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Case Details (Sorted by Vaccination Date)

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VAERS ID:151207 (history)  Vaccinated:2000-04-20
Age:7.0  Onset:2000-04-22, Days after vaccination: 2
Gender:Male  Submitted:2000-04-22, Days after onset: 0
Location:Illinois  Entered:2000-05-03, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES471204 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilation procedure
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Three x Two inch swelling in right deltoid area. Red, warm to touch vax. Treatment: Omnicef 250 mg daily for five days. Soreness at site day of vax. Redness and swelling noted on 04/22 when child awoke.

VAERS ID:151839 (history)  Vaccinated:2000-04-20
Age:1.4  Onset:2000-04-20, Days after vaccination: 0
Gender:Female  Submitted:2000-04-22, Days after onset: 2
Location:New Jersey  Entered:2000-05-11, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Conjunctivitis
Preexisting Conditions: Mild development delay
Diagnostic Lab Data: All tests-nml
CDC Split Type: NJ200012
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0137BA3IM 
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESP1290AB3IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P090522  
Administered by: Other     Purchased by: Public
Symptoms: Convulsion, Pyrexia, Sepsis
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt was seen for well visit with conjunctivitis. 45 minutes post vax, pt experienced Tonic/clonic generalized seizure. Pt was seen in ER with a fever of 104.8, nml exam. Pt was admitted to rule out sepsis, antibiotics were given. Discharged on 4/22/00 with neg cultures, no fever and normal exam.

VAERS ID:152824 (history)  Vaccinated:2000-04-20
Age:0.6  Onset:2000-04-21, Days after vaccination: 1
Gender:Male  Submitted:2000-04-21, Days after onset: 0
Location:Arizona  Entered:2000-06-08, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin
Current Illness: otitis media
Preexisting Conditions: treated for congenital syphilis, VSD, atopic dermatitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0056FA2IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1975J2IMRL
Administered by: Private     Purchased by: Public
Symptoms: Convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt received vaccines on 4/20/00. On 4/21/00 at 8:00 AM had seizure lasting <10 minutes. Had fever all night. Had a second brief seizure with combined fever at 11:00 on same day. Seen by MD on 4/21/00 with temp of 103.8.

VAERS ID:152831 (history)  Vaccinated:2000-04-20
Age:12.0  Onset:2000-04-20, Days after vaccination: 0
Gender:Female  Submitted:2000-04-21, Days after onset: 1
Location:Wisconsin  Entered:2000-06-08, Days after submission: 48
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: NONE
Diagnostic Lab Data: UA, strep test
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM307A20IMRA
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES40061AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Dizziness, Dyspnoea, Hypersensitivity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: At approximately 10 PM, the child complained of dizziness, abdominal cramping, later complained of difficulty breathing. Dad later called for medical help. He was encouraged to seek medical care. Went to the hospital. Left hospital at 6:30 AM and saw MD. MD felt it was a vaccine reaction, probably the Hep B. Pt was given Advil.

VAERS ID:152929 (history)  Vaccinated:2000-04-20
Age:1.1  Onset:2000-04-21, Days after vaccination: 1
Gender:Male  Submitted:2000-04-24, Days after onset: 3
Location:Minnesota  Entered:2000-06-08, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: WBC - 9200
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER 2SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.171950SCLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.172750SCRL
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt experienced a fever of 104.5, no focal findings.

VAERS ID:153623 (history)  Vaccinated:2000-04-20
Age:60.0  Onset:2000-04-24, Days after vaccination: 4
Gender:Female  Submitted:2000-05-08, Days after onset: 14
Location:Pennsylvania  Entered:2000-06-09, Days after submission: 32
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1714J SCLA
Administered by: Private     Purchased by: Private
Symptoms: Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Local reaction at injection site noted 5 days post vax site raised with erythema, no macules or papules noted. Rash around forehead not the extremities the trunk and lower legs.

VAERS ID:153730 (history)  Vaccinated:2000-04-20
Age:21.0  Onset:2000-04-21, Days after vaccination: 1
Gender:Female  Submitted:2000-04-27, Days after onset: 6
Location:Nebraska  Entered:2000-06-09, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergy to penicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09683701IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Localized 10 x 15 cm erytherma same day of injection, in the left deltoid. Treatment Claritin and Ibuprofen.

VAERS ID:155630 (history)  Vaccinated:2000-04-20
Age:0.3  Onset:2000-04-20, Days after vaccination: 0
Gender:Male  Submitted:2000-06-22, Days after onset: 63
Location:Maryland  Entered:2000-06-28, 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: Zantac
Current Illness: NONE
Preexisting Conditions: GERD
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM920A21IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1787J1IMLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R03011SCLL
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: History of fever of 104 within 4-5 hours post vax. Remained elevated for 4-5 hours and returned to normal.

VAERS ID:157925 (history)  Vaccinated:2000-04-20
Age:1.0  Onset:2000-04-20, Days after vaccination: 0
Gender:Female  Submitted:2000-07-21, Days after onset: 92
Location:North Carolina  Entered:2000-07-25, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1968J1IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0876J2IMLL
Administered by: Private     Purchased by: Public
Symptoms: Irritability, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt experienced a fever of 103 to 104 a few hours post vax that lasted for 2 days, with marked irritability.

VAERS ID:158150 (history)  Vaccinated:2000-04-20
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:2000-06-22
Location:Minnesota  Entered:2000-07-28, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin, acetylsalicylic acid
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: 20000187531
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IMLA
Administered by: Other     Purchased by: Other
Symptoms: Pain
SMQs:
Write-up: On 4/20/00, the pt received his 3rd dose of Lymerix and subsequently, he experienced bilateral biceps and shoulder pain. No treatment was given. The most recent information, received on 6/21/00, reports the outcome of the event as unresolved.

VAERS ID:159046 (history)  Vaccinated:2000-04-20
Age:1.3  Onset:2000-04-23, Days after vaccination: 3
Gender:Male  Submitted:2000-07-28, Days after onset: 96
Location:Wisconsin  Entered:2000-08-22, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Private     Purchased by: Private
Symptoms: Anorexia, Infection, Pyrexia, Rash, Screaming
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hostility/aggression (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: High fever of 105.6F, screaming all night, wouldn''t eat or drink. This occurred 3 days after vaccines. Once, fever came down, rash developed over entire body. He was sick for 2 weeks.

VAERS ID:159935 (history)  Vaccinated:2000-04-20
Age:20.0  Onset:2000-04-21, Days after vaccination: 1
Gender:Male  Submitted:2000-09-13, Days after onset: 145
Location:New Mexico  Entered:2000-09-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, Chemistry, LFT''s, TSH, ESR, HIV-all nml
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0473IM 
Administered by: Military     Purchased by: Military
Symptoms: Abdominal discomfort, Arthralgia, Dizziness, Fatigue, Headache, Myalgia, Sinus congestion, Tremor, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: On 4/20/00, pt received the 4th documented Anthrax vaccine. (Pt claims it was the 7th vaccine since the 1st on 5/23/99). Pt reports, within 24-48 hours, feeling tired, having GI upset, headache and shakes. Symptoms continue and also include blurred vision, dizziness, myalgias, arthralgias and sinus congestion. Medical evaluation is negative. Rx''d IV fluids, antihistamines, antacids. No significant improvement. Pt 1st came to medical attention on 5/17/00 and reported symptoms for 2 weeks which said date of the onset to 5/3/00, but also said "since receiving the shot".

VAERS ID:162125 (history)  Vaccinated:2000-04-20
Age:1.5  Onset:2000-04-21, Days after vaccination: 1
Gender:Female  Submitted:2000-06-13, Days after onset: 53
Location:California  Entered:2000-10-10, Days after submission: 119
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC Split Type: HQ5869315MAY2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4693964IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD. 3IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: On April 21, 2000, she developed an injection site reaction characterized by redness and swelling. The swelling extended to involve her entire thigh. This is 1 of 3 patients from this facility who developed an injection site reaction.

VAERS ID:166468 (history)  Vaccinated:2000-04-20
Age:40.0  Onset:2000-04-21, Days after vaccination: 1
Gender:Female  Submitted:2000-10-06, Days after onset: 168
Location:New York  Entered:2001-03-05, Days after submission: 150
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ8444112JUL2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4988176   
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A pharmacist reported a pt received a vaccine on 4/20/2000. The next day pt developed a fever of 103 deg F, reaction characterized by redness and swelling. The fever ad injection site reaction resolved after 3 days.

