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Found 593491 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:41717 (history)  Vaccinated:1992-04-15
Age:5.0  Onset:1992-04-15, Days after vaccination: 0
Gender:Female  Submitted:1992-04-28, Days after onset: 13
Location:Wisconsin  Entered:1992-05-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Unknown
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Pt recvd vax 15APR92 & had vasovagal rxn (probably) & passed out; it was as soon as needle inserted was given Adrenalin & then to ER;

VAERS ID:41719 (history)  Vaccinated:1992-04-23
Age:5.0  Onset:1992-04-23, Days after vaccination: 0
Gender:Female  Submitted:1992-04-24, Days after onset: 1
Location:Texas  Entered:1992-05-04, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES2939494IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES2899324PO 
Administered by: Private     Purchased by: Private
Symptoms: Headache, Injection site pain, Myalgia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Shortly p/vax pt c/o pain @ site, h/a & body aches; fever to 103; devel overnight w/vomiting x 3; rx Tigan & APAP;

VAERS ID:41752 (history)  Vaccinated:1992-04-27
Age:5.0  Onset:1992-04-29, Days after vaccination: 2
Gender:Male  Submitted:1992-05-01, Days after onset: 2
Location:Pennsylvania  Entered:1992-05-05, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tine by Merieux lot# G09212 LFA
Current Illness: well
Preexisting Conditions: multiple AOM
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3269144IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3229444PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Oedema, Pain, Rash
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), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt recvd booster on 27APR92; Noted swelling & erythema @ site on 29APR92; LUE started proximal 1/3 extending to elbow along lateral aspect; c/o pain w/flexion or extention;

VAERS ID:41806 (history)  Vaccinated:1992-03-09
Age:5.0  Onset:1992-03-10, Days after vaccination: 1
Gender:Male  Submitted:1992-03-11, Days after onset: 1
Location:Arkansas  Entered:1992-05-07, Days after submission: 56
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Amoxicillin; decongestant
Current Illness: NONE
Preexisting Conditions: allergic-hayfever
Diagnostic Lab Data: NONE
CDC Split Type: AR9212
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3189093IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.G01023SCRA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Monday noc devel redness & swelling in rt leg where pt recvd DTP is painful & unable to bend; Not aware of pt having fever has been giving APAP; Tuesday eve noted rash-red on back-itchy; taken to MD for eval;

VAERS ID:41809 (history)  Vaccinated:1992-04-22
Age:5.0  Onset:1992-04-22, Days after vaccination: 0
Gender:Female  Submitted:1992-04-22, Days after onset: 0
Location:Arkansas  Entered:1992-05-07, Days after submission: 15
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: AR9215
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3149604IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3149423PO 
Administered by: Public     Purchased by: Public
Symptoms: Arrhythmia, Cyanosis, Dizziness, Hyperhidrosis, Hypoventilation, Stupor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Hypoglycaemia (broad)
Write-up: 5 min p/ recving vax became dizzy followed by unresponsiveness, cyanosis, cold/clammy, shallow respirations, thready carotid pulse lasting 4-5 mins. P/ 20 min was alert & active s/ cyanosis. was sent to PMD.

VAERS ID:41820 (history)  Vaccinated:1992-04-24
Age:5.0  Onset:1992-04-24, Days after vaccination: 0
Gender:Female  Submitted:1992-04-27, Days after onset: 3
Location:South Dakota  Entered:1992-05-07, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mantoux TB skin test by Connaught lot# 233012 ID
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: SD92006
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3189064IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0648D4PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pts mom phoned reporting that pt was very irritable w/constant crying & t102.4; no local rxn, i.e. tenderness or redness; APAP was given q 3 hrs; MD prescribed DPh; did not take to MD t100 27APR92;

VAERS ID:41863 (history)  Vaccinated:1992-04-07
Age:5.0  Onset:1992-04-07, Days after vaccination: 0
Gender:Female  Submitted:1992-04-10, Days after onset: 3
Location:Nebraska  Entered:1992-05-11, Days after submission: 31
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: NE9213
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209044 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0651A3PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt c/o sore arm & had a sl fever evening recvd vax; next day devel 2-3in patch that was red & puffy but not sore to touch; had no fever; improved by evening; went to MD 2nd day later; MD stated this was result of vax; gave ATB;

VAERS ID:41878 (history)  Vaccinated:1992-05-06
Age:5.0  Onset:1992-05-06, Days after vaccination: 0
Gender:Female  Submitted:1992-05-06, Days after onset: 0
Location:Ohio  Entered:1992-05-11, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: OH92036
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3169753 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0638C3PO 
Administered by: Public     Purchased by: Public
Symptoms: Injury, Pallor, Syncope, Vasodilatation
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Pt given DTP/OPV approx 2-3 min p/injection pt collapsed & fell to floor in waiting area; pt pale, unconscious, laceration on chin, dazed, warm to touch;

VAERS ID:41904 (history)  Vaccinated:1992-04-22
Age:5.0  Onset:1992-04-22, Days after vaccination: 0
Gender:Male  Submitted:1992-05-05, Days after onset: 13
Location:Colorado  Entered:1992-05-12, 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: mild eczema
Preexisting Conditions: reactive airway disease
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3149093IM 
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM700HL0IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3169512PO 
Administered by: Private     Purchased by: Private
Symptoms: Asthma, Cough, Rhinitis, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Generalized urticarial rash, rhinorrhea, cough, wheeze, w/in 1 hr of vax adm. Tx:SQ Epi $g all s/s resolved

VAERS ID:41905 (history)  Vaccinated:1992-05-05
Age:5.0  Onset:1992-05-06, Days after vaccination: 1
Gender:Female  Submitted:1992-05-07, Days after onset: 1
Location:Wisconsin  Entered:1992-05-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES1B311254IMGM
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0120V1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3169523PO 
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: Red, hot area rt gluteus. Given DPT in site 5May92, 4" area cellulitus. WMC. APAP. Amox 250 X 10 days

VAERS ID:41928 (history)  Vaccinated:1992-05-04
Age:5.0  Onset:0000-00-00
Gender:Female  Submitted:1992-05-07
Location:Ohio  Entered:1992-05-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3169754 RA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site reaction
SMQs:
Write-up: localized rxn to DPT, Rt deltoid, apply ice, give APAP/observe. F/U w/ MD on 8May92 sooner if neccessary.

