

Result pages: prev   1667 1668 1669 1670 1671 1672 1673 1674 1675 1676 1677 1678 1679 1680 1681 1682 1683 1684 1685 1686 1687 1688 1689 1690 1691 1692 1693 1694 1695 1696 1697 1698 1699 1700 1701 1702 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 1743 1744 1745 1746 1747 1748 1749 1750 1751 1752 1753 1754 1755 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780 1781 1782 1783 1784 1785 1786 1787 1788 1789 1790 1791 1792 1793 1794 1795 1796 1797 1798 1799 1800 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819 1820 1821 1822 1823 1824 1825 1826 1827 1828 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1839 1840 1841 1842 1843 1844 1845 1846 1847 1848 1849 1850 1851 1852 1853 1854 1855 1856 1857 1858 1859 1860 1861 1862 1863 1864 1865   next


VAERS ID:178284 (history)  Vaccinated:2001-11-19
Age:0.5  Onset:2001-11-19, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Tennessee  Entered:2001-11-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: rash;UNK. DTAP;2;.00;In Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURU05320A2IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT145022IMRL
Administered by: Private     Purchased by: Private
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Mom states had a rash 3 days after vaccinations on 9/18/01. Today, per Mom, same rash on abdomen, tiny red dots. Gave dose of Benadryl with no change-child appeared fine. No fever at present time-97.9.

VAERS ID:178626 (history)  Vaccinated:2001-11-19
Age:41.0  Onset:2001-11-19, Days after vaccination: 0
Gender:Female  Submitted:2001-11-29, Days after onset: 10
Location:Connecticut  Entered:2001-12-05, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR00608AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: The patient reported progressive numbness from the fingertips on her left hand, to the fingertips on her right hand, to the toes on both feet. The patient experienced a feeling of heaviness in both forearms. These symptoms began 15 minutes after the injection.

VAERS ID:178628 (history)  Vaccinated:2001-11-19
Age:66.0  Onset:2001-11-20, Days after vaccination: 1
Gender:Male  Submitted:2001-11-20, Days after onset: 0
Location:Kansas  Entered:2001-12-05, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergic to mold and pollen.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0702AA IM 
Administered by: 0     Purchased by: 0
Symptoms: Face oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: The patient developed hives on both arms and behind his knees and near the joints. The patient''s lip was swollen in the A.M., but the shot may not be related.

VAERS ID:179259 (history)  Vaccinated:2001-11-19
Age:37.0  Onset:2001-11-20, Days after vaccination: 1
Gender:Female  Submitted:2001-12-09, Days after onset: 19
Location:Massachusetts  Entered:2001-12-19, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD75  LA
Administered by: Private     Purchased by: 0
Symptoms: Erythema, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Five cm erythematous raised macule.

VAERS ID:179404 (history)  Vaccinated:2001-11-19
Age:56.0  Onset:2001-11-20, Days after vaccination: 1
Gender:Female  Submitted:2001-12-01, Days after onset: 11
Location:New Jersey  Entered:2001-12-26, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cozaar; zinc; Prilosec; Claritin; Celebrex; Flonase; Quinine sulfa; Xanax
Current Illness: NONE
Preexisting Conditions: High blood pressure; gastro-reflux; arthritis; nasal allergy; leg cramps
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE08341LA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain upper, Arthralgia, Headache, Hyperhidrosis, Muscular weakness, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: The pt developed chills, muscle aches, headache, stomach pain and fever which started 18 hours, post vax, and lasted about 3 days. Then she had a lot of sweating. She relapsed on 11/26/01 and had similar symptoms with joint pain and weakening in muscles.

VAERS ID:179620 (history)  Vaccinated:2001-11-19
Age:74.0  Onset:2001-11-19, Days after vaccination: 0
Gender:Female  Submitted:2001-12-22, Days after onset: 33
Location:Pennsylvania  Entered:2002-01-02, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Public
Symptoms: Contusion, Injection site erythema, Injection site mass, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Immediate pain, redness. In about 1 hour shot raised about 1 inch round lump and pain continued. In a few hours 1/3 upper arm turned black and blue and pain continued. Next day and for two additional days movement in upper right arm caused radiated pain. Lump disappeared in one week. Discoloration faded and disappeared in three weeks.

VAERS ID:182780 (history)  Vaccinated:2001-11-19
Age:57.0  Onset:2001-11-19, Days after vaccination: 0
Gender:Male  Submitted:2002-03-18, Days after onset: 119
Location:Kentucky  Entered:2002-03-25, 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: Allergic to Prevacid, Fexoterad ine, hypertension, GERD, Lumbago
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR0701AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain at injection site onset less than 12 hrs post vaccination. Pain lasted 3-4 weeks. No fever, no redness and no swelling. Was seen in ER 2 weeks after injection and diagnosed with cervicalgia (neck and right arm pain).

VAERS ID:185779 (history)  Vaccinated:2001-11-19
Age:29.0  Onset:2001-12-01, Days after vaccination: 12
Gender:Female  Submitted:2002-05-15, Days after onset: 164
Location:New York  Entered:2002-05-30, 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: Zoloft
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES01120528
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0426L0SC 
Administered by: Private     Purchased by: Private
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow)
Write-up: Information has ben received from a physician concerning a 29 year old female with no past medical history and no known drug allergies who on 11/19/2001 was vaccinated with the first dose of varicela SC. There was no illness at the time of vaccination. Concomitant therapy included Zoloft. It was reported that on 12/01/2001, the pt developed a varicella like rash at the injection site with approximately 20 vesicular lesions. The physician reported that the rash "looks like atypical chicken pox." It was reported that the pt recovered on 12/10/2001. No further info is expected.

VAERS ID:180458 (history)  Vaccinated:2001-11-19
Age:62.0  Onset:2001-11-19, Days after vaccination: 0
Gender:Male  Submitted:2002-01-18, Days after onset: 60
Location:Foreign  Entered:2002-01-24, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nicorette; ibuprofen; diclofenac; sertraline; aspirin; paraffins-wool fat
Current Illness:
Preexisting Conditions: Diabetes mellitus; anxiety; dry skin; peripheral vascular disorder
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0201USA00410
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IM 
Administered by: 0     Purchased by: 0
Symptoms: Inflammation
SMQs:
Write-up: Information has been received from a health authority concerning a 62 year old male who was vaccinated on 19-NOV-2001 with a dose of Pneumovax 23. On 19-NOV-2001 the pt experienced inflammation from his shoulder to the elbow involving total circumference of the arm. The pt presented to the physician and cold compress and hydrocortisone 1 percent was prescribed. The pt recovered after treatment on 23-NOV-2001. The pt''s events were considered to be disabling by the reporter. No further information is available.

VAERS ID:188282 (history)  Vaccinated:2001-11-19
Age:43.0  Onset:2001-12-04, Days after vaccination: 15
Gender:Female  Submitted:2002-08-14, Days after onset: 252
Location:Foreign  Entered:2002-08-01, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Becotide; salbutamol
Current Illness:
Preexisting Conditions: Hysterectomy; oedema lower limb; asthma; depression; dermatitis contact
Diagnostic Lab Data: Temperature measurement - no increase in temperature.
CDC 'Split Type': WAES0207USA02485
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0294L   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Joint range of motion decreased, Pain
SMQs:, Arthritis (broad)
Write-up: Information has been received from a health professional concerning a 43 year old female who on 11/19/01 was vaccinated with 1 dose of pneumococcal vaccine 23 polyvalent (lot#639187/0294L; batch #HN50010) in the right upper arm. On 12/04/01, the patient consulted her physician with a complaint of pain from the right upper arm that the patient described as coming on since the vaccination with pneumococcal vaccine 23 polyvalent. At this time, the patient''s right arm had no erythema present but there was general tenderness over the deltoid to the outer of the middle third of the humerus and abduction was painful. The patient did not have an increase in temperature. Since 12/4/01, the patient''s houlder pain continued. In 03/02, the patient was referred to a physiotherapist because of a right frozen shoulder. The patient received a steroid injection for the frozen right shoulder and there was improvement when she was discharged from physiotherapy on 6/10/02. The patient continued to have a lot of shoulder pain and there was evidence of decreased abduction of the shoulder. Right shoulder pain and right frozen shoulder were considered important medical events. Additional information is expected.

VAERS ID:232451 (history)  Vaccinated:2001-11-19
Age:75.0  Onset:2001-11-23, Days after vaccination: 4
Gender:Female  Submitted:2002-10-10, Days after onset: 320
Location:Foreign  Entered:2005-01-19, Days after submission: 832
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin; Prazosin; Bendrofluazide; Dixarit; Morphine; Co-codamol; Ventolin; Beclomethasone; Ipratropium; Valsartan
Current Illness:
Preexisting Conditions: Atherosclerosis; Chronic airways obstruction
Diagnostic Lab Data:
CDC 'Split Type': PJP200200021
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Vestibular disorder
SMQs:, Vestibular disorders (narrow)
Write-up: A report was received on 1/7/02, concerning a 75 year old female patient who was hospitalized for vestibular disorder NOS 4 days after receiving an influenza vaccine on 11/19/01. The patient had a medical history of chronic obstructive airways disease, and atherosclerosis. She was receiving the following medications concomitantly: Aspirin, Prazosin, Bendroflumethiazide, Clonidine, Morphine, Paracetamol + codeine, Salbutamol, Beclomethasone, Valsartan, and Ipratropium. The patient was hospitalized for an acute vestibular disorder on 11/23/01, from which she recovered on 11/26/01. There was insufficient information to determine the reporter''s causality assessment.

VAERS ID:178202 (history)  Vaccinated:2001-11-20
Age:18.0  Onset:2001-11-21, Days after vaccination: 1
Gender:Female  Submitted:2001-11-23, Days after onset: 2
Location:Florida  Entered:2001-11-26, 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: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUB016AB SCLA
Administered by: Other     Purchased by: Other
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: One day post vax, pt had macular/papular rash all over arms and legs.

VAERS ID:178235 (history)  Vaccinated:2001-11-20
Age:29.0  Onset:2001-11-21, Days after vaccination: 1
Gender:Female  Submitted:2001-11-23, Days after onset: 2
Location:New York  Entered:2001-11-27, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mantoux Lot CO834AB Interdermal
Current Illness: NONE
Preexisting Conditions: Latex allergy
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEUR    
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40180450IMRA
Administered by: 0     Purchased by: 0
Symptoms: Hypoaesthesia, Malaise, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 11/20/2001 Vaccine 3 PM. 11/21/2001 Felt ill, warm temp 102, nausea. Went home early from work, vomiting. 11/22/2001 Temp 99.9, nausea continues, no vomiting. 11/23/2001 arm numb.

