MedAlerts Home
  Read the MedAlerts Blog Subscribe to the MedAlerts Blog 

Found 544402 cases in entire database

Case Details (Sorted by Vaccination Date)

This is page 1766 out of 5445

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


VAERS ID:157922 (history)  Vaccinated:2000-07-18
Age:5.9  Onset:2000-07-18, Days after vaccination: 0
Gender:Male  Submitted:2000-07-20, Days after onset: 2
Location:New York  Entered:2000-07-25, 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: PPD 0.1ml ID
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0009K2IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0108K1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 2 hours post vax pt started developing small rash (wheels) on the neck and back. Condition gradually increased and progressed to include extremities and face. Pt was treated with diphenhydramine with no relief. Pt taken to the ER.

VAERS ID:157929 (history)  Vaccinated:2000-07-18
Age:2.0  Onset:2000-07-18, Days after vaccination: 0
Gender:Female  Submitted:2000-07-20, Days after onset: 2
Location:Wisconsin  Entered:2000-07-25, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1979J4IMLL
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Approximately 4 hours post vax pt developed pinpoint red rash on chest. Doctor notified and Benadryl given. Rash resolved within 24 hours.

VAERS ID:157999 (history)  Vaccinated:2000-07-18
Age:  Onset:2000-07-18, Days after vaccination: 0
Gender:Unknown  Submitted:2000-07-18, Days after onset: 0
Location:California  Entered:2000-07-27, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM991A2 IMRA
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1615H IMRA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.N0727  RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0120J SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1451J SCRA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Hypersensitivity, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt experienced acute redness of face, itchy rash on arms and legs and one episode of vomiting. On exam, positive urticarial rash on arms and legs mildly on thorax.

VAERS ID:158166 (history)  Vaccinated:2000-07-18
Age:1.8  Onset:2000-07-19, Days after vaccination: 1
Gender:Male  Submitted:2000-07-20, Days after onset: 1
Location:Oregon  Entered:2000-07-31, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4693963IMRL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R06682SCRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712060IMLL
Administered by: Private     Purchased by: Private
Symptoms: Screaming, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Had swelling and fitful crying X 24 hours.

VAERS ID:158184 (history)  Vaccinated:2000-07-18
Age:51.0  Onset:2000-07-19, Days after vaccination: 1
Gender:Female  Submitted:2000-07-19, Days after onset: 0
Location:Michigan  Entered:2000-07-31, Days after submission: 12
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: MI2000053
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0162AA IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site oedema, Injection site warmth, Oedema, Pruritus, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Symptoms started in the middle of the night with swelling, heat and intense itching of the upper arm and of the injection site, from shoulder to 2" above elbow was covered with one large hive. Temp was 98.9. The pt was instructed to take Tylenol and Benadryl.

VAERS ID:158263 (history)  Vaccinated:2000-07-18
Age:5.0  Onset:2000-07-19, Days after vaccination: 1
Gender:Female  Submitted:2000-07-21, Days after onset: 2
Location:Washington  Entered:2000-08-02, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS922A24IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R06913SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0108R1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Red, swollen at site of injection. Required antibiotic treatment.

VAERS ID:158267 (history)  Vaccinated:2000-07-18
Age:59.0  Onset:2000-07-19, Days after vaccination: 1
Gender:Female  Submitted:2000-07-21, Days after onset: 2
Location:California  Entered:2000-08-02, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hypertension, hypercholesterolemia
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)LEDERLE LABORATORIES471039 IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 3.0 cm induration with erythema locally. She also complained of pain for 72 hours, dull constant to left axilla.

VAERS ID:158334 (history)  Vaccinated:2000-07-18
Age:5.0  Onset:2000-07-19, Days after vaccination: 1
Gender:Female  Submitted:2000-07-21, Days after onset: 2
Location:Washington  Entered:2000-08-02, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM922A24IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R069133SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0108K1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The pt experienced redness, swelling at the site of injection requiring antibiotic treatment.

VAERS ID:158503 (history)  Vaccinated:2000-07-18
Age:57.0  Onset:2000-07-18, Days after vaccination: 0
Gender:Female  Submitted:2000-07-20, Days after onset: 2
Location:Texas  Entered:2000-08-07, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 7/20/00 PPD skin test-neg, Diovan
Current Illness: NONE
Preexisting Conditions: Increased BP, allergy to pollen and shellfish
Diagnostic Lab Data:
CDC Split Type: TX00090
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1501J0SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7345AA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Dizziness, Dyspnoea, Eye pain, Feeling hot, Nausea, Skin discolouration, Swelling face
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Post vax, skin became bright bluish-red from head to soles of feet and hot to touch, followed, immediately by dizziness, nausea, abdominal cramps, SOB, eyes burning and lips swelling. Pt took 2 Benadryl capsules and applied icepack to face and felt better within 1 hour of arriving home. Pt stated she arrived home about 5 minutes after leaving health dept.

VAERS ID:158663 (history)  Vaccinated:2000-07-18
Age:  Onset:2000-07-31, Days after vaccination: 13
Gender:Unknown  Submitted:0000-00-00
Location:New York  Entered:2000-08-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV008 SC 
Administered by: Military     Purchased by: Unknown
Symptoms: Oedema, Subcutaneous nodule
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Back of arm swollen, lump under skin.

VAERS ID:159334 (history)  Vaccinated:2000-07-18
Age:24.0  Onset:2000-07-20, Days after vaccination: 2
Gender:Male  Submitted:2000-08-29, Days after onset: 40
Location:Colorado  Entered:2000-08-31, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Mouth Wound
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ8840121JUL2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4998305 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injury, Muscle spasms
SMQs:, Dystonia (broad), Accidents and injuries (narrow), Hostility/aggression (broad)
Write-up: A physician reported that the pt sustained a wound to his mouth from wire mesh on 7/18/00. The pt''s neck was wrenched when he sustained the mouth injury. The mouth wound required stitches and the pt''s mouth was kept open for 2 hours. He received TD Absorbed, Ultrafined, ibuprofen and penicillin for wound management. The pt''s last dose of TD was administered 6 or 7 years ago. On 7/20/00, 36 hours, post vax, the pt developed intermittent muscle spasms of the right upper jaw. He was seen in the ER and treated with diazepam. He was reportedly recovering as of 8/9/00.

VAERS ID:159824 (history)  Vaccinated:2000-07-18
Age:16.0  Onset:2000-07-18, Days after vaccination: 0
Gender:Male  Submitted:2000-07-19, Days after onset: 1
Location:Georgia  Entered:2000-09-15, Days after submission: 58
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to PCN
Diagnostic Lab Data: NONE
CDC Split Type: GA00086
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1821J0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Stomach discomfort, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Same day post vax, the pt began to have an upset stomach. The next day, the pt vomited at noon and again about 2 pm. He also had a low grade fever.

VAERS ID:160123 (history)  Vaccinated:2000-07-18
Age:29.0  Onset:2000-07-20, Days after vaccination: 2
Gender:Female  Submitted:2000-09-18, Days after onset: 60
Location:Florida  Entered:2000-09-26, 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: Levoxyl, Ortho-cept
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3094A21IMRA
Administered by: Private     Purchased by: Private
Symptoms: Lymphadenopathy
SMQs:
Write-up: Noted enlarged lymph node about right clavicle on anterior chest wall of a few days duration following hep vaccine #2 and again after hep vaccine #3.

VAERS ID:161414 (history)  Vaccinated:2000-07-18
Age:7.0  Onset:2000-07-19, Days after vaccination: 1
Gender:Male  Submitted:2000-08-17, Days after onset: 29
Location:Pennsylvania  Entered:2000-10-05, Days after submission: 49
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unspecified antibiotic
Current Illness: Sickle cell pain crisis
Preexisting Conditions: Sickle cell disease NOS
Diagnostic Lab Data: UNK
CDC Split Type: HQ8990126JUL2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES 0IM 
Administered by: Private     Purchased by: Other
Symptoms: Joint swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: A physician reported that a 7 year old male received an injection of Prevnar on 7/18/00. He was hospitalized due to sickle cell pain crisis and was receiving antibiotic therapy at the time of immunization. One day, post vax, the child developed swelling of an elbow. He recovered.

VAERS ID:160446 (history)  Vaccinated:2000-07-18
Age:0.5  Onset:0000-00-00
Gender:Female  Submitted:2000-09-28
Location:West Virginia  Entered:2000-10-11, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0161CA1IM 
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1064J1IM 
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES591313A1IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R01011  
Administered by: Public     Purchased by: Other
Symptoms: Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Child had "tremors", post vax. Saw MD who felt tremors were caused by DTAP given. I am unable to reach child''s mother X 2 and has not returned my call.

VAERS ID:161057 (history)  Vaccinated:2000-07-18
Age:0.1  Onset:2000-07-18, Days after vaccination: 0
Gender:Female  Submitted:2000-10-20, Days after onset: 94
Location:Alabama  Entered:2000-10-30, Days after submission: 10
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: Tobrex opth drops
Current Illness: Upper respiratory illness
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, blood culture, Chem 7-all nml IGM, organic acids
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3199C91IMLL
Administered by: Private     Purchased by: Private
Symptoms: Coma, Convulsion, Dyskinesia, Herpes simplex, Hypotonia, Salivary hypersecretion
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Mom and baby were out shopping and mom noted baby to be limp and then she started jerking and foaming at the mouth. She was unresponsive. Dx''d with Herpes Simplex. Diagnosed with seizure episode

VAERS ID:163492 (history)  Vaccinated:2000-07-18
Age:28.0  Onset:2000-08-08, Days after vaccination: 21
Gender:Female  Submitted:2000-08-09, Days after onset: 1
Location:Idaho  Entered:2000-12-08, Days after submission: 121
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control
Current Illness: NONE
Preexisting Conditions: PCN allergy
Diagnostic Lab Data: NONE
CDC Split Type: ID00051
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3231B61IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R03461SCRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0173K0SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0154AA1IMRA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Joint stiffness, Joint swelling, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt complained of pain in hips, wrists, ankles, fingers stiff and swollen, thigh muscle aching and skin hurts. Had to come home from work on 08/08/2000 with possible low grade temperature.