VAERS ID:166528 (history)  Vaccinated:2000-04-20
Age:1.2  Onset:2000-04-20, Days after vaccination: 0
Gender:Female  Submitted:2000-07-19, Days after onset: 90
Location:Georgia  Entered:2001-03-05, Days after submission: 229
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Immune Serum Globulin
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: HQ4478525APR2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (ACETONE INACTIVATED DRIED)PFIZER/WYETH 1SCLL
Administered by: Private     Purchased by: Other
Symptoms: Crying, Cyanosis, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Approximately 1.5 hrs post vaccine pt awoke crying and shaking. Mother noticed while child was sleeping that her lips were blue and she was trembling.

VAERS ID:169173 (history)  Vaccinated:2000-04-20
Age:12.0  Onset:2000-04-27, Days after vaccination: 7
Gender:Male  Submitted:2001-04-20, Days after onset: 358
Location:Texas  Entered:2001-04-24, 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: Multivitamins; Dimetapp
Current Illness:
Preexisting Conditions: Allergy to peanuts and suspected allergy to milk
Diagnostic Lab Data: Lab data revealed an eosinophil percentage of 32% with a WBC of 6,000 (for a calculated eosinophil count of 1920) with a normal hematocrit, hemoglobin and platelet count. Subsequently, WBC-7,800 with 41% eosinophils (for a calculated eosino
CDC Split Type: 20000167951
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM645A20IM 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood alkaline phosphatase increased, Diarrhoea, Eosinophilia, Fatigue, Malaise, Nausea, Oral intake reduced, Weight decreased
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Biliary system related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 4/20/00, the pt received his 1st dose of Havrix. Physician reported that he was experiencing severe fatigue, epigastric discomfort and diarrhea. Physician reported that the pt had severe eosinophilia and that he could not be sure it was not present prior to the Havrix. Additionally, he was not sure that the fatigue developed after the Havrix. The gastrointestinal discomfort has improved. The diarrhea occurred for 1 day only, then resolved. On 5/19/00, physician visit: Physician noted that the pt had a 1 month history of unusual fatigue and eosinophilia noted on peripheral blood counts. No fever was noted with the pt''s recent symptoms, but the pt did complain of abdominal discomfort and a sense of abdominal fullness and nausea after completing 1/2 of his meal. He had diarrhea for 1 day in early May, 2000, with normal stools since that time. He had been so fatigued that he had been unable to participate in his usual tennis competition and had missed some school. There is no history of unusual exposure to illness or toxins and no travel to exotic sites. He did receive a routine Hep-A vaccine. Physical exam was normal. On 5/19/00, Allergist visit: It is unclear whether the pt''s symptoms began before or after receiving the Havrix on 4/20/00. However, his parents contacted physician on 4/27/00 with at least a 1 week history of fatigue, malaise and epigastric discomfort. He had no other GI symptoms (except for car sickness) prior to this episode. Allergist had no explanation for the pt''s significant eosinophilia. The fact that he has had prior normal eosinophil percentages on his hemograms suggested that this was an acute event (which was hoped was resolving) rather than something related to his prior peanut allergy or mild allergic rhinitis. It is possible that he experienced an idiosyncratic reaction to the Hep-A vaccine. It is possible that he may have eosinophilic gastroenteritis. Hypereosinophilic syndrome would require absolute eosinophil count, 1500 per micro liter for more than 6 months. Current eosinophil co

VAERS ID:169734 (history)  Vaccinated:2000-04-20
Age:  Onset:2000-04-24, Days after vaccination: 4
Gender:Female  Submitted:2000-05-02, Days after onset: 8
Location:Virginia  Entered:2001-05-09, Days after submission: 372
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal
Current Illness:
Preexisting Conditions: Pt is a known epileptic on Lamictal.
Diagnostic Lab Data:
CDC Split Type: U2000003000
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES  SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Condition aggravated, Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: It was reported that a female pt received a Menomune A/C/Y/W-135 vaccination on 4/20/00. Reportedly, on 4/24/00, the pt experienced a seizure. The pt is a known epileptic on Lamictal. Further information requested.

VAERS ID:170521 (history)  Vaccinated:2000-04-20
Age:28.0  Onset:2000-04-20, Days after vaccination: 0
Gender:Male  Submitted:2001-05-29, Days after onset: 404
Location:Virginia  Entered:2001-06-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0314SC 
Administered by: Military     Purchased by: Military
Symptoms: Injection site cyst
SMQs:
Write-up: The pt experienced a 1/4" diameter subcutaneous cyst at location of vax. Cyst present since immunization.

VAERS ID:174796 (history)  Vaccinated:2000-04-20
Age:  Onset:0000-00-00
Gender:Male  Submitted:2001-08-23
Location:New Jersey  Entered:2001-08-29, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pulmicort; Proventil;
Current Illness:
Preexisting Conditions: Allergic to sulfa; asthma;
Diagnostic Lab Data: Parvovirus - Positive; Lyme titer - Positive;
CDC Split Type: 20010200361
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IM 
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Fatigue, Headache, Joint swelling, Laboratory test abnormal, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 04/20/2000 the patient received his 3rd dose of Lymerix. Reportedly, he "did well" until approximately late April 2001 or early May 2001, when he began to experience headaches, fatigue, and red patches on his torso and legs. His symptoms were never evaluated by a physician. Reportedly, every week after the beginning of May, a new symptom would develop. One day "pinky edema, next morning finger edema" appeared to develop in the middle joints of fingers. The patient stated that the edema traveled to his left knee then to his shoulders. The patient experienced pain. The adverse events "headaches, joint edema, and joint pain" do not meet ICH serious criteria, but are being submitted as an expedited report by special FDA request per the 06/28/2000 letter.

VAERS ID:180225 (history)  Vaccinated:2000-04-20
Age:16.0  Onset:2000-04-20, Days after vaccination: 0
Gender:Female  Submitted:2000-10-13, Days after onset: 176
Location:Ohio  Entered:2002-01-22, Days after submission: 466
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: passed out;DTP (Mfr not specified);;4.00;In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Closed head injury (MVA), fearful of injections, passed out while sitting watching a film
Diagnostic Lab Data:
CDC Split Type: 20000301152
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Report #20000030115-2 describes fainting in a pt who rec''d Engerix-B for the prophylaxis of hepatitis B. This report was rec''d from the pt''s mother and has not been verified by a physician or other hlth professional. The pt has no known allergies. The pt is very fearful of injections. At age 4-5, the pt rec''d diphtheria-tetanus-pertussis and passed out (1988-89). In 10/93 she experienced a closed head injury (MVA). There was no loss of consciousness she had a laceration only. The pt has no history of seizure disorder. She passed out while sitting watching a film on 12/21/99. The pt rec''d Havrix on 3/22/00 and diptheria-tetanus on 3/30/00 (no adverse event). On 3/22/00 (IM-L deltoid) and 4/20/00 (IM) the pt rec''d her first and second adult doses of Engerix-B, within seconds after receiving dose 2 of Engerix-B, she became lightheaded, fainted, was revived with smelling slats and vomited. The adverse events resolved within 10 minutes of the injection.

VAERS ID:194623 (history)  Vaccinated:2000-04-20
Age:0.8  Onset:2000-04-20, Days after vaccination: 0
Gender:Female  Submitted:2002-12-05, Days after onset: 959
Location:Tennessee  Entered:2002-12-05
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: rash and mild temperature, fussiness;Measles Mumps Rubella (Priorix);1;12;In Sibling
Other Medications:
Current Illness: chicken pox
Preexisting Conditions:
Diagnostic Lab Data: hearing test, speech assessment, allergy screening, neurology consultation.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1970J1IMLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abnormal behaviour, Autism, Decreased appetite, Irritability
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)
Write-up: refusal to eat foods once enjoyed, refusal to nurse which ended breastfeeding, lack of eye contact, fussy, behavior continued until autism diagnosis was given.

VAERS ID:204711 (history)  Vaccinated:2000-04-20
Age:8.0  Onset:2003-06-03, Days after vaccination: 1139
Gender:Male  Submitted:2003-06-04, Days after onset: 1
Location:Georgia  Entered:2003-06-10, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1725J1 RA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0453J0 LA
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up:

VAERS ID:239211 (history)  Vaccinated:2000-04-20
Age:  Onset:2004-12-15, Days after vaccination: 1700
Gender:Female  Submitted:2005-05-16, Days after onset: 151
Location:Montana  Entered:2005-06-07, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: waes0503usa02260
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information was received from a nurse concerning a kindergarten student who on 20 APR 2000 was vaccinated with a dose of Varicella. In 15 DEC 2004 the student developed chickenpox. According to the school nurse there were 58 other elementary school students and 34 of them had previously been vaccinated with a dose of Varicella. Unspecified medical attention was sought. There was no information regarding the present status of the student. No product quality complaint was involved. Additional information was requested.