VAERS ID:178354 (history)  Vaccinated:2001-11-20
Age:0.6  Onset:2001-11-20, Days after vaccination: 0
Gender:Female  Submitted:2001-11-20, Days after onset: 0
Location:New Mexico  Entered:2001-11-28, 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 (INFANRIX)SMITHKLINE BEECHAM525A21IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0875J1IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT11281 RL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4808971IMLL
Administered by: Public     Purchased by: Public
Symptoms: Crying, Febrile convulsion
SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Pt developed a seizure associated with a fever of 104.8F and crying.

VAERS ID:178356 (history)  Vaccinated:2001-11-20
Age:0.3  Onset:2001-11-20, Days after vaccination: 0
Gender:Male  Submitted:2001-11-21, Days after onset: 1
Location:Arkansas  Entered:2001-11-28, 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM522A21IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0409L1IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA611AA1IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT07861 LL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4841311IMRL
Administered by: Private     Purchased by: Other
Symptoms: Agitation, Injection site erythema, Injection site swelling
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt developed redness and swelling to left thigh and uncontrollable crying. Treated with Motrin, cool compresses and hydrocortisone cream.

VAERS ID:178359 (history)  Vaccinated:2001-11-20
Age:0.3  Onset:2001-11-20, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Arizona  Entered:2001-11-28
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 BEECHAM521A21IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA614AA1IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT13901SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4828731IMRL
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Immunizations given about 13:30. Mom noticed a red area at the Prevnar site at about 18:00.

VAERS ID:178413 (history)  Vaccinated:2001-11-20
Age:76.0  Onset:2001-11-20, Days after vaccination: 0
Gender:Female  Submitted:2001-11-28, Days after onset: 8
Location:West Virginia  Entered:2001-11-29, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levoxyl; Norvasc; Lasix; Lanoxin; Lopressor ASA
Current Illness: NONE
Preexisting Conditions: Diabetes mellitus type II; hypertension; episodic atrial fibrillation
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0996L0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt complained of swollen and painful arm. Prescribed Benadryl by on-call MD. Improved by AM of 11/21/01.

VAERS ID:178436 (history)  Vaccinated:2001-11-20
Age:13.0  Onset:2001-11-20, Days after vaccination: 0
Gender:Male  Submitted:2001-11-21, Days after onset: 1
Location:Michigan  Entered:2001-11-30, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergies, Asthma, ADD.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR60710AA IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0461L IMLA
Administered by: Private     Purchased by: 0
Symptoms: Oedema, Pain, Pyrexia, Vasodilation procedure
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Left arm swelling, pain and heat at injection site. Fever. Some better today recovery.

VAERS ID:178437 (history)  Vaccinated:2001-11-20
Age:1.8  Onset:2001-11-20, Days after vaccination: 0
Gender:Male  Submitted:2001-11-26, Days after onset: 6
Location:Kentucky  Entered:2001-11-30, 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: NONE
Current Illness: 11/21/2001 seen, Diagnosis: Otitis
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': KY2001088
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0701AA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Discomfort, Injection site erythema, Injection site swelling, Joint range of motion decreased
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Large swelling and redness left detoid. Pt complains of discomfort. Not using arm as well as usual.

VAERS ID:178491 (history)  Vaccinated:2001-11-20
Age:50.0  Onset:2001-11-20, Days after vaccination: 0
Gender:Male  Submitted:2001-11-23, Days after onset: 3
Location:Pennsylvania  Entered:2001-12-03, 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: Hytrim, Prinil, Glucopgae and Starlix
Current Illness: NONE
Preexisting Conditions: History of CMV 1/01 with encephalypathy, Hypertension and Diabetes mellitus.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM147B90IMRA
Administered by: Private     Purchased by: Private
Symptoms: Paralysis, Rash
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow)
Write-up: Paralysis of right upper extremity for 1-2 days after vaccine given and rash on chest wall. Rash persistent 3 days after vaccine given.

VAERS ID:178560 (history)  Vaccinated:2001-11-20
Age:33.0  Onset:2001-11-20, Days after vaccination: 0
Gender:Male  Submitted:2001-11-26, Days after onset: 6
Location:Indiana  Entered:2001-12-04, 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':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4018032 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dizziness, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: High temp - 103.3F, dizziness, vomiting, weakness, ten hrs of symptoms.

VAERS ID:178564 (history)  Vaccinated:2001-11-20
Age:0.3  Onset:2001-11-21, Days after vaccination: 1
Gender:Male  Submitted:2001-11-23, Days after onset: 2
Location:Michigan  Entered:2001-12-04, 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: Tylenol
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURU0537DA1IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS4792661IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT145021IMLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4818171IMRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site rash, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: On 11/21/2001 the patient''s temperature was 100.3 with erythema and induration at the injection site. On 11/22/2001 the erythema and induration increased to the size of a nickel. On 11/23/2001 the erythema and induration was 2.6cm x 1.5cm.

VAERS ID:178584 (history)  Vaccinated:2001-11-20
Age:  Onset:2001-11-20, Days after vaccination: 0
Gender:Female  Submitted:2001-11-21, Days after onset: 1
Location:Connecticut  Entered:2001-12-04, 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: Premarin, ?
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0923L0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Injection site swelling, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: L arm swelling (upper arm) with warmth + diffuse erythema

VAERS ID:178592 (history)  Vaccinated:2001-11-20
Age:99.0  Onset:2001-11-23, Days after vaccination: 3
Gender:Male  Submitted:2001-12-04, Days after onset: 11
Location:Michigan  Entered:2001-12-05, Days after submission: 1
Life Threatening? No
Died? Yes
   Date died: 2001-11-23
   Days after onset: 0
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: Positive for bacteria in urine, polynephritis, WBC 40,000 +.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO691AA5IMRA
Administered by: Other     Purchased by: Private
Symptoms: Nephritis, Pyrexia, Urinary retention, Urine analysis abnormal, White blood cell disorder
SMQs:, Acute renal failure (broad), Haematopoietic leukopenia (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad)
Write-up: High fever 1 AM on 11/23/2001. Taken to hospital. Diagnosis of Urosepsis.

VAERS ID:178614 (history)  Vaccinated:2001-11-20
Age:1.3  Onset:2001-11-22, Days after vaccination: 2
Gender:Male  Submitted:2001-11-29, Days after onset: 7
Location:Michigan  Entered:2001-12-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: redbess, swelling at site;Pneumo, 7-valent (Prevnar);2;0;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS507A23IMRL
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Injection site erythema, Injection site mass, Injection site reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt right leg swelled up to knee to hip and became hard and red. Pt was admitted to hospital for concern of cellulitis.

VAERS ID:178749 (history)  Vaccinated:2001-11-20
Age:1.0  Onset:2001-11-21, Days after vaccination: 1
Gender:Male  Submitted:2001-12-03, Days after onset: 12
Location:New York  Entered:2001-12-07, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
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.1041K2IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT14461SCLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1082L0SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1893K0SCLL
Administered by: Public     Purchased by: Public
Symptoms: Furuncle, Injection site mass, Pyrexia, Rhinitis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Call from Mom 11/28/2001 8 days after injections. Mom reports two lumps left leg described as "knots" or lumps at injection site. Mom called again 12/04/2001 one lump described as a boil without a head remains left leg also child congested with fever on/off since 11/20/2001.

VAERS ID:178752 (history)  Vaccinated:2001-11-20
Age:1.8  Onset:2001-11-29, Days after vaccination: 9
Gender:Female  Submitted:2001-12-03, Days after onset: 4
Location:Georga  Entered:2001-12-07, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5210A21 RL
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT13902 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0380L0 LL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0575L0 LL
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Rash all over body and fever.

VAERS ID:178776 (history)  Vaccinated:2001-11-20
Age:22.0  Onset:2001-11-22, Days after vaccination: 2
Gender:Female  Submitted:2001-12-04, Days after onset: 12
Location:Oregon  Entered:2001-12-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO699AA0  
Administered by: Private     Purchased by: Private
Symptoms: Urticaria, Vasodilation procedure
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Hypersensitivity (narrow)
Write-up: Red welt developed. 4.5 cm by 6 cm, No treatment administered.

VAERS ID:178797 (history)  Vaccinated:2001-11-20
Age:13.0  Onset:2001-11-25, Days after vaccination: 5
Gender:Female  Submitted:2001-11-27, Days after onset: 2
Location:Ohio  Entered:2001-12-10, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Sulfa drugs allergy
Diagnostic Lab Data:
CDC 'Split Type': OH0068
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5202A20IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0606L1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Eye swelling, Hypersensitivity, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: On 11/25/01, had puffy and itchy eyes which spread to hives on trunk on 11/27/01. On 11/27/01, was seen by MD and prescribed Cortisone pills, saying reaction to Hep-B shot.

VAERS ID:179084 (history)  Vaccinated:2001-11-20
Age:  Onset:2001-11-30, Days after vaccination: 10
Gender:Female  Submitted:2001-12-14, Days after onset: 14
Location:Idaho  Entered:2001-12-17, 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: NONE
Preexisting Conditions: ASA, Sulfa, PMH: asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUB071AA IM 
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1159L IM 
Administered by: Military     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt with increased pain, redness and fever following injection, and developed cellulitis L deltoid.

VAERS ID:179118 (history)  Vaccinated:2001-11-20
Age:4.0  Onset:2001-11-22, Days after vaccination: 2
Gender:Female  Submitted:2001-11-23, Days after onset: 1
Location:Idaho  Entered:2001-12-17, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin
Current Illness: Head cold symptoms
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': ID01073
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM505A4IMLA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM706A20IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEUR08160SCRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1520K1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Infection, Oedema, Vasodilation procedure
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Mother states child woke up at 10:30 AM left arm swollen, very red, hot and firm across entire arm from shoulder to 2-3 inches above elbow. Called ER was told warm compress and Tylenol. Swelling increased and arm became bluish. Took child to ER. States that ER MD told her this was the worst infection to immunizations he had ever seen. Child given antibiotic (augmentin) and advised to use Motrin for discomfort.