VAERS ID:166898 (history)  Vaccinated:2000-07-18
Age:2.0  Onset:2000-07-18, Days after vaccination: 0
Gender:Female  Submitted:2001-02-26, Days after onset: 223
Location:New York  Entered:2001-03-12, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamins,
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAMA941A23IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0299K1IMRL
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site reaction, Injection site swelling, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt''s mother reports post vaccine that evening injection site red 3" diameter, by morning the swelling encompassed the entire front of left leg.

VAERS ID:167110 (history)  Vaccinated:2000-07-18
Age:5.0  Onset:2000-08-12, Days after vaccination: 25
Gender:Female  Submitted:2001-02-23, Days after onset: 195
Location:Mississippi  Entered:2001-03-16, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 15 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: #3: either lederle Lot # 466-925 or Aventis Lot # U0045BA.
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CT Scan, Labs, Spinal Tap, MRI, Chest X-ray- all Nml. EEG - capture the 8 min. seizure.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU0045BA IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PFIZER/WYETHP04731   
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1326J SC 
Administered by: Other     Purchased by: Other
Symptoms: Convulsion, Encephalopathy, Epilepsy, Hypoxia, Loss of consciousness, Pyrexia, Urinary incontinence, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Respiratory failure (broad)
Write-up: On 08/07/00, days after vaccinations, the patient began running a very high fever (105+). The fever finally was controlled on 08/10 or 08/11. On 08/12, she had a seizure. She was taken to the ER, placed on O2 and given Ativan; duration was about 45 minutes. This patient''s history was totally remarkable prior to this event. She had tolerated all prior immunizations well, with no obvious reactions. After sleeping post-ictally for about 4 hours, she was transferred to a hospital. She was placed under the care of a pediatric neurologist. Her second seizure occurred almost exactly 24 hours after the first one; eight hours later she had a series of 3-4 seizures back to back. She was given a loading of Dilantin IV of that time and followed up with maintenance doses every 12 hours. She went another day with no seizures, but they began a three day span where she had 10-20 per day. Her liver was chewing up the Dilantin fast. Free levels would not remain in the therapeutic range. The third day, in the afternoon, she began having seizures in serial fashion. She was then transferred to the PICU and loaded with Phenobarbital, did stop the seizures, she stayed in the PICU for five days. Topomax was added to the AED regimen. She was moved back to the floor for five more days, then discharged home on those three meds. During the 1st three days in the hospital, they did a repeat spinal tap, MRI, and an EEG. The infectious disease unit also got involved in the CSF and blood tests, sending out for all sorts of tests. She had a repeat EEG in her room on Thursday (day 5) which captured an 8 minute seizure. Her seizures were classified as complex partial, secondarily generalized, multifocal. She lost consciousness, and did experience tonic-clonic convulsive movements that were observed on both sides; but not simultaneously. During the first several episodes, she also lost bladder control and one time she vomited. She also received Diastat on several occasions to stop the seizures. Sometimes she seemed to respond to it; sometimes not. It is now six and a half months later, she is on her fifth different AED combination, and the seizures remain uncontrolled. She has epilepsy. The 60 day follow up states intractable seizures; AED therapy ongoing but ineffective; surgical evaluation opinion is unanimous in opposition to surgery in the pt''s case. Doc 211184 states that seizures have diminished in frequency from a peak of 45-50 per month during 6 months; of 2001 (march-august) to 15-20 per month from september to the present. Diagnosed with encephalopathy of unknown origin.

VAERS ID:167223 (history)  Vaccinated:2000-07-18
Age:0.2  Onset:2000-07-18, Days after vaccination: 0
Gender:Male  Submitted:2001-03-05, Days after onset: 230
Location:Connecticut  Entered:2001-03-16, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD. 0 LL
Administered by: Private     Purchased by: Private
Symptoms: Anorexia, Crying, Injection site erythema, Injection site mass, Injection site swelling, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad)
Write-up: Immediately, during injection, baby was crying hysterically. When I picked him up he fell asleep instantly (a deep sleep). He would not awaken through walking to car and going into car seat (this is unusual for him). He slept on car ride and also when he was removed and still sleeping, placed on bed. I tried to wake him to breast feed as he was over due to eat. He would not wake up. I tried rousing him several times but I couldn''t get him up until 19:00. This is not usual for him. Still refused to nurse. Finally at 19:30, he nursed but after that cried hysterically. Fell asleep again and slept several more hours. He woke at around midnight again. Next day was awake and alert as usual but had large red and swollen egg type lump at the injection sites. Both done next to each other, so don''t know which caused the problem. Swelling lasted 4 days. Doctor said, before administrating it, that there are zero possible side effects so I didn''t report them to her, immediately, as it would have fallen on deaf ears.

VAERS ID:170866 (history)  Vaccinated:2000-07-18
Age:5.0  Onset:2000-08-01, Days after vaccination: 14
Gender:Male  Submitted:2001-05-30, Days after onset: 302
Location:New York  Entered:2001-06-01, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Temperature 101.6F
CDC Split Type: WAES00110044
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0400K1SCRL
Administered by: Private     Purchased by: Private
Symptoms: Pain, Pyrexia, Rash morbilliform, Tongue ulceration
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 5 year old white male who on 07/18/00 was vaccinated with the 2nd dose of MMRII, in the right thigh. Two to three weeks, post vax, the pt was seen in a physician''s office, after having developed a disseminated measles-type rash. It was noted that the pt had a fine rash over both arms. The reporter also noted that the pt develo9ped an increased temperature of 101.6F, bilateral leg pain and an ulcer on the tip and left side of the tongue. The pt received treatment with fluids, acetaminophen (Tylenol) and ibuprofen (Motrin). On an unspecified date, the pt recovered. No further information is expected.

VAERS ID:171610 (history)  Vaccinated:2000-07-18
Age:1.5  Onset:2000-07-27, Days after vaccination: 9
Gender:Female  Submitted:2001-05-15, Days after onset: 292
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WAES00072583
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Rash pustular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: On 07/27/2000 the patient developed redness and 3 pustules at the injection site. The physician had not been contacted at the time of the report. Additional information has been requested.

VAERS ID:171629 (history)  Vaccinated:2000-07-18
Age:25.0  Onset:2000-08-02, Days after vaccination: 15
Gender:Female  Submitted:2001-05-15, Days after onset: 286
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WAES00080780
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.6315241012J0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site swelling, Injection site vesicles, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: On 08/02/2000 the patient developed a blister with swelling at the injection site. On 08/04/2000 the patient experienced a fever of 102F. The patient took Tylenol and the fever resolved in 2 days. It was reported that the injection site blister persisted. Follow up information from a physician reported that on 08/04/2000 "conservative management" was suggested to the patient. The patient did not return for follow up since that time. No further information is expected.

VAERS ID:174005 (history)  Vaccinated:2000-07-18
Age:37.0  Onset:2000-07-18, Days after vaccination: 0
Gender:Female  Submitted:2001-07-30, Days after onset: 377
Location:Unknown  Entered:2001-08-07, 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: WAES00071771
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1217J IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Injection site reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: The night of vaccination, the pt experienced hives. The next day the reaction worsened and the pt developed a local deltoid reaction and arthralgias. The pt sought medical attention and was rx with Claritin and a 9 day taper of Prednisone was started. The pt did not require hospitalization. The pt''s symptoms persisted. Additional information has been requested. This is a consolidation of two reports concerning the same pt.

VAERS ID:175062 (history)  Vaccinated:2000-07-18
Age:  Onset:0000-00-00
Gender:Male  Submitted:2000-08-17
Location:New Hampshire  Entered:2001-09-05, Days after submission: 384
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ9958417AUG2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)PFIZER/WYETH468484 IM 
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Injection site erythema, Injection site pain, Injection site reaction, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Post vax pt developed an injection site reaction characterized by redness, warmth, and pain. He was seen by MD who made a diagnosis of cellulitis and prescribed dicloxacillin. The pt recovered. This is 1 of 2 pts from this facility who developed cellulitis following receipt of Pnu-Imune 23 lot 468-484.

VAERS ID:187172 (history)  Vaccinated:2000-07-18
Age:0.8  Onset:2000-07-18, Days after vaccination: 0
Gender:Female  Submitted:2002-03-07, Days after onset: 597
Location:Pennsylvania  Entered:2002-07-02, Days after submission: 116
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unk
Current Illness: Unk
Preexisting Conditions: Unk
Diagnostic Lab Data: Unk
CDC Split Type: HQ1208806MAR2002
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES471202 IM 
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: A pediatrician reported that, over a year ago, a 9 month old female received a dose of Prevnar on 18 JUL 2000. That same day the child experienced vomiting, diarrhea, irritability and a low grade temperature which lasted three days. The child recovered.

VAERS ID:160503 (history)  Vaccinated:2000-07-18
Age:  Onset:2000-07-19, Days after vaccination: 1
Gender:Female  Submitted:2000-10-09, Days after onset: 82
Location:Foreign  Entered:2000-10-12, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Paracetamol
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 20000293191
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM  IM 
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER  SC 
Administered by: Other     Purchased by: Other
Symptoms: Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: On 7/19/00, the pt developed a petechial rash. The pt was hospitalized. The most recent information received on 10/4/00 reports the outcome of the pt as recovered. No other details were given and further information will not be available.

VAERS ID:160523 (history)  Vaccinated:2000-07-18
Age:  Onset:2000-07-19, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Foreign  Entered:2000-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Paracetamol
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC Split Type: HQ2052811OCT2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS  IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER48695   
Administered by: Other     Purchased by: Other
Symptoms: Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: On 7/19/00, the pt developed a petechial rash and was hospitalized. The pt recovered. Petechiae is unexpected per the Investigator Brochure.