VAERS ID:41935 (history)  Vaccinated:1992-04-13
Age:5.0  Onset:0000-00-00
Gender:Female  Submitted:1992-05-05
Location:Massachusetts  Entered:1992-05-14, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC Split Type: QC925
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MASS. PUB HLTH BIOL LABDTP276 IM 
Administered by: Private     Purchased by: Other
Symptoms: Oedema, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Redness & swelling from elbow to shoulder;

VAERS ID:41939 (history)  Vaccinated:1992-04-03
Age:5.0  Onset:1992-04-05, Days after vaccination: 2
Gender:Female  Submitted:1992-04-15, Days after onset: 9
Location:Mississippi  Entered:1992-05-14, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: eye infect
Preexisting Conditions: eye infect-allergy-related, states MD
Diagnostic Lab Data: Lupus, lyme & rheumatic fever, rheumatoid arthritis, sed rate, mononucleoisis & strep throat done; cat scatch fever test; awaiting results;
CDC Split Type: MS9211
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209064IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3209343PO 
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Hypokinesia, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Had fever of 102, devel transient rash that spread over body & went away no sooner then they came-was eventually unable to raise arms & lt leg w//joint pains; pt was taken to MD on 6APR92 @ 10AM; given meds; pt adm to hosp & tests done;

VAERS ID:41946 (history)  Vaccinated:1992-04-28
Age:5.0  Onset:1992-04-29, Days after vaccination: 1
Gender:Female  Submitted:1992-05-04, Days after onset: 5
Location:Nevada  Entered:1992-05-14, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: 30APR92 WBC on admission 16.9; 1MAY92 WBC-11.6; Profile 6-WNL
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3169154IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.2029T1SCRA
Administered by: Private     Purchased by: Public
Symptoms: Leukocytosis, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: sudden onset vomiting, inc temp 104.8 orally 29APR92; 30APR92 hospitalized;

VAERS ID:41969 (history)  Vaccinated:1992-03-02
Age:5.0  Onset:1992-03-04, Days after vaccination: 2
Gender:Female  Submitted:1992-04-07, Days after onset: 33
Location:Georgia  Entered:1992-05-15, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type: GA9276
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3089184IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0943T1SC 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0642M3PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 3" x 2" red, hot, swollen advised to call MD -give APAP & apply warm soaks;

VAERS ID:41973 (history)  Vaccinated:1992-04-22
Age:5.0  Onset:1992-04-22, Days after vaccination: 0
Gender:Female  Submitted:1992-04-24, Days after onset: 2
Location:Georgia  Entered:1992-05-15, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp swelling, lethary @ 15mos w/DTP #3; sibling exp swelling back of neck
Other Medications: allergy shots
Current Illness: NONE
Preexisting Conditions: multi allergy & asthma under MD care
Diagnostic Lab Data:
CDC Split Type: GA9280
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3189084IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1531T1SCRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0651D3PO 
Administered by: Public     Purchased by: Public
Symptoms: Dysphagia, Face oedema, Injection site hypersensitivity, Injection site pain, Somnolence, Thinking abnormal, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (narrow), Dementia (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 (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt recvd DTP/OPV/MMR on 22APR92 @1PM by 4-5PM pt face began to swell w/sm part of neck; no diff in breathing w/some diff in swallowing; lg red, feverish local rxn @ site w/pain; drowsiness present on day of vax; incoherence;

VAERS ID:41974 (history)  Vaccinated:1992-04-20
Age:5.0  Onset:1992-04-20, Days after vaccination: 0
Gender:Male  Submitted:1992-04-21, Days after onset: 1
Location:Georgia  Entered:1992-05-15, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: CAT Scan & EEG to determine cause of sz;
CDC Split Type: GA9281
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3189084IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0943T1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0643A3PO 
Administered by: Public     Purchased by: Public
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Pt recved vax approx 1230PM then had sz w/o fever @ approx 530PM; d/c from hosp 22APR92 doing well;

VAERS ID:41978 (history)  Vaccinated:1992-03-30
Age:5.0  Onset:1992-03-30, Days after vaccination: 0
Gender:Female  Submitted:1992-04-01, Days after onset: 2
Location:Georgia  Entered:1992-05-15, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: GA9285
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES 3 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1531T3SC 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES065LD1PO 
Administered by: Public     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: 8cm splotchy edematous area on rt upper arm; full ROM w/o pain;

VAERS ID:41989 (history)  Vaccinated:1992-04-23
Age:5.0  Onset:1992-04-23, Days after vaccination: 0
Gender:Male  Submitted:1992-04-24, Days after onset: 1
Location:Ohio  Entered:1992-05-15, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: OH92027
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3169753IMLL
Administered by: Public     Purchased by: Public
Symptoms: Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: vomiting w/in 1 hr of vax; mom called hlth dept & then pvt MD; by noon temp had went up to 102.7 ax; c/o h/a;

VAERS ID:41991 (history)  Vaccinated:1992-04-21
Age:5.0  Onset:1992-04-24, Days after vaccination: 3
Gender:Male  Submitted:1992-04-28, Days after onset: 4
Location:Ohio  Entered:1992-05-15, 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: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: OH92029
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3169754IMLL
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Infection, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: 2 days p/vax pt c/o legs hurting, couldn''t walk, ankle edema (no local rxn); took pt to MD 27APR92 dx infection; notified clinic 28APR92 suspected rxn to vax;

VAERS ID:42056 (history)  Vaccinated:1992-04-21
Age:5.0  Onset:1992-04-23, Days after vaccination: 2
Gender:Female  Submitted:1992-05-11, Days after onset: 18
Location:New York  Entered:1992-05-19, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3229104IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0120V1IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3169564IM 
Administered by: Private     Purchased by: Private
Symptoms: Neuropathy, Speech disorder
SMQs:, Peripheral neuropathy (narrow), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: 23APR92 problem w/speech on 24APR92; pt taken to hosp 25APR92 uvula deviates lt assume IX or X nerve palsy; gradually recovered w/no rxn;

VAERS ID:42059 (history)  Vaccinated:1992-05-15
Age:5.0  Onset:1992-05-15, Days after vaccination: 0
Gender:Male  Submitted:1992-05-15, Days after onset: 0
Location:Ohio  Entered:1992-05-19, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: LOM-to be put on Amoxil
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0409V0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3-4 minutes p/vax pt devel redness & hives along face, arms, legs, & abdomen;

VAERS ID:42118 (history)  Vaccinated:1992-05-05
Age:5.0  Onset:1992-05-06, Days after vaccination: 1
Gender:Female  Submitted:1992-05-07, Days after onset: 1
Location:Missouri  Entered:1992-05-21, 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: Mantoux TB skin test by Sclavo lot# 196
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: MO92024
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209084IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1662T1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous, Injection site hypersensitivity, Injection site mass
SMQs:, Severe cutaneous adverse reactions (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5 1/2 cm inuration & bright reddness of lt outer thigh 15 cm reddness, erythema present vesicular rash @ area of outer induration; no generalized sx-afebrile;

VAERS ID:42136 (history)  Vaccinated:1992-05-11
Age:5.0  Onset:1992-05-12, Days after vaccination: 1
Gender:Female  Submitted:1992-05-13, Days after onset: 1
Location:Nebraska  Entered:1992-05-22, 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: NKA
Diagnostic Lab Data:
CDC Split Type: NE9214
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209044IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0651A123PO 
Administered by: Public     Purchased by: Other
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Mom states localized redness noted @ inject site 11MAY92; AM of 12MAY92 mom noted redness, some swelling & heat to inject site & including arm-above elbow on posterior side; 13MAY92 mom brought pt to clinic to eval rxn; cellulitis given ATB

VAERS ID:42139 (history)  Vaccinated:1992-05-13
Age:5.0  Onset:1992-05-13, Days after vaccination: 0
Gender:Female  Submitted:1992-05-14, Days after onset: 1
Location:Nebraska  Entered:1992-05-22, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pts siblings exp inc temp @ 4mos w/DTP #2;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NE9217
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209044IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0651A3PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Oedema, Pyrexia, Vasodilatation, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Became hot & cranky, temp inc to 103, APAP & cool bath; temp cont thru noc; vomited x 2 AM 4AM & 6AM the AM p/the shot 14MAY92 AM temp cont 103 & rt arm is swollen but no redness;

VAERS ID:42158 (history)  Vaccinated:1992-04-29
Age:5.0  Onset:1992-05-05, Days after vaccination: 6
Gender:Female  Submitted:1992-05-05, Days after onset: 0
Location:Alaska  Entered:1992-05-26, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type: AK92016
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3149583IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3129242PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: DTP admin to pt 29Apr92. Mom noticed reddeness @ inject site 5May92 then inspected by RN-erythema 2"wide X 3"long.No induration, afebrile,0 limintations in ROM.Sl tender to touch. P/-warm compresses to be applied by mom tonight & tomorrow.