VAERS ID:179184 (history)  Vaccinated:2001-11-20
Age:1.3  Onset:2001-11-21, Days after vaccination: 1
Gender:Male  Submitted:2001-11-21, Days after onset: 0
Location:Georga  Entered:2001-12-18, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data: N/A
CDC 'Split Type': GA01110
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS996A23IMLA
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1670K2IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Feeling hot, Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: On 11/21/2001, at 8 am, patient''s parent reports that his child''s left arm was warm to the touch and swollen. When they came into the clinic around 12:50, patient''s arm was noted to be warm to the touch and red from the shoulder to about two inches from his elbow.

VAERS ID:179294 (history)  Vaccinated:2001-11-20
Age:32.0  Onset:2001-11-20, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Iowa  Entered:2001-12-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CT of head-nml
CDC 'Split Type': IA01015
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0382AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Eye disorder, Headache, Muscle twitching, Photophobia
SMQs:, Dyskinesia (broad), Dystonia (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: The pt developed an onset of headache, photophobia and eyelid twitching about 5-6 hours, post vax. No history of similar symptoms.

VAERS ID:179295 (history)  Vaccinated:2001-11-20
Age:28.0  Onset:2001-12-03, Days after vaccination: 13
Gender:Female  Submitted:2001-12-05, Days after onset: 2
Location:California  Entered:2001-12-20, 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: chlorpheniramine maleate (antihistamine); BCP
Current Illness:
Preexisting Conditions: Allergic to amoxicillin; history of Sabanhoca ?
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS217A4 IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT1153 SC 
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0463AA IM 
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD0160440PO 
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: The pt called the clinic on 12/9/01 to report abdominal cramping and with an urge to vomit (no emesis) several hours, post vax, of taking 1st dose (capsule) of oral Typhoid (on 12/3/01). This resolved spontaneously. (No rash or itching). It was taken on an empty stomach as per instructions.

VAERS ID:179370 (history)  Vaccinated:2001-11-20
Age:45.0  Onset:2001-11-20, Days after vaccination: 0
Gender:Male  Submitted:2001-12-21, Days after onset: 31
Location:New Hampshire  Entered:2001-12-26, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': NH0126
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO690AA6IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad)
Write-up: At 1:30 PM pt was weak and feverish. At 2:30 PM pt took Tylenol and went to sleep. Did not take temperature. At 5 PM felt fine.

VAERS ID:179506 (history)  Vaccinated:2001-11-20
Age:16.0  Onset:2001-11-21, Days after vaccination: 1
Gender:Male  Submitted:2001-12-21, Days after onset: 30
Location:West Virginia  Entered:2001-12-27, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WV0114
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5223B90IMRA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt was given 1st dose of Hepatitis B on 11/20/2001. Mother reported that he started having hives on 11/21/2001. Hives migrated and appeared off 1 cm for the next 6 days.

VAERS ID:179848 (history)  Vaccinated:2001-11-20
Age:52.0  Onset:2001-12-19, Days after vaccination: 29
Gender:Male  Submitted:2002-01-03, Days after onset: 15
Location:Illinois  Entered:2002-01-10, Days after submission: 7
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Diabetes, PCN and sulfa (allergies) and epilepsy.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO671BA1IM 
Administered by: Private     Purchased by: Private
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: On November 20, 2001, this employee received the flu vaccine. On December 19, 2001 he was diagnosed with GBS. He was hopsitalized for one week and is recuperating at home. His completed recovery may take three months.

VAERS ID:180027 (history)  Vaccinated:2001-11-20
Age:74.0  Onset:2001-12-06, Days after vaccination: 16
Gender:Female  Submitted:2002-01-08, Days after onset: 33
Location:Ohio  Entered:2002-01-16, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HydroDiuril; Cenestin; lansoprazole
Current Illness:
Preexisting Conditions: Hypertension
Diagnostic Lab Data: CT; MRI; Nerve conduction test
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4018038 IM 
Administered by: Private     Purchased by: Private
Symptoms: Guillain-Barre syndrome, Hypoaesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: Acute Guillian-Barre syndrome. Symptoms: numbness of hands and feet. Onset approximately 12/06/2001. Neurologist attributed to vaccine reaction. Treatment: 6 plasmapheresis treatments.

VAERS ID:180123 (history)  Vaccinated:2001-11-20
Age:77.0  Onset:2001-11-21, Days after vaccination: 1
Gender:Male  Submitted:2001-11-28, Days after onset: 7
Location:California  Entered:2002-01-18, Days after submission: 51
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0593AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Hypokinesia, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: On 11/21/01, the pt stated his arm became very painful and he was unable to raise it up. It remained painful and difficult to lift for the next several days. Pt consulted with MD and was put on cortisone and pain meds on 11/27/01. Message on 11/18/01, indicated 10% to 15% improvement.

VAERS ID:180337 (history)  Vaccinated:2001-11-20
Age:1.2  Onset:2001-11-22, Days after vaccination: 2
Gender:Female  Submitted:2001-12-27, Days after onset: 35
Location:New York  Entered:2002-01-23, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Antibiotic Septra
Current Illness: Chronic sinus and ear
Preexisting Conditions: Possible allergy to Augmentin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1076L2IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1084L0SC 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4818153IM 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0564L0SC 
Administered by: Private     Purchased by: Private
Symptoms: Injection site rash, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Suspect rash on chin on the day of the vaccination. No temperature. On Thanksgiving, she had a rash around the site and then on her stomach and back. She had a temperature last night, inside ear and around mouth.

VAERS ID:180706 (history)  Vaccinated:2001-11-20
Age:18.0  Onset:2001-11-27, Days after vaccination: 7
Gender:Male  Submitted:2002-01-24, Days after onset: 58
Location:Tennessee  Entered:2002-01-30, Days after submission: 6
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: Many blood tests; hospitalized 4 days; HIV test; Mono; Lupus; MS; STD; Leukemia and Biopsy of nodules-all neg
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE11931LA2IMLA
Administered by: Other     Purchased by: Private
Symptoms: Pain, Skin nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 1 week after flu shot the pt had complaints of severe pain in both legs and feet. Also started to have painful nodules on legs and bottom of feet. Had flu shot for the last 2 years; administered by another co. Presently on valium, prednisone and pain med. Pt was hospitalized for 4 days from another facility. Annual follow up states pt had painful nodules that developed on his legs. "Took 2 months to go away." He did not take a flu shot in 2002

VAERS ID:180960 (history)  Vaccinated:2001-11-20
Age:42.0  Onset:2001-11-21, Days after vaccination: 1
Gender:Female  Submitted:2002-01-31, Days after onset: 71
Location:Illinois  Entered:2002-02-06, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0671BA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: The day after receiving the flu vaccine, the employee complained of tingling and numbness in left arm. Still has slight tingling.

VAERS ID:181420 (history)  Vaccinated:2001-11-20
Age:11.0  Onset:2001-12-01, Days after vaccination: 11
Gender:Female  Submitted:2002-02-15, Days after onset: 76
Location:Nebraska  Entered:2002-02-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40180521IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction
SMQs:
Write-up: Swelling, tenderness, redness to injection site. Area felt warm to touch for several days with these symptoms.

VAERS ID:181539 (history)  Vaccinated:2001-11-20
Age:13.0  Onset:2001-11-21, Days after vaccination: 1
Gender:Male  Submitted:2001-11-30, Days after onset: 9
Location:Georga  Entered:2002-02-20, Days after submission: 82
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': GA02004
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5210A21IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0024L1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Rash papular
SMQs:
Write-up: On 11/21/2001 noticed "bumps" on his chest before going to bed. "Bumps" spread under right arm and onto his back. Denies itching or fever. Still has them.

VAERS ID:181765 (history)  Vaccinated:2001-11-20
Age:0.5  Onset:2001-11-20, Days after vaccination: 0
Gender:Female  Submitted:2002-07-26, Days after onset: 247
Location:Unknown  Entered:2002-02-27, Days after submission: 148
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: UNK
Diagnostic Lab Data: Body temp on 11/20/01 104.5 deg F.
CDC 'Split Type': U200200109
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM525A21IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0875J1IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEUR4808971IMRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4808371IMLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Convulsion, Crying, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: From information received on 2/1/02, it was reported that a 6 month old female received a 2nd dose of Prevnar, Infanrix, Pedvax-Hib (MSD) and Polio vaccines on 11/20/01. The child developed a seizure associated with a fever of 104.5F and crying. No additional information was available as of the date of this report. From follow-up correspondence received on 2/14/02, the correct lot numbers were provided for all products.

VAERS ID:182619 (history)  Vaccinated:2001-11-20
Age:0.2  Onset:2001-11-20, Days after vaccination: 0
Gender:Female  Submitted:2001-12-20, Days after onset: 30
Location:Florida  Entered:2002-03-19, Days after submission: 89
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: hernia
Diagnostic Lab Data:
CDC 'Split Type': FL02001
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM516A20IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1640K0IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEUR13900SCLL
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4815490IMRL
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Crying, Screaming, Vomiting
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), 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), Generalised convulsive seizures following immunisation (narrow)
Write-up: The baby was crying non-stop for four hours and was inconsolable, no fever, vomited and possible seizure and took the baby to the hospital and was released after exam.

VAERS ID:182778 (history)  Vaccinated:2001-11-20
Age:0.9  Onset:2001-11-21, Days after vaccination: 1
Gender:Female  Submitted:2001-12-12, Days after onset: 21
Location:New Mexico  Entered:2002-03-25, Days after submission: 103
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: otitis media
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': NM120301
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4749510 GM
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: High fever 24 hrs post vaccination.

VAERS ID:183060 (history)  Vaccinated:2001-11-20
Age:  Onset:2002-03-22, Days after vaccination: 122
Gender:Male  Submitted:2002-03-26, Days after onset: 4
Location:Michigan  Entered:2002-04-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1637K2IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0736L0SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0563L0SC 
Administered by: Public     Purchased by: Public
Symptoms: Drug ineffective, Herpes zoster, Rash macular
SMQs:, Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: Mom reports child woke up on 03/22/2002 with a blotch about size of half dollar coin on left lower back. Seen at the clinic on 03/23/2002. Spots developed on left leg. Seen by a doctor on 03/25/2002 which he told mom that he thought the child had shingles.