VAERS ID:160700 (history)  Vaccinated:2000-07-18
Age:  Onset:2000-07-19, Days after vaccination: 1
Gender:Female  Submitted:2000-10-13, Days after onset: 86
Location:Foreign  Entered:2000-10-18, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Paracetamol
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U2000007330
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Other     Purchased by: Other
Symptoms: Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: "It was reported that a girl (date of birth and age not stated) was vaccinated on 7/18/00 and 1 day, post vax, she presented with a petechial rash. She was hospitalized and recovered. Duration of the symptoms was not specified. Further information is not expected. Case is closed."

VAERS ID:183907 (history)  Vaccinated:2000-07-18
Age:60.0  Onset:2000-07-20, Days after vaccination: 2
Gender:Female  Submitted:2002-04-23, Days after onset: 642
Location:Foreign  Entered:2002-04-25, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Haloperidol
Current Illness: UNK
Preexisting Conditions: Ankle fracture, Cholecystectomy
Diagnostic Lab Data: Mild disturbed EEG following excess of slow activity;
CDC Split Type: B0264871A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Other     Purchased by: Other
Symptoms: Apathy, Cognitive disorder, Dizziness, Faecal incontinence, Hypoacusis, Laboratory test abnormal, Nausea, Urinary incontinence
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (broad)
Write-up: This report describes the occurrence of a rapid cognitive deterioration (differential diagnoses of Lewy body disease, Creutzfeld Jacob disease or rapidly progressive Alzheimer dementia) in a 60 year old female patient receiving Havrix (hepatitis A vaccine). On 18 June 2001, a booster dose of Havrix was given. On 02 June 2001, 2 days after vaccination, this patient developed a rapidly progressive cognitive deterioration with initial symptoms or sensation of dizziness and nausea for which she was treated rather unsuccessfully with Celestone. She became increasingly apathetic and absent. She was disoriented and bradyphrenic and may be somewhat less steady. On 30 June 2001, her husband came back from a travel and he found his wife ill and noticed that the house was less well kept than usual, however no changes in her behavior, nor in her independence. On 17 July 2001, she pretended having given a phone call which she actually did not do. From then on, her husband noticed that she became increasingly apathetic and absent. He also got the impression that she was having some hearing loss. On 08 August 2001, she was seen by an ENT specialist and she was found to have an abnormal audiogram. Subsequently, she was referred to a neurologist. On clinical examination she was found to be bradyphrenic, apathetic, disoriented with hearing loss on the left side. Subsequently, she was hospitalized. During hospitalization, she experienced an incontinence problem. Extensive investigations were performed but no diagnosis could be set. After 7 weeks she was discharged. After discharge, her husband tried to motivate and orientate her by using calendars to teach her the concept of day. However, hearing remained variable diminished as well as her speech. The husband noticed that she had increasing difficulties in finding words. She confabulated and sometimes showed comprehension difficulties. She had one more episode with incontinence. Her husband noticed that she started to improve and particularly that she regained interest. In spite of

VAERS ID:157881 (history)  Vaccinated:2000-07-19
Age:3.0  Onset:2000-07-19, Days after vaccination: 0
Gender:Male  Submitted:2000-07-20, Days after onset: 1
Location:North Carolina  Entered:2000-07-24, 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: otitis media
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712030IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 3 x 2 1/2 inch area of mild erythema at injection site.

VAERS ID:157914 (history)  Vaccinated:2000-07-19
Age:13.0  Onset:2000-07-19, Days after vaccination: 0
Gender:Male  Submitted:2000-07-19, Days after onset: 0
Location:Illinois  Entered:2000-07-25, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: normal BP; normal pulse
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0214J IMRA
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIESU0266BA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Fall, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: A few minutes post vax pt became faint, fell and struck his head in the lobby. Pt had some clonic movements, no urinary or bowel incontinence. Pt awoke alert. Pt was observed for about 30 minutes and sent home.

VAERS ID:157919 (history)  Vaccinated:2000-07-19
Age:1.0  Onset:2000-07-21, Days after vaccination: 2
Gender:Female  Submitted:2000-07-24, Days after onset: 3
Location:New York  Entered:2000-07-25, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N00262SCLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1307J0SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1367J0SCLL
Administered by: Other     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)
Write-up: Pt experienced fever of 103.8 and 20 second seizure 2 days post vax. Pt treated with Motrin and Tylenol. Pt experienced additional seizures and temperature of 103.3 5 days post vax.

VAERS ID:158089 (history)  Vaccinated:2000-07-19
Age:35.0  Onset:2000-07-24, Days after vaccination: 5
Gender:Female  Submitted:2000-07-29, Days after onset: 5
Location:Arkansas  Entered:2000-07-28, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CA of cervix, hysrterectomy. Arthritis of back.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES470536 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Hospitalized for swelling to left upper and given IV antibiotics. Released from hospital 07/24/2000. Hospitalized X 2 days. Treated for cellulitis of injection site. D/C DGX is local reaction to tetanus toxoid w/ necrosis of fat.

VAERS ID:158106 (history)  Vaccinated:2000-07-19
Age:1.5  Onset:2000-07-20, Days after vaccination: 1
Gender:Female  Submitted:2000-07-21, Days after onset: 1
Location:North Carolina  Entered:2000-07-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: OM
Diagnostic Lab Data: NONE
CDC Split Type: NC00045
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4705253IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS601063A3IMRL
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Rash maculo-papular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 8cm X 5cm splotchy, erythema, mostly medial to injection site of DTAP.

VAERS ID:158176 (history)  Vaccinated:2000-07-19
Age:0.2  Onset:2000-07-19, Days after vaccination: 0
Gender:Female  Submitted:2000-07-20, Days after onset: 1
Location:Indiana  Entered:2000-07-31, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM916A20IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0652K0IMLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R050620 LL
Administered by: Public     Purchased by: Other
Symptoms: Hypothermia, Injection site warmth, Night sweats, Oliguria, Somnolence, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tumour lysis syndrome (broad)
Write-up: At 14:00 feeding, post vax, the pt has vomited curdled milk after every feeding (large amount). Mother feeding both breast milk and formula. Infant wants to eat, but vomits. She is urinating smaller amounts but no darker. Last BM on 7/18/00, no diarrhea. Temperature is 96.9 (axillary). She is not acting her usual self. Halfway sleepy, injection site warmer and has night sweating but no redness. Mother had an allergy to yeast when she was in middle school and had to be desensitized before she took Hep-B vaccine. Mother had called MD and he instructed her to only give Pedialyte for 24 hours. Thinks it might be a "bug". On 7/21, still not keeping anything down except Pedialyte. Suppository RX started. Unable to keep formula, no temperature or diarrhea. No increase in redness or warmness at injection sites.

VAERS ID:158192 (history)  Vaccinated:2000-07-19
Age:69.0  Onset:2000-07-19, Days after vaccination: 0
Gender:Male  Submitted:2000-07-28, Days after onset: 9
Location:Florida  Entered:2000-08-01, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Coronary artery disease, chronic obstructive pulmonary disease, and history of chronic sinusitis
Diagnostic Lab Data:
CDC Split Type: WAES00072090
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Pneumonia
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Information has been received from a healthcare facility concerning a 69 year old male pt who on 7/19/00 was vaccinated. On 7/19/00, the pt developed redness and swelling at the injection site. On approximately 7/22/00, the pt experienced shortness of breath and was admitted to the hospital on 7/24/2000 with a dx of pneumonia. Additional information has been requested.

VAERS ID:158230 (history)  Vaccinated:2000-07-19
Age:0.3  Onset:2000-07-21, Days after vaccination: 2
Gender:Male  Submitted:2000-07-21, Days after onset: 0
Location:Washington  Entered:2000-08-01, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM922A24IMLL
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: On 7/21/00, mom noticed swollen, red, tender area on left knee below injection site.

VAERS ID:158233 (history)  Vaccinated:2000-07-19
Age:22.0  Onset:2000-07-19, Days after vaccination: 0
Gender:Female  Submitted:2000-07-24, Days after onset: 5
Location:Washington  Entered:2000-08-01, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to Amoxicillin, codeine, Ceclor, asthma, hay fever
Diagnostic Lab Data: O2 sats-100%
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P0739 SC 
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESEJN194A0SC 
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.R0178 IM 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR1059 PO 
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Sensory disturbance
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Hypersensitivity (broad)
Write-up: 45 minutes post vax, the pt began the sensation of swollen lips and periorbital edema and the sensation of difficulty breathing. Symptoms gradually diminished but still has subtle facial erythema 5 days later.

VAERS ID:158266 (history)  Vaccinated:2000-07-19
Age:0.9  Onset:2000-07-19, Days after vaccination: 0
Gender:Male  Submitted:2000-07-27, Days after onset: 8
Location:Missouri  Entered:2000-08-02, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0039AA2IMLA
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1477J1IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R02362 LL
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Roseola, Viral infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Same day post vax, the pt developed fever of 105. Treated at home with Tylenol. Taken to physician on 7/20/00 and dx with viral illness. Developed rash after 5 days. Fever lasted for approximately 5 days. Physician was notified and dx as roseola.

VAERS ID:158270 (history)  Vaccinated:2000-07-19
Age:4.0  Onset:2000-07-20, Days after vaccination: 1
Gender:Male  Submitted:2000-07-24, Days after onset: 4
Location:Washington  Entered:2000-08-02, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM921A24IMLA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R02353 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.092651SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Swelling and redness on left upper arm measuring 14/5 cm by 9 cm.

VAERS ID:158595 (history)  Vaccinated:2000-07-19
Age:24.0  Onset:2000-07-20, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:2000-08-08
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: Completely deaf
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM  IM 
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES  IM 
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUA260AA SC 
Administered by: 0     Purchased by: 0
Symptoms: Dizziness, Hyperhidrosis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Pt had sweating, vomiting and dizziness.