VAERS ID:42166 (history)  Vaccinated:1992-04-16
Age:5.0  Onset:1992-04-17, Days after vaccination: 1
Gender:Male  Submitted:1992-05-06, Days after onset: 19
Location:Illinois  Entered:1992-05-26, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp WNL-tender p/DTP w/sl redness & fever;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: IL9234
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3189094IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3149423PO 
Administered by: Public     Purchased by: Public
Symptoms: Oedema, Pain, Pyrexia, Somnolence, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 17APR92 fever "temp not taken" felt warm -not hot; lethargic 17APR & 18APR alert & responsive "laid around x 2 days; lt arm from immun, site to elbow pink & swollen-very tender; tc 6MAY92 mom states that pt is fine;

VAERS ID:42171 (history)  Vaccinated:1992-04-10
Age:5.0  Onset:1992-04-10, Days after vaccination: 0
Gender:Female  Submitted:1992-04-17, Days after onset: 7
Location:Kansas  Entered:1992-05-26, Days after submission: 39
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: Urine culture-neg;
CDC Split Type: KS92020
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3149584IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0859T1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES2879484PO 
Administered by: Public     Purchased by: Public
Symptoms: Gaze palsy, Haematuria, Malaise, Myalgia, Pyrexia, Urine analysis abnormal, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Ocular motility disorders (narrow), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever 105 w/in 1 hrs, listless, eyes rolled back, talking out of head, red-sore arms for 24 hrs; had blood, & nitrite in urine;

VAERS ID:42172 (history)  Vaccinated:1992-04-14
Age:5.0  Onset:1992-04-14, Days after vaccination: 0
Gender:Male  Submitted:1992-04-17, Days after onset: 3
Location:Kansas  Entered:1992-05-26, Days after submission: 39
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: KS92021
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3149584 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0859T1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3229493PO 
Administered by: Public     Purchased by: Public
Symptoms: Myalgia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Inc yever 104 to 104.5 w/in a few hrs p/vax vomited, dry heaves, extremely sore arm 3 days;

VAERS ID:42175 (history)  Vaccinated:1992-05-13
Age:5.0  Onset:1992-05-13, Days after vaccination: 0
Gender:Male  Submitted:1992-05-15, Days after onset: 2
Location:Kansas  Entered:1992-05-26, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: migraines-MD dx
Diagnostic Lab Data:
CDC Split Type: KS92024
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209074IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1638T1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3049543PO 
Administered by: Public     Purchased by: Public
Symptoms: Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mom called 15MAY92 reported that pt who recvd DTP/MMR/OPV on 13MAY92 had adverse rxn stated pt exp severe h/a, vomiting & t102-103 high fever approx 30" p/inject; parents took pt to MD who dx immun rxn;

VAERS ID:42197 (history)  Vaccinated:1992-04-21
Age:5.0  Onset:1992-04-22, Days after vaccination: 1
Gender:Male  Submitted:1992-04-23, Days after onset: 1
Location:Oregon  Entered:1992-05-28, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: OR9233
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3169154IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0651H3PO 
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: P woke 130AM on 22APR92 w/vomiting & t104.5 oral was not able to retain APAP; cont w/t102-104 fever & vomiting until 5PM on 22APR92; ate small amt of dinner which was retained-fever was 98.9 oral; 23APR92 t102 advised to contact MD;

VAERS ID:42211 (history)  Vaccinated:1991-07-16
Age:5.0  Onset:1991-07-23, Days after vaccination: 7
Gender:Female  Submitted:1991-10-10, Days after onset: 79
Location:Wyoming  Entered:1992-05-28, Days after submission: 231
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp temp @ 1 yr w/DTP? #2 or #3 dose;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WY9106
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3049224IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0762T1IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3009453PO 
Administered by: Public     Purchased by: Other
Symptoms: Headache, Myalgia, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: About 1 wk later got rash chest, cheeks, severe h/a, achiness, t101-102 2-3 days;

VAERS ID:42231 (history)  Vaccinated:1992-03-23
Age:5.0  Onset:1992-03-23, Days after vaccination: 0
Gender:Male  Submitted:1992-05-22, Days after onset: 59
Location:New York  Entered:1992-05-28, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3149580 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1705T0 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3069600PO 
Administered by: Private     Purchased by: Private
Symptoms: Pain, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: High fevers x 4 days; t102-104; lethargic x 10 days; arm discomfort x 4 wks;

VAERS ID:42261 (history)  Vaccinated:1992-05-04
Age:5.0  Onset:1992-05-06, Days after vaccination: 2
Gender:Female  Submitted:1992-05-11, Days after onset: 5
Location:Florida  Entered:1992-05-29, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3049224 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3189464PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Macular rash on lt thigh distal to inject site 2 days p/DTP shot;

VAERS ID:42274 (history)  Vaccinated:1992-05-18
Age:5.0  Onset:1992-05-20, Days after vaccination: 2
Gender:Male  Submitted:1992-05-20, Days after onset: 0
Location:South Dakota  Entered:1992-05-29, 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: PPD by Sclavo lot# 42A07;
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: CBC Plt 241; hct 37.8; WBC 7.8; S 68 L32;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3189064IMGM
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0648D3PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Erythema 7mm diameter, warm to touch, sl swelling et tenderness;

VAERS ID:42298 (history)  Vaccinated:1992-05-15
Age:5.0  Onset:1992-05-16, Days after vaccination: 1
Gender:Female  Submitted:1992-05-18, Days after onset: 2
Location:Michigan  Entered:1992-05-29, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MICHIGAN DEPT PUB HLTHTR12164IMLL
Administered by: Private     Purchased by: Other
Symptoms: Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: lt thigh tender along quadriceps; pt apprehensive about passive ROM of hip prom lt hip; myalgic secondary to DTP advil susp, rest cal if necessary;

VAERS ID:42300 (history)  Vaccinated:0000-00-00
Age:5.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:1992-05-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES320969  L
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swellowing & fever time of inject;