VAERS ID:183222 (history)  Vaccinated:2001-11-20
Age:69.0  Onset:0000-00-00
Gender:Female  Submitted:2002-04-02
Location:Texas  Entered:2002-04-08, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspar; Armature thyroid; Claritin-D the day before vaccination
Current Illness: Rhinitis from allergies
Preexisting Conditions: Rhinitis-sinus allergy, took Claritin-D capsule the day before vaccination
Diagnostic Lab Data: PMP ordered EKG report, but symptoms re: heart have continued on
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0682AA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Bundle branch block, Cough, Heart rate increased, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Guillain-Barre syndrome (broad)
Write-up: Extremely rapid heart beat, very deep and constant cough; 4 degrees of fever; extreme weakness and exhaustion from 11/01 through the end of 1/02. Exhaustion easily and "heart flurries inside".

VAERS ID:184757 (history)  Vaccinated:2001-11-20
Age:20.0  Onset:2001-11-27, Days after vaccination: 7
Gender:Male  Submitted:2002-05-05, Days after onset: 158
Location:Wisconsin  Entered:2002-05-17, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Deaf; Cerebral Palsy
Diagnostic Lab Data: X-rays (stomach, chest sides; upper GI; EEG; blood tests; Cat Scan; UA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1047L1IM 
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain upper, Flushing, Insomnia, Myalgia, Nausea, Oral intake reduced, Pyrexia, Stupor, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Flushed, low fever, hands shaking, continuous nausea, muscle aches, spacing out, decreased appetite (now no appetite), sleep twitches, sleeplessness (no sleep), stomach pain for 5 months and ongoing. Since 11/01, been to doctor 15 times and he is now on meds to help bring him up, meds for nausea and meds for sleep.

VAERS ID:186816 (history)  Vaccinated:2001-11-20
Age:58.0  Onset:2001-11-20, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Unknown  Entered:2002-06-21
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': PJP200200354
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER760041 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)
Write-up: An anonymised single pt print was received on 06/17/2002 concerning a 58 year old male pt, who experienced myocardial infarction 4 hrs after receiving FluVirin on 11/20/2001. At the time of reporting, the pt had recovered. There was insufficient info to determine the reporter''s causality assessment.

VAERS ID:191853 (history)  Vaccinated:2001-11-20
Age:48.0  Onset:2001-11-20, Days after vaccination: 0
Gender:Female  Submitted:2001-12-28, Days after onset: 38
Location:Indiana  Entered:2002-10-23, Days after submission: 298
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': U200101224
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0687AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: From correspondence received at manufacturer on 12/4/01 it was reported that a 48 year old female patient received a Fluzone SV 2001-2002 vaccination administered on 11/20/01. Within 6-9 hours that patient developed aching joints and dull ache at the injection site--unresolved.

VAERS ID:191880 (history)  Vaccinated:2001-11-20
Age:  Onset:0000-00-00
Gender:Female  Submitted:2002-01-14
Location:Illinois  Entered:2002-10-23, Days after submission: 281
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': U200200012
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0671BA  LA
Administered by: Other     Purchased by: Other
Symptoms: Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: It was reported that a female patient received a dose of Fluzone SV 01-02 vaccine on 11/20/01 administered in her left deltoid, lot # U0671BA. Sometime after the vaccination (date not specified) the patient developed tingling in her left arm. Symptoms persisted for approximately 2 weeks, described as a painful tingling, Motrin was prescribed. Currently the tingling is still present, appears to be positional, comes and goes, somewhat alleviated by movement, more noticeable if leaning on arm for period of time.

VAERS ID:193216 (history)  Vaccinated:2001-11-20
Age:76.0  Onset:2001-12-07, Days after vaccination: 17
Gender:Male  Submitted:0000-00-00
Location:Colorado  Entered:2002-11-14
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Bronchyestacy, MDS Syndrome
Preexisting Conditions: Poor appetite, weight loss, Hypothyroid-BPH
Diagnostic Lab Data: Biopsy of sural nerve
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0945K   
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Eczema, Hypoaesthesia, Influenza like illness, Marrow hyperplasia, Oedema, Oedema peripheral, Pain, Paralysis, Peroneal nerve palsy, Pruritus, Pyrexia, Rash, Sleep disorder, Thrombophlebitis, Vasculitis
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vasculitis (narrow), Hypersensitivity (narrow), Arthritis (broad), Myelodysplastic syndrome (broad)
Write-up: Two weeks after flu-pneumonia shots I got flu like symptoms and skin rash. Gradually the rash on my legs turns in vasulitis and foot drop. In December of last year I contracted unusual and extremely severe skin rash and flu like symptoms, just two weeks after my flu-pneumonia shots. One week later, I got typical flu like symptoms, with joint pain, fevers with temperatures over a 100 deg. F. This condition went on for five weeks. I spent five days in a local hospital. I was treated with antibiotic Augmentum and eventually my temperatures came down to normal by 1/20. However, the rash which started before the flu gradually spread all over my body. It was of very unusual character, extremely irritating burning and itching to a point where I was not able to sleep. Eventually the rash spread all over my body. The dermatologist ordered a biopsy, which was done and came back negative, so no pathogen was found responsible and that condition was diagnosed as eczema. A variety of cortisone ointments were prescribed with little or no healing effect. In early February, I noticed swelling on my ankles and some strange pinching sensation when I pressed with my finger the soft tissue. MD, who was subtitling for my primer physician did not make any conclusion and simply said it is common for older people. Later the same month, I again went to see my primer physician MD and I was started on ointments Triamcinolone Acenonide cream 0.025%. This was the first cream which started to reduce the rash and itching. However, the rash persisted to stay on both legs. Under the skin patches of very painful strips developed along the tibia bone. In late May 2002 this condition worsened even more and then started a pinching and stabbing sensation. Also both legs and ankles got more swollen and the swelling gradually has spread further up to the knee. The reddish spots were inflamed and sensitive to touch and it started to appear around the front leg bone and some dark blue spots occurred on the right leg. This condition was getting worse and w

VAERS ID:193895 (history)  Vaccinated:2001-11-20
Age:4.0  Onset:2001-11-21, Days after vaccination: 1
Gender:Female  Submitted:2002-11-18, Days after onset: 362
Location:Tennessee  Entered:2002-11-26, Days after submission: 8
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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0601L1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Autism, Cognitive disorder, Coma, Hypokinesia, Malaise, Pyrexia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: High fever, malaise, unresponsive, loss of speech and motor coordination. Fever-1wk off and on. Malaise-1wk. Unresponsiveness-~2wks. Loss of speech-~12 mos. taking speech therapy now. Motor coordination-~6 mos. Diagnosed mild autistic. Patient is exhibiting diminished mental capacity and has been diagnosed as austistic. However, her physical capabilities have returned to normal. Annual follow up on 12/16/03: "Vaccine recipient has not recovered from the adverse events that was provided for this vaccination. A lowered function of mental faculties. Due to the above, pt has been deemed as disabled by the social security board."

VAERS ID:196356 (history)  Vaccinated:2001-11-20
Age:45.0  Onset:2002-02-11, Days after vaccination: 83
Gender:Female  Submitted:2003-01-09, Days after onset: 332
Location:Kansas  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: Cigarette smoker
Diagnostic Lab Data: Titer (NOS)-"0" on 2/11/02
CDC 'Split Type': A0361253A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5239A42IM 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Laboratory test abnormal
SMQs:, Lack of efficacy/effect (narrow)
Write-up: The vaccinee received injections of Engerix-B on 5/1/01 (lot ENG5178A4), 6/17/01 (lot ENG5178A4) and 11/20/01 (lot ENG5239A4). On 2/11/02, a "titer" (NOS) was "0". The reporter considered the negative titer to be probably related to Engerix-B administration.

VAERS ID:209309 (history)  Vaccinated:2001-11-20
Age:  Onset:2001-11-28, Days after vaccination: 8
Gender:Male  Submitted:2003-09-06, Days after onset: 646
Location:Kansas  Entered:2003-09-16, Days after submission: 10
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: 7/15/03 Autism diagnosis.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0903L0LL 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4831683LL 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0827L0RL 
Administered by: Private     Purchased by: Unknown
Symptoms: Agitation, Antisocial behaviour, Autism, Cognitive disorder, Dysphonia, Neurodevelopmental disorder, Pharyngitis, Pyrexia, Rhinitis, Speech disorder
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal infections (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (narrow)
Write-up: 11/26/01 Fever 102. Patient also seemed agitated. Took to doctor on 11/28/01; developed a cold and crying. 12/26/01 cold still, raspy voice, taking Amoxil; fever down 100.5. 1/10/02 cold still. 1/25/02 cold still; taking Zyrtec. 2/2/02 Switched doctors; took off milk and cleared up in 3 days. 2/12/02 Pneumonia; Biavil. The 60 day follow up received on 12/24/03 states autism diagnosis 7/15/03. Areas of concern: communication, imitation skills (motor and vocal), transitions and following one step directions. marked impairment in the use of multiple nonverbal behaviors. Lack of spontaneous seeking to share enjoyment, interests or achievements with others. Lack of social or emotional reciprocity. Delay in or total lack of development of spoken language. Lack of varied, spontaneous make-believe or social imitative play. Encompassing preoccupation with interest that is abnormal in intensity or focus. Stereotyped and repetitive motor mannerism for walking, hair twirling. Persistent preoccupation with parts of objects (visual inspection). Nurse follow up on 08/19/04 states: "autism; Language disorder."

VAERS ID:217805 (history)  Vaccinated:2001-11-20
Age:19.0  Onset:2001-11-22, Days after vaccination: 2
Gender:Female  Submitted:2004-03-12, Days after onset: 841
Location:Alaska  Entered:2004-03-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Group B streptococcus UTI;
Diagnostic Lab Data: WBC elevated, lab test abn
CDC 'Split Type': AK200424
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN0 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abortion, Back pain, Headache, Laboratory test abnormal, Nausea, Vomiting, White blood cell disorder
SMQs:, Acute pancreatitis (broad), Haematopoietic leukopenia (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: Headache, lower back pain, nausea, vomiting, loss of unborn child. Lasted for two weeks; resulted in hospitalization. Nurse follow up on 05/18/04: spontaneous rupture of membranes.