VAERS ID:158608 (history)  Vaccinated:2000-07-19
Age:1.3  Onset:2000-07-20, Days after vaccination: 1
Gender:Female  Submitted:2000-07-21, Days after onset: 1
Location:Georgia  Entered:2000-08-08, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: GA00081
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM922A23IMLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site mass, 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 an area the size of a fifty cent piece that was red, swollen, firm and warm to the touch. Pt is bearing weight without difficulty and is extremely active. Does not appear to be in any distress. Mom was instructed to use cool compress and Tylenol.

VAERS ID:158637 (history)  Vaccinated:2000-07-19
Age:2.0  Onset:2000-07-20, Days after vaccination: 1
Gender:Female  Submitted:2000-07-27, Days after onset: 7
Location:Illinois  Entered:2000-08-08, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hep B vaccine - SKB 7/19
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES2988 IM 
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS3024 IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.2991 SC 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.2995 SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.3031 SC 
Administered by: Private     Purchased by: Other
Symptoms: Lethargy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: The same day of the vax, the pt experienced a fever of 104. The following morning the fever had dropped to 100.4. The pt also experienced lethargy.

VAERS ID:158685 (history)  Vaccinated:2000-07-19
Age:5.0  Onset:2000-07-22, Days after vaccination: 3
Gender:Male  Submitted:2000-07-31, Days after onset: 9
Location:Montana  Entered:2000-08-09, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: serum amylase, cbc - wnl
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM922A24IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R0235L3SC 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1712J1SC 
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Parotitis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hypersensitivity (broad)
Write-up: 4 days post vax, the pt experienced parotitis on the right side. The pt also experienced a fever and redness of the cheek.

VAERS ID:158754 (history)  Vaccinated:2000-07-19
Age:1.5  Onset:2000-07-19, Days after vaccination: 0
Gender:Female  Submitted:2000-08-02, Days after onset: 14
Location:California  Entered:2000-08-14, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: eczema
Diagnostic Lab Data: CBC, sed. rate-both nml
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712190IMLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Same day post vax, the pt developed urticaria which worsened through the night prompting office visit the following morning. Exam showed urticaria, significant, but otherwise normal. Treated with Atarax.

VAERS ID:158891 (history)  Vaccinated:2000-07-19
Age:1.3  Onset:2000-07-28, Days after vaccination: 9
Gender:Male  Submitted:2000-08-07, Days after onset: 10
Location:Pennsylvania  Entered:2000-08-16, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Children''s Tylenol
Current Illness: Viral URI
Preexisting Conditions:
Diagnostic Lab Data: CXR-nml, blood ox-neg,
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1787J IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1275J0SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES471221 IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0091K SCRL
Administered by: Private     Purchased by: Other
Symptoms: Cough, Febrile convulsion, Nasal congestion, Otitis media
SMQs:, Anaphylactic reaction (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Taken to ER for febrile seizure. Had cough and congestion for a few days. Seizure lasted 4-5 minutes and received albuterol en route to ER. Dx''d with ear infection and treated with amoxicillin.

VAERS ID:158986 (history)  Vaccinated:2000-07-19
Age:1.0  Onset:2000-07-28, Days after vaccination: 9
Gender:Male  Submitted:2000-08-17, Days after onset: 20
Location:Maryland  Entered:2000-08-18, 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: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0154K2IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1031J2SCLL
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Rash, Somnolence
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow)
Write-up: 9 days post vax, the pt developed a fever of 102 which continued over 7/29/00. The pt slept allot and then the fever resolved on 7/30/00. The following day, the pt developed a patch of bumps over the belly, back and hands, feet, and legs.

VAERS ID:159086 (history)  Vaccinated:2000-07-19
Age:1.2  Onset:2000-07-21, Days after vaccination: 2
Gender:Male  Submitted:2000-08-09, Days after onset: 19
Location:Colorado  Entered:2000-08-23, Days after submission: 14
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:
Current Illness: slight cough
Preexisting Conditions: NONE
Diagnostic Lab Data: CT scan, LP, blood culture, urine culture-all neg
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1658J0SCLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1082K0SCRL
Administered by: Private     Purchased by: 0
Symptoms: Convulsion, Pneumonia aspiration, Sinusitis
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Prolonged seizure over 60 minutes in duration (staring, jerky body movements) received 6 ml of Valium, phenobarbitol, and other anticonvulsants in ER. Received breathing tube, stomach tube, catheter, antibiotics, and anticonvulsants in pediatric ICU. Also diagnosed with sinussitis and aspiration pneumonia.

VAERS ID:159549 (history)  Vaccinated:2000-07-19
Age:18.0  Onset:2000-07-25, Days after vaccination: 6
Gender:Male  Submitted:2000-08-09, Days after onset: 15
Location:Hawaii  Entered:2000-09-11, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1860J0SCRA
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis, Injection site hypersensitivity, Pain, Rash pruritic, Rash vesicular, Upper respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Developed itchy rash 6 days post vax in same area of shot with body ache, URI symptoms. Two days later, he developed other lesions, papuli with surrounding erythema and eventual ulcer in center of trunk, chest, and back. Prescribed medication for possible cellulitis.

VAERS ID:159770 (history)  Vaccinated:2000-07-19
Age:0.6  Onset:2000-08-18, Days after vaccination: 30
Gender:Male  Submitted:2000-09-08, Days after onset: 21
Location:New York  Entered:2000-09-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4676732IMRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712280IMLL
Administered by: Private     Purchased by: Private
Symptoms: Abnormal sleep-related event, Insomnia, Irritability
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: The pt experienced irritability and fussiness at night, won''t sleep lying down. Up several times at night.

VAERS ID:160070 (history)  Vaccinated:2000-07-19
Age:0.3  Onset:2000-07-20, Days after vaccination: 1
Gender:Female  Submitted:2000-09-06, Days after onset: 48
Location:Texas  Entered:2000-09-25, Days after submission: 19
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: TX00121
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (CERTIVA)NORTH AMERICAN VACCINESD0081IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1237H1IMLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R06181SCRL
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: One day, post vax, pt developed a rash on her face and legs of little, fine bumps. The rash on her face began to disappear after 1 week.

VAERS ID:160134 (history)  Vaccinated:2000-07-19
Age:43.0  Onset:2000-08-03, Days after vaccination: 15
Gender:Female  Submitted:2000-09-12, Days after onset: 40
Location:Washington  Entered:2000-09-26, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.0504J0SC 
Administered by: Other     Purchased by: Public
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: On 8/3/00 pt phoned with a complaint of swelling at ankles, knees and wrists. Pt saw PMD on 8/8/00 and at that time, swelling was resolving. Condition continued to improve and eventually resolved.

VAERS ID:161413 (history)  Vaccinated:2000-07-19
Age:0.3  Onset:2000-07-20, Days after vaccination: 1
Gender:Male  Submitted:2000-09-19, Days after onset: 61
Location:Maryland  Entered:2000-10-05, Days after submission: 16
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: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ8914824JUL2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4726531IM 
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS4684871IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R13451IM 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4716490IMRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site pain, Injection site reaction, Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: A physician reported that a 4 month old male received Prevnar, Acel-Imune, Hib-Titer, and IPV (Aventis Pasteur SA) vaccines on 7/19/00. The next morning, he developed an injection site reaction characterized by tenderness, a mass, and petechiae at the site of Prevnar administration. The petechiae extended down the length of his right leg. The infant was seen by the physician.

VAERS ID:161504 (history)  Vaccinated:2000-07-19
Age:0.3  Onset:2000-07-19, Days after vaccination: 0
Gender:Female  Submitted:2000-08-15, Days after onset: 27
Location:Georgia  Entered:2000-10-05, Days after submission: 51
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: heat rash
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ8880524JUL2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM922A21IM 
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0295K1IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P099721IM 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4696920IM 
Administered by: Private     Purchased by: Private
Symptoms: Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Following the vax, the pt became very sleepy. She was still sleepy on the following day. Additional information received from the vaccine provider indicated that the infant also received Infanrix, Pedvaxhib, and IPV.

VAERS ID:160456 (history)  Vaccinated:2000-07-19
Age:18.0  Onset:2000-07-19, Days after vaccination: 0
Gender:Female  Submitted:2000-08-25, Days after onset: 37
Location:Tennessee  Entered:2000-10-11, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergies: PCN, Ceclor; History of chickenpox disease
Diagnostic Lab Data: Pt reported negative varicella titer prior to vaccine.
CDC Split Type: TN00039
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1694J0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site haemorrhage, Injection site pain, Injection site rash, Injection site swelling, Laboratory test abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt reports large area of swelling, bruising, some rash and extreme pain in area of injection. Painful for approx. 2 weeks. Described by pt as an area approx. 6" in diameter. Still a small area of discoloration on 8/24/2000.

VAERS ID:160758 (history)  Vaccinated:2000-07-19
Age:0.3  Onset:2000-07-19, Days after vaccination: 0
Gender:Female  Submitted:2000-10-05, Days after onset: 78
Location:Illinois  Entered:2000-10-20, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0278CA1IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0300K1IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R12501SCRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4716490IMRL
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea haemorrhagic, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)
Write-up: The pt experienced bloody diarrhea and a fever of 102.2 following the Prevnar vaccination on the same day. No treatment received. The symptoms resolved spontaneously.