VAERS ID:42306 (history)  Vaccinated:1992-05-18
Age:5.0  Onset:1992-05-19, Days after vaccination: 1
Gender:Female  Submitted:1992-05-20, Days after onset: 1
Location:West Virginia  Entered:1992-05-29, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rxn 18JUN87 & 18AUG87 t103 w/DTp #1 & 2;
Other Medications: PPD by Sclavo
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2G310103IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0263V1IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0647B3PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Elevated temp 101; hard reddened area around inject site; hives noted for 6-8cm below inject site

VAERS ID:42308 (history)  Vaccinated:1992-05-13
Age:5.0  Onset:1992-05-15, Days after vaccination: 2
Gender:Male  Submitted:1992-05-20, Days after onset: 5
Location:Maine  Entered:1992-05-29, 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:
Current Illness: NONE
Preexisting Conditions: mild hyperphenylacaninemia
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3189064 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1371T1 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3189464PO 
Administered by: Other     Purchased by: Public
Symptoms: Injection site reaction, Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Macular erythematous rash of face & chest w/itching appearing 36-48hrs p/vax w/11.5cm x 5.5cm area of discoloration of upper arm @ DTP site;

VAERS ID:42342 (history)  Vaccinated:1992-05-07
Age:5.0  Onset:1992-05-07, Days after vaccination: 0
Gender:Male  Submitted:1992-05-07, Days after onset: 0
Location:Washington  Entered:1992-06-01, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: rt OM in ER
Preexisting Conditions: NONE
Diagnostic Lab Data: HGB-11.6; t99.6;
CDC Split Type: WA92716
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209054 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0655L4PO 
Administered by: Public     Purchased by: Public
Symptoms: Gaze palsy, Hypertonia, Injury, Muscle twitching, Otitis media
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Ocular motility disorders (narrow)
Write-up: @ approx 1040PM, pt recvd DTP/OPV & approx 5 mins later started to stiffen, while still on mom''s lap, & eyes rolled back w/few jerks of arms; pts head hit the edge of the desk when put on floor PHN called for other PHN to call 911;

VAERS ID:42363 (history)  Vaccinated:1992-05-22
Age:5.0  Onset:1992-05-22, Days after vaccination: 0
Gender:Female  Submitted:1992-05-22, Days after onset: 0
Location:Kansas  Entered:1992-06-02, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3229154 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1492S1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0654L3PO 
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt became pale w/c/o dizziness BP 80/40;

VAERS ID:42368 (history)  Vaccinated:1992-05-01
Age:5.0  Onset:1992-05-02, Days after vaccination: 1
Gender:Female  Submitted:1992-05-06, Days after onset: 4
Location:West Virginia  Entered:1992-06-02, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TB tine
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3069274IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0929T1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0638E3PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: Large reddened area noticed around inject site of DTP & 4-4 1/2" below inject site;

VAERS ID:42370 (history)  Vaccinated:1992-05-20
Age:5.0  Onset:1992-05-20, Days after vaccination: 0
Gender:Male  Submitted:1992-05-21, Days after onset: 1
Location:California  Entered:1992-06-02, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES1D31006  RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.925T1 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0648F PO 
Administered by: Other     Purchased by: Public
Symptoms: Abdominal pain, Diarrhoea, Malaise
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: sx started 20MAY92 @ 5PM w/stomach ache, not feeling well, diarrhea started @ 830PM; no fever, no other sx present;

VAERS ID:42441 (history)  Vaccinated:1992-05-26
Age:5.0  Onset:1992-05-27, Days after vaccination: 1
Gender:Male  Submitted:1992-05-29, Days after onset: 2
Location:Illinois  Entered:1992-06-03, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: familial tendency to high fevers
Diagnostic Lab Data: NONE
CDC Split Type: IL9239
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3229144 GM
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1557T1 GM
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0653B4PO 
Administered by: Public     Purchased by: Public
Symptoms: Febrile convulsion
SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Febrile sz occuring day p/vax;

VAERS ID:42447 (history)  Vaccinated:1992-05-15
Age:5.0  Onset:1992-05-16, Days after vaccination: 1
Gender:Male  Submitted:1992-05-27, Days after onset: 11
Location:Colorado  Entered:1992-06-03, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209063IMLL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM190HK1IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3169563PO 
Administered by: Private     Purchased by: Private
Symptoms: Crying, Dyspnoea, Gait disturbance, Headache, Injury, Somnolence, Stupor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), 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), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)
Write-up: Pt recvd DTP 15MAY92 @ 2PM & 930AM 16MAY92 pt had whiney moan, started shaking head & calling mom; threw self forward, fell to the ground, turned white, staring up but didn''t recognize mom; breathing labored, vomited, head hurts, groggy;

VAERS ID:42451 (history)  Vaccinated:1992-04-25
Age:5.0  Onset:1992-04-25, Days after vaccination: 0
Gender:Male  Submitted:1992-05-20, Days after onset: 25
Location:Kansas  Entered:1992-06-04, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: ear problems
Diagnostic Lab Data: NONE
CDC Split Type: KS92026
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3269814IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0225V1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Delirium, Insomnia, Pyrexia, Thinking abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt devel fever by 3PM the day of vax started @ 101, towards evening fever was approaching 105; mom gave ASA & advil; awake most of first noc speaking incoherent @ times; mom stated delirious; Pt seen by MD o 14MAY92;

VAERS ID:42468 (history)  Vaccinated:1992-05-18
Age:5.0  Onset:1992-05-18, Days after vaccination: 0
Gender:Male  Submitted:1992-06-02, Days after onset: 15
Location:Michigan  Entered:1992-06-04, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MICHIGAN DEPT PUB HLTHTR1217A4IMA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3169603PO 
Administered by: Private     Purchased by: Private
Symptoms: Hallucination, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: T103-104, emesis, hallucinations; no sz acitivty; 19MAY92 t102, nl neuro exam, still emesis until PM;

VAERS ID:42484 (history)  Vaccinated:1992-03-02
Age:5.0  Onset:1992-03-03, Days after vaccination: 1
Gender:Female  Submitted:1992-03-10, Days after onset: 7
Location:Minnesota  Entered:1992-06-05, Days after submission: 86
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt inc t104 w/DTP every dose;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to PCN
Diagnostic Lab Data:
CDC Split Type: MN92028
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3049244 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3129203PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site oedema, Injection site pain, Pyrexia, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: MD called to report seeing pt in office w/t104, vomiting; localized swelling, & tenderness in area of DTP; observed 4 hrs; no neurologic complications; mom reports pt was also groggy & difficult to wake; states pt ran t w/prev vax;

VAERS ID:42595 (history)  Vaccinated:1992-05-11
Age:5.0  Onset:1992-05-14, Days after vaccination: 3
Gender:Female  Submitted:1992-05-14, Days after onset: 0
Location:Texas  Entered:1992-06-08, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: TX9273
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3089234IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0649M4PO 
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Asthma, Cough, Gastroenteritis, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt was seen in MD office t99.7 oral gives hx of spontaneous & resolved rash, wheezing, non productive cough, stomachache, vomiting; dx gastroenteritis & acute asthmatic exacerbation given breathing tx w/Ventolin;