VAERS ID:232271 (history)  Vaccinated:2001-11-20
Age:19.0  Onset:2001-11-27, Days after vaccination: 7
Gender:Male  Submitted:2002-10-10, Days after onset: 316
Location:Unknown  Entered:2005-01-14, Days after submission: 827
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': PJP200200092
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE11931LA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain, Skin nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: A report was received from a health professional on 1/30/02 regarding an 18 year old male patient who experienced nodules on legs and bottom of feet after receiving a Fluvirin vaccine on 11/20/01. The patient had a previous flu vaccine in 2000. On 11/20/01 the patient received a Fluvirin vaccine and on 11/27/01 the patient experienced severe pain in both legs and feet, he also started to have painful nodules on legs and bottom of feet. The patient was admitted to hospital where he remained for four days. The patient was treated with Diazepam, Prednisolone and Paracetamol. Hepatitis B and Meningitis vaccines were given approximately 2 weeks after the event. It is not known if the patient had recovered at the time of reporting the event. There was insufficient information to determine the reporter''s causality assessment.

VAERS ID:232350 (history)  Vaccinated:2001-11-20
Age:40.0  Onset:2001-11-20, Days after vaccination: 0
Gender:Female  Submitted:2002-10-10, Days after onset: 323
Location:Unknown  Entered:2005-01-14, Days after submission: 827
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': PJP200100447
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES757377 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: A report was received from a health professional on 11/20/2001 regarding a 40 year old female patient who was inadvertently given last year''s Fluvirin vaccine on 11/20/2001. There was no adverse event reported. There was insufficient information to determine the reporter''s causality assessment.

VAERS ID:237972 (history)  Vaccinated:2001-11-20
Age:1.0  Onset:2004-05-07, Days after vaccination: 899
Gender:Male  Submitted:2005-05-16, Days after onset: 374
Location:Massachusetts  Entered:2005-05-24, 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: Rash
Preexisting Conditions: Drug hypersensitivity
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0405USA01006
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Rash, Viral infection
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a health professional concerning a 41 month old male with a history of ibuprofen allergy (causes tongue swelling) who on 11/20/01 was vaccinated in the left arm with a first dose of varicella virus vaccine live (lot 05772). The patient''s mom called to report an outbreak of vesicles that started on 5/7/04. No blood work or tests were done and the patient was not seen in the office. It was reported that at the time of vaccination the patient had no fever-just rash. No other information was reported. Follow up information indicated that the lot number was not available. Additional follow up indicated that the patient recovered on 6/25/04. Additional information is not expected.

VAERS ID:281266 (history)  Vaccinated:2001-11-20
Age:1.0  Onset:2006-05-01, Days after vaccination: 1623
Gender:Female  Submitted:2007-05-16, Days after onset: 380
Location:Ohio  Entered:2007-05-24, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0608USA05426
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella
SMQs:
Write-up: Information has been received from a physician concerning a 5 year old female who on 20-NOV-2001 was vaccinated with a dose of Varivax. On 01-MAY-2006 the patient developed breakthrough, thee was no lesion count. The patient received no treatment and she was not hospitalized. No further information was available. There was no product quality complaint involved. Additional information has been requested.

VAERS ID:344810 (history)  Vaccinated:2001-11-20
Age:1.0  Onset:2001-11-20, Days after vaccination: 0
Gender:Female  Submitted:2009-04-26, Days after onset: 2713
Location:Texas  Entered:2009-04-26
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: FEVER~Varicella (no brand name)~UN~1~Patient
Other Medications: N/A
Current Illness: NO
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPIPV: DTP + IPV (NO BRAND NAME)UNKNOWN MANUFACTURER59542IMLL
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER59543IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1273 IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.4747251IMLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abnormal behaviour, Crying, Diarrhoea, Eczema, Emotional disorder, Hypophagia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: fever, diarrhea, crying (insolable), stopped eating typical foods she liked, needed to be in constant motion (baby jumper)to be happy, didn''t want to be held, no eye contact, how she played changed (stacking objects only play), stopped making any sound at all 6/17/09 PCP records - DOS 11/18/00 to 5/27/02 Assessment: Eczematous dermatitis Records indicate healthy newborn. At about 1 year of age child presented with a rash. Dermatology consult - Eczematous dermatitis./ksk

VAERS ID:388958 (history)  Vaccinated:2001-11-20
Age:4.0  Onset:2010-01-02, Days after vaccination: 2965
Gender:Male  Submitted:2010-05-14, Days after onset: 131
Location:New York  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: serum immunoglobulin G, 01/04/10, 7.57; serum immunoglobulin M, 01/04/10, <1:10
CDC 'Split Type': WAES1002USA01357
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Blood immunoglobulin G, Blood immunoglobulin M, Mumps, Parotitis, Vaccine breakthrough infection
SMQs:, Oropharyngeal infections (narrow)
Write-up: Information has been received from a physician concerning a 13 year old (also reported as 10 year old) male who on 11-DEC-1998 and 20-NOV-2001 was vaccinated with the first and second dose of MMR II respectively (route, site and lot number not reported). On 02-JAN-2010 the patient experienced mumps. The patient was diagnosed on 04-JAN-2010. The patient parotitis was on right side and was afebrile. On 04-JAN-2010, the first blood work was done which revealed serum IgM <1:10 and serum IgG 7.57. The outcome for mumps was not reported. This is one of several reports from the same source. Additional information has been requested.

VAERS ID:179272 (history)  Vaccinated:2001-11-20
Age:42.0  Onset:2001-11-26, Days after vaccination: 6
Gender:Female  Submitted:2001-12-17, Days after onset: 21
Location:Foreign  Entered:2001-12-20, 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': 20010282741
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS128C60IMLA
Administered by: Other     Purchased by: Other
Symptoms: Cholelithiasis, Pruritus, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gallbladder related disorders (narrow), Gallstone related disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)
Write-up: Report describes the occurrence of cholelithiasis in a 42 year old female receiving Twinrix adult for prophylaxis. 6 days post vaccine 11/26/01 the pt experienced generalized itching. On 11/27 pt experienced nausea and vomiting which lasted until 11/29/01. A cholelithiasis and an obstructive icterus were diagnosed. The pt was hospitalized due to these events and a cholecystectomy was carried out. Generalized itching, nausea and vomiting were resolved. The reporter considered that the events were unrelated to Twinrix adult. This case was upgraded to serious on 12/14/01.

VAERS ID:181666 (history)  Vaccinated:2001-11-20
Age:2.0  Onset:2001-11-21, Days after vaccination: 1
Gender:Male  Submitted:2002-02-19, Days after onset: 90
Location:Foreign  Entered:2002-02-25, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Body temperature on 11/21/01-39C
CDC 'Split Type': WAES0202USA01332
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0908K IM 
Administered by: 0     Purchased by: 0
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a health authority that was originally reported by a physician concerning a 2 year old male who on 11/20/01 was vaccinated IM with a dose (lot 636376/0908K; batch HM72400) of pneumococcal vaccine 23 polyvalent. On 11/21/01, 36 hours post vax, the pt developed induration (average diameter: 7-8cm), redness and injection site pain. A fever greater than 39C was dx''d. He was treated with unspecified therapy, and subsequently recovered without sequelae. Induration, redness, injection site pain and fever were considered to be disabling. No further information is available. The case is closed.

VAERS ID:182017 (history)  Vaccinated:2001-11-20
Age:1.6  Onset:2001-11-20, Days after vaccination: 0
Gender:Male  Submitted:2002-03-04, Days after onset: 104
Location:Foreign  Entered:2002-03-06, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC 'Split Type': 1122101
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: A nurse reported that a 19 month old male received injections of Prevnar and Polio vaccine on 11/20/2001. That day, he developed a fever of 39 deg. C., rash, and "an encystment of the inoculation zone." He was hospitalized for two days. On 11/22/2001, he recovered. The physician considered these events to be serious with a severe intensity and a "probably" relationship between Prevnar administration and the events.

VAERS ID:437884 (history)  Vaccinated:2001-11-20
Age:62.0  Onset:0000-00-00
Gender:Male  Submitted:2011-10-11
Location:Foreign  Entered:2011-10-12, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical history included type-C liver cirrhosis, for which he had been hospitalized once or twice per year for treatment.
Diagnostic Lab Data: Laboratory analyses revealed liver dysfunction and a serum ammonium concentration of 237 ul/dl. There was no significant inflammatory reaction and antibodies for the influenza virus in paired sera were not significantly elevated. A lumbar tap revealed a pressure of 140 mmH2O, and cerebrospinal fluid examination revealed a protein concentration of 280 mg/dl, five cells per microliter, and in IgG concentration of 101 Ug/ml. MR diffusion- and T2-weighted images exhibited high signal intensities in midbrain, bilateral occipital cortices, right insular cortex, temporal operculum, inferior frontal gyrus, and left frontal white matter. MR images obtained three weeks after admission showed no abnormalities in the spinal cord. One month after admiss
CDC 'Split Type': 201109627
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Acute disseminated encephalomyelitis, Ammonia increased, Bladder dysfunction, Blood immunoglobulin G, CSF cell count normal, CSF immunoglobulin G index, CSF pressure increased, CSF protein increased, Cerebral small vessel ischaemic disease, Convulsion, Dysuria, Endotracheal intubation, Hepatic function abnormal, Hyperreflexia, Influenza virus test negative, Liver function test abnormal, Myoclonus, Nervous system disorder, Nuclear magnetic resonance imaging brain abnormal, Pseudobulbar palsy, Respiratory failure
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Ischaemic cerebrovascular conditions (narrow), 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), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad)
Write-up: Initial report retrieved on 27 September 2011 via a search of the scientific literature. ABSTRACT: We describe two adult cases of neurologic complications occurring after influenza vaccination. The first case was a 62-year-old man who experienced convulsions 5 days after vaccination, and the second case was a 70-year-old man who exhibited paraplegia 7 days after vaccination. Diagnoses of acute disseminated encephalomyelitis and transverse myelitis with acute motor axonal neuropathy were made, respectively, and steroid pulse therapy and intravenous gammaglobulin therapy alleviated the patients'' symptoms. Although the efficacy and cost benefit of influenza vaccination have been widely accepted, such neurologic complications might occur in the elderly or even in adults. CASE REPORT: Patient 1 was a 62-year-old man who had been diagnosed with type-C liver cirrhosis, for which he had been admitted to our hospital once or twice per year for treatment. Five days after an influenza vaccination (HA type, 22-7-B) administered by a home doctor on November 20, 2001, generalized convulsion occurred and the patient was admitted to our hospital. He was intubated transiently in the emergency room because of respiratory failure. Myoclonic movement was found on the left side of his face when he was transferred to a neurological ward. There was no apparent paresis. His reflexes were generally hyperactive, and pseudobulbar palsy and dysuria were noted. Laboratory analyses revealed liver dysfunction and a serum ammonium concentration of 237 ul/dl. There was no significant inflammatory reaction and antibodies for the influenza virus in paired sera were not significantly elevated. A lumbar tap revealed a pressure of 140 mmH2O, and cerebrospinal fluid examination revealed a protein concentration of 280 mg/dl, five cells per microliter, and an IgG concentration of 101 Ug/ml. MR diffusion- and T2-weighted images exhibited high signal intensities in midbrain, bilateral occipital cortices, right insular cortex, temporal operculum, inferior frontal gyrus, and left frontal white matter. Although MR images obtained 3 weeks after admission showed no abnormalities in the spinal cord, the patient presented bladder dysfunction and thus we diagnosed him as having ADEM. The left facial myoclonus disappeared after daily intravenous administration of 1000 mg methylprednisolone for 3 days. The same dosage was administered again one week later, and the pseudobulbar palsy was ameliorated. One month later the dysuria also was alleviated. At that time the abnormal-intensity lesion in MRI disappeared. Serum ammonium level decreased to around 150 ul/dl by administration of branched amino acid and he was discharged without any sequelae. The events for the second patient in this report are captured in case 2011-09628. Note: The case of the first patient was also described in a table in another literature report which is captured in case 2011-09459. The table contained other reported cases of post-influenza vaccination encephalomyelitis/ADEM published since 1982. The cases in this table which also contained a possible sanofi pasteur influenza vaccine are found in the following: E2005-00990, 2010-00355, 2011-09626, and 2011-09595.