VAERS ID:264808 (history)  Vaccinated:2000-04-20
Age:5.0  Onset:2006-10-10, Days after vaccination: 2364
Gender:Male  Submitted:2006-10-12, Days after onset: 2
Location:Unknown  Entered:2006-10-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER   UN
Administered by: Other     Purchased by: Other
Symptoms: Viral infection
SMQs:
Write-up: Chicken pox lesions 50-100.

VAERS ID:165532 (history)  Vaccinated:2000-04-20
Age:  Onset:2000-04-30, Days after vaccination: 10
Gender:Female  Submitted:2001-01-30, Days after onset: 275
Location:Foreign  Entered:2001-02-02, 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: Mother had very itchy rash all over body during pregnancy which also lasted 1 month after delivery.
Diagnostic Lab Data:
CDC Split Type: 20010018922
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAMA931A2A1IMLL
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURERA93A47A1IMLL
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER 1SC 
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER 1PO 
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Hypokinesia, Irritability, Pyrexia, Vomiting projectile
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: On 4/20/00, the pt received her 2nd dose of DTP-HIB and experienced difficulty in settling. During the following week, the pt screamed a lot, had a mild temperature and experienced projectile vomiting. It was later noted that the pt had weakness of limbs, was not reaching with hands and not using right arm and leg. The reporter indicated that the reaction was medically significant and that the screaming and pyrexia were consistent with a reaction to the Pertussis component, also that it was unlikely to be Guillain-Barre syndrome as not typically unilateral involving just limbs. The significance of the maternal rash during mother''s pregnancy with this child, is unknown. The pt received a 3rd dose of DTP-HIB and polio sabin on 6/29/00, with no adverse effect. When seen on 10/23/00, there was minimal reduction of use in right upper arm and no hypotonia or hypertonia in any limbs. The problem with the right leg became more apparent when the vaccinee started using a walker as the leg was dragged at times. The reporter is unclear as to cause. The most recent information received on 1/24/01, reports that the vaccinee has recovered from the pyrexia, screaming, vomiting and being difficult to settle and that she is recovering from the weakness of limbs. Further tests are ongoing with regards to the vaccines not using her right arm or leg. No other details were given. No further information is expected.

VAERS ID:151086 (history)  Vaccinated:2000-04-21
Age:2.0  Onset:2000-04-21, Days after vaccination: 0
Gender:Male  Submitted:2000-04-24, Days after onset: 3
Location:California  Entered:2000-04-25, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Delayed speech, bronchitis 10/99
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM6499AZ0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Respiratory distress
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Developed respiratory distress and grunting, 2 hours post vax. Sent to ER for evaluation.

VAERS ID:151835 (history)  Vaccinated:2000-04-21
Age:0.2  Onset:2000-04-21, Days after vaccination: 0
Gender:Female  Submitted:2000-05-10, Days after onset: 19
Location:California  Entered:2000-05-11, Days after submission: 1
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ4612226APR2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4693960IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.  IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R04420IMLL
Administered by: Private     Purchased by: Other
Symptoms: Anaphylactic reaction, Grunting, Pallor
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: A physician reported that a 2 month old infant, five hours post vax, became pale and developed grunting. The infant was taken to an ER and treated with oxygen, IV fluids and Solu-Medrol. The infant recovered. These events are considered medically important. Additional information, received from the physician on 4/25/2000, indicated that the 2 month old female developed an anaphylactic reaction. She remained recovered.

VAERS ID:152322 (history)  Vaccinated:2000-04-21
Age:21.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Texas  Entered:2000-05-24
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: CBC-WNC, Strep Cx - neg
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 0SC 
Administered by: Military     Purchased by: Military
Symptoms: Malaise, Pyrexia, Upper respiratory tract congestion, Vaccination complication
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt experienced malaise, fever, URI symptoms for 24-48 hours post 1st vax. Could not rule out post vaccination syndrome.

VAERS ID:152811 (history)  Vaccinated:2000-04-21
Age:0.2  Onset:0000-00-00
Gender:Female  Submitted:2000-04-21
Location:California  Entered:2000-06-08, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4693960IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0050K0IMLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R044420IMLL
Administered by: Private     Purchased by: Private
Symptoms: Pallor, Shock
SMQs:, Anaphylactic reaction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: The baby receive the vaccines at 10:00 AM and by 3:00 PM became pale, shocky and was rushed to the ER. Pt was treated with IV Solumedrol.

VAERS ID:152906 (history)  Vaccinated:2000-04-21
Age:1.5  Onset:2000-04-22, Days after vaccination: 1
Gender:Male  Submitted:2000-04-29, Days after onset: 7
Location:North Carolina  Entered:2000-06-08, Days after submission: 40
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: NC00028
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0045BA4IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1355J0IMLL
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The pt experienced swelling in the right thigh 1-2 days post vax. Became red and hot. Was still walking had no fever, and was not acting ill. Treated with Tylenol, Motrin and Benadryl. Keflex was added on 4/23/00. Much improved on 4/24/00.

VAERS ID:152931 (history)  Vaccinated:2000-04-21
Age:1.4  Onset:2000-04-21, Days after vaccination: 0
Gender:Male  Submitted:2000-04-23, Days after onset: 2
Location:Iowa  Entered:2000-06-08, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0008CB3IMLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R04442SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0925J0SCRL
Administered by: Private     Purchased by: 0
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Within 10 minutes of vax, the child developed raised hives with erythemic area encompassing hives. Right cheek and right side of forehead.

VAERS ID:153031 (history)  Vaccinated:2000-04-21
Age:0.5  Onset:2000-04-21, Days after vaccination: 0
Gender:Male  Submitted:2000-05-02, Days after onset: 11
Location:Michigan  Entered:2000-06-08, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levsin
Current Illness: otitis media
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0008BA1IM 
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0964J1IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P065721IM 
Administered by: Private     Purchased by: Private
Symptoms: Aggression, Injection site erythema
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (narrow)
Write-up: The pt experienced local erythema, temp of 98 degrees, inconsolable for 2 hours. Treated with children''s Motrin.

VAERS ID:153119 (history)  Vaccinated:2000-04-21
Age:2.7  Onset:2000-04-22, Days after vaccination: 1
Gender:Male  Submitted:2000-04-24, Days after onset: 2
Location:Illinois  Entered:2000-06-08, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD / Connaught # 250611, Tylenol
Current Illness: URI
Preexisting Conditions: chronic otitis media
Diagnostic Lab Data: NONE
CDC Split Type: IL00024
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES7387AA3IMLA
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA457AA3IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt developed erythema at injection site with minimal swelling and pruritis. Normal movement of arm and fingers, no pain. Treated with Atarax, cool compresses and Motrin.

VAERS ID:153246 (history)  Vaccinated:2000-04-21
Age:7.0  Onset:2000-04-21, Days after vaccination: 0
Gender:Male  Submitted:2000-04-21, Days after onset: 0
Location:Ohio  Entered:2000-06-08, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1686J1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hives all over with mild wheezing. Treated with 25mg po Benadryl.

VAERS ID:153265 (history)  Vaccinated:2000-04-21
Age:4.0  Onset:2000-04-23, Days after vaccination: 2
Gender:Male  Submitted:2000-04-24, Days after onset: 1
Location:Unknown  Entered:2000-06-08, Days after submission: 45
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 BEECHAM917AZ4IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1087J1SCRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The pt experienced swelling around injection site.

VAERS ID:153347 (history)  Vaccinated:2000-04-21
Age:0.2  Onset:2000-04-22, Days after vaccination: 1
Gender:Male  Submitted:2000-05-05, Days after onset: 13
Location:Maine  Entered:2000-06-09, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: Mild URI
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAMA919A20IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0461J0IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P073920IMRL
Administered by: Private     Purchased by: Public
Symptoms: Coma
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)
Write-up: Unresponsive episode 26 hours, post vax. Event lasted about 15 minutes.

VAERS ID:153507 (history)  Vaccinated:2000-04-21
Age:33.0  Onset:2000-04-27, Days after vaccination: 6
Gender:Female  Submitted:2000-05-01, Days after onset: 4
Location:Unknown  Entered:2000-06-09, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The pt received the MMR vaccine on 4/21/00. The pt developed a hard area around the injection site post 6 days. The pt made doctors appointment, site of vaccine injection was 4 x 5 cm area of erythema and induration. No fluctuance or axilla. Doctor determined pt developed cellulitis post vax. Pt refused IV antibiotics, prescription written for oral Cephalexin.

VAERS ID:153661 (history)  Vaccinated:2000-04-21
Age:57.0  Onset:2000-04-22, Days after vaccination: 1
Gender:Female  Submitted:2000-04-28, Days after onset: 6
Location:Texas  Entered:2000-06-09, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prempro
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: 00TX056
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0989580 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Injection site erythema, Injection site oedema
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt developed swelling in right deltoid, fever and a large red area covered all of the deltoid. Was unable to raise arm. Monday, swelling decreasing and redness clearing. Pt can move arm today (4/25) and swelling is almost gone.