VAERS ID:37255 (history)  Vaccinated:1991-04-01
Age:5.0  Onset:1991-04-01, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1992-06-09
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: no relevant hx
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES91040393
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.2240S   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dyspnoea, Pharyngitis, Tongue oedema
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recvd MMR vax on 1APR91 & 10 to 15 minutes post vax pt exp thickness of tongue, sore throat, difficulty breathing; PE was nl w/no resp distress; tx w/DPH & pt recovered;

VAERS ID:37438 (history)  Vaccinated:1991-06-22
Age:5.0  Onset:1991-06-22, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:1992-06-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES91061515
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt recvd MMR vax on 22JUN91 following the vax pt devel a low grade (99) cyclical type fever & leg pain @ the shins;

VAERS ID:37501 (history)  Vaccinated:1991-04-04
Age:5.0  Onset:1991-04-04, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:1992-06-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: allergy dogs; allergy environmental;
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES91091128
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.2258S1  
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES2959303PO 
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recvd booster dose of MMR vax on 4APR91, was also given OPV; immed following vax pt exp hives; pt was treated w/Epi & recovered; no further details were provided;

VAERS ID:37534 (history)  Vaccinated:1991-11-06
Age:5.0  Onset:1991-11-06, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:1992-06-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NOV91 Serum electrolytes-nl; Serum glucose-nl; serum calcium-nl; CT Scan-nl; EEG-abn;
CDC Split Type: WAES91110348
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0852T   
Administered by: Private     Purchased by: Private
Symptoms: Electroencephalogram abnormal, Grand mal convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Pt recvd MMR vax on 6NOV91 & approx 2 1/2 hrs following va pt exp a grand mal sz; pt was hospitalized & a neuro exam & CT Scan were nl; EEG was abn;

VAERS ID:42631 (history)  Vaccinated:1992-05-28
Age:5.0  Onset:1992-05-28, Days after vaccination: 0
Gender:Male  Submitted:1992-06-01, Days after onset: 4
Location:Iowa  Entered:1992-06-09, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: hx of febrile seizures-latest 6 mos prior
Diagnostic Lab Data: NONE temp in ER 40.C;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 28MAY 10AM DTP recvd by 11AM feverish, h/a, emesis x 1; temp to 106 despite antipyretics; no other sx; 29MAY 0200 hrs visit to ER;

VAERS ID:42644 (history)  Vaccinated:1992-06-02
Age:5.0  Onset:1992-06-03, Days after vaccination: 1
Gender:Female  Submitted:1992-06-03, Days after onset: 0
Location:New York  Entered:1992-06-09, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3169654IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0121O1IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3149434PO 
Administered by: Private     Purchased by: Private
Symptoms: Febrile convulsion, Muscle twitching, Neck pain, Pyrexia, Screaming, Stupor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt recvd DT/OPV/MMR on 2JUN92 in afternoon & woke up in AM 3JUN92 w/vomiting, stared off into space w/occ twitchs w/fever;

VAERS ID:42647 (history)  Vaccinated:1992-06-03
Age:5.0  Onset:1992-06-03, Days after vaccination: 0
Gender:Male  Submitted:1992-06-04, Days after onset: 1
Location:Texas  Entered:1992-06-09, 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: bilateral talipes equinovarus (clubbed feet) corrected surgically; ventricular septal defect-closed spontaneously
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES3209714 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0649C4PO 
Administered by: Private     Purchased by: Private
Symptoms: Gaze palsy, Hypotonia, Muscle twitching, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Approx 30 sec p/vax pt grimaced, became pale & had dec muscle tone; eyes rolled back & had 3 jerking movements of head & arms; episode lasted only a few seconds; pt felt nauseated;

VAERS ID:42653 (history)  Vaccinated:1992-05-27
Age:5.0  Onset:1992-05-27, Days after vaccination: 0
Gender:Male  Submitted:1992-06-06, Days after onset: 10
Location:Alabama  Entered:1992-06-10, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE x/puncture wound to foot
Preexisting Conditions: NONE
Diagnostic Lab Data: Nl serum glucose;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209064 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0189V1 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3149413PO 
Administered by: Private     Purchased by: Private
Symptoms: Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)
Write-up: 15-20 mins or sooner p/inject became very lethargic & nearly unarousable; no sz activity; somnolence lasted about 2 hrs; was up & able to talk but very quiet; p/2 hrs was up & playful; stable BP & resp; no fever;

VAERS ID:42658 (history)  Vaccinated:1992-04-21
Age:5.0  Onset:1992-04-27, Days after vaccination: 6
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:1992-06-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: erythromycin, Ceclor, Kelfex-all cause hives/rash
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES3209693IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES637L32PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: Pt devel hives surrounding the inject site 6 days p/recvd acellular pertussis vax; Hives resolved in 2 days w/DPH;

VAERS ID:42737 (history)  Vaccinated:1992-03-24
Age:5.0  Onset:1992-03-26, Days after vaccination: 2
Gender:Female  Submitted:1992-05-22, Days after onset: 56
Location:Pennsylvania  Entered:1992-06-11, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: PA92138
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3089244IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1557T1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3149373PO 
Administered by: Public     Purchased by: Public
Symptoms: Abscess, Cellulitis
SMQs:
Write-up: 26MAR92 seen @ hosp ER dx sterile abscess, cellulitis of lt arm; tx sling, warm compresses, Keflex; resolved 31MAR92;

VAERS ID:42755 (history)  Vaccinated:1992-04-23
Age:5.0  Onset:1992-04-23, Days after vaccination: 0
Gender:Male  Submitted:1992-04-27, Days after onset: 4
Location:Georgia  Entered:1992-06-12, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: GA92103
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209084IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1531T1SCA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0651D3PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Dyspnoea, Injection site hypersensitivity, Pallor, Pharyngitis, Pyrexia, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 23APR92 tc from mom states crying since DTP, leg hurting, vomiting, t102-103 & onset difficult breathing @ 330PM; advised ER exam; fainted

VAERS ID:42758 (history)  Vaccinated:1992-05-04
Age:5.0  Onset:1992-05-04, Days after vaccination: 0
Gender:Female  Submitted:1992-05-07, Days after onset: 3
Location:Georgia  Entered:1992-06-12, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxil, Tritarate
Current Illness: sinus infect wk a/vax
Preexisting Conditions: touch of allergy
Diagnostic Lab Data: NONE
CDC Split Type: GA92106
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209084IML
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0943T1IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3189404PO 
Administered by: Public     Purchased by: Public
Symptoms: Oedema, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Started fever same days as vax & has cont through today; fever has varied 99-101, redness & swelled size of grape; MD tx w/Ceclor & heat;

VAERS ID:42763 (history)  Vaccinated:1992-04-23
Age:5.0  Onset:1992-04-24, Days after vaccination: 1
Gender:Female  Submitted:1992-05-01, Days after onset: 7
Location:Georgia  Entered:1992-06-12, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: GA92112
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209084IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1531T1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0651D3PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: lt arm red-warm to touch approx 3 cm size; taken to MD 24APR92 was put on Augmentin; mom called back Monday morning states got redder went to MD pt hospitalized put on IV ATB; d/c 27APR92;