VAERS ID:160838 (history)  Vaccinated:2000-07-19
Age:44.0  Onset:2000-07-20, Days after vaccination: 1
Gender:Female  Submitted:2000-10-18, Days after onset: 90
Location:Florida  Entered:2000-10-24, 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: Zoloft, Synthroid, Ultram, Soma
Current Illness:
Preexisting Conditions: Fibromyalgia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (NO BRAND NAME)MICHIGAN DEPT PUB HLTHRV1621IMLA
Administered by: Public     Purchased by: Public
Symptoms: Conjunctivitis, Erythema multiforme, Headache, Malaise, Pyrexia, Rash, Stevens-Johnson syndrome, Vasculitis
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vasculitis (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow)
Write-up: Post second dose on July 19, 2000 within 24 hours, she started to develop symptoms that were characterized as fever, malaise, headaches, conjunctivitis of her left eye and a rash that progressively involved her entire body. Her symptoms were relentless and did not abate and for this reason on July 28th, 2000, she went to ER and was evaluated and found a generalized rash to be present. The clinical diagnosis of erythema multiforme was given with possible vasculitis. At that point in time, she was started on Solu-Medrol and Levaquin. This apparently induced some remission of her symptoms, however, the symptoms came back after the effects of the Corticosteroid wore off. Her symptoms were severe enough on July 31,2000, for her to go back to ER. At that point in time, she was rechecked at another facility with rash, headaches and fever. She was again diagnosed as having erythema multiforme and at that point in time, she was discharged to her family. She returned to the ER on August 5, 2000. At that point in time, her symptoms returned. She complained of rash located on her whole body and the fever was no longer present. At that point in time, she was given Solu-Medrol again and was advised to follow up with her personal doctor. On Aug 15, 2000, she was evaluated and found to have a clinical picture consistent with Stevens-Johnson syndrome. At that, point in time, she was referred to an allergist and was advised to stop all medications. In that interim of time, essentially the last two and a half weeks, her symptoms have gradually subsided but not completely with still scars present over areas where the rash was present.

VAERS ID:161834 (history)  Vaccinated:2000-07-19
Age:1.0  Onset:2000-07-19, Days after vaccination: 0
Gender:Male  Submitted:2000-11-01, Days after onset: 105
Location:Indiana  Entered:2000-11-14, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712030IMLL
Administered by: Private     Purchased by: Private
Symptoms: Decreased appetite, Fatigue, Listless, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad)
Write-up: The pt developed a fever approximately 4-5 hours post vax. The pt became listless. The fever went as high as 102. He had a poor appetite and drank very little. By the following day, the fever had resolved, but the pt still had a poor appetite and was tired.

VAERS ID:163006 (history)  Vaccinated:2000-07-19
Age:45.0  Onset:2000-07-21, Days after vaccination: 2
Gender:Male  Submitted:2000-11-25, Days after onset: 127
Location:Unknown  Entered:2000-12-04, 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
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM230B90IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: 2 days post vaccination, the pt experienced 2 weeks of severe joint pains, muscle aches, headache. Was unable to work for approximately 2 weeks.

VAERS ID:165029 (history)  Vaccinated:2000-07-19
Age:1.3  Onset:2000-07-28, Days after vaccination: 9
Gender:Male  Submitted:2000-12-06, Days after onset: 131
Location:Pennsylvania  Entered:2001-01-22, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: Viral upper respiratory infection
Preexisting Conditions: URI viral NOS
Diagnostic Lab Data: X-ray of chest-nml; Blood culture-neg
CDC Split Type: HQ3509010NOV2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1787J IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1275J0SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES471221 IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0091K SCRL
Administered by: Other     Purchased by: Other
Symptoms: Cough, Febrile convulsion, Nasal congestion, Otitis media
SMQs:, Anaphylactic reaction (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: This report concerns a 15 month old male who received Prevnar, Comvax, Varivax and MMRII vaccines on 7/19/00. On 7/26/00, the child developed a cough and congestion. On 7/28/00, he experienced a febrile seizure which lasted for 4 to 5 minutes. ER services was called and the child was treated with albuterol. He was seen in an ER and dx''d with an ear infection. The child was treated with amoxicillin.

VAERS ID:166139 (history)  Vaccinated:2000-07-19
Age:0.3  Onset:2000-08-27, Days after vaccination: 39
Gender:Female  Submitted:2001-02-21, Days after onset: 178
Location:Unknown  Entered:2001-02-26, Days after submission: 5
Life Threatening? No
Died? Yes
   Date died: 2000-08-27
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Gastroesophageal reflux disease (The child experienced a life-threatening event due to GERD at 12 days of age.
Diagnostic Lab Data: NONE
CDC Split Type: HQ7326116FEB2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM961A20IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0427K1IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS4701400IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R066840 LA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4725420IMRL
Administered by: 0     Purchased by: 0
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)
Write-up: Information has been received from an investigator concerning a 3 month old female who received her 1st injection of Prevnar, Hib-Titer, Infanrix and IPV vaccines and her 2nd injection of Recombivax-HB vaccine on 7/19/00, as part of a study trial. On 8/27/00, the child died due to sudden infant death syndrome. Both the investigator and the medical monitor agree that this event was not related to vaccine administration.

VAERS ID:166475 (history)  Vaccinated:2000-07-19
Age:  Onset:0000-00-00
Gender:Unknown  Submitted:2000-08-04
Location:New York  Entered:2001-03-05, Days after submission: 213
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: HQ9290301AUG2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4998127 IM 
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: A nurse reported pt received vaccine on 7/19/200 and subsequently developed an injection site reaction characterized by redness, festering, swelling and pain.

VAERS ID:167160 (history)  Vaccinated:2000-07-19
Age:1.3  Onset:2000-07-19, Days after vaccination: 0
Gender:Male  Submitted:2001-03-08, Days after onset: 232
Location:Pennsylvania  Entered:2001-03-19, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES591453A3IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0405K0SCLA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712280IMRL
Administered by: Private     Purchased by: Other
Symptoms: Autism, Diarrhoea, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Fever and diarrhea, lasting several hours. Treated with Tylenol, per recommended dose. Pt dx''d as being Autistic (2/6/01).

VAERS ID:168448 (history)  Vaccinated:2000-07-19
Age:4.0  Onset:2000-08-07, Days after vaccination: 19
Gender:Male  Submitted:2001-02-27, Days after onset: 204
Location:Oklahoma  Entered:2001-04-10, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: WBC-4,800; Hgb 12.6; Platelets-9,000 on 8/9/00; on 8/18/00 platelets-468,000
CDC Split Type: OK0111
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0278BA0IMLA
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0290K IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM622B0IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R044520SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1504J0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Contusion, Haemoptysis, Leukopenia, Lymphadenopathy, Mouth ulceration, Petechiae, Thrombocytopenia
SMQs:, Severe cutaneous adverse reactions (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (narrow), Hypersensitivity (broad)
Write-up: Complained of petechial bruises. Saw doctor on 8/9/00, 2 days, post vax, with bruises on legs, sores in mouth, blood on lips in the AM for 2 days. No recent illness or tick or insect bites. Swelling 1+ at inguinal nodes and 2+ at axillary nodes; bruises and petechia. Treated with Prelone. On 8/22/00, phone call from mom. She wants to stop sibling from receiving IZ''s based on what happened with this son and advised her to speak with the doctor about the advantages and disadvantages and she said she would consider this and call back.

VAERS ID:168702 (history)  Vaccinated:2000-07-19
Age:52.0  Onset:0000-00-00
Gender:Male  Submitted:2001-02-22
Location:Texas  Entered:2001-04-13, Days after submission: 49
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: CBC, Diff, ESR, RAST
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM585A1 IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R1433 SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0266BA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: The pt experienced urticaria 2 weeks post vax. Has had chronic urticaria since then.

VAERS ID:170132 (history)  Vaccinated:2000-07-19
Age:0.2  Onset:2000-07-21, Days after vaccination: 2
Gender:Male  Submitted:2001-05-15, Days after onset: 298
Location:Florida  Entered:2001-05-23, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 17 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EEGs - abn, MRI - normal, metabolic or infectious disease.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM902A20IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1245J IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R05060IMRL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712110IMRL
Administered by: Private     Purchased by: Public
Symptoms: Convulsion, Dyskinesia, Electroencephalogram abnormal, Infantile spasms, Microcephaly, Neurodevelopmental disorder, Staring
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Congenital, familial and genetic disorders (narrow), Convulsions (narrow), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Neonatal disorders (narrow), Generalised convulsive seizures following immunisation (narrow)
Write-up: One day post vax, the pt began to have episodes of jerking then of jerking and staring. These were brief occurring 2-3 times a day. Over the next several weeks, the episodes became more frequent. He required hospitalization for seizure control and was diagnosed with infantile massive spasms. He has since become severely developmentally delayed and microcephalic. He is on medication but his seizures are not controlled.

VAERS ID:170383 (history)  Vaccinated:2000-07-19
Age:1.6  Onset:2000-07-21, Days after vaccination: 2
Gender:Female  Submitted:2001-05-20, Days after onset: 303
Location:Maryland  Entered:2001-05-30, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ;PREVNAR;1;3;In Sibling
Other Medications: Nystatin for fungal infections, cortisone for severe eczema
Current Illness: Rhinitis, severe fungal infection in groin and diaper area
Preexisting Conditions: Allergies to milk, soy; severe eczema; recurrent otitis media X 10, chronic rhinorrhea; chronic allergic rhinitis
Diagnostic Lab Data: Occupational therapy, speech and language therapy, educational evaluations which were abnormal. CBC; Chemistry Panel; urine organic acids test; Lactic acid test; blood mercury; neurology; psychologist; immunologist; allergist; audiology exa
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4693953IMRL
HIBV: HIB (HIBTITER)LEDERLE LABORATORIES4718013IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R125222 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0405K0SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0447K0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal distension, Abnormal behaviour, Aphasia, Asthenia, Diarrhoea, Difficulty in walking, Eczema, Injection site erythema, Injection site pain, Irritability, Nasal congestion, Opisthotonus, Oral intake reduced, Otitis media, Pyrexia, Rash, Screaming, Skin ulcer, Sleep disorder, Somnolence
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Dystonia (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: On 7/20/00, the day after receiving vaccines, pt was very irritable and sleepy. She slept nearly all day and then again at night. Her left leg and left arms were sore and red at the injection sites. On 7/21/00, 2 days, post vax, she developed a fever of 102.3F with it''s highest at 103.1F. She began to cry for prolonged periods up to 8 hours. She also had intermittent screaming for no apparent reason. Over the next week, she continued to be very irritable and did not want to walk or use the stairs which she previously had done. She wanted to be very still and not moved around. She began to wake in the middle of the night several times, screaming and unable to go back to bed. On 7/29/00, her fever returned between 100F-102F (ax). She would still cry and scream and would arch her back and cry harder as if in a tantrum when anyone would try to comfort her. On 7/30/00, she developed a rash over her entire body. She was taken to the doctor and dx''d with a post vaccine varicella rash. She was put on steroids and Benadryl. On this same day, she stopped talking and her appetite continued to diminish. She stopped responding to loud noises or any sounds other than music from her favorite TV shows. She became glued to the TV set and did not want to do anything else. She seemed physically weak and when she did walk, it was an abnormal gait with 1 shoulder up and her head tilted to the side. She then started to put everything in her mouth, as if she were a baby again. She continued with the eczema, nasal congestion and other symptoms. On 9/23/00, she began to have a fever of 102 (ax), severe diarrhea 4-5 times a day, not eating well (drinking only) and began to pull at her left ear. She was rarely making eye contact. We thought her PE tubes may have been clogged and consulted her ENT. Two days later, still with diarrhea she had abdomen distention and she had open sores on her vaginal and rectal areas. She had brown drainage from her left ear. I insisted on taking her back to the doctor and he ordered stool cultures which were