VAERS ID:178176 (history)  Vaccinated:2001-11-21
Age:4.0  Onset:2001-11-22, Days after vaccination: 1
Gender:Female  Submitted:2001-11-22, Days after onset: 0
Location:Massachusetts  Entered:2001-11-26, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergy to nuts
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0676AA IMRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Hot, red, puffy from injection site upper arm to elbow. Localized reaction to injection site. Keflex prescribed.

VAERS ID:178551 (history)  Vaccinated:2001-11-21
Age:39.0  Onset:2001-11-21, Days after vaccination: 0
Gender:Female  Submitted:2001-11-27, Days after onset: 6
Location:Illinois  Entered:2001-12-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE11931LA3IMLA
Administered by: Other     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Developed rash on face.

VAERS ID:178554 (history)  Vaccinated:2001-11-21
Age:5.0  Onset:2001-11-22, Days after vaccination: 1
Gender:Male  Submitted:2001-11-27, Days after onset: 5
Location:California  Entered:2001-12-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Penicillin
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR40180282IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: Red, raised patch overlaying entire left deltoid.

VAERS ID:178629 (history)  Vaccinated:2001-11-21
Age:32.0  Onset:2001-11-22, Days after vaccination: 1
Gender:Female  Submitted:2001-11-28, Days after onset: 6
Location:Michigan  Entered:2001-12-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETHU0986011 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain, Pruritus, Rash maculo-papular, Vasodilation procedure
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 11/22/2001 post vax, the patient developed fiery erythema, hot to touch, palpable hardness and extreme pruritus of the lateral aspect of the upper arm from the acromiun process to the elbow. On 11/23/2001 the patient experienced body wide pruritus with diffuse, reddened blotchy areas body wide. The patient self-medicated with oral Benadryl. On 11/28/2001 the injection site had a 6cm area of diffuse redness. The patient complained of mild to moderate pain at the injection site. The other symptoms were resolved.

VAERS ID:178630 (history)  Vaccinated:2001-11-21
Age:79.0  Onset:2001-11-21, Days after vaccination: 0
Gender:Female  Submitted:2001-11-29, Days after onset: 8
Location:New Hampshire  Entered:2001-12-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prinivil, coumadin, thyroid, and Atrovent NS.
Current Illness:
Preexisting Conditions: Hypothyroidism, fibromyalgia, arthritis and hyperlipidemia.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0713AA2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Somnolence, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: The patient experienced tremors and chills approximately 4 hours after the vaccination. These symptoms lasted 4 hours. The patient experienced lethargy the following day.

VAERS ID:178709 (history)  Vaccinated:2001-11-21
Age:66.0  Onset:2001-11-21, Days after vaccination: 0
Gender:Male  Submitted:2001-11-30, Days after onset: 9
Location:Oklahoma  Entered:2001-12-06, 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: Zocor, Vioxx, HCTZ and Celebrex
Current Illness:
Preexisting Conditions: HTN, Hyperlipidemia, osteoarthritis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4710400IMLA
Administered by: Private     Purchased by: Private
Symptoms: Oedema, Pyrexia, Vasodilation procedure
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Fever developed during the evening of 11/21/2001. It was over 103 the afternoon of the 11/22/2001. Family took pt to ER, but did not want to wait the 4 hours it would be before seeing the doctor. Pt''s daughter gave alcohol rubs (she''s an RN) and managed to break the fever. On 11/22/2001 left upper arm swollen, hot to touch. Pt recovered by 11/24/2001.

VAERS ID:178726 (history)  Vaccinated:2001-11-21
Age:44.0  Onset:2001-11-21, Days after vaccination: 0
Gender:Male  Submitted:2001-12-03, Days after onset: 12
Location:New Jersey  Entered:2001-12-07, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Epinephrine
Current Illness: NONE
Preexisting Conditions: Denied, Reference Consent Form
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0683CA18IMLA
Administered by: Other     Purchased by: Other
Symptoms: Amblyopia, Chest pain, Dizziness
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Check out"feeling dizzy", blurring vision, blood pressure systolic=80 (Pre Vaccine B/P 142/92). Slight chest pressure. Epinephrine ADM, 911 notified, transported to RWJ, evaluated and discharged.

VAERS ID:178744 (history)  Vaccinated:2001-11-21
Age:4.0  Onset:0000-00-00
Gender:Male  Submitted:2001-11-30
Location:Michigan  Entered:2001-12-07, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Cough
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS513A24IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT11283SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0736L1SCLL
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis
SMQs:
Write-up: Cellulitis left thigh. Keflex 250 mg TID for 10 days, warm soaks and Benadryl PO q 4-6 hours.

VAERS ID:178877 (history)  Vaccinated:2001-11-21
Age:79.0  Onset:0000-00-00
Gender:Female  Submitted:2001-11-26
Location:Oregon  Entered:2001-12-12, 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:
Current Illness: Cough
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1449K0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Oedema, Vasodilation procedure
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Examined on 11/23/2001 at 3 PM. Red, slightly swollen, warm to touch area 5" by 7.5'' on lateral interior aspect right forearm. Pt states swelling had decreased in last 24 hours.

VAERS ID:179206 (history)  Vaccinated:2001-11-21
Age:11.0  Onset:2001-11-21, Days after vaccination: 0
Gender:Male  Submitted:2001-11-27, Days after onset: 6
Location:California  Entered:2001-12-18, 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: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Blood glucose 105; Blood hemoglobin 14
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESUO381AA5IMLA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5204A22IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS706A20IMRA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Blood glucose increased, Dyskinesia, Laboratory test abnormal
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Pt received TD, Hep A dose 1 and Hep B dose 3 on 11/21/2001. A few minutes after, pt fell on the floor and had jerky movements of lower extremities for a few seconds only, afterwards he felt a little bit weak but is awake, alert and coherent. Pt is referred to ER for further evaluation.

VAERS ID:179243 (history)  Vaccinated:2001-11-21
Age:1.1  Onset:2001-11-29, Days after vaccination: 8
Gender:Male  Submitted:2001-11-29, Days after onset: 0
Location:Unknown  Entered:2001-12-19, 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:
Current Illness: Mild runny nose
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC and diff-WNL
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0482L2IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0597L0SCLA
PNC: PNEUMO (PREVNAR)PFIZER/WYETH4792372IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1137K0SCLL
Administered by: Military     Purchased by: Military
Symptoms: Listless, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad)
Write-up: 7 days, post vax, the pt had a temperature of 105.4F (rectal) with listlessness and minimal other symptoms.

VAERS ID:179618 (history)  Vaccinated:2001-11-21
Age:7.0  Onset:2001-11-21, Days after vaccination: 0
Gender:Male  Submitted:2001-11-23, Days after onset: 2
Location:Unknown  Entered:2002-01-02, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Local reaction;UNK. INFLUENZA VACCINE;5;4.00;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH    
Administered by: Other     Purchased by: 0
Symptoms: Injection site erythema, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Local swelling, redness, itching started on arm 4-6 hours after flu vaccine administration. No fever, dysphagia, wheeze, SOB or any systemic symptoms.

VAERS ID:179946 (history)  Vaccinated:2001-11-21
Age:10.0  Onset:2001-11-21, Days after vaccination: 0
Gender:Female  Submitted:2001-12-28, Days after onset: 37
Location:New York  Entered:2002-01-14, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4018023 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site warmth, Scar
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Severe local reaction with warmth, erythema, pain and a scar.

VAERS ID:180089 (history)  Vaccinated:2001-11-21
Age:18.0  Onset:2001-11-27, Days after vaccination: 6
Gender:Female  Submitted:2002-01-15, Days after onset: 49
Location:New York  Entered:2002-01-17, 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: Insulin pump
Current Illness: NONE
Preexisting Conditions: IDDM
Diagnostic Lab Data: WBC-14.4; CBC, mono spot and antistcotol-all neg
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURU0726AA0IM 
Administered by: Private     Purchased by: Other
Symptoms: Diarrhoea, Pruritus, Rash, Viral infection, Vomiting, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: The pt developed an itchy rash on palms and distal end of forearms, feet itchy. Erythema distal tibia area. Mild sore throat; no temperature; no cough; an episode of vomiting and diarrhea on 11/26/01. Seen on 11/28/01 with viral exanthem on feet and hands.