VAERS ID:42768 (history)  Vaccinated:1992-04-27
Age:5.0  Onset:1992-04-28, Days after vaccination: 1
Gender:Male  Submitted:1992-04-28, Days after onset: 0
Location:Tennessee  Entered:1992-06-12, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: cough
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC Split Type: TN9255
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3189064IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1662T1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0648M4PO 
Administered by: Public     Purchased by: Public
Symptoms: Nausea, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Put to bed @ 1030PM given APAP awoke mom @ 4AM 28APR92 nauseated, fever high, shaking; step-dad carried pt to local ER; t103 ax seen by MD 6AM told that nausea & temp was rxn to shots given inject for nausea & oral APAP which pt vomited up;

VAERS ID:42782 (history)  Vaccinated:1992-05-15
Age:5.0  Onset:1992-05-16, Days after vaccination: 1
Gender:Female  Submitted:1992-05-19, Days after onset: 3
Location:Tennessee  Entered:1992-06-12, Days after submission: 24
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: TN9269
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3229144IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1898T1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0646D4PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 5-6cm reddened area noted on lt deltoid surrounded by large amt of edema; area warm to touch; c/o very tender painful to touch;

VAERS ID:42799 (history)  Vaccinated:1992-06-03
Age:5.0  Onset:1992-06-04, Days after vaccination: 1
Gender:Male  Submitted:1992-06-05, Days after onset: 1
Location:Minnesota  Entered:1992-06-12, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2G310104IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0649K3PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt recvd vax 3JUN92 & today has 6x6 cm induration & 9x14 cm redness @ site; given meds;

VAERS ID:42817 (history)  Vaccinated:1992-05-28
Age:5.0  Onset:1992-05-29, Days after vaccination: 1
Gender:Female  Submitted:1992-06-09, Days after onset: 11
Location:Arizona  Entered:1992-06-12, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rxn 3 3//4 yrs w/DTP #4;
Other Medications: TB tine mono vac by Merieux lot# G05212
Current Illness: NONE
Preexisting Conditions: Sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1986T1 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES652E43PO 
Administered by: Private     Purchased by: Private
Symptoms: Oedema, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Lt arm red, hot to touch & swollen lasted approx 72 hrs; mom gave DPH & APAP;

VAERS ID:42830 (history)  Vaccinated:1992-04-30
Age:5.0  Onset:1992-04-30, Days after vaccination: 0
Gender:Female  Submitted:1992-05-08, Days after onset: 8
Location:California  Entered:1992-06-15, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mantoux-PPD by Scalvo lot# 212;
Current Illness: NA
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: CA9256
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3149573IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1702T1 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3169493PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Pyrexia, Rash, Skin nodule
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 30APR92 felt warm & fussy 30APR92 evening, muscle soreness @ site; 4MAY92 & 5MAY92 t103.1 w/APAP; 6MAY92 lump w/tenderness behind lt ear; 7MAY92 rash, fine, pink, rough, lasted 5 days; started on face then covered trunk, no fever w/rash;

VAERS ID:42835 (history)  Vaccinated:1992-03-31
Age:5.0  Onset:1992-04-01, Days after vaccination: 1
Gender:Male  Submitted:1992-04-02, Days after onset: 1
Location:Utah  Entered:1992-06-15, Days after submission: 73
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: UT920010
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3169164IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0929T1SC 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3129184PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Agitation, Hypokinesia, Malaise, Oedema, Pain, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt recvd DTP/OPV/MMR on 31MAR92 & refused to move arm p/vax; Wed AM awoke crying c/o pain & can''t move; mom noted redness & mild swelling1APR92 awoke from nap w/fever & edema extending to & including elbow; c/o malaise;

VAERS ID:42867 (history)  Vaccinated:1992-06-09
Age:5.0  Onset:0000-00-00
Gender:Female  Submitted:1992-06-12
Location:Maryland  Entered:1992-06-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1664T1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema multiforme, Urticaria
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hives devel 10JUN92 & 11JUN92 erythema multiforme; Tavist given;

VAERS ID:42873 (history)  Vaccinated:1992-06-04
Age:5.0  Onset:1992-06-05, Days after vaccination: 1
Gender:Female  Submitted:1992-06-08, Days after onset: 3
Location:Arizona  Entered:1992-06-15, 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: TB tine by Merieux lot # G0521-2
Current Illness: NONE
Preexisting Conditions: Sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES320971  RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0302V1 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES652E64PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Oedema, Pain, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: rt leg red swollen & hot to touch, very tender reaction lasted 72 hrs; started on DPH;

VAERS ID:42876 (history)  Vaccinated:1992-06-03
Age:5.0  Onset:1992-06-04, Days after vaccination: 1
Gender:Female  Submitted:1992-06-05, Days after onset: 1
Location:Florida  Entered:1992-06-16, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Steroid nasal spray, Preventil, Slobid
Current Illness: URI 2 wks prior
Preexisting Conditions: severe asthma
Diagnostic Lab Data: NONE
CDC Split Type: FL92020
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3109644IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3169533PO 
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous, Hypersensitivity, Oedema, Vasodilatation
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Wednesday evening lt arm was swollen, red & hot, blisters noted; taken to hos Thursday AM; dx allergic rxn; rx DPH, ice;

VAERS ID:42884 (history)  Vaccinated:1992-05-13
Age:5.0  Onset:1992-05-15, Days after vaccination: 2
Gender:Female  Submitted:1992-05-25, Days after onset: 10
Location:Indiana  Entered:1992-06-16, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Amoxicillin allergy; C-section birth no complicatins;
Diagnostic Lab Data: NONE
CDC Split Type: IN9225
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3229134IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0645M4PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Pyrexia, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 15MAY redness & welts around inject site; temp 16MAY pt to immediate care approx 1PM; t100 rash, swelling local rxn around inject site 3x6 cm w/annal border, inc warmth; rx DPH; referred to family MD; resolved approx 4 days/mom;

VAERS ID:42889 (history)  Vaccinated:1992-06-04
Age:5.0  Onset:1992-06-04, Days after vaccination: 0
Gender:Female  Submitted:1992-06-09, Days after onset: 5
Location:Maine  Entered:1992-06-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: ME92011
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3182065IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1371T2IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3189394PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Had hives w/in 1 hrs of having vax needed epi & steroids 3 time w/4 visits to the hosp; pt is still taking DPh;

VAERS ID:43052 (history)  Vaccinated:1992-06-10
Age:5.0  Onset:1992-06-10, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Missouri  Entered:1992-06-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: well child
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: MO92042
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3189094 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1662T1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0644A4PO 
Administered by: Public     Purchased by: Public
Symptoms: Mouth ulceration, Pharyngitis
SMQs:, Severe cutaneous adverse reactions (broad), Agranulocytosis (broad), Systemic lupus erythematosus (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approx 3 hrs p/vax pt c/o sore throat; throat was red, palate was red; lips had two blisters; pt seen by MD Thursday had addtl blisters on inside of mouth;

