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Found 557344 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:48036 (history)  Vaccinated:1992-09-02
Age:6.2  Onset:1992-09-02, Days after vaccination: 0
Gender:Female  Submitted:1992-09-09, Days after onset: 7
Location:Minnesota  Entered:1992-12-14, Days after submission: 96
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: MN92040
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2M310913IMA
Administered by: Public     Purchased by: Public
Symptoms: Injection site reaction, 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: t102, local reaction, fever & vomiting x 4 days;

VAERS ID:48252 (history)  Vaccinated:1992-10-19
Age:6.6  Onset:1992-10-20, Days after vaccination: 1
Gender:Male  Submitted:1992-12-15, Days after onset: 56
Location:Alabama  Entered:1992-12-21, 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 (NO BRAND NAME)UNKNOWN MANUFACTURER2A411032 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES243702PO 
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: area 4x4 cm redness & warmth lt deltoid area;

VAERS ID:48619 (history)  Vaccinated:1992-08-25
Age:6.3  Onset:1992-08-26, Days after vaccination: 1
Gender:Male  Submitted:1992-09-15, Days after onset: 20
Location:Michigan  Entered:1993-01-04, Days after submission: 111
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: allergic cough med
Diagnostic Lab Data:
CDC Split Type: MI92132
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0433V1SCLL
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Headache, Infection, Influenza, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: day p/vax had fever 103-104 ax; c/o stomach hurts, h/a off & on; to MD who stated intestional flu w/flu virus;

VAERS ID:48652 (history)  Vaccinated:1992-11-10
Age:6.1  Onset:1992-11-10, Days after vaccination: 0
Gender:Male  Submitted:1992-11-11, Days after onset: 1
Location:Michigan  Entered:1993-01-04, Days after submission: 54
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: MI92167
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MICHIGAN DEPT PUB HLTHTR1218B4 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1053V1 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3329624PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Insomnia, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: mom states pt began getting rash 10NOV92 p/getting vax; mom states was up all noc because of rash; mom states pt is not having difficulty breathing; seen by MD 11NOV92 w/rash (hives);

VAERS ID:48820 (history)  Vaccinated:1992-12-10
Age:6.2  Onset:1992-12-10, Days after vaccination: 0
Gender:Male  Submitted:1992-12-21, Days after onset: 11
Location:Oregon  Entered:1993-01-11, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Decadron IM; ? petit mal sz, felt couldn''t swallow;
CDC Split Type: OR9277
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3289334 LA
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Dysphagia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: pt fainted shortly p/inject; trendelenburg brought pt out of same, BP WNL, lungs clear, heart rate approx 70 per minute;

VAERS ID:48825 (history)  Vaccinated:1992-11-23
Age:6.4  Onset:1992-11-23, Days after vaccination: 0
Gender:Male  Submitted:1992-11-24, Days after onset: 1
Location:South Carolina  Entered:1993-01-11, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pt exp fever w/Pertusis @ 8mos w/DTP #1;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to pertussis as an infant
Diagnostic Lab Data: NONE
CDC Split Type: SC92142
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES3269642IMLL
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Muscle twitching, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: the evening p/vaxs pt started running 105 fever & jerking; went to ER; no infection noted in ears or throat;

VAERS ID:49376 (history)  Vaccinated:1993-01-12
Age:6.5  Onset:1993-01-13, Days after vaccination: 1
Gender:Unknown  Submitted:0000-00-00
Location:California  Entered:1993-01-25
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:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.1424V2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Hypokinesia, Neck pain
SMQs:, Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: pt had Hep B vax 12JAN93 approx 6PM woke AM of 13JAN unable to move neck to left-could turn head carefully to rt & touch chin to chest; neck hurt only when tried to turn or when in process of lying down; c/o h/a & dizziness;

VAERS ID:49395 (history)  Vaccinated:0000-00-00
Age:6.0  Onset:0000-00-00
Gender:Female  Submitted:1992-08-20
Location:Ohio  Entered:1993-01-25, Days after submission: 158
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp fever 104 for 7 days & vomiting w/DTP;
Other Medications: NA
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type: 920303201
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES    
Administered by: Other     Purchased by: Other
Symptoms: Blindness, Headache
SMQs:, Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad)
Write-up: pt recvd vax & had severe h/a for 2 days; 1 mo later, no vision during a h/a; h/a persisting as of 20AUG92; tx w/APAP;