VAERS ID:181255 (history)  Vaccinated:2001-11-21
Age:0.3  Onset:2001-11-21, Days after vaccination: 0
Gender:Male  Submitted:2002-01-29, Days after onset: 69
Location:Hawaii  Entered:2002-02-12, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM517A21IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0660L1IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT11891SCRA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4818151IMLL
Administered by: Private     Purchased by: 0
Symptoms: Hypotonia, Irritability, Musculoskeletal stiffness, Pyrexia, Staring
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad)
Write-up: After 4 month shots, the baby had a temperature of 101F and about 3 hours of fussiness. Had decreased tone and staring spells intermittently. Also with bursts of crying and stiffness lasting about 1 minute. Baby "fine", mother says.

VAERS ID:182136 (history)  Vaccinated:2001-11-21
Age:49.0  Onset:2001-11-22, Days after vaccination: 1
Gender:Female  Submitted:2002-02-08, Days after onset: 78
Location:Michigan  Entered:2002-03-08, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: "General environmental allergies and cats"
Diagnostic Lab Data: NONE
CDC 'Split Type': MI2002019
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4018033 IMLA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5239A4 IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT13102 SCRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURR14074 IMLA
Administered by: Public     Purchased by: 0
Symptoms: Apnoea, Choking, Fatigue, Headache, Injection site pain, Pharyngeal oedema, Pharyngolaryngeal pain
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Client reports "vaccines on 11/21/01 at 10:30 AM" followed by "slight headache, sore arm and felt tired". On 11/22/01, client reports she awoke at 02:30 with "choking, very sore and swollen throat and positional apnea". Client states she "took an antihistamine" and "improved in 1 1/2 hours".

VAERS ID:183778 (history)  Vaccinated:2001-11-21
Age:33.0  Onset:2001-11-23, Days after vaccination: 2
Gender:Female  Submitted:2002-03-15, Days after onset: 112
Location:Missouri  Entered:2002-04-23, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: Latex allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dyspnoea, Lethargy, Pneumonia
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Acute onset of shortness of breath and weakness. No hives or rash. Taken to the medical center. Unstable in ER with weak pulse and lethargic. Admitted to the hospital and was diagnosed pneumonia.

VAERS ID:214305 (history)  Vaccinated:2001-11-21
Age:3.5  Onset:2003-12-10, Days after vaccination: 749
Gender:Female  Submitted:2003-12-12, Days after onset: 2
Location:California  Entered:2003-12-23, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Varicella (Varivax);;0;6;In Sibling
Other Medications: NONE
Current Illness: Upper Respiratory Infection
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.082LL0SCRL
Administered by: Private     Purchased by: Private
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow)
Write-up: Varicella

VAERS ID:214810 (history)  Vaccinated:2001-11-21
Age:38.0  Onset:2001-11-25, Days after vaccination: 4
Gender:Female  Submitted:2003-12-31, Days after onset: 766
Location:Pennsylvania  Entered:2004-01-13, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Titer was (-) after the last series.;Hep B (unknown mfr);3;37;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: Seasonal allergy
Diagnostic Lab Data: 2 years worth of tests and treatment on file. Lab test abnormal.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 5 LA
Administered by: Public     Purchased by: Private
Symptoms: Bacterial infection, Chest pain, Constipation, Cough, Dyspnoea, Influenza like illness, Laboratory test abnormal, Pneumonia, Pyrexia, Systemic lupus erythematosus, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Developed fever, flu-like symptoms and ongoing infection which resulted in pneumonia. Also developed lupus which resulted in pneumonia caused by pseudomonas and staphaureous infection-IV for 4 weeks after one week hospitalization. The medical record received on 2/11/04 states short of breath, vomiting, chest pain, constipation and productive cough.

VAERS ID:216452 (history)  Vaccinated:2001-11-21
Age:1.2  Onset:0000-00-00
Gender:Male  Submitted:2004-02-09
Location:Kansas  Entered:2004-02-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Not completely
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)AVENTIS PASTEURAG00AA3IMLL
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.0906L0SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0224L0SCLL
Administered by: Public     Purchased by: Public
Symptoms: Abasia, Nervous system disorder, Speech disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Mother reports that within 1 week after pt got his MMR, he stopped walking and talking and has gradually improved. Still in speech therapy.

VAERS ID:225476 (history)  Vaccinated:2001-11-21
Age:1.3  Onset:2001-11-23, Days after vaccination: 2
Gender:Male  Submitted:2004-08-06, Days after onset: 986
Location:Mississippi  Entered:2004-08-17, Days after submission: 11
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: Autism
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURU0378CA3 LL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0480L1 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0155L0 RA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0238L0 LA
Administered by: Public     Purchased by: Public
Symptoms: Abnormal behaviour, Aggression, Antisocial behaviour, Autism, Pyrexia, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (narrow)
Write-up: Patient stopped progressing after 18 month shots. he has been diagnosed autistic. He is lacking in many areas, i.e. potty training, language, social skills, behavior. His behavior is volatile. He bites, head slams, and is very physical with my 5.5 year old girl. I noticed all of these things within days. Follow up:Fever developed after vaccination. Mom treated it with alternating doses of Tylenol and Motrin x 2 days. Nurse follow up on 10/20/04 states: "Medical records review confirms diagnosis of autism." Per the follow up report-Patient is delayed in so many areas except motor skills. He is not wanting to potty train. He eats non-edible items such as pencils, chalk, porcelain and wood. He is self injuting when angry or upset. His language is less than 24 month. He is very destructive in the home such as breaking glass and flipping furniture. On occasion, this school year, he has shown some aggression towards classmates. He cannot sleep more than 2-3 hours per night without medication. He is currently taking Clonidine 0.1M, Trazodone 50 mg, Seroquel 25 mg, once daily at bedtime. He is obsessive with man things like certain foods, certain movies, toys and closing doors. He is also obsessed with water and is unaware of danger about water. He does not understand about fear like fire, cars in the road, climbing, breaking glass with his bare hands. He bites often and sometimes so severe he can break the skin through clothing hisself and daughter as well. I feel like this is a pretty good picture of patient. I could go on and on.

VAERS ID:179939 (history)  Vaccinated:2001-11-21
Age:  Onset:2001-11-21, Days after vaccination: 0
Gender:Female  Submitted:2002-01-09, Days after onset: 49
Location:Foreign  Entered:2002-01-14, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 2001026941
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5130C62IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Balance disorder, Delirium, Dizziness, Headache, Hearing impaired, Nausea, Neuritis, Sensory disturbance, Vaccine positive rechallenge, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad)
Write-up: On 5/21/01, the pt received her 1st dose of Engerix-B. Post vax, the pt felt nauseous and vomited. On 5/30/01, the events resolved. On 6/21/01, the pt received her 2nd dose of Engerix-B and experienced vomiting. On 6/30/01, the event resolved. The reporter considered the reactions to the 1st two doses moderate in intensity. On 11/21/01, the pt received her 3rd dose of Engerix-B (batch ENG5130C6) and experienced nausea, vomiting, dizziness, loss of balance and delirium which is considered to be an "Other Important Medical Event". A dx of vestibular neuritis was made. The reporter considered the reactions to the 3rd dose to be severe in intensity. The most recent information received on 1/4/02, reports that on 12/11/01, the events resolved except the sensitivity to light and pressure on head, which are ongoing. The reporter also considered all of these events to be related to the vaccine. The pt has been referred to a consultant neurologist for investigation. Further information has been requested.

VAERS ID:192666 (history)  Vaccinated:2001-11-22
Age:67.0  Onset:2001-11-24, Days after vaccination: 2
Gender:Male  Submitted:2002-10-31, Days after onset: 341
Location:Oregon  Entered:2002-11-06, 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
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Lung disorder, Pneumonia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: 2 days after injection, got high fever which led to pneumonia (hospitalized 2 days) and COPD.

VAERS ID:216579 (history)  Vaccinated:2001-11-22
Age:39.0  Onset:2001-11-22, Days after vaccination: 0
Gender:Female  Submitted:2004-02-17, Days after onset: 817
Location:Maryland  Entered:2004-02-17
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Avalide ( High Blood Pressure Med).
Current Illness: None other than the Allergic Reaction symptoms that came from the Flu Vaccine
Preexisting Conditions: None Medical records states Hx of CA of breast. PMH: cervical cancer, HTN, MI, left breast mass, asthma. ETOH & cigarette abuse.
Diagnostic Lab Data: MRI, Sonograms, Blood Work, Urinalysis, x-rays, Allergy Tests/ Screening, Stereotactic Core Biopsy on my left Breast. LABS: WBC 11.4, Amylase 42, EKG WNL, abdominal xray WNL
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abscess, Breast neoplasm, Chest pain, Erythema, Hypersensitivity, Injection site abscess, Loss of consciousness, Pain, Pyrexia, Swelling, Thinking abnormal, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tumours of unspecified malignancy (narrow), Breast tumours of unspecified malignancy (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)
Write-up: I received the Flu Vaccine thru work and Twenty minutes after receiving the Flu Shot : I had severe chest pains and I passed out. I regained conciousness and went home for the rest of the day. My arm got red , & swollen. I broke out in hives and had a 103-104 degree fever. The needle hole weeped clear liquid. I got delirious and tried to cut my arm off with a butcher knife. I saw the company doctor. I also saw my Primary Care Physcian. They both told me that it was an allergic reaction to the Flu Vaccine and that I should never get it again or it would kill me..... 8 months later, I''m still having problems and went back to my primary care physican. He sent me for MRI''s and Sonograms on my arm and to a Surgeon. They found 7 small (5mM) areas of Fluid but concluded that they would re-absorb into my body and that they were Sterile Abscesses. They never cultured them though , but they concluded that they were Sterile abscesses like children get when they get a shot. I''ve been putting up with this pain and constant symptoms for 2 1/2 years now. I recently have been in severe pain and now am on Oxycoten and Tramadols so I can function to go to work. I also was told that they found a Mass in my left breast now, because I went to the Hospital 2 days before Christmas (2003) because I was in so much pain that I thought that I was dying. I went for Mammagrams , sonograms, MRI''s on my arm and sonograms for my arm. I have went to a Breast surgeon specialist and have had to have a Stereotactic Core Biopsy done on my left breast . Thank God they have told me that it''s not cancer but then I have to ask... what the heck is it? The Flu Shot was given 2 1/2 years ago........ and I still have the needle hole and it still weeps liquid out of it and it still gets red and swollen and I break out in hives and I get fevers and I have severe pain that I''ve been on heavy pains killers for over 3 months now. I have exhausted my sick leave and my vacation here at work... I am now taking time off as Leave Without Pay. Can you help me? I d