VAERS ID:43075 (history)  Vaccinated:1992-06-10
Age:5.0  Onset:1992-06-10, Days after vaccination: 0
Gender:Female  Submitted:1992-06-11, Days after onset: 1
Location:Pennsylvania  Entered:1992-06-22, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rxn @ 19mos w/HIB #1 dose;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: still''s mummer
Diagnostic Lab Data: NONE
CDC Split Type: PA92142
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3269124IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1151T1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3089604PO 
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Agitation, Asthenia, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: @ 7PM on 10-JUN92 pt had unconsolable crying for 2 hrs then intermittently all noc; from 7PM to early AM had severe stomache ache, t104, weakness in legs;

VAERS ID:43117 (history)  Vaccinated:1992-06-15
Age:5.0  Onset:1992-06-15, Days after vaccination: 0
Gender:Male  Submitted:1992-06-17, Days after onset: 2
Location:North Carolina  Entered:1992-06-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: nausea
Preexisting Conditions: RDS, apnea, heart m, sz @ birth;
Diagnostic Lab Data:
CDC Split Type: NC92031
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3149574IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1638T1SCRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0643C3PO 
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Cyanosis, Dyspnoea, Injection site pain, Pallor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: states pt c/o nausea a/vax; 1/2-3/4 hrs post vax pt began vomiting, pale lips looked blue, c/o chest pain; mom noted some SOB; c/o pain in area DTP inject; pt improved 2 hrs later d/c home;

VAERS ID:43126 (history)  Vaccinated:1992-06-15
Age:5.0  Onset:1992-06-16, Days after vaccination: 1
Gender:Female  Submitted:1992-06-18, Days after onset: 2
Location:Oklahoma  Entered:1992-06-23, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES1F310224IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1961T1SCLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3229443PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction, Oedema, Pain, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Local rxn, red, rash, pain, swelling;

VAERS ID:43139 (history)  Vaccinated:1992-05-28
Age:5.0  Onset:1992-05-28, Days after vaccination: 0
Gender:Male  Submitted:1992-06-01, Days after onset: 4
Location:Michigan  Entered:1992-06-23, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: MI9282
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MICHIGAN DEPT PUB HLTHTR1217A4IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1483T1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3189393PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Headache, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: @ approx 630PM pt began to c/o h/a which grad became more severe; t100 mom gave APAP h/a becam excruciating w/pt holding head & crying due to pain; pt went to bed 830PM awoke 130AM 29MAY92 vomited, t103;

VAERS ID:43142 (history)  Vaccinated:1992-06-17
Age:5.0  Onset:1992-06-19, Days after vaccination: 2
Gender:Female  Submitted:1992-06-19, Days after onset: 0
Location:Illinois  Entered:1992-06-23, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: just local rxn on leg
Preexisting Conditions:
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3149604IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0145V1IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3209283PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt presented @ office w/large local rxn, lt thigh had large reddened area measuring 3 3/4" x 5" very warm to touch & tender to touch; tx heat, message, DPH & APAP to be cautious w/next booster of tetanus, should get no further pertussis;

VAERS ID:43160 (history)  Vaccinated:1992-06-08
Age:5.0  Onset:1992-06-08, Days after vaccination: 0
Gender:Female  Submitted:1992-06-20, Days after onset: 12
Location:Louisiana  Entered:1992-06-25, 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:
Current Illness: normal PE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0330V1  
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3169544PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Asthma, Rhinitis, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt had wheezing, sneezing, & hives 15'' p/taking MMR/OPV; lungs bilateral wheezing noted which cleaared by Proventil inhaler of Epi; referred to ER for eval;

VAERS ID:43202 (history)  Vaccinated:1992-06-11
Age:5.0  Onset:1992-06-11, Days after vaccination: 0
Gender:Male  Submitted:1992-06-19, Days after onset: 8
Location:Pennsylvania  Entered:1992-06-29, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp irritability, high fever, joint pain @ 17mos w/MMR #1 dose;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to Amoxicillin
Diagnostic Lab Data:
CDC Split Type: PA92151
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3189084IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3189403PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Anorexia, Nausea, Pyrexia, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Devel fever 103.9 ax w/in 1 hr of receiving vax; vomited yellow liquid 2x; anorexic, nauseated, lethargic & very irritable x 2 days; tx APAP, cool applications, rest;

VAERS ID:43227 (history)  Vaccinated:1992-06-16
Age:5.0  Onset:1992-06-17, Days after vaccination: 1
Gender:Female  Submitted:1992-06-23, Days after onset: 6
Location:Missouri  Entered:1992-06-29, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3089254 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0189V1 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3169834PO 
Administered by: Private     Purchased by: Private
Symptoms: Pain, Pyrexia, Skin nodule, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: t103, redness, induration, pain;

VAERS ID:43232 (history)  Vaccinated:1992-06-16
Age:5.0  Onset:1992-06-17, Days after vaccination: 1
Gender:Male  Submitted:1992-06-22, Days after onset: 5
Location:Illinois  Entered:1992-06-29, 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: NA
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3149604IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0189V1IMRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3209284PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt vax''d on 16JUN92 & had large local rxn w/redness, warmth this faded but a residual area of redness @ site of inject; area is hard, sl raised, tender to touch; informed this may take a long time to heal even several wks-to use heat;

VAERS ID:43233 (history)  Vaccinated:1992-06-18
Age:5.0  Onset:1992-06-20, Days after vaccination: 2
Gender:Female  Submitted:1992-06-22, Days after onset: 2
Location:Michigan  Entered:1992-06-29, 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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2H3103T  L
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0652D PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site mass, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: swelling @ site, 4" circle around inject site-raised & hot to touch

VAERS ID:43244 (history)  Vaccinated:1992-04-15
Age:5.0  Onset:1992-04-15, Days after vaccination: 0
Gender:Female  Submitted:1992-06-18, Days after onset: 64
Location:Missouri  Entered:1992-06-30, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MO92043
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209084IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.2302S1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3149333PO 
Administered by: Public     Purchased by: Public
Symptoms: Oedema, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approx 1 hr p/vax pt began to swell & hives developed; DPH given w/good results but p/effect of DPH wore off, arm swelled again; swelling lasted x 2-3 days;

VAERS ID:43276 (history)  Vaccinated:1992-06-18
Age:5.0  Onset:1992-06-20, Days after vaccination: 2
Gender:Male  Submitted:1992-06-24, Days after onset: 4
Location:Florida  Entered:1992-06-30, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp site rxn w/DTP lt thigh
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER 5IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES 3PO 
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 30 hrs p/vax lt deltoid red welt appeared 4" wide (as big as moms hand) hot to touch & sore (according to pt);

VAERS ID:43284 (history)  Vaccinated:1992-06-17
Age:5.0  Onset:1992-06-18, Days after vaccination: 1
Gender:Male  Submitted:1992-06-19, Days after onset: 1
Location:Virginia  Entered:1992-07-01, 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: NA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type: VA92059
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3289334IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1703T4SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3209344PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: redness, hardness, hives @ inject site; hives alos on lt leg; referred to family MD who ordered antihistamines;

VAERS ID:43290 (history)  Vaccinated:1992-04-23
Age:5.0  Onset:1992-04-24, Days after vaccination: 1
Gender:Male  Submitted:1992-06-26, Days after onset: 63
Location:New Hampshire  Entered:1992-07-01, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3169754IMRA
Administered by: Private     Purchased by: Public
Symptoms: Arthralgia, Injection site oedema, Oedema, Vasodilatation
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), Arthritis (broad)
Write-up: Edema inject site;