VAERS ID:171605 (history)  Vaccinated:2000-07-19
Age:31.0  Onset:2000-08-01, Days after vaccination: 13
Gender:Female  Submitted:2001-05-15, Days after onset: 287
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac; vitamins;
Current Illness:
Preexisting Conditions: Herpes zoster exposure; Pregnancy (LMP-6/13/00); Per F/U 6/17/02-depression
Diagnostic Lab Data: Serum varicella zoster - negative
CDC Split Type: WAES00072428
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Herpes zoster, Infection transmission via personal contact, Laboratory test abnormal, Viral infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: The patient was vaccinated 07/19/2000. Subsequently, the patient learned that she was pregnant. It was noted that the patient''s husband developed shingles and that the patient was tested for varicella antibodies on 06/29/2000 and the result was negative. On 08/01/2000, it was reported that the patient has developed "3 pock marks that she thinks might have been chickenpox". The patient sought unspecified medical attention. Additional information has been requested. This report is part of the pregnancy registry. F/U 6/17/02: received from an MA reported that on 7/31/01, the pt delivered a healthy, full term male, 8lbs 1oz (39 weeks from LMP) via normal delivery. The pt had no complications during labor/delivery. The infant did not have any feature of congenital varicella zoster syndrome. Additional info has been requested.

VAERS ID:173752 (history)  Vaccinated:2000-07-19
Age:44.0  Onset:2000-07-19, Days after vaccination: 0
Gender:Female  Submitted:2001-07-23, Days after onset: 369
Location:Florida  Entered:2001-08-01, Days after submission: 9
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: WAES01052034
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0903J1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Bone development abnormal, Injection site pain, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from an RN concerning a 44 year old white female who on 7/19/00 was vaccinated with Hep-B. On 7/19/00, the pt experienced sore left arm, 5" below injection site. The pt was instructed to use a warm compress and Tylenol. As of 7/31/00, the pt continued to have pain and soreness in the left arm below the injection site. On 5/12/01, the pt developed severe pain in left arm that included tingling in the digits of the left hand and numbness in the left hand. In follow-up, the RN reported that on 7/12/01, the pt was dx''d with "spurring". The physician felt that the spurring was not related to the vaccination with Hep-B. Upon internal review, spurring was considered to be an "Other Medical Event". No further information is expected.

VAERS ID:174991 (history)  Vaccinated:2000-07-19
Age:65.0  Onset:2000-07-20, Days after vaccination: 1
Gender:Female  Submitted:2000-10-18, Days after onset: 90
Location:Massachusetts  Entered:2001-09-05, Days after submission: 322
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Esgic; Zantac
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ1984410OCT2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4628100IMRA
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURERTD67 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: A healthcare professional reported that a 65 year old female received an injection of Pnu-Imune 23 and Tetanus Toxoid vaccines on 7/19/00. The next day, the pt developed an injection site reaction at the site of the Pnu-Imune 23 administration. She was dx''d with cellulitis and treated with Rocephin and Keflex. This is 1 of 2 pts from this facility who experienced this event following receipt of Pnu-Imune 23, lot 462810.

VAERS ID:180457 (history)  Vaccinated:2000-07-19
Age:1.3  Onset:2001-05-01, Days after vaccination: 286
Gender:Male  Submitted:2002-06-03, Days after onset: 398
Location:Arizona  Entered:2002-01-24, Days after submission: 129
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: Hospitalization; pneumonia NOS; pneumonia respiratory syncytial viral
Diagnostic Lab Data: Computed axial 12/01 results not reported; hearing test 12/01 hearing loss confirmed 100% R side and 60% L side; neurological exam 1/29/02; hearing test 9/01 normal; physical examination 1/29/02; pulse oximetry 2/5/02 never dropped below 94
CDC Split Type: WAES0112USA02878
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0402K0SC 
Administered by: Other     Purchased by: Other
Symptoms: Hearing impaired, Nervous system disorder
SMQs:, Hearing impairment (narrow)
Write-up: Information has been received from a physician concerning a male pt who was vaccinated with a dose of MMRII. Subsequently, the pt experienced loss of hearing. On 12/27/01, the physician reported that the pt was was now 2.5 years old and he was going to be seen for his loss of hearing. The physician was unsure when the pt received his vaccination. Follow-up information from the physician, who is an ear specialist, reported that he saw the pt and has confirmed his hearing loss. The physician has also determined that the pt has some neurological issues and he referred the pt to a neurologist to determine if the neurological issues may have a role in his hearing loss. The physician reported that he does not know if the child''s hearing loss is associated with the MMRII, however the pt''s mother is convinced that the hearing loss was due to the vaccine. Upon internal review, the pt''s loss of hearing and neurological issues were considered to be an "Other Important Medical Event". Additional information has been requested. Follow up info indicated that on 1/29/02, the pt was referred for a neurologic evaluation in the context of his acute progressive hearing loss. At this time, the pt was a 34 month old toddler whose mother noted that as a newborn he had normal hearing, then in September 2001, four momths ago, he was tested and had normal hearing. In December 2001, he was diagnosed wiht a 100% right-sided hearing loss and a 60% left-sided hearing loss. He was recently fitted with hearing aids. About a month ago in December 2001, he had a CT scan done to see if he had an anatomical abnormality to account for his hearing loss. His mother also reported that he had multiple words at one year of age and then had progressive loss of vocabulary between the ages of 15 ad 18 months of age. At this point he was unable to make any choices in his words. His mother believes that he does know some colors and for instance can match colors, but it is really difficult ot assess his knowledge base because of his hearing loss. With the reg

VAERS ID:181464 (history)  Vaccinated:2000-07-19
Age:1.8  Onset:2001-02-15, Days after vaccination: 211
Gender:Male  Submitted:2002-02-13, Days after onset: 363
Location:New York  Entered:2002-02-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: development delay;UNCLASSIFIED/UNSPECIFIED VACCINE;;.00;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI, EEG, blood work, eye exam
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM960A2 IM 
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0787K IM 
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURR1251   
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES472037 IM 
Administered by: Private     Purchased by: Other
Symptoms: Apathy, Neurodevelopmental disorder
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad)
Write-up: The pt hlth appeared to thrive but between 3 and 4 months, the developmental delay started. It''s been a gradual progression but with each round of vaccinations his development delays worsen. By 7 months his smiling, and laughing abated and he seemed to be retreating into his own world. To this date he is not sitting or crawling. The combined effects of the vaccinations have resulted in the pt''s delayments. Pt also had the same vaccines on 9/18/00 and 11/15/00.

VAERS ID:183997 (history)  Vaccinated:2000-07-19
Age:2.0  Onset:2002-04-22, Days after vaccination: 642
Gender:Male  Submitted:2002-04-23, Days after onset: 1
Location:Missouri  Entered:2002-04-30, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cough, conjunctivitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0430K2IM 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4716490IM 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1898J0SC 
Administered by: Private     Purchased by: Other
Symptoms: Rash papular
SMQs:
Write-up: Papulovesicular lesions-scalp/upper back and chest. Prescribed Zovirax.

VAERS ID:214840 (history)  Vaccinated:2000-07-19
Age:4.0  Onset:2003-12-30, Days after vaccination: 1259
Gender:Female  Submitted:2004-01-08, Days after onset: 9
Location:New Mexico  Entered:2004-01-13, 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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Unknown
Symptoms: Infection
SMQs:
Write-up: No adverse events. Child rec verbal dx of "chicken pox" from NP. child has had immunization for varicella. 4 other children from same day care reported s/s of varicella within short period of time. Four all received varicella imm but at different times.

VAERS ID:217543 (history)  Vaccinated:2000-07-19
Age:0.0  Onset:2000-08-02, Days after vaccination: 14
Gender:Male  Submitted:2004-03-08, Days after onset: 1314
Location:Florida  Entered:2004-03-08
Life Threatening? No
Died? Yes
   Date died: 2000-08-10
   Days after onset: 8
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: sinus infection
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (DITANRIX)SMITHKLINE BEECHAM956A21IMRL
HBPV: HIB POLYSACCHARIDE (HIBIMUNE)LEDERLE LABORATORIES4684871IMLL
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER3198A21IMLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER14331IMRL
Administered by: Private     Purchased by: Unknown
Symptoms: Convulsion, Injury, Irritability, Pyrexia, Respiratory arrest, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Respiratory failure (narrow)
Write-up: Within 14 days child had fussiness,fever,vomiting ,Seizures, respiratory arrest. Child passed on August 10,2000.Caregiver charged with infants death. Case being appealed. Per autopsy report, cause of death was shaken baby syndrome.