VAERS ID:49664 (history)  Vaccinated:0000-00-00
Age:6.0  Onset:0000-00-00
Gender:Female  Submitted:1992-10-30
Location:California  Entered:1993-01-29, Days after submission: 91
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Augmenting for bite
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO4508
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST. 2  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Face oedema, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/3rd dose of vax devel erythema, swelling over eyes in 3 specific areas; eyes very swollen; given 4th dose w/no exacerbation; Bitten on the forearm by ferrel cat which was not caught;

VAERS ID:50032 (history)  Vaccinated:1992-07-24
Age:6.7  Onset:1992-07-31, Days after vaccination: 7
Gender:Male  Submitted:1992-12-21, Days after onset: 143
Location:Virginia  Entered:1993-01-29, 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: cervical adenitis, lo grade temp, lt OM
Preexisting Conditions:
Diagnostic Lab Data: Rabies antibody titer=1:200 20AUG92 phone report;
CDC Split Type: CO4387
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST. 3IMGM
Administered by: Unknown     Purchased by: Unknown
Symptoms: Condition aggravated, Hypokinesia, Nuchal rigidity
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: cervical adenopathy, poss ear infect on lt, stiff neck w/some limitation of motion; tx Amantidine; superficial scratch on back of neck @ hairline by rabid fox; 8SEP92 pt recovered;

VAERS ID:49579 (history)  Vaccinated:1992-10-27
Age:6.5  Onset:1992-10-29, Days after vaccination: 2
Gender:Male  Submitted:1992-11-02, Days after onset: 4
Location:New Jersey  Entered:1993-02-01, Days after submission: 91
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: asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE)LEDERLE LABORATORIES337909  LA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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: 2-3 days p/vax pt devel t102 & became nauseated (lasted 1 noc); several nocs p/exp achiness, & stomache pains; no redness, swelling, or warmth to the inject site;

VAERS ID:49582 (history)  Vaccinated:1993-01-21
Age:6.0  Onset:1993-01-21, Days after vaccination: 0
Gender:Male  Submitted:1993-01-27, Days after onset: 6
Location:New Hampshire  Entered:1993-02-01, Days after submission: 5
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 LABORATORIES2C410124IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0668D3PO 
Administered by: Private     Purchased by: Public
Symptoms: Ecchymosis, Injection site hypersensitivity, Injection site oedema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: moderate deltoid swelling blotchy redness & mild ecchymoses @ site of inject;

VAERS ID:49600 (history)  Vaccinated:1993-01-21
Age:6.9  Onset:1993-01-22, Days after vaccination: 1
Gender:Female  Submitted:1993-01-22, Days after onset: 0
Location:Florida  Entered:1993-02-02, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt''s sibling exp cellulitis w/DTP #5 & 2;
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES332999 IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0668C PO 
Administered by: Other     Purchased by: Public
Symptoms: Cellulitis, Injection site mass, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 7cm x 5cm indurated hot are lt thigh; cellulitis secondary to vax;

VAERS ID:49855 (history)  Vaccinated:1992-12-13
Age:6.0  Onset:0000-00-00
Gender:Female  Submitted:1992-12-16
Location:California  Entered:1993-02-08, Days after submission: 54
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: allergic to Amoxicillin
Diagnostic Lab Data: NONE
CDC Split Type: BER10073
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD127391A PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Diarrhoea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: vomiting & diarrhea; taken to urgent care because 103.6 fever & cont to vomit & can not hold in fluids;

VAERS ID:49871 (history)  Vaccinated:1993-02-02
Age:6.1  Onset:1993-02-02, Days after vaccination: 0
Gender:Female  Submitted:1993-02-03, Days after onset: 1
Location:Hawaii  Entered:1993-02-11, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 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 LABORATORIES2M310910IMRL
Administered by: Other     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, 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: 5.5cm x 3cm red, raised, tender, indurated @ inject site on rt thigh; responded to warm compresses; no generalized sx noted;

VAERS ID:50061 (history)  Vaccinated:1993-02-04
Age:6.9  Onset:1993-02-04, Days after vaccination: 0
Gender:Female  Submitted:1993-02-10, Days after onset: 6
Location:New Jersey  Entered:1993-02-18, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3249000IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 315PM devel hive @ inject site; hive 2 1/2 cm x 1 cm, BP 102/62, P92; c/o itching @ site of inject; DPH given;

VAERS ID:50243 (history)  Vaccinated:1993-01-04
Age:6.0  Onset:1993-01-06, Days after vaccination: 2
Gender:Female  Submitted:1993-01-11, Days after onset: 5
Location:Georgia  Entered:1993-02-22, Days after submission: 42
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: GA93008
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0262V1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Myalgia, Skin nodule
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: 11JAN93 mom reports that pt has nodule which is increasing in size; pt c/o soreness to affected area;