VAERS ID:153858 (history)  Vaccinated:2000-04-21
Age:2.0  Onset:2000-06-08, Days after vaccination: 48
Gender:Male  Submitted:2000-06-08, Days after onset: 0
Location:Colorado  Entered:2000-06-09, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1845H0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: Pt received vax, father exhibited chicken pox.

VAERS ID:153873 (history)  Vaccinated:2000-04-21
Age:0.3  Onset:2000-04-21, Days after vaccination: 0
Gender:Female  Submitted:2000-04-26, Days after onset: 5
Location:Georgia  Entered:2000-06-09, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Having soft, formed green stools.
Preexisting Conditions: PPS (Peripheral Pulmonic Stenosis)
Diagnostic Lab Data:
CDC Split Type: GA00052
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM917A21IMLL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3068A21IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0287K1IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P082321 RL
Administered by: Public     Purchased by: Unknown
Symptoms: Agitation, Screaming
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)
Write-up: Pt started screaming approximately three hours after vax, the infant was inconsolable and after screaming for three hours, she was taken to ER with normal PE.

VAERS ID:154178 (history)  Vaccinated:2000-04-21
Age:61.0  Onset:2000-04-22, Days after vaccination: 1
Gender:Female  Submitted:2000-05-22, Days after onset: 30
Location:Minnesota  Entered:2000-06-14, Days after submission: 23
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: Demerol, Ansaids allergy
Diagnostic Lab Data: BP normal but heart rate was 102.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49881083IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Lethargy, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt complained of feeling lethargic, no energy, achy, malaise, next morning post vax. Later that same day 4/22, she experienced fever and chills. The TD injection site was painful but no swelling, redness or lump. She slep well and woke up feeling fine on 4/23.

VAERS ID:157569 (history)  Vaccinated:2000-04-21
Age:1.5  Onset:2000-04-22, Days after vaccination: 1
Gender:Female  Submitted:2000-05-03, Days after onset: 11
Location:Virginia  Entered:2000-07-20, Days after submission: 78
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin w/Clavulanate
Current Illness: ear infection
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ4682227APR2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES  IM 
Administered by: Private     Purchased by: Other
Symptoms: Agitation, Condition aggravated, Infection, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: The mother of an 18 month old female reported that her daughter received an injection of Prevnar on 4/21/00. Ten to 14 days prior to immunization, the child developed an ear infection. The infection was initially treated with amoxicillin, then amoxicillin/clavulanate. On 4/22/00, the symptoms of the child''s ear infection worsened. The child became listless, her fever became higher and she cried and held her ear.

VAERS ID:158158 (history)  Vaccinated:2000-04-21
Age:25.0  Onset:2000-05-19, Days after vaccination: 28
Gender:Female  Submitted:2000-07-25, Days after onset: 67
Location:Texas  Entered:2000-07-31, Days after submission: 6
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: atrial septal defect repaired at age 3
Diagnostic Lab Data: CBC, SMAC, ABG, chest x-ray, ANA, HCV, ventilation perfusion scan
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM350A40IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0011AA2IMLA
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Blood pressure decreased, Cough, Dyspnoea, Heart rate increased, Hyperhidrosis, Hypoxia, Pallor, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt developed shortness of breath, extreme fatigue, low blood pressure, episodic low grade fever, hypoxia, quickening of the heart (up to 90), tremors, pale, clamminess, cold, sweating, weakness, and cough. Doc 198136 states the following: Hypersensitivity to environmental allergens, developed food allergies. A follow up report received 8/1/2000 adds: Pt states that symptoms had sudden onset. She was seen that day (5/19/2000) by her physician who ordered several tests all of which were WNL. In late June-early July, she was hospitalized as symptoms worsened. More tests were performed including CXR, echocardiogram and blood tests for oxygen content of her blood. Admitting diagnosis was hypoxia. She consulted with a pulmonary-critical care specialist after discharge from the hospital. Again, all tests were negative or WNL. Pt states she obtained a copy of the package insert from SmithKline and that "all my symptoms are there." She plans follow-up with PCP later this week to discuss this. Currently her health status is slowly improving. Her breathing has become easier and she is able to cook for herself. She continues to sleep a lot and feel fatigued.

VAERS ID:158942 (history)  Vaccinated:2000-04-21
Age:1.4  Onset:2000-04-21, Days after vaccination: 0
Gender:Male  Submitted:2000-04-25, Days after onset: 4
Location:California  Entered:2000-08-16, Days after submission: 113
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: U2000002930
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES0996080 IM 
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Post vax, the pt developed a rash over body a few hours post vax.

VAERS ID:162096 (history)  Vaccinated:2000-04-21
Age:1.5  Onset:2000-04-22, Days after vaccination: 1
Gender:Female  Submitted:2000-06-07, Days after onset: 46
Location:Alabama  Entered:2000-10-10, Days after submission: 125
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ4430125APR2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4670103IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A nurse reported that an 18 month old female received an injection of Acel-Imune on 4/21/00. The next day, she developed an injection site reaction characterized by a 5" area of redness, edema and warmth. The child also developed a fever of 99.8F. She was treated with topical and oral Benadryl. As of 4/24/00, the injection site reaction was "smaller", but the swelling and warmth persisted. This is 1 of 3 pts from this facility who developed an injection site reaction following receipt of 2 different lots of Acel-Imune.

VAERS ID:163387 (history)  Vaccinated:2000-04-21
Age:26.0  Onset:2000-04-24, Days after vaccination: 3
Gender:Female  Submitted:2000-06-21, Days after onset: 58
Location:Washington  Entered:2000-11-14, Days after submission: 146
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: allergy to codeine, erythromycin
Diagnostic Lab Data:
CDC Split Type: 20000185231
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3094A22IMRA
Administered by: Private     Purchased by: Private
Symptoms: Paraesthesia, Skin burning sensation
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: On 4/21/00 the pt experienced a burning sensation down the right arm which was considered by the physician to be persistent paresthesia in an ulnar distribution. The pt was treated with anti-inflammatories. The outcome is resolving. On 4/24/00, the pt experienced pain and tingling sensation in the pt''s fourth and fifth fingers with decreased grip and tenderness, in addition to a burning sensation to the arm/hand. Outcome of this event is ongoing.

VAERS ID:163441 (history)  Vaccinated:2000-04-21
Age:  Onset:0000-00-00
Gender:Female  Submitted:2000-08-23
Location:Vermont  Entered:2000-11-14, Days after submission: 83
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: 20000253481
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3203A43IM 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Subsequent to receiving three doses of Engerix B, the pt was found to be a non-responder. On 04/21/2000, the pt received the fourth dose of Engerix B. She was again found to be a non-responder. As of 08/09/2000, the outcome of the event is unknown.

VAERS ID:166467 (history)  Vaccinated:2000-04-21
Age:48.0  Onset:2000-04-21, Days after vaccination: 0
Gender:Female  Submitted:2000-07-14, Days after onset: 84
Location:Iowa  Entered:2001-03-05, Days after submission: 234
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: HQ8270107JUL2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES  IM 
Administered by: Private     Purchased by: Other
Symptoms: Pruritus, Rash, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt reports she received vaccine on 4/21/2000. Post vaccine she developed rash on her arm. The rash then became generalized; itched and burned. The rash persisted as of 7/6/2000.

VAERS ID:166492 (history)  Vaccinated:2000-04-21
Age:49.0  Onset:2000-04-28, Days after vaccination: 7
Gender:Female  Submitted:2000-07-11, Days after onset: 74
Location:Michigan  Entered:2001-03-05, Days after submission: 237
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: 745216
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4998304 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: A medical assistant reported that a pt received vaccine on 4/21/00, one week later she developed and injection site reaction characterized by large area of redness, swelling.

VAERS ID:167484 (history)  Vaccinated:2000-04-21
Age:14.0  Onset:2000-04-21, Days after vaccination: 0
Gender:Unknown  Submitted:2001-03-07, Days after onset: 320
Location:Virginia  Entered:2001-03-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00042481
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Muscle twitching, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dyskinesia (broad), Dystonia (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Information has been received from a consumer concerning a 14 year old family member who on 4/21/00 was vaccinated with "the final dose" of Hep-B vaccine. "Soon afterwards, the pt experienced arm soreness "deep in the muscle" and twitching. The pt sought unspecified medical attention. Additional information has been requested.