VAERS ID:178831 (history)  Vaccinated:2001-11-22
Age:0.3  Onset:2001-11-22, Days after vaccination: 0
Gender:Female  Submitted:2001-12-03, Days after onset: 11
Location:Foreign  Entered:2001-12-11, 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: Pentavac 11/22/01
Current Illness:
Preexisting Conditions: The child has no relevant medical history. On 11/22/02 he girl also received a dose of Pentavac (IM) and she developed an intense redness at the injection site.
Diagnostic Lab Data: ECU negative
CDC 'Split Type': 20010284991
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPIHI: DT+IPV+HIB+HEPB (NO BRAND NAME)UNKNOWN MANUFACTURER    
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5145C2 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Apnoea, Crying, Depressed level of consciousness, Hypotonia, Injection site erythema, Injection site reaction, Pallor
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (narrow)
Write-up: This report concerns a 3 month old child. On 11/22/01, a dose of Engerix-B (IM) was given. On the same day, post vax, the girl developed apnea, hypotonia, pallor, reduced responsiveness, persistent crying and an injection site reaction. Subsequently, she was hospitalized. On 11/23/01, she was discharged and had completely recovered. The reporting physician considered the events to be possibly related to Engerix-B. No further details will be available. This case has therefore been closed. The follow up states the lot number for Engerix B (5145C2). On the same day, four hours after vaccination the symptoms started. ECU was done and revealed to be negative. Lab test was performed and the results were pending. The reporting physician considered the events to be probably related to Engerix B.

VAERS ID:180020 (history)  Vaccinated:2001-11-22
Age:47.0  Onset:2001-11-24, Days after vaccination: 2
Gender:Male  Submitted:2002-03-12, Days after onset: 108
Location:Foreign  Entered:2002-01-16, Days after submission: 55
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: The pt is addicted to alcohol and had a depressive state.
Diagnostic Lab Data: All lab findings including CSF were normal (not specified). 3/4/02 Follow up CSF: no cells, total protein 157 mg/L, albumin 206 mg/L (normal). No intathekal isolated Ig synthesis, oligoclonal bands negative. Serum and urine: routine paramet
CDC 'Split Type': U200200013
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEUR 0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Depression, Neuritis, Paresis
SMQs:, Peripheral neuropathy (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (narrow)
Write-up: It was reported that a 47 year old man was vaccinated with a booster dose of inactivated Polio vaccine in the right deltoid muscle on 11/22/01. On 11/24/01, he presented with a C5 radiculitis and neuritis of the brachial plexus right, including paresis of the deltoid and infraspinous muscle. He was admitted to the hospital and treated with immunoglobulins for 5 days and corticosteroids, which led to an improvement. At the time of this report, the pt has not yet recovered. It is worth noting that the pt is addicted to alcohol and had a depressive phase with a suicide attempt with antidepressants on 11/24/01. On 12/13/01, his emotional state was normal again. Further information is expected. From follow up correspondence received at manufacturer on 2/4/02 on a different reporting form received through health authority, it was indicated that differential diagnosis such as a cervical disk prolapse and a traumatic lesionof the brachial plexus could be ruled out during hospitalization. The following examinations were performed: EMG, ENG, MRI of the cervical spine, lumbar puncture. The report is dated 1/10/02, at that date, the patient was not yet recovered. further information is expected. From faxed follow up correspondence received at manufacturer on 3/12/02 it was reported in the hospital notes, final diagnosis of autoimmunological reaction on the vaccine was made. it was prognosed that total recovery will take about 3 months. The following laboratory results were reported: CSF no cells, total protein 357mg/L, albumin 204mg/L. No intrathecal isolated Ig synthesis, oligoclonal bands negative. Serum and urine: routine parameters normal, TPHA serology negative. Further information is not expected. File closed.

VAERS ID:187688 (history)  Vaccinated:2001-11-22
Age:1.3  Onset:2001-11-27, Days after vaccination: 5
Gender:Unknown  Submitted:2002-10-10, Days after onset: 316
Location:Foreign  Entered:2002-07-17, Days after submission: 85
Life Threatening? No
Died? Yes
   Date died: 2001-11-27
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NKA
Diagnostic Lab Data: Autopsy - subacute cystitis with a focus of acute pyelonephritis in the left kidney; Diagnostic lab test - haemoculture sterile; Spinal Tap - sterile (All done on 11/27/01.
CDC 'Split Type': WAES0206USA02446
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cystitis, Pyelonephritis
SMQs:
Write-up: Information has been received from a health authority concerning a 15 month old patient who on 11/22/2001 was vaccinated with the first dose of MMRII vaccine. On 11/27/01, the patient died. An autopsy revealed a subacute cystitis with a focus of acute pyelonephritis in the left kidney. The physician who reported the case to the health authority concluded that this disorder was not the cause of death. Lab results included: sterile Haemoculture and spinal fluid. No further information is available. dollow up information indicated that the patient was being treated with Priorix not MMRII (MSD) as previously reported. Therefore WAES#0206USA02446 is being deleted from our files for MMRII

VAERS ID:232456 (history)  Vaccinated:2001-11-22
Age:57.0  Onset:2001-11-23, Days after vaccination: 1
Gender:Female  Submitted:2002-10-10, Days after onset: 320
Location:Foreign  Entered:2005-01-19, Days after submission: 832
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroxine (Levothyroxine sodium) 150mcg
Current Illness:
Preexisting Conditions: Influenza
Diagnostic Lab Data:
CDC 'Split Type': PJP200200043
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Injection site erythema, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: A report was received on 1/21/02 concerning a 57 year old female patient who experienced generalized itching and erythema which was considered medically significant after receiving an influenza vaccine on 11/22/01. On 11/22/01 the patient received an influenza vaccine. On 11/23/01 the patient experienced generalized itching and erythema. The reaction was considered serious medically significant (OMIC) by the reporter because the generalized itching was very sore and red at the injection site. The patient had not recovered at the time of reporting the event. There was insufficient information to determine the reporter''s causality assessment. The patient had a previous adverse reaction, influenza like illness, after hepatitis B vaccination in October 2001.

VAERS ID:178500 (history)  Vaccinated:2001-11-23
Age:  Onset:2001-11-23, Days after vaccination: 0
Gender:Female  Submitted:2001-11-26, Days after onset: 3
Location:Ohio  Entered:2001-12-03, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO683CA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Anxiety, Back pain, Blood pressure increased, Dry skin, Feeling hot, Heart rate increased, Laryngospasm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Hypertension (narrow), Hypersensitivity (narrow)
Write-up: Flu shot given. Approximately 9 minutes later, pt reported, "felt funny, heart racing" BP 174/94, P 126, R 12. Skin warm, dry, pink, ho SOB. At 6:24 AM 160/90-92-12. Nose stuffy, feels better 6:23 AM 134/90-92-12 better 6:32 AM 132/86-80-12. No heart racing, calmer. 6:38 AM 126/82-76-12, okay back to work. 6:46 AM 16/82-124-24 back hurts, racing heart and throat slight tightness. Gave Epi. 0.5cc SQ. Skin cool and dry pt fearful, medic called, arrived 6:53 AM BP 170/100-140 lungs clear. Medic feels reaction is anxiety, leave 7:11 AM. 7:13 AM 140/82-92-12. Pt back to work. 7:40 AM working, no symptoms or complaints. 140/82-88, color pink, skin warm and dry. This was the pt''s first time getting a flu shot.

VAERS ID:178533 (history)  Vaccinated:2001-11-23
Age:13.0  Onset:2001-11-24, Days after vaccination: 1
Gender:Female  Submitted:2001-11-26, Days after onset: 2
Location:California  Entered:2001-12-04, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0684AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Red, raised patch overlying entire left deltoid.

VAERS ID:178553 (history)  Vaccinated:2001-11-23
Age:42.0  Onset:2001-11-25, Days after vaccination: 2
Gender:Female  Submitted:2001-11-27, Days after onset: 2
Location:Massachusetts  Entered:2001-12-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: fever, oint pain and swellin at injectin site;UNK. HEPATITIS B;3;32.00;In Patient
Other Medications: Zoloft, Accolate, Flovent, etc
Current Illness: NONE
Preexisting Conditions: Asthma (grade 4), etc
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURVO571AD IM 
Administered by: Private     Purchased by: Other
Symptoms: Asthma
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Fever, rash, small bumps reddened and white all over arms, legs, chest, etc. Joint pain (severe), headache, facial, neck swelling, eye swelling and nausea. MD stated "classic" drug or serum sickness/reaction". Symptoms for 2 weeks. Treated with Benadryl and Tylenol. Also worsening in asthma symptoms, increase in asthma meds. MD suspicious of thimersol allergy. No history of egg allergy.

VAERS ID:181560 (history)  Vaccinated:2001-11-23
Age:10.0  Onset:2001-11-25, Days after vaccination: 2
Gender:Male  Submitted:2002-02-13, Days after onset: 80
Location:Massachusetts  Entered:2002-02-20, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.04131IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Abdominal pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: After each of two hepatitis B shots, child experienced severe abdominal pain.

Result pages: prev   1667 1668 1669 1670 1671 1672 1673 1674 1675 1676 1677 1678 1679 1680 1681 1682 1683 1684 1685 1686 1687 1688 1689 1690 1691 1692 1693 1694 1695 1696 1697 1698 1699 1700 1701 1702 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 1743 1744 1745 1746 1747 1748 1749 1750 1751 1752 1753 1754 1755 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780 1781 1782 1783 1784 1785 1786 1787 1788 1789 1790 1791 1792 1793 1794 1795 1796 1797 1798 1799 1800 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819 1820 1821 1822 1823 1824 1825 1826 1827 1828 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1839 1840 1841 1842 1843 1844 1845 1846 1847 1848 1849 1850 1851 1852 1853 1854 1855 1856 1857 1858 1859 1860 1861 1862 1863 1864 1865   next

New Search

Link To This Search Result:
http://www.medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=1766&PERPAGE=100&ESORT=VAX-DATE


Copyright © 2014 National Vaccine Information Center. All rights reserved.
407-H Church Street, Vienna, Virginia 22180