VAERS ID:50246 (history)  Vaccinated:1993-01-12
Age:6.3  Onset:1993-01-12, Days after vaccination: 0
Gender:Male  Submitted:1993-01-12, Days after onset: 0
Location:Georgia  Entered:1993-02-22, Days after submission: 41
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: GA93011
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2M310914IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0557V1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0657L3PO 
Administered by: Public     Purchased by: Public
Symptoms: Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: approx 5 mins p/shot pt became pale & clammy; placed in step mom''s lap w/feet in air p/about 5 mins-color had returned; pt felt fine; no nausea or pain anywhere; pt did not loose consciousness @ anytime;

VAERS ID:50344 (history)  Vaccinated:1993-01-05
Age:6.9  Onset:1993-01-05, Days after vaccination: 0
Gender:Unknown  Submitted:1993-01-05, Days after onset: 0
Location:Maryland  Entered:1993-02-26, Days after submission: 52
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Tine by Lederle lot# 332980 5JAN93;
Current Illness: NONE
Preexisting Conditions: rt mid-axillary llipoma
Diagnostic Lab Data:
CDC Split Type: MD93001
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0969V1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Asthma, Laryngospasm, Rash
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (narrow), Dystonia (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: erythema of face, cervical region; tightness on throat as per pollant; lungs: bilateral resp & wheezes w/rhonchi;

VAERS ID:50412 (history)  Vaccinated:1993-01-12
Age:6.6  Onset:1993-01-13, Days after vaccination: 1
Gender:Female  Submitted:1993-02-05, Days after onset: 23
Location:Idaho  Entered:1993-03-01, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: ID93013
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2M310913IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0557V1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0666A3PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Pruritus, Rash maculo-papular, 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: the day p/vax pt devel red-raised 2x2 area on lt deltoid w/red blotchy rash extending down arm; pruritis was noted; seen by MD, hives dx & DPH prescribed; rash lasted 48 hrs;

VAERS ID:50468 (history)  Vaccinated:1993-02-17
Age:6.0  Onset:1993-02-18, Days after vaccination: 1
Gender:Female  Submitted:1993-02-24, Days after onset: 6
Location:Oklahoma  Entered:1993-03-03, 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: Dimetapp
Current Illness: URI-viral
Preexisting Conditions: hx of infrequent urticaria;
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1053A40IMA
Administered by: Military     Purchased by: Military
Symptoms: Condition aggravated, Erythema multiforme
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recvd Engerix-vax initial dose 17FEB93; on 18FEB93 devel hives treated w/DPH; on 19FEB93 devel erythema multiforme treated w/steroids recovery completed on follow-up 22FEB93; pt had hx of recurrent hives;

VAERS ID:50578 (history)  Vaccinated:1993-02-15
Age:6.2  Onset:1993-02-18, Days after vaccination: 3
Gender:Male  Submitted:1993-02-22, Days after onset: 4
Location:Florida  Entered:1993-03-08, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1092A21 LA
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Asthenia, Crying, Hypertonia, Myalgia, Pyrexia, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 18FEB93 915AM pt woke up screaming; mom noted arms & hands flexing while rest of body tense t103R; pt told mom everything in room was moving slowly then fast; went to sleep 1 hr later screaming again; pt tired & achey feeling;

VAERS ID:50579 (history)  Vaccinated:1993-01-07
Age:6.1  Onset:1993-01-10, Days after vaccination: 3
Gender:Male  Submitted:1993-02-22, Days after onset: 43
Location:Florida  Entered:1993-03-08, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1057A20 LA
Administered by: Private     Purchased by: Private
Symptoms: Agitation, Crying, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)
Write-up: 9JAN93 pt vomited @ MN; 10JAN93 pt woke up screaming on 3 different occasions that noc; @ least an hr apart; no noted fever;

VAERS ID:50663 (history)  Vaccinated:1992-12-02
Age:6.5  Onset:1992-12-04, Days after vaccination: 2
Gender:Female  Submitted:1992-12-04, Days after onset: 0
Location:Colorado  Entered:1993-03-10, Days after submission: 96
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO93010
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2A411273IMLA
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Gaze palsy, Hypertonia, Pyrexia, Somnolence, Stupor, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recvd vax 2DEC92 & 4DEC92 AM began clenching & unclenching hands quickly, knees shook, eyes rolled back in head, unresponsive lasted 10 sec; pt slept most of 3DEC92; pt called clinic & advised to call MD; t38.1, collapse, sz;