VAERS ID:43292 (history)  Vaccinated:1992-05-26
Age:5.0  Onset:1992-05-29, Days after vaccination: 3
Gender:Male  Submitted:1992-06-01, Days after onset: 3
Location:California  Entered:1992-07-01, Days after submission: 30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt recvd PPD;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES1D310063 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0925T1 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0648F3PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Dermatitis exfoliative, Pruritus, Pyrexia, Rash maculo-papular, Vasodilatation
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 29MAY underarm red & peeling underarm & down side & back-under lt arm-devel white bumps; 26MAY very warm, no temp ck; c/o itchy given neosporin ointment;

VAERS ID:43303 (history)  Vaccinated:1992-05-15
Age:5.0  Onset:1992-05-15, Days after vaccination: 0
Gender:Male  Submitted:1992-06-09, Days after onset: 25
Location:Texas  Entered:1992-07-02, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: neg
Other Medications:
Current Illness: neg
Preexisting Conditions: neg
Diagnostic Lab Data: NONE
CDC Split Type: TX92105
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3129364IM 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0649M4PO 
Administered by: Public     Purchased by: Public
Symptoms: Hypersensitivity, Hypokinesia, Pyrexia, Vasodilatation, Vomiting
SMQs:, Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mom said pt had fever 103, & body was flushed red all over & that pt could not move entire body & vomiting lasted about 16-18 hrs; did not take pt to MD called MD & on 5JUN92 felt was allergic reaction;

VAERS ID:43307 (history)  Vaccinated:1992-06-02
Age:5.0  Onset:1992-06-02, Days after vaccination: 0
Gender:Male  Submitted:1992-06-02, Days after onset: 0
Location:Texas  Entered:1992-07-02, Days after submission: 30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: TX92109
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3129364IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0190V1SCLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3189364PO 
Administered by: Public     Purchased by: Public
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Vasovagal response; <1 min p/vax, pt fainted; recovered w/ammonia inhalant promptly;

VAERS ID:43315 (history)  Vaccinated:1992-05-29
Age:5.0  Onset:1992-05-30, Days after vaccination: 1
Gender:Male  Submitted:1992-06-29, Days after onset: 30
Location:New Jersey  Entered:1992-07-02, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0428T1IMA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: generalized urticaria w/in 24 hrs p/Hep B vax;

VAERS ID:43320 (history)  Vaccinated:1992-06-23
Age:5.0  Onset:1992-06-24, Days after vaccination: 1
Gender:Male  Submitted:1992-06-25, Days after onset: 1
Location:Michigan  Entered:1992-07-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MICHIGAN DEPT PUB HLTHTRI1217A4 RL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.02631 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0649K4PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Rash maculo-papular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Local swelling from shot; mac rash on leg to knee;

VAERS ID:43321 (history)  Vaccinated:1992-06-08
Age:5.0  Onset:0000-00-00
Gender:Female  Submitted:1992-06-17
Location:Massachusetts  Entered:1992-07-02, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: HIV
Diagnostic Lab Data: CBC & CXR done p/shot dx pneumonia;
CDC Split Type: MA926
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MASS. PUB HLTH BIOL LABDTP2764IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Injection site mass, Injection site oedema, Injection site pain, Pneumonia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt devel pain, swelling, induration, & fever 101.5; also had reduced ROM to lt arm; sx devel w/in 24 hrs p/shot & by 15JUN92 pt had fever, pain, & swelling; dx w/pneumonia;

VAERS ID:43421 (history)  Vaccinated:1992-06-16
Age:5.0  Onset:1992-06-16, Days after vaccination: 0
Gender:Male  Submitted:1992-06-29, Days after onset: 13
Location:Illinois  Entered:1992-07-10, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp t103+ w/DTP#4;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: IL9248
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209074IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0115V1SC 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3189424PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Arthralgia, Dysphagia, Pyrexia, Tongue oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hostility/aggression (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: sl tongue swelling, difficulty swallowing wrist & ankle pain, t100.4 about 3 hrs p/vax; later temp 103.3; tx APAP; pt cried excessively p/shot;

VAERS ID:43427 (history)  Vaccinated:1992-06-25
Age:5.0  Onset:1992-06-25, Days after vaccination: 0
Gender:Male  Submitted:1992-06-26, Days after onset: 1
Location:North Carolina  Entered:1992-07-10, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NC92028
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3149574IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1638T1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0653F3PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 25JUN92 t103.1 ax (w/o point added); pt seen by MD 26JUN92 w/highest temp 104; pt lifeless but had a good noc;

VAERS ID:43436 (history)  Vaccinated:1992-06-30
Age:5.0  Onset:1992-07-01, Days after vaccination: 1
Gender:Male  Submitted:1992-07-02, Days after onset: 1
Location:Kansas  Entered:1992-07-10, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: KS92045
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209074 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0055T1SCRL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3089603PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site reaction
SMQs:
Write-up: large local rxn w/in 2 days of vax on lt leg to side of inject site;

VAERS ID:43474 (history)  Vaccinated:1992-06-15
Age:5.0  Onset:1992-06-15, Days after vaccination: 0
Gender:Male  Submitted:1992-06-15, Days after onset: 0
Location:Michigan  Entered:1992-07-13, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MI9286
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MICHIGAN DEPT PUB HLTHTR1211B4IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1663T1SCLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0654L3PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Immed p/vax given a bump, smaller than dime sized, devel; the bump became penny sized & look more like a large hive or wheal; pt having no other problems; red & warm;

VAERS ID:43476 (history)  Vaccinated:1992-04-16
Age:5.0  Onset:1992-04-21, Days after vaccination: 5
Gender:Male  Submitted:1992-04-22, Days after onset: 1
Location:Mississippi  Entered:1992-07-13, Days after submission: 82
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: NA
CDC Split Type: MS9213
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3209044IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1635T1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3209343PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Myalgia, Oedema, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Pt recvd vax 16APR92 & mom noticed 21APR92 when helping pt w/bath rt arm was swollen; 22APR92 6cm x 4cm knot noted @ inject site rt arm; warm to touch; redness extedning to 8cm x 8cm around inject site; t98.6 c/o soreness; seen by MD;

VAERS ID:43493 (history)  Vaccinated:1992-06-23
Age:5.0  Onset:1992-06-23, Days after vaccination: 0
Gender:Male  Submitted:1992-06-23, Days after onset: 0
Location:Utah  Entered:1992-07-13, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: none but had done this a/when had blood drawn 1 1/2 yrs ago;
Diagnostic Lab Data:
CDC Split Type: UT920020
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)SCLAVO127A34 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1369T1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0654H3PO 
Administered by: Public     Purchased by: Public
Symptoms: Gaze palsy, Shock, Stupor, Syncope, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: approx 1/2 hr p/recvd vax eyes rolled back in head, collapsed, tremors; then curled up in ball p/1-2 minutes regained consciousness, started vomiting; mom could not arouse; called clinic referred to ER; dx neurogenic shock;

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