VAERS ID:167630 (history)  Vaccinated:2000-04-21
Age:25.0  Onset:2000-04-21, Days after vaccination: 0
Gender:Female  Submitted:2001-03-07, Days after onset: 320
Location:Georgia  Entered:2001-03-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00100229
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1960J1  
Administered by: Private     Purchased by: Private
Symptoms: Headache, Influenza, Injection site erythema, Injection site pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a health professional concerning a white 25 year old female ophthalmic technician who was vaccinated with a second dose of Hepatitis B vaccine. Subsequently, the patient experienced nausea, vomiting, diarrhea, "possible" fever, and injection site pain and redness of the right arm. The patient told the health care professional "she was not sure if she picked up a flu, or if this was in response to the vaccination." Unspecified medical attention was sought. Upon follow-up the patient received from the health professional, the 2nd dose of hepatitis B vaccine was administered "midday" on 04/21/00 in the right deltoid. Later in the afternoon on 04/21/00, the patient experienced headache in addition to nausea, vomiting, diarrhea, "possible" fever, and injection site pain and redness of the right arm. The reporter indicated that the patient''s experiences resolved on approximately 04/23/00. No additional information is expected.

VAERS ID:167572 (history)  Vaccinated:2000-04-21
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2001-03-15
Location:California  Entered:2001-03-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Pregnancy LMP 4/12/00
Diagnostic Lab Data:
CDC Split Type: WAES00060369
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Abortion, Foetal disorder
SMQs:, Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: Information has been received from a health care professional concerning a 25 year old female who on 4/21/00 was vaccinated with 1 dose of varicella virus vaccine live. Subsequently, the pt learned that she was pregnant; LMP:4/12/00. Follow-up information from the health care professional reported that the pt had a spontaneous abortion. She did not know at what weeks of gestation this occurred. No further information is available. Follow up on 06/29/2001: "Adverse event onset date/time, lot # for vaccine 1 is not provided."

VAERS ID:169042 (history)  Vaccinated:2000-04-21
Age:0.2  Onset:2000-04-21, Days after vaccination: 0
Gender:Female  Submitted:2001-11-20, Days after onset: 578
Location:Unknown  Entered:2001-04-25, Days after submission: 209
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: HQ9759317APR2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES921A20IM 
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0IM 
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES 0IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD. 0  
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Aspiration, Choking, Convulsion, Drooling, Gastrooesophageal reflux disease, Pallor, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a post marketing surveillance study concerning a 2 month old female. On 04/21/00, the infant received Prevnar, Hib, DTaP, Hepatitis B vaccine, IPV. The same day, upon awakening from a nap, she appeared to be choking on saliva. The infant developed pallor for approximately 5 to 10 minutes. She was seen in the ER and was found to have developed a fever of 101.2 degrees. At this visit the infant was diagnosed with fever with possible seizure vs. possible aspiration vs. reflux episode. Parents refused admission preferring to return to the hospital if necessary. These events were considered to be medically important. Choking and fever are expected; pallor is unexpected. As of 04/06/01, both medical monitor and investigator''s assessment of relatedness is unknown. Follow up info received on 11/12/2001 clarified the description of the reported events. On 04/21/2000, while sleeping, the child "turned blue quit breathing, and was shaking, and salivating at the mouth." The child was treated with Tylenol. No personal history of seizure activity was noted. The child has since recovered with no recurrence of similar events following subsequent vaccinations.

VAERS ID:169275 (history)  Vaccinated:2000-04-21
Age:2.0  Onset:2001-04-07, Days after vaccination: 351
Gender:Male  Submitted:1999-04-08, Days after onset: 730
Location:Unknown  Entered:2001-04-30, Days after submission: 753
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: Physical exam
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R06172   
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1711J SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1728J SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Herpes zoster, Viral infection
SMQs:
Write-up: Shingles, 1 year after varivax vaccination.

VAERS ID:169665 (history)  Vaccinated:2000-04-21
Age:80.0  Onset:2000-04-25, Days after vaccination: 4
Gender:Female  Submitted:2001-05-01, Days after onset: 371
Location:New York  Entered:2001-05-10, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: x-ray 2 different times at the hospital.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008179   
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This patient had pain in the area where her shots were administered. Saw own MD - x-rays (2 times). Orthopedic, Cortisone shot - physical therapy.

VAERS ID:172326 (history)  Vaccinated:2000-04-21
Age:52.0  Onset:2000-08-01, Days after vaccination: 102
Gender:Male  Submitted:2001-06-07, Days after onset: 310
Location:Wisconsin  Entered:2001-06-22, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM104A20IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Knee pain in both knees approx. 3 months after last shot of series. Pain is an arthritis-like feeling in knees. (Series of 3 shots) 2nd on 5/19/99 and 3rd on 5/16/00.

VAERS ID:173935 (history)  Vaccinated:2000-04-21
Age:24.0  Onset:2000-04-24, Days after vaccination: 3
Gender:Female  Submitted:2002-10-08, Days after onset: 897
Location:Wisconsin  Entered:2001-08-07, Days after submission: 427
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NKA
Diagnostic Lab Data: Body Temo - 04/24/00 - 99.5 F
CDC Split Type: WAES00070640
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0045J0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site inflammation, Injection site reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a registered nurse concerning a 24 year old female patient with no known allergies who on 04/09/00 was vaccinated in the left deltoid with the first dose of pneumococcal vaccine 23 polyvalent (lot #630097/0045J)/ On 04/24/00, the patient experienced a severe local reaction in the left deltoid region. It was noted that the estimated area was approximately 4-5 cm and warm and firm,but not fluctant. The patient''s temperature was 99.5 degrees fahrenheit and she had been taking Tylenol. On an unspecified date,the patient recovered. Two other patients (WAES numbers 00051264 & 00070168) had similar experiences. No furhter information is available.

VAERS ID:189081 (history)  Vaccinated:2000-04-21
Age:0.2  Onset:2000-04-21, Days after vaccination: 0
Gender:Female  Submitted:2002-08-16, Days after onset: 847
Location:Unknown  Entered:2002-08-20, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC Split Type: HQ3741014AUG2002
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES 0IM 
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0IM 
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES 0IM 
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEUR 0SC 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES 0IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Febrile convulsion
SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Information has been received from an investigator regarding a 2 month old female who received her 1st dose of Prevnar, as well as, DTAP, HbOC, Hep-B and IPV as part of the study, "Post-Marketing Evaluation Of Prevnar Pneumococcal 7-Valent Conjugate Vaccine (CRM197 Protein Conjugate): Safety Of Prevnar Administered Concurrently With Routine Infant Vaccinations At 2, 4, 6, and 12 to 15 Months Of Age" on 4/21/00. That evening, the pt was seen in the ER at 21:30 and a dx of "possible" febrile seizure was made. She recovered. Information has been forwarded to the manufacturers of IPV. Febrile seizure is considered to be an "Other Important Medical Event". The investigator considered this event (febrile seizure expected per USPI) "possibly" related to study vaccine administration. The medical monitor''s assessment was unknown.

VAERS ID:191520 (history)  Vaccinated:2000-04-21
Age:55.0  Onset:2000-10-01, Days after vaccination: 163
Gender:Female  Submitted:2002-12-13, Days after onset: 803
Location:Connecticut  Entered:2002-10-18, Days after submission: 56
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: HRT
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: Sural nerve / gastrocnemius biopsy, 4/16/01: "Necrotizing vesculitls".
CDC Split Type: A0382513A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 2 LA
Administered by: Private     Purchased by: Private
Symptoms: Hypoaesthesia, Neuropathy, Polyarteritis nodosa, Pyrexia, Vasculitis
SMQs:, Peripheral neuropathy (narrow), Interstitial lung disease (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vasculitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This report describes the occurrence of polyarteritis nodosa in a 55 year old female who was vaccinated with Lyme disease vaccine recombinant OspA (LYMErix) for prophylaxis. This report was received from the subject and has not been verified by a physician. The subject''s medical history and concurrent conditions were not reported. Concurrent medications included unspecified hormone replacement therapy which was discontinued in 2001 because of legs. The subject reportedly received LYMErix on 4/27/99, 6/1/99, and 4/21/00. She reported that in October 2000, during a vacation, her legs were aching more than usual. She thought this was due to work self-treated with ibuprofen (Motrin). She stated that in March 2001, she felt lousy and by the end of March had a temperature of 100 to 101 degrees F. At this time, she sought medical attention from her physician. He referred her to a rheumatologist. The rheumatologist reportedly made a diagnosis of poyarteritis nodosa. The subject was reportedly hospitalized for 10 days in April 2001. She states that currently her feet and the sides of her legs to the knees were numb. She stated that her right hand and two fingers were numb and tingling with pins and needles sensations. She stated that her feet feel as though she is walking on rocks. *F/UP report on l2/17/02: Add''l info was received from the rheumatologist on 12/2/02. The rheumatologist confirmed that the onset of polyarteritis nodose was March 01, 11 mts post-immunization. Sural? nerve and gastroenemius biopsy performed on 4/26/01 demonstrated necrotizing vasculitis. The rheumatologist stated that the subject developed neuropathy 2ndary to polyarteritis nodosa. The rheumatologist considered the polyartoritis nodosa to be life-threatening, and to polyarteritis nodosa. The rheumatologist considered the polyartoritis nodosa to be life-threatening, and to have resulted in severe or permanent disability. The relationship of the event to LYMErix was not spec''d. As of 11/15/02, the polyarteritis nodosa had improved, the neuropath

VAERS ID:200810 (history)  Vaccinated:2000-04-21
Age:4.0  Onset:2003-03-30, Days after vaccination: 1073
Gender:Male  Submitted:2003-04-01, Days after onset: 2
Location:Florida  Entered:2003-04-02, 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: Well child
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURR06172SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1713J0SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0083K0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Pharyngitis, Rash, Rash papular, Rhinitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Office visit for spreading rash on face, neck , arms, and legs. erythemic papules, vesicular, not pustular with increased number since morning. No involvement or lower trunk or groin. Cold symptoms for 48 hours. Symptomatic care, Benadryl in office.

VAERS ID:215497 (history)  Vaccinated:2000-04-21
Age:59.0  Onset:0000-00-00
Gender:Male  Submitted:2004-01-21
Location:Unknown  Entered:2004-01-23, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The patient''s medical history, concurrent conditions and concurrent medications were not reported.
Diagnostic Lab Data: UNK
CDC Split Type: A0493517A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 3UNUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Arthralgia, Arthritis, Autoimmune disorder, Headache, Incorrect dose administered, Influenza like illness, Joint swelling, Lyme disease, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Dementia (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow)
Write-up: This report described the occurrence of Lyme arthritis and/or Lyme disease in a 59 year old male pt who received Lyme disease vaccine recombinant OspA (LYMErix) for prophylaxis. This report was received as part of litigation proceedings, and has not been verified by a physician or other health care professional. This case is VAERS ID 215497. The pt received injections of LYMErix on 4/29/99, in May 1999, received this third injection on an unspecified date and received a fourth injection on 4/21/00 "according to the client." This represents an inappropriate schedule of drug administration, in that only three doses of LYMErix are recommended. On 1/12/04, the pt''s attorney alleged that the pt developed "treatment resistant Lyme arthritis and/or treatment resistant Lyme disease," with symptoms including "right toe pain, joint pain and swelling, and tingling of his hands." The attorney further alleged that the pt suffered pain that was described as "at times debilitating" and which "severely limited his employment options and opportunities." According to the attorney, the pt was under the care of a general practitioner, and received anti-inflammatory and other medications without relief of symptoms. Information from Annual Follow-up report states this adverse event was received through the litigation process. Additional information regarding the event, including outcome information, is being pursued through the litigation process and will be reported if obtained. A treatment of Injuries was received on 21 April 2006. The statement of injuries indicated that the subject suffers and has suffered from the following additional conditions in addition to those already reported Flu like symptoms, tingling of extremities, headaches, possible memory loss and decreased activities of daily life. He additionally suffers from rheumatologic, neurologic and or cognitive impairment of an autoimmune, immune-mediated, or other mechanism, all caused by vaccination with LYMERIX. At the time of reporting, the outcome of the event was not specified. Future expedited VAERS reports for this LYMERIX case shall be referred to KH-IND 5420, which is a change from past reports referencing the voluntarily-revoked license (STN 103757).

VAERS ID:153841 (history)  Vaccinated:2000-04-22
Age:1.5  Onset:2000-04-23, Days after vaccination: 1
Gender:Female  Submitted:2000-06-05, Days after onset: 43
Location:Ohio  Entered:2000-06-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4670103IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.  IMRL
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Injection site erythema, Injection site inflammation, Injection site mass, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Excessive swelling around entire circumference of upper leg, extending down 1/2 of leg, very hot to touch, inflamed and hard. Baby very uncomfortable, no fever, swelling x 10 days, redness x 3 weeks. Treatment soaking and ibuprofen. Follow up 11/01/2000: "Do not have, unable to provide."

VAERS ID:162126 (history)  Vaccinated:2000-04-22
Age:4.0  Onset:2000-04-24, Days after vaccination: 2
Gender:Female  Submitted:2000-06-13, Days after onset: 50
Location:California  Entered:2000-10-10, Days after submission: 119
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ5869415MAY2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4693964IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD. 4IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: April 24, 2000 the child developed an injection site reaction characterized by a 3 inch area of redness, swelling, and pain at the site. The patient recovered. This is 1 of 3 patients from this facility who developed reaction.

VAERS ID:224333 (history)  Vaccinated:2000-04-22
Age:42.0  Onset:2004-04-01, Days after vaccination: 1440
Gender:Male  Submitted:0000-00-00
Location:Illinois  Entered:2004-07-26
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Inconclusive
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 2  
Administered by: Private     Purchased by: Other
Symptoms: Amblyopia, Amnesia, Arthralgia, Arthritis, Back pain, Fatigue, Gastrointestinal disorder, Headache, Myalgia, Paraesthesia, Photosensitivity reaction, Pruritus, Rash, Thinking abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Optic nerve disorders (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Severe arthritis, back aches, headache, muscle aches, chronic fatigue. GI distress. Pain killers (hydrocodone). Follow up per medical record: back pain, numbness of limbs, lack of concentration, memory loss, joint pains, rash, itching, photo sensitivity, blurred vision.

VAERS ID:153516 (history)  Vaccinated:2000-04-23
Age:2.0  Onset:2000-04-24, Days after vaccination: 1
Gender:Female  Submitted:2000-04-29, Days after onset: 5
Location:D.C.  Entered:2000-06-09, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.RO69532IMLA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Periorbital oedema, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Child developed fever to 103.1 (orally) starting approximately 16 hours post vax, with associated periorbital swelling and facial splotchy erythema. Symptoms lasted approximately 24 hours.

VAERS ID:151140 (history)  Vaccinated:2000-04-24
Age:1.5  Onset:2000-04-26, Days after vaccination: 2
Gender:Male  Submitted:2000-04-26, Days after onset: 0
Location:Pennsylvania  Entered:2000-05-01, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712020IMLA
Administered by: Private     Purchased by: Private
Symptoms: Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)
Write-up: Hyporesponsive - mother could not awaken child this morning even when bathing him. No fever or other signs of illness.

VAERS ID:151160 (history)  Vaccinated:2000-04-24
Age:30.0  Onset:2000-04-25, Days after vaccination: 1
Gender:Female  Submitted:2000-04-26, Days after onset: 1
Location:Virginia  Entered:2000-05-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV048B5SC 
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Neck and body aches starting day of vax. Itching, redness and swelling on the site - induration and erythema involves approximately 3 cm above injection and 15 cm below injection.

VAERS ID:151163 (history)  Vaccinated:2000-04-24
Age:1.1  Onset:2000-04-25, Days after vaccination: 1
Gender:Female  Submitted:2000-04-26, Days after onset: 1
Location:Florida  Entered:2000-05-02, 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
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712030IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilation procedure
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: The following morning post vax, noticed site of injection was warm, red, swollen to size of silver dollar.

VAERS ID:151647 (history)  Vaccinated:2000-04-24
Age:50.0  Onset:2000-04-24, Days after vaccination: 0
Gender:Female  Submitted:2000-05-02, Days after onset: 8
Location:Oregon  Entered:2000-05-08, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES00042536
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0750J1IM 
Administered by: Other     Purchased by: Other
Symptoms: Anaphylactic shock, Rash
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Same day post vax, pt developed rash all over and was taken by ambulance to the ER with anaphylactic shock (considered an other medical event). At the time of this report, the pt had not yet been discharged from the ER. Additional information has been requested. Follow up received indicated the pt has recovered. No further information is expected.

VAERS ID:151667 (history)  Vaccinated:2000-04-24
Age:5.0  Onset:2000-05-01, Days after vaccination: 7
Gender:Male  Submitted:2000-05-02, Days after onset: 1
Location:Florida  Entered:2000-05-08, 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: Atarax, Calamine, and Aveeno
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712030IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1462J0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt received vax on 04/24/2000. He came to the office on 05/01/2000 with about 300 lesions.

VAERS ID:151772 (history)  Vaccinated:2000-04-24
Age:1.6  Onset:2000-04-24, Days after vaccination: 0
Gender:Male  Submitted:2000-05-15, Days after onset: 21
Location:Kansas  Entered:2000-05-09, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0173CA3IMLL
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIESUA489AA3IMLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712100IMRL
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hives all over body 4 hours post vax administration. No distress, playful. Seen by physician.

VAERS ID:151804 (history)  Vaccinated:2000-04-24
Age:34.0  Onset:2000-04-28, Days after vaccination: 4
Gender:Male  Submitted:2000-05-02, Days after onset: 4
Location:Alaska  Entered:2000-05-10, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: mildly elevated liver function
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0473SC 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR02341IM 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt developed an onset of joint pain right 1st MTP (metatarsal phalangeal), left heel and both elbows 4 days post vax.

VAERS ID:151846 (history)  Vaccinated:2000-04-24
Age:28.0  Onset:2000-04-25, Days after vaccination: 1
Gender:Male  Submitted:2000-04-27, Days after onset: 2
Location:South Carolina  Entered:2000-05-11, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergy to PCN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0473SCLA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Headache, Injection site erythema, Injection site mass, Myalgia, Rash macular
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt experienced arthralgias, myalgias, headache, started post 4th Anthrax vaccine. Pt also had an 8 1/2 x 12 cm erythematous macula on left upper arm at injection site with a central nodule.

VAERS ID:152105 (history)  Vaccinated:2000-04-24
Age:31.0  Onset:2000-05-04, Days after vaccination: 10
Gender:Female  Submitted:2000-05-16, Days after onset: 12
Location:Wisconsin  Entered:2000-05-19, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Varicella exposure
Diagnostic Lab Data: Deoxyribonucleic acid - results pending, serum varicella zoster - positive, colonoscopy - no lesion found.
CDC Split Type: WAES00051034
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1728J SC 
Administered by: Other     Purchased by: Other
Symptoms: Dehydration, Infection
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad)
Write-up: Information received concerning a female with positive varicella titer, prior to vax, who on 04/20 was in close contact with her son who had wild type chicken pox and a streptococcal A bacterial infection. On 04/24, the pt was vax because of her exposure to chicken pox and the fact that she had no known history of chicken pox. The reporter drew a varicella titer prior to vax which was positive. On 05/04, the reporter stated that the pt developed ''a very severe case of chicken pox and was hospitalized for dehydration. The pt was discharged from the hospital at an unspecified date. The reporter stated that she ''does not believe that the pt''s experience is related to the varicella virus vax, but rather to her close exposure to her son with wild-type varicella.'' On 05/08 the pt was seen in the physician''s office and 3 specimens were collected for PCR analysis, however results are pending. Further information has been requested.

VAERS ID:152206 (history)  Vaccinated:2000-04-24
Age:4.0  Onset:2000-04-25, Days after vaccination: 1
Gender:Male  Submitted:2000-05-13, Days after onset: 18
Location:California  Entered:2000-05-22, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1715J1SC 
Administered by: Private     Purchased by: Private
Symptoms: Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)
Write-up: Pt developed bells palsy, treated with steroids and is improving. Occurred approximately 24 hours post MMR vax.

VAERS ID:152321 (history)  Vaccinated:2000-04-24
Age:32.0  Onset:2000-04-25, Days after vaccination: 1
Gender:Male  Submitted:2000-05-17, Days after onset: 22
Location:Kansas  Entered:2000-05-24, 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: PCN and hay fever allergies.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0470SCRA
Administered by: Military     Purchased by: Military
Symptoms: Influenza like illness, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Onset beginning 1 day post vax. Flu-like symptoms 2-3 days post vax. Swelling in arm 4-5 days and localized approximately 5 inches across.

VAERS ID:152575 (history)  Vaccinated:2000-04-24
Age:24.0  Onset:2000-04-24, Days after vaccination: 0
Gender:Female  Submitted:2000-05-23, Days after onset: 29
Location:New Mexico  Entered:2000-06-01, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Dizziness, Fatigue, Hypoaesthesia, Influenza like illness, Pharyngitis, Rhinitis
SMQs:, Agranulocytosis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt experienced a woozy feeling, dizziness, cold and flu type symptoms, extreme fatigue, parts of extremities falling asleep, joints sore.

VAERS ID:152899 (history)  Vaccinated:2000-04-24
Age:22.0  Onset:2000-04-25, Days after vaccination: 1
Gender:Female  Submitted:2000-04-29, Days after onset: 4
Location:Oregon  Entered:2000-06-08, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho-Cyclen
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3203A41IMLA
Administered by: Other     Purchased by: Other
Symptoms: Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)
Write-up: 8 hours post vax, the pt vomited 4 or more times. Now feeling shaky, no headache or chest tightness. She feels different than when she had food poisoning-very little nausea or warning of vomiting.

VAERS ID:152958 (history)  Vaccinated:2000-04-24
Age:4.5  Onset:2000-04-25, Days after vaccination: 1
Gender:Male  Submitted:2000-04-26, Days after onset: 1
Location:Maryland  Entered:2000-06-08, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rhinocort, Ritalin, Flovent, Serevent, Singulair, albuterol, Prevacid, Tegretol, Claritin
Current Illness:
Preexisting Conditions: Asthma, seizure disorder, food allergy, reflux
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0045CA1IMLA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R009830SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1087J/1301J1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Fatigue, Injection site erythema, Injection site oedema, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: On 4/25/00, pt was very tired. In the afternoon, he started to wheeze and had one seizure. Mother noticed area of injections were red and swollen.

VAERS ID:153014 (history)  Vaccinated:2000-04-24
Age:1.5  Onset:2000-04-24, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:California  Entered:2000-06-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CA000041
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4693973IMLA
Administered by: Public     Purchased by: Public
Symptoms: Feeling hot, Injection site erythema, Injection site mass, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Post vax, that night, pt''s mother noted reddened left upper arm. It progressively became swollen, indurated and warm to touch and increasing in size. Pt was brought in 4/26/00 to get evaluated. PO antibiotics prescribed and told to elevate arm and observe for exacerbation or return to clinic.

VAERS ID:153147 (history)  Vaccinated:2000-04-24
Age:0.7  Onset:2000-04-24, Days after vaccination: 0
Gender:Female  Submitted:2000-04-25, Days after onset: 1
Location:Iowa  Entered:2000-06-08, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: IA00011
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM920A21IMLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P06571SCRL
Administered by: Public     Purchased by: Other
Symptoms: Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Temperature 100 on the evening of 4/25/00. Woke up the next morning with red, approximately 1cm sized spots. On 4/25/00 to doctor and had full blown hives at 13:45.

VAERS ID:153235 (history)  Vaccinated:2000-04-24
Age:17.0  Onset:2000-04-24, Days after vaccination: 0
Gender:Female  Submitted:2000-04-25, Days after onset: 1
Location:North Carolina  Entered:2000-06-08, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: NC00030
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3201A20IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1284J1SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU00012AA5IMLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Hypotension, Malaise, Panic reaction, Paraesthesia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Pt in for college IZ and post vax, she fell into mom''s arms and laid on the floor. The RN was at pt''s side. BP 120/68. EMS was called and when they arrived, pt stated she felt better. EMS sent away. Pt states complaints of tingling over body, headache, and "feeling sick". EMS recalled by PMD. BP 80/48, lying down and 90/50 sitting up per RN. EMS arrived, pt transported to ER. Doctor feels pt had a panic attack and not a reaction from shots per RN.

VAERS ID:153262 (history)  Vaccinated:2000-04-24
Age:2.3  Onset:2000-04-25, Days after vaccination: 1
Gender:Male  Submitted:2000-04-26, Days after onset: 1
Location:Wisconsin  Entered:2000-06-08, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: perisstent subcutaneous nodule ;UNK. DTAP; ;1.70;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4670103IM 
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site mass, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The area of erythema measuring 13 cm long and 11 cm wide over the right deltoid with accompanying warmth and mild induration. Benadryl recommended with close follow up for progression.

VAERS ID:153278 (history)  Vaccinated:2000-04-24
Age:14.0  Onset:2000-04-24, Days after vaccination: 0
Gender:Male  Submitted:2000-04-27, Days after onset: 3
Location:New York  Entered:2000-06-08, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mantoux
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3201A20IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0072AA5IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The pt experienced a large reddened area around the injection site, which was approximately 1 inch long and 1 1/2 inch wide, warm to the touch, no complaint of fever, no complaint of pain at site on arm.

VAERS ID:153280 (history)  Vaccinated:2000-04-24
Age:18.0  Onset:2000-04-24, Days after vaccination: 0
Gender:Female  Submitted:2000-04-30, Days after onset: 6
Location:California  Entered:2000-06-09, Days after submission: 40
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
HEPA: HEP A (VAQTA)MERCK & CO. INC.0723J0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Asthenia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: The pt felt weak and fainted for 2-3 seconds. This happened 1-2 minutes after immunization. The pt took 1-2 sips of Coke and recovered.

VAERS ID:153302 (history)  Vaccinated:2000-04-24
Age:33.0  Onset:2000-04-26, Days after vaccination: 2
Gender:Female  Submitted:2000-04-27, Days after onset: 1
Location:Oklahoma  Entered:2000-06-09, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: sinus problems
Preexisting Conditions: seasonal allergies
Diagnostic Lab Data: NONE
CDC Split Type: OK0016
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM651A0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site vesicles
SMQs:
Write-up: The pt experienced fluid filled blisters on left deltoid one inch from injection site, noticed two days post vax after removing bandaid.

VAERS ID:153374 (history)  Vaccinated:2000-04-24
Age:17.0  Onset:2000-04-25, Days after vaccination: 1
Gender:Male  Submitted:2000-04-26, Days after onset: 1
Location:South Carolina  Entered:2000-06-09, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: SC00028
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3135C90IMRA
Administered by: Public     Purchased by: Public
Symptoms: Disorientation, Dizziness, Eye disorder, Muscle twitching
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: One days after receiving vaccines, the pt began experiencing episodes of disorientation with dizziness. Still has a day later. Also left eye began twitching on day after the vax, still continues with interruption. No other symptoms. All symptoms resolved in 4 days.

VAERS ID:153430 (history)  Vaccinated:2000-04-24
Age:1.0  Onset:2000-05-04, Days after vaccination: 10
Gender:Female  Submitted:2000-05-04, Days after onset: 0
Location:Massachusetts  Entered:2000-06-09, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Poly-Vi-Sol with Fe, nystatin cream
Current Illness: NONE
Preexisting Conditions: Milk soy intolerance
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST. 2SC 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1084J0SC 
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Symptoms of rash and fever. Plan to observe.

VAERS ID:153582 (history)  Vaccinated:2000-04-24
Age:5.1  Onset:2000-04-25, Days after vaccination: 1
Gender:Male  Submitted:2000-04-28, Days after onset: 3
Location:Massachusetts  Entered:2000-06-09, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0040CA2IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Left arm red - not tender and swollen; complaint of itchy, local measures.

VAERS ID:153642 (history)  Vaccinated:2000-04-24
Age:1.5  Onset:2000-04-25, Days after vaccination: 1
Gender:Female  Submitted:2000-05-10, Days after onset: 15
Location:Oklahoma  Entered:2000-06-09, Days after submission: 30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: OK0022
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAMA919A23IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Immunization site swollen and red.

VAERS ID:153653 (history)  Vaccinated:2000-04-24
Age:0.3  Onset:2000-05-10, Days after vaccination: 16
Gender:Female  Submitted:2000-05-15, Days after onset: 5
Location:Oklahoma  Entered:2000-06-09, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: OK0018
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM922A21IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0050K2IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R03972SCLL
Administered by: Public     Purchased by: Public
Symptoms: Musculoskeletal stiffness, Somnolence, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Hypoglycaemia (broad)
Write-up: Eyes half closed as going to sleep, arms held straight out and then she shook all over from the waist up.

VAERS ID:153660 (history)  Vaccinated:2000-04-24
Age:13.0  Onset:2000-04-25, Days after vaccination: 1
Gender:Female  Submitted:2000-04-28, Days after onset: 3
Location:Texas  Entered:2000-06-09, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flovent, Proventil, Beconase
Current Illness: NONE
Preexisting Conditions: Congenital heart defect, mega colon, Petot Mal seizure
Diagnostic Lab Data:
CDC Split Type: 00TX057
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1524J0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1009J0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Localized erythematous area 6cmx6cm on right arm at site of injection.

VAERS ID:153663 (history)  Vaccinated:2000-04-24
Age:3.0  Onset:2000-04-25, Days after vaccination: 1
Gender:Female  Submitted:2000-05-15, Days after onset: 20
Location:Pennsylvania  Entered:2000-06-09, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ceftin
Current Illness: Sinusitis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS512453A3IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site warmth, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 4" redness directly below injection site deep red to purple, warm & tender to touch. Skin peeling away.

VAERS ID:153892 (history)  Vaccinated:2000-04-24
Age:62.0  Onset:2000-04-24, Days after vaccination: 0
Gender:Female  Submitted:2000-05-01, Days after onset: 7
Location:Unknown  Entered:2000-06-09, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0154AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Joint swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt states was fine day of vax, 4/25/2000, had joint achiness and Wed 4/26/2000 all over with swelling from shoulder to elbow on left arm, 4/27/00 6" area of hives on left upper arm, states no SOB, wheeze or dysphagia.

VAERS ID:154195 (history)  Vaccinated:2000-04-24
Age:3.0  Onset:2000-05-09, Days after vaccination: 15
Gender:Male  Submitted:2000-06-06, Days after onset: 28
Location:Washington  Entered:2000-06-14, 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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0039CA1IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P12311 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0125J0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Pain
SMQs:
Write-up: Pt experienced right leg pain in back of knee after 2 weeks.

VAERS ID:157194 (history)  Vaccinated:2000-04-24
Age:18.0  Onset:2000-04-24, Days after vaccination: 0
Gender:Female  Submitted:2000-09-25, Days after onset: 154
Location:Utah  Entered:2000-07-18, Days after submission: 69
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho-tri-cyclene, PPD
Current Illness: severe sunburn
Preexisting Conditions: exercise induced asthma, ovarian cysts.
Diagnostic Lab Data: Throat culture-positive for strep
CDC Split Type: UT002712
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3082A40IMLA
Administered by: Other     Purchased by: Private
Symptoms: Bacterial infection, Diarrhoea, Headache, Hypoaesthesia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Nausea, Pain, Pharyngolaryngeal pain
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Headache, body aches, sore throat, skin aches, nausea, diarrhea, arm aching where injection was given, numbness in arm, rubber arm. Localized redness/swelling.

VAERS ID:173013 (history)  Vaccinated:2000-04-24
Age:0.3  Onset:2000-04-28, Days after vaccination: 4
Gender:Male  Submitted:2001-06-25, Days after onset: 423
Location:Virginia  Entered:2001-07-06, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES01061488
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIESUO039CA IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.633575/1478J IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R0235  RL
Administered by: Private     Purchased by: Other
Symptoms: Dyskinesia, Encephalopathy, Microcephaly, Myoclonus
SMQs:, Neuroleptic malignant syndrome (broad), Congenital, familial and genetic disorders (narrow), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 4/28/00, 4 days post vaccination, pt experienced greater than 20 myoclonic jerks during the day and was hospitalized for 1 day. There was no cyanosis. It was reported that the patient had microcephalopathy and status encephalopathy. Subsequently the pt recovered. The microcephalopathy and status encephalopathy were considered significant medical events. The reporting investigator felt that the events were possibly related to study therapy. No further info is available.

VAERS ID:216913 (history)  Vaccinated:2000-04-24
Age:67.0  Onset:0000-00-00
Gender:Male  Submitted:2004-02-05
Location:Unknown  Entered:2004-02-26, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin;
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: A0407629A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 2  
Administered by: Other     Purchased by: Other
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: This report describes the occurrence of arthritis in a 67 year old male who was vaccinated with Lyme disease vaccine recombinant OspA (Lymerix) for prophylaxis. This report was received from the subject and has not been verified by a physician or other healthcare professional. The subject''s medical history and concurrent conditions were not reported. The subject''s concurrent medications reportedly included unspecified vitamins. The subject reported that he received injections of Lymerix on 04/24/1999, 05/24/1999 and 04/24/00. He stated, "within a relatively short time thereafter, I was stricken with, what was diagnosed as ''Arthritis''." The subject was reportedly seen by a "specialist", who prescribed celecoxib (Celebrex). The "specialist" reportedly wanted to perform hip replacement surgery. The subject stated that, after two weeks of celecoxib therapy, "my condition did improve somewhat (I could walk without dragging my foot)." The subject also reported that he began taking "the maximum daily amount" of glucosamine and chondroitin (Osteo Biflex), which "seemed to help". The subject stated, "Despite all of that, I have, nevertheless, not been able to play tennis or do other things that I enjoy. Now, (4) years later [sic], I am finding the helpful effects of Glucosamine Chondroitin diminishing and the Arthritis re-asserting itself."

VAERS ID:232053 (history)  Vaccinated:2000-04-24
Age:1.2  Onset:2004-12-29, Days after vaccination: 1710
Gender:Male  Submitted:2005-01-09, Days after onset: 11
Location:Iowa  Entered:2005-01-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper Respiratory Infection
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1462J0SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug ineffective, Viral infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Clinical varicella.

VAERS ID:273082 (history)  Vaccinated:2000-04-24
Age:1.0  Onset:2007-02-18, Days after vaccination: 2491
Gender:Female  Submitted:2007-02-21, Days after onset: 3
Location:Massachusetts  Entered:2007-02-26, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1355J   
Administered by: Private     Purchased by: Public
Symptoms: Body temperature increased, Pruritus, Skin lesion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 50 Lesions, low grade temp, itchy

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