VAERS ID:50800 (history)  Vaccinated:1993-03-09
Age:6.0  Onset:1993-03-09, Days after vaccination: 0
Gender:Male  Submitted:1993-03-09, Days after onset: 0
Location:New York  Entered:1993-03-15, 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:
Current Illness: NONE
Preexisting Conditions: allergies-milk products;
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3359304IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1705T1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3409254PO 
Administered by: Other     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: papular urticaria rash immed p/shots were given; given DPH;

VAERS ID:50876 (history)  Vaccinated:1993-02-23
Age:6.9  Onset:1993-02-23, Days after vaccination: 0
Gender:Male  Submitted:1993-03-08, Days after onset: 13
Location:Utah  Entered:1993-03-17, Days after submission: 9
Life Threatening? Yes
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: CBC, ESR, Chem panel all nl;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3269643IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3349453PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Brain oedema, Hallucination, Headache, Hypokinesia, Insomnia, Myalgia, Neck pain, Thinking abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: severe h/a & severe pain in back of neck, aching in entire body so bad unable to walk, unable to sleep entire noc of 23FEB93; didn''t know any of family & hallucinating & posturing of hands, suspected brain & brain stem swelling; t100-102;

VAERS ID:50889 (history)  Vaccinated:1993-02-03
Age:6.5  Onset:1993-02-04, Days after vaccination: 1
Gender:Female  Submitted:1993-03-10, Days after onset: 34
Location:Montana  Entered:1993-03-18, 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: MT93010
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2B411524IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3309293PO 
Administered by: Public     Purchased by: Public
Symptoms: Influenza, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: mom states that pt woke up w/fever of 103 R; pt had flu; pt seen by MD;

VAERS ID:51822 (history)  Vaccinated:1992-10-02
Age:6.1  Onset:1992-10-06, Days after vaccination: 4
Gender:Male  Submitted:1992-10-20, Days after onset: 14
Location:Colorado  Entered:1993-04-12, Days after submission: 174
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
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH49282171 LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: cluster of vesicles just below vax site; reddened base but no induration; tender to pressure; no drainage; no other rash inject site lt arm;

VAERS ID:53270 (history)  Vaccinated:1992-08-24
Age:6.0  Onset:1992-08-25, Days after vaccination: 1
Gender:Female  Submitted:1992-08-27, Days after onset: 2
Location:New York  Entered:1993-04-12, Days after submission: 228
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: healthy
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: 920308301
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES324900 IMA
Administered by: Private     Purchased by: Private
Symptoms: Hypotonia, Pyrexia, Stupor, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt recvd vax 24AUG92 & had fever of 39.5 ax & vomited several times; 26AUG parents reported that pt collapsed twice & was briefly unresponsive-not thought to be sz; MD dx hypotonia; also on 26AUG had fever & vomited; rx w/APAP; recovered;

VAERS ID:51937 (history)  Vaccinated:1992-10-15
Age:6.1  Onset:1992-11-06, Days after vaccination: 22
Gender:Male  Submitted:1993-02-08, Days after onset: 94
Location:Michigan  Entered:1993-04-19, Days after submission: 69
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? Yes
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MI93052
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0803V1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Generalised oedema, Nephrotic syndrome, Rash, Urinary tract infection, Weight increased
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Proteinuria (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 31OCT92 pt swelled up gained 20# in 2 wks had a rash; no fever; pt taken to MD mom told pt OK then returned dx URI; dx nephrotic synd;

VAERS ID:53388 (history)  Vaccinated:1992-04-28
Age:6.5  Onset:1992-04-30, Days after vaccination: 2
Gender:Male  Submitted:1992-05-01, Days after onset: 1
Location:Connecticut  Entered:1993-05-11, Days after submission: 375
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: NONE
Preexisting Conditions: pt recvd MMR lot# 1638T on 23JAN89;
Diagnostic Lab Data: NONE
CDC Split Type: 920153201
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3189084IML
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1638T1SCL
Administered by: Private     Purchased by: Private
Symptoms: Gait disturbance, Injection site hypersensitivity, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 1 of 3 pts who recvd DTP/MMR; immunized from the same DTP vial pt devel fever 101 & 8 cm area of erythema below the inject site; pt also limping; seen by MD; treated w/APAP;