VAERS ID:217456 (history)  Vaccinated:2000-07-19
Age:52.0  Onset:0000-00-00
Gender:Female  Submitted:2004-03-05
Location:Hawaii  Entered:2004-03-09, 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: Hydrodiuril mg;
Current Illness: NONE
Preexisting Conditions: Fluid retention;
Diagnostic Lab Data: Diagnostic lab (06/27/02): Negative titer RCV; Diagnostic lab (02/18/03): Negative titer results;
CDC Split Type: WAES0301USA01007
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0473K0  
Administered by: Public     Purchased by: Other
Symptoms: Drug ineffective, Weight decreased
SMQs:, Lack of efficacy/effect (narrow), Hyperglycaemia/new onset diabetes mellitus (broad)
Write-up: Information has been received from a RN concerning a 52 year old white non-smoking female pt with no known allergies, no chronic illness and no illness at time of vaccination who on 07/19/00 was vaccinated with a first dose of hepatitis B vaccine recombinant (yeast) in the left deltoid (Lot # 635178/0473K), a second dose on 08/23/00 in the left deltoid (Lot # 635178/0473K), a third dose on 01/26/01 in the right deltoid (Lot # 636021/0839K). On 06/27/02, anti-hbs titer was negative. A booster series was administered-first booster dose on 07/09/02 (Lot # 642096/0069M), a second booster dose on 09/10/02 in the left deltoid (Lot # 642096/0069M), and a third booster dose on 01/13/03 in the left deltoid (Lot # 644078/0940M). On 06/27/02 and 02/18/03, the pt failed to respond to the vaccine (had not converted to immunity after 6 hepatitis B injections). Concomitant therapy included hydrochlorothiazide (manufacturer unknown) indicated for fluid retention. It was also noted that the pt developed a 100lb weight loss in the 3 years that she received injections and that her weight was 300lbs. On 05/21/00 and on 05/05/02 her weight was 200lbs. The outcome was unknown. Additional information has been requested.

VAERS ID:224599 (history)  Vaccinated:2000-07-19
Age:4.0  Onset:2004-07-19, Days after vaccination: 1461
Gender:Male  Submitted:2004-07-21, Days after onset: 2
Location:Texas  Entered:2004-08-02, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Vaccine not specified;;;0;In Sibling
Other Medications: QD X 10 d. Elocon 0.1% ointment
Current Illness: Atopic dermatitis face-body
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURU1272CA4IMRL
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURX05553IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0951N1SCRA
Administered by: Public     Purchased by: Unknown
Symptoms: Feeling hot, Injection site erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 5: mom states right leg is swollen, hot and redness after vaccines. Pt complained of pain x 3 days. Erythema 3x3 around injection site right lateral thigh. 12.5/55g 7.5 ml q8x3days. Keflex 250/ 5 po 7.5 q 8 hours x 10 days. (seen by doctor)

VAERS ID:237755 (history)  Vaccinated:2000-07-19
Age:6.0  Onset:2004-02-26, Days after vaccination: 1317
Gender:Female  Submitted:2005-05-16, Days after onset: 444
Location:Unknown  Entered:2005-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0404USA00423
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 6 year old female who was vaccinated on 07/19/2000 with a dose of varicella virus vaccine live (Oka/Merck). The patient was seen on 02/26/2004 with over 50 pox over his entire body. No fever and no itching was noted. The child was noted to have chickenpox breakthrough. Unspecified medical attention was sought. There was no product quality complaint. The reporter indicated that 19 other patients were vaccinated with a dose of varicella virus vaccine live (Oka/Merck) and developed chickenpox breakthrough/shingles. No further information is expected.

VAERS ID:237920 (history)  Vaccinated:2000-07-19
Age:7.0  Onset:2004-05-06, Days after vaccination: 1387
Gender:Male  Submitted:2005-05-16, Days after onset: 375
Location:Unknown  Entered:2005-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0404USA02615
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection, Skin ulcer
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a health professional concerning a 7 year old male patient who on 07/19/2000 was vaccinated with a dose of varicella virus vaccine live. Subsequently, on approximately 05/06/2004, the patient developed breakthrough chickenpox with less than 50 lesions. Follow up information indicated that there was not a single report of adverse reaction following varicella vaccination. The reporter indicated that 49 other patients developed breakthrough cases of chickenpox. No additional information is expected.

VAERS ID:238680 (history)  Vaccinated:2000-07-19
Age:3.0  Onset:2004-10-03, Days after vaccination: 1537
Gender:Male  Submitted:2005-05-16, Days after onset: 225
Location:Pennsylvania  Entered:2005-06-01, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0410USA00902
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0447K   
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster, Injection site erythema, Injection site pain, Injection site rash, Skin ulcer
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 7 yr old male who on 19Jul00 was vaccinated in the left arm with a dose of varicella virus vaccine live (lot 635981/0447K). On 03Oct04 the pt complained of soreness in his left arm. He had difficulty lifting his arm due to this soreness. On 05Oct04, he developed a rash on his left arm with a dermatomal distribution C 7-8. The rash had an erythematous base and clustered lesions. He was diagnosed with Herpes Zoster. Interventions included acyclovir (Zovirax) oral suspension. It was reported that the pt was recovering and will be seen again in two weeks. There was no product quality complaint involved. The pt''s herpes zoster was considered to be an other important medical event (OMIC) by the reporter. Additional information has been requested.

VAERS ID:239187 (history)  Vaccinated:2000-07-19
Age:1.3  Onset:2005-03-09, Days after vaccination: 1694
Gender:Male  Submitted:2005-05-16, Days after onset: 67
Location:Ohio  Entered:2005-06-07, Days after submission: 22
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: WAES0503USA01880
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Viral infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a physician concerning a 5 year old male who on 07/19/2000 was vaccinated with a dose of varicella virus vaccine live. The physician reported that on 03/09/2005 the pt developed a case of breakthrough characterized by 10-15 pox on his arms, torso, and face after being exposed at school. The pt was noted to be afebrile and had no itching. Unspecified medical attention was sought but no tx was required. At the time of this report, the pt was recovering. Additional information has been requested.

VAERS ID:256374 (history)  Vaccinated:2000-07-19
Age:1.0  Onset:2005-06-29, Days after vaccination: 1806
Gender:Female  Submitted:2006-05-12, Days after onset: 317
Location:Ohio  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WAES0507USA02055
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0087K0 UN
Administered by: Public     Purchased by: Other
Symptoms: Drug ineffective, Viral infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a woman working in a physicians office concerning a 5 year old white female, with no medical history and no allergies, who on 7/19/2000 was vaccinated with a first dose in the right thigh of varicella virus vaccine live (lot 632724/0087K). It was noted that the patient was well at the time of vaccination and there were no adverse events following prior vaccinations. On 6/29/2005 the patient was infected with varicella. It was noted that a full recovery was expected without the need for a follow up. There were no laboratory or diagnostic tests performed. Unspecified medical attention was sought. Additional information is not expected.

VAERS ID:256834 (history)  Vaccinated:2000-07-19
Age:5.0  Onset:2005-03-24, Days after vaccination: 1709
Gender:Female  Submitted:2006-05-12, Days after onset: 413
Location:Unknown  Entered:2006-05-17, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0510USA08942
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow)
Write-up: Varicella Information has been received from a physician and a school nurse concerning an 9 year old female who on 19-JUL-2000 was vaccinated with a dose of varicella virus vaccine live (Oka/Merck). It was also noted that the patient was vaccinated with a dose of measles virus vaccine live (Ender-Edmonston) (+) mumps virus vaccine live (Jeryl-Lynn) (+) rubella virus vaccine live (Wistar RA 27/3) on 13-SEP-1996 and 02-JUN-2000. A school nurse reported to the physician that between 24-MAR-2005 and 09-MAY-2005 the child developed a mild case of break through varicella with less than 50 lesion. Unspecified medical attention was sought. The outcome was recovered. A product quality complain was not involved. No additional information is expected.

VAERS ID:262986 (history)  Vaccinated:2000-07-19
Age:1.2  Onset:2006-09-11, Days after vaccination: 2245
Gender:Female  Submitted:2006-09-12, Days after onset: 1
Location:Georgia  Entered:2006-09-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Unknown
Preexisting Conditions: NONE
Diagnostic Lab Data: diagnosed varicella chicken pox in office
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous, Drug ineffective, Viral infection
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: Patient presented today in office with greater than 50 poxes - over entire body.

VAERS ID:287862 (history)  Vaccinated:2000-07-19
Age:1.0  Onset:2007-08-04, Days after vaccination: 2572
Gender:Female  Submitted:2007-08-10, Days after onset: 6
Location:Maine  Entered:2007-08-10
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: Past history of eczema
Diagnostic Lab Data: Varicella titer - + varicella zoster 8/6/07
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1413T2IMRL
Administered by: Private     Purchased by: Public
Symptoms: Eschar, Rash, Rash pruritic, Varicella zoster virus serology positive
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Mom questions if exposure at YMCA on 7/21/07. Itchy rash started on 8/4/07. No rash. No fever/ill sx. Sites not affected. By 8/6 most lesions have begun to crest over. Scattered 2-3 mm pimples, some with eschar over face/trunk, few on arms. OTC treatments for comfort.