VAERS ID:52594 (history)  Vaccinated:1993-02-04
Age:6.0  Onset:1993-02-25, Days after vaccination: 21
Gender:Male  Submitted:1993-05-12, Days after onset: 75
Location:Unknown  Entered:1993-05-14, Days after submission: 2
Life Threatening? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations: pt exp double vision, dizziness @ 6 w/Engerix-B #1 dose;
Other Medications: NONE
Current Illness:
Preexisting Conditions: pt has hx of neurological disorders in the past;
Diagnostic Lab Data:
CDC Split Type: EBU930746
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
Administered by: Other     Purchased by: Other
Symptoms: Aphasia, Coordination abnormal, Encephalitis, Neoplasm, Neuropathy, Nystagmus, Paraesthesia, Vertigo
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (narrow), Ocular motility disorders (narrow), Tumours of unspecified malignancy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recvd 2nd dose of vax 4FEB92 & 3 wks post inject exp double vision, dizziness & encephalitis; pt''s MD states devel vertigo, nystagmus, truncal ataxia, aphasia & numbness of the lt side of face; MRI''s done; demyelination of cerebellum;

VAERS ID:52650 (history)  Vaccinated:1993-04-14
Age:6.0  Onset:1993-04-14, Days after vaccination: 0
Gender:Female  Submitted:1993-04-27, Days after onset: 13
Location:Montana  Entered:1993-05-17, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp rxn @ 8mos w/DTP # 2, 3, & 4;
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: UA-WNL;
CDC Split Type: MT93019
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES2H411623IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0672K3PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Asthenia, Hypotonia, Pyrexia, Somnolence, Urinary incontinence, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), 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), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: devel t104 1130PM, vomited throughout noc; had been given APAP; very weak, lethargic, lost control of bladder; while sleeping would cry, thrash around; seen in ER 730AM; mom reports pt limp like noodle;

VAERS ID:52820 (history)  Vaccinated:1993-04-16
Age:6.6  Onset:0000-00-00
Gender:Female  Submitted:1993-04-16
Location:Maryland  Entered:1993-05-19, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3429114IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1269V SC 
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3409303PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: 4.5cm wheal & flair immed @ inject site for MMR;

VAERS ID:52943 (history)  Vaccinated:1993-05-05
Age:6.1  Onset:1993-05-15, Days after vaccination: 10
Gender:Female  Submitted:1993-05-17, Days after onset: 2
Location:Florida  Entered:1993-05-20, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: fracternal twin recvd MMR same date w/no reaction;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1686V1SCLL
Administered by: Private     Purchased by: Private
Symptoms: Erythema multiforme
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: E. multiforme involving face, legs, arms, trunk;

VAERS ID:53197 (history)  Vaccinated:1993-03-26
Age:6.4  Onset:1993-04-02, Days after vaccination: 7
Gender:Male  Submitted:1993-05-17, Days after onset: 44
Location:Florida  Entered:1993-05-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: WBC-9.8; Hgb 12.8; Plt-152;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1503V1SC 
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: erythematous rash on abdo started approx 7 days p/receiving MMR vax;

VAERS ID:53570 (history)  Vaccinated:1993-04-28
Age:6.0  Onset:1993-04-29, Days after vaccination: 1
Gender:Female  Submitted:1993-05-10, Days after onset: 11
Location:Ohio  Entered:1993-06-03, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Antibiotics for ear & throat infects;
Current Illness: ear throat infect & abcessed teeth;
Preexisting Conditions: abcessed teeth-took Erythromycin;
Diagnostic Lab Data: x-rays show abscessed tests;
CDC Split Type: OH93032
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES2B410063IMLA
Administered by: Public     Purchased by: Public
Symptoms: Condition aggravated
SMQs:
Write-up: pt recvd vax 28APR93 pt had oral temp 99.7 & Abcessed teeth; 29APR93 t102-103 taken to ER & adm x 3 hrs for IV''s; 30APR93 seen by MD ordered x-ray & blood test; noc child''s t104;

VAERS ID:53809 (history)  Vaccinated:1993-02-04
Age:6.8  Onset:1993-02-04, Days after vaccination: 0
Gender:Male  Submitted:1993-02-05, Days after onset: 1
Location:Pennsylvania  Entered:1993-06-09, Days after submission: 123
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt''s sibling exp redness & swelling @ site of inject @ 2mos w/DTP #1;
Other Medications: Epi, DPH
Current Illness: NONE
Preexisting Conditions: allergy to bee stings;
Diagnostic Lab Data: blood work done @ hosp;
CDC Split Type: PA93015
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0670V1SC 
Administered by: Public     Purchased by: Public
Symptoms: Back pain, Cyanosis, Hyperhidrosis, Pallor, Somnolence
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: approx 10 min p/receiving vax c/o back pain, very pale, lethargic, diaphoretic & cyanotic around mouth; pt laid down w/feet elevated, pulse 110, BP 90/60; MD administered 0.3 Epi & DPH; pt was given 02;

VAERS ID:54520 (history)  Vaccinated:1993-06-23
Age:6.0  Onset:1993-06-24, Days after vaccination: 1
Gender:Female  Submitted:1993-06-25, Days after onset: 1
Location:Unknown  Entered:1993-07-06, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3329870 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)PFIZER/WYETH0672M12 PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: lt thigh redness, tenderness;

VAERS ID:55116 (history)  Vaccinated:1993-07-27
Age:6.0  Onset:1993-07-28, Days after vaccination: 1
Gender:Female  Submitted:1993-08-03, Days after onset: 6
Location:Kentucky  Entered:1993-08-06, 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: PPD
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3329993 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.087241IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3389283PO 
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: local reaction to vax red, hot tender, faded over 48 hrs;

VAERS ID:55164 (history)  Vaccinated:1993-08-05
Age:6.2  Onset:1993-08-05, Days after vaccination: 0
Gender:Male  Submitted:1993-08-05, Days after onset: 0
Location:California  Entered:1993-08-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: BP, P,R only;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2E410733 LA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Hypotonia, Pallor
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: pt stood up from getting shot said felt funny, turned pale, & went limp; mom caught pt; no loss of consciousness; BP 100/62, HR regular, BP p/3mins 108/74; tired;

VAERS ID:55282 (history)  Vaccinated:1993-07-28
Age:6.8  Onset:1993-07-29, Days after vaccination: 1
Gender:Female  Submitted:1993-08-13, Days after onset: 15
Location:Colorado  Entered:1993-08-17, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp anaphylaxis @ 2mos w/DTP #1;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: anaphylaxis secondary to DTP vax ok w/DT;
Diagnostic Lab Data: UA-nl; throat cult-neg;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0841W0 LA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Asthenia, Oedema, Osteoarthritis, Pruritus, Pyrexia, Rash, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 29JUL-2AUG fatigue, edema, hives, rash, itching; 3AUG fever; 5AUG red, swollen, painful joint;

VAERS ID:55405 (history)  Vaccinated:1993-08-02
Age:6.3  Onset:1993-08-03, Days after vaccination: 1
Gender:Female  Submitted:1993-08-06, Days after onset: 3
Location:Idaho  Entered:1993-08-23, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: ID93057
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES3549350IMLL
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Oedema peripheral
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: swelling of the thigh extending over knee cap; caused difficulty walking;

VAERS ID:55415 (history)  Vaccinated:1993-08-05
Age:6.1  Onset:1993-08-05, Days after vaccination: 0
Gender:Male  Submitted:1993-08-09, Days after onset: 4
Location:Missouri  Entered:1993-08-23, Days after submission: 14
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: hx of previous seizures eval
Diagnostic Lab Data:
CDC Split Type: MO93070
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2O410784IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1204V1 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0679F3PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Convulsion, Hypoventilation, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow), Hypoglycaemia (broad)
Write-up: approx 10 mins p/administration of vax pt had generalized clonic/tonic activity for 1-2 mins; resp depressed but w/o apnea; post ictal state noted BP 116/60, P72;

VAERS ID:55539 (history)  Vaccinated:1993-08-05
Age:6.5  Onset:1993-08-05, Days after vaccination: 0
Gender:Female  Submitted:1993-08-05, Days after onset: 0
Location:Texas  Entered:1993-08-27, 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: NONE
Diagnostic Lab Data: NONE
CDC Split Type: TX93133
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES3J410624 RL
HIBV: HIB (HIBTITER)LEDERLE PRAXSISM190JF0 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1504V1 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3529474PO 
Administered by: Public     Purchased by: Public
Symptoms: Gaze palsy, Pallor, Stupor, Urinary incontinence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: pt non-responsive for 30 seconds, eyes rolled back, lip color pallor, incontin of urine; p/30 seconds pt was responsive upon stimuli, lip color light pink; pulse & resp nl;

VAERS ID:55589 (history)  Vaccinated:1993-08-17
Age:6.6  Onset:1993-08-17, Days after vaccination: 0
Gender:Male  Submitted:1993-08-19, Days after onset: 2
Location:California  Entered:1993-08-30, 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: rubella (disease) 2JUN93 per mom;
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES2D410784IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0682F2PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Oedema, Pain, Pyrexia, Rash, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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 vax 17AUG93; t37.8 that evening & cont through the next day; swelling & erythema occurred upon awakening on 18AUg93; initially arm was very painful but pt was able to use arm if needed; warm to touch, induration

VAERS ID:55779 (history)  Vaccinated:1993-08-23
Age:6.0  Onset:1993-08-23, Days after vaccination: 0
Gender:Male  Submitted:1993-08-30, Days after onset: 7
Location:Alabama  Entered:1993-09-07, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness:
Preexisting Conditions: bells palsey
Diagnostic Lab Data:
CDC Split Type: AL93038
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3549331 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1506V1 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3469321PO 
Administered by: Public     Purchased by: Other
Symptoms: Bradycardia, Cyanosis, Hypotension, Hypotonia, Pallor, Stupor, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: 915AM pt recvd vax & approx 920AM mom had pt in arms who was limp, gray, lips were cyanotic, non responsive; pt was breathing BP 60/40, apical pulse 56 weak; ambulance called; vomiting;

VAERS ID:55799 (history)  Vaccinated:1993-06-10
Age:6.5  Onset:1993-06-11, Days after vaccination: 1
Gender:Male  Submitted:1993-06-11, Days after onset: 0
Location:Michigan  Entered:1993-09-07, Days after submission: 88
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: history of asthma
Preexisting Conditions: not being treated @ present time;
Diagnostic Lab Data:
CDC Split Type: MI93098
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MICHIGAN DEPT PUB HLTHTR1219A4 RL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3489432PO 
Administered by: Public     Purchased by: Public
Symptoms: Condition aggravated, Dyspepsia, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3AM morning of 11JUN93 woke mom w/t104.2, sl wheezing, h/a, stomach upset-no vomiting; has been on APAP & using cool compresses; lowest temp 103.4 @ 830AM;

VAERS ID:55824 (history)  Vaccinated:1993-08-11
Age:6.0  Onset:1993-08-12, Days after vaccination: 1
Gender:Male  Submitted:1993-08-18, Days after onset: 6
Location:Missouri  Entered:1993-09-07, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma long term;
Diagnostic Lab Data:
CDC Split Type: MO93077
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3449174IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1691V1SCLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES679F3PO 
Administered by: Public     Purchased by: Public
Symptoms: Malaise, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 12AUG devel temp of 102.5 early AM; vomited afternoon temp went down; 13AUG & 14AUG listless, no temp, no rash; 15AUG93 devl very red pen point size rash on cheeks, around mouth, arms & upper trunk; temp 99.3 17AUG93, sl red rash;

VAERS ID:55875 (history)  Vaccinated:1993-08-31
Age:6.4  Onset:1993-08-31, Days after vaccination: 0
Gender:Female  Submitted:1993-08-31, Days after onset: 0
Location:Alaska  Entered:1993-09-07, Days after submission: 7
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: routine check up
Preexisting Conditions: NONE
Diagnostic Lab Data: healthy kid all around;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1119A20IMLL
Administered by: Private     Purchased by: Public
Symptoms: Abdominal pain, Arthralgia, Headache, Hypotonia, Nausea, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Hypoglycaemia (broad)
Write-up: pt recvd vax c/o vague abdo pain then nausea; pt turned grey 1" later, went totally limp w/in 1" later; checked by MD pulse steady resp adequate; color slowly returned in 15 mins; 10 mins p/fainting c/o joint pain h/a;

VAERS ID:56234 (history)  Vaccinated:1993-07-06
Age:6.5  Onset:1993-07-06, Days after vaccination: 0
Gender:Female  Submitted:1993-07-08, Days after onset: 2
Location:Oregon  Entered:1993-09-24, Days after submission: 78
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: OR9331
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2D410371IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0670M1PO 
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 6JUL onset fever 102 & vomiting 4-5 hrs p/vax; also c/o dizziness; vomited x 3 during noc; tc to mom 7JUL Am-fever down, no more vomiting; tc form mom 4PM 7JUL fever 104.3, nausea; APAP given;

VAERS ID:56351 (history)  Vaccinated:1993-08-19
Age:6.7  Onset:0000-00-00
Gender:Female  Submitted:1993-09-27
Location:Pennsylvania  Entered:1993-09-29, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES93090217
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Purpura, Pyrexia, Urinary retention
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt recvd vax 19AUG93 & devel purpura, fever, & was unable to urinate; pt was admitted to hosp where sx described as Henoch-Schonlein Purpura;

VAERS ID:56365 (history)  Vaccinated:1993-08-16
Age:6.8  Onset:1993-08-16, Days after vaccination: 0
Gender:Female  Submitted:1993-08-19, Days after onset: 3
Location:Tennessee  Entered:1993-09-30, Days after submission: 42
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: chronic sinus problems-tested for allergies-has none;
Diagnostic Lab Data: NONE
CDC Split Type: TN93086
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3509164IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0340W1 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0656C4PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Oedema peripheral, Pain, Pruritus, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recvd 16AUG93 that evening lt arm was swollen, hot, tender; By Tuesday a rash had broken out @ the vax site & was itching all over; called MD & told to take DPH; seen by 18AUG;

VAERS ID:56417 (history)  Vaccinated:1993-06-14
Age:6.4  Onset:1993-06-14, Days after vaccination: 0
Gender:Female  Submitted:1993-06-17, Days after onset: 3
Location:Maryland  Entered:1993-10-05, Days after submission: 110
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: MD93035
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2E410604IMLA
Administered by: Public     Purchased by: Public
Symptoms: Ecchymosis, Hypokinesia, Oedema, Pain, Rash, Skin nodule, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: as soon as arrived home mom noted bruising, swelling, hard knot; pt c/o pain in arm x 3-4 days; was reluctant to move arm x 3-4 days; 17JUN noted 2'' induration & 4" erythema & tender to touch & warm;

VAERS ID:56499 (history)  Vaccinated:1993-08-03
Age:6.4  Onset:1993-08-03, Days after vaccination: 0
Gender:Male  Submitted:1993-08-17, Days after onset: 14
Location:California  Entered:1993-10-12, Days after submission: 56
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CA93079
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3439834 LA
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Injection site oedema, Oedema peripheral, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)
Write-up: severe crying for 2 hrs following vax admin; arm became quite warm & swollen; inject site still warm & swollen 4 days p/inject w/pt favoring & holding the arm;

VAERS ID:56546 (history)  Vaccinated:1993-02-25
Age:6.0  Onset:1993-02-25, Days after vaccination: 0
Gender:Female  Submitted:1993-09-28, Days after onset: 214
Location:North Carolina  Entered:1993-10-14, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Similar rxn p/DTP & OPV 05JUN87 and p/pedDT, OPV, MMR 17JUL92;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NC9378
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3269641 LL
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Anorexia, Cough, Diarrhoea, Hypotonia, Pallor, Pyrexia, Somnolence
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Pseudomembranous colitis (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), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt recvd vax & 45mins to 1 hr later exp temp almost to 104, diarrhea, loss of appetite, hacking cough, lethargic, gray, restless, limp, irritable;

VAERS ID:56623 (history)  Vaccinated:1993-09-21
Age:6.0  Onset:1993-09-24, Days after vaccination: 3
Gender:Female  Submitted:1993-09-24, Days after onset: 0
Location:Alaska  Entered:1993-10-18, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pt exp rxn w//DTP @ 2yrs old w/2nd dose;
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: AK93021
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3429011IMLA
Administered by: Public     Purchased by: Public
Symptoms: Ecchymosis, Headache, Injection site oedema, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recvd vax & 48 hrs later mom noticed large, swollen area lt arm; t102, c/o brain felt jiggly; arm area bruised;

VAERS ID:56755 (history)  Vaccinated:1993-06-28
Age:6.4  Onset:1993-06-28, Days after vaccination: 0
Gender:Male  Submitted:1993-06-28, Days after onset: 0
Location:California  Entered:1993-10-25, Days after submission: 119
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)UNKNOWN MANUFACTURER 2IM 
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 0IM 
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER 2IM 
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Chills, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: weakness, vomiting, rigors, high fever, 20 mins p/inject;

VAERS ID:56963 (history)  Vaccinated:1993-09-23
Age:6.5  Onset:1993-09-30, Days after vaccination: 7
Gender:Male  Submitted:1993-10-07, Days after onset: 7
Location:Illinois  Entered:1993-11-02, Days after submission: 26
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: IL93108
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Drug ineffective, Face oedema, Infection, Lacrimal disorder, Otitis media, Rash, Skin nodule, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Lack of efficacy/effect (narrow), Extravasation events (injections, infusions and implants) (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 23SEP93 reddened ears, rash on face w/in a few days, bumps on knuckles, eyes puffy & watery & rash on front of legs; dx measles;

VAERS ID:60220 (history)  Vaccinated:1992-12-28
Age:6.0  Onset:1992-12-28, Days after vaccination: 0
Gender:Female  Submitted:1993-02-10, Days after onset: 44
Location:California  Entered:1993-11-03, Days after submission: 266
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: EBU930240
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM    
Administered by: Private     Purchased by: Private
Symptoms