VAERS ID:307340 (history)  Vaccinated:2000-07-19
Age:1.6  Onset:2000-07-21, Days after vaccination: 2
Gender:Female  Submitted:2008-03-18, Days after onset: 2797
Location:Unknown  Entered:2008-03-19, 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: Unknown
Current Illness: Eczema; Metabolic disorder
Preexisting Conditions: Fever; Bilateral otitis media; Otitis media recurrent; Eustachian tube operation
Diagnostic Lab Data: audiogram 11/13/00 normal; electroencephalography 04/06/0 - No Seizure Discharges; diagnostic laboratory 05?/??/01 normal; G-Band test; magnetic resonance 03/14/01 normal; diagnostic laboratory 05?/??/01 - indicated underlying mitochondrial
CDC Split Type: WAES0803USA01188
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 3UNUN
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC. 3UNUN
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEUR 2UNUN
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Audiogram normal, Autism, Autism spectrum disorder, Balance disorder, Biopsy muscle abnormal, Body temperature increased, CSF test abnormal, Childhood disintegrative disorder, Complex partial seizures, Condition aggravated, Convulsion, Crying, Decreased appetite, Depressed level of consciousness, Developmental delay, Diarrhoea, Dysuria, Electroencephalogram abnormal, Encephalopathy, Irritability, Laboratory test, Lethargy, Mastoiditis, Metabolic disorder, Middle ear effusion, Mitochondrial DNA mutation, Nuclear magnetic resonance imaging normal, Opisthotonus, Otitis media, Pica, Pyrexia, Rash, Regressive behaviour, Respiratory tract congestion, Rhinorrhoea, Screaming, Sleep disorder, Tonic convulsion, Unresponsive to stimuli
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Congenital, familial and genetic disorders (narrow), Convulsions (narrow), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Dystonia (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Information has been received a case in litigation concerning an 18 month old female, who at birth weighed 8 lb. 10 oz. with eczema, and a history of bilateral otitis media (subsequent months between July 1999 to January 2000), "PE" tube insertion in January 2000, minor complaints at well visits (unspecified) and fever. Her mother''s pregnancy was complicated by gestational diabetes. Her vaccination history included: hepatitis B vaccine (Recombinant) (manufacturer unspecified), a first dose on 27-DEC-1998 and a second dose on 26-JAN-1999; poliovirus vaccine inactivated (manufacturer unspecified), Hib conj vaccine (OMPC) (manufacturer unspecified), a first dose on 12-MAR-1999, 27-APR-1999, 28-JUN-1999; and diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid (manufacturer unspecified, first dose on 12-MAR-1999, second dose 27-APR-1999, and 28-JUN-1999. According tot he medical records, the child consistently met her developmental milestones during the first eighteen months of her life. The record of an October 5, 1999 visit tot he Pediatric Center notes that the was mimicking sounds, crawling, and sitting. The record of her 12-month pediatric examination notes that she was using the words "Mom" and "Dad", pulling herself up, and cruising. On 19-JUL-2000, at a pediatric visit, it was noted that the child "spoke well", was "active and alert", had normal bowel movements and slept through the night. At the end of the examination she was vaccinated with MMR II. Concomitant therapy included VARIVAX, PEDVAXHIB, diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid and poliovirus vaccine. It was noted that due to the patient''s otitis media, her mother did not allow the patient to receive the standard 12 and 15 month childhood immunizations. Two days after her immunizations (21-JUL-2000), she exhibited a deceased response to stimuli. The mother spoke with the pediatrician, who it was reported told the mother that the patient was having a normal reaction to her immun

VAERS ID:162558 (history)  Vaccinated:2000-07-19
Age:20.0  Onset:2000-07-19, Days after vaccination: 0
Gender:Male  Submitted:2000-11-20, Days after onset: 124
Location:Foreign  Entered:2000-11-24, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U2000008260
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEVX: JAPANESE ENCEPHALITIS (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow)
Write-up: The same day of vax, the pt was hospitalized due to hypertension. Outcome is recovered without sequelae.

VAERS ID:167101 (history)  Vaccinated:2000-07-19
Age:  Onset:2000-07-19, Days after vaccination: 0
Gender:Female  Submitted:2001-03-14, Days after onset: 238
Location:Foreign  Entered:2001-03-16, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 20010063171
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM  IM 
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER  SC 
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER  PO 
Administered by: Other     Purchased by: Other
Symptoms: Depressed level of consciousness, Pallor, Tachycardia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: This report describes the occurrence of a fluctuating consciousness status (stupor) in a girl of unknown age receiving Infanrix. This case was received via the Australian regulatory authorities. On 07/19/00, a dose of Infanrix and Polio Sabin were given. The same day, after vaccination, this girl experienced a fluctuating consciousness status with tachycardia (pulse was rapid but strong) and pallor. Subsequently, she was hospitalized. She was treated with Adrenaline. At a date as yet unknown, she had recovered and was discharged. The reporting physician considered the events to be possibly related to Infanrix- and or Polio Sabin. No additional info will be available.

VAERS ID:158617 (history)  Vaccinated:2000-07-20
Age:0.5  Onset:0000-00-00
Gender:Female  Submitted:2000-07-28
Location:Mississippi  Entered:2000-08-08, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MS00081
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0056FA2IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R06682 RL
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: The pt experienced a light red rash appearing on torso and head approximately 30 minutes post vax.

VAERS ID:158730 (history)  Vaccinated:2000-07-20
Age:1.0  Onset:2000-07-29, Days after vaccination: 9
Gender:Male  Submitted:2000-08-01, Days after onset: 3
Location:Texas  Entered:2000-08-11, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (CERTIVA)NORTH AMERICAN VACCINES40137BA3IM 
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS596353A3IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R12942  
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0260K0SC 
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712172IM 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 10-11 days post vax, pt developed a varicella-like rash and low grade fever.

VAERS ID:158847 (history)  Vaccinated:2000-07-20
Age:0.7  Onset:2000-07-20, Days after vaccination: 0
Gender:Male  Submitted:2000-07-25, Days after onset: 5
Location:Missouri  Entered:2000-08-15, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Vaccine not specified;;;0;In Sibling
Other Medications:
Current Illness: NONE
Preexisting Conditions: colic
Diagnostic Lab Data: NONE
CDC Split Type: MO2000058
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM920A22IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0150K2IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1093J2IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R02362 RL
Administered by: Public     Purchased by: Public
Symptoms: Hypertension, Injection site mass, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypertension (narrow)
Write-up: Same day post vax, the pt developed a temperature of 102 and a knot on left thigh. On 7/21/00, the pt had temperature of 103 and hypertension. Given Tylenol and Motrin. On 7/22/00, the pt''s temperature was 104. He was taken to ER and treated with Tylenol.

VAERS ID:159902 (history)  Vaccinated:2000-07-20
Age:0.5  Onset:2000-07-20, Days after vaccination: 0
Gender:Male  Submitted:2000-07-21, Days after onset: 1
Location:New York  Entered:2000-09-19, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: NY520012
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM917A20IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0964J0IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P02410 LL
Administered by: Public     Purchased by: Public
Symptoms: Crying, Injection site hypersensitivity, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow)
Write-up: 1 1/2 hours after vax adminstered pt screamed x 2 1/2 hours high pitched scream, vomited 2 times. ER advised to give Tylenol, low grade fever of 100 rectally. Redness at site size of dime.

VAERS ID:160146 (history)  Vaccinated:2000-07-20
Age:0.3  Onset:2000-07-24, Days after vaccination: 4
Gender:Male  Submitted:2000-09-20, Days after onset: 58
Location:Montana  Entered:2000-09-27, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM960A21IMLL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0053K1IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R04441SCLL
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4712200IMRL
Administered by: Private     Purchased by: Other
Symptoms: Injection site oedema, Irritability
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Fussy without fever for 5-7 days post vax. Evaluated on 7/24 with significant swelling of thigh at injection site. .

VAERS ID:160803 (history)  Vaccinated:2000-07-20
Age:1.2  Onset:2000-07-28, Days after vaccination: 8
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:2000-10-23
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: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P12142SCLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0103K0SCLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0074K0SCRL
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Onset of fever, 103-104 degrees, 8 days post vax, lasting for 3 days. On the third day she broke out in a rash which lasted an additional 3 days. Given Tylenol for temperature. Rash primarily on trunk. Had appearance of heat rash. Symptoms abated by approximately 08/02/00.

VAERS ID:161047 (history)  Vaccinated:2000-07-20
Age:39.0  Onset:2000-07-20, Days after vaccination: 0
Gender:Female  Submitted:2000-10-20, Days after onset: 92
Location:Louisiana  Entered:2000-10-27, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.R07892 IM 
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Post vax, the pt became lightheaded and faint. Ammonia inhalant given along with ice packs.

VAERS ID:161048 (history)  Vaccinated:2000-07-20
Age:25.0  Onset:2000-07-26, Days after vaccination: 6
Gender:Female  Submitted:2000-10-20, Days after onset: 86
Location:Alabama  Entered:2000-10-27, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.R0178 IM 
Administered by: Other     Purchased by: Other
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Post vax, the pt developed nausea and vomiting.

VAERS ID:176521 (history)  Vaccinated:2000-07-20
Age:41.0  Onset:2001-07-20, Days after vaccination: 365
Gender:Female  Submitted:2001-10-10, Days after onset: 82
Location:New York  Entered:2001-10-22, Days after submission: 12
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: hyperglycemia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY128A20IM 
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Dizziness, Headache, Hypotension, Immune system disorder, Nausea, Photosensitivity reaction, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Pt developed a vise-like headache, nausea, photosensitivity, hypotension, shaking rigors and dizziness. Symptoms persisted for 4 hours. Pt was given Benadryl X 2 doses in office. Dx''d with depressed immune system.

VAERS ID:181020 (history)  Vaccinated:2000-07-20
Age:  Onset:0000-00-00
Gender:Female  Submitted:2000-11-22
Location:Colorado  Entered:2002-02-06, Days after submission: 441
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: U200000600
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0061AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction
SMQs:
Write-up: It was reported that a female pt rec''d TTOX-tetanus Toxoid absorbed vaccination on 7/20/00. Approx 2 days later the pt developed a 3 inch by 31/2 inch local reaction at the site of injection. Further information requested. From additional correspondence rec''d on9/21/00, it was reported. Reviewed no additional information at this time. No further information is expected. This case is closed.

VAERS ID:234646 (history)  Vaccinated:2000-07-20
Age:  Onset:2005-02-20, Days after vaccination: 1676
Gender:Female  Submitted:0000-00-00
Location:Georgia  Entered:2005-03-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: 02/20/2005- Rash started at night. 02/21/2005 went to MD''s office and diagnosed with chicken pox. Vaccine Failure.

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

New Search

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


Copyright © 2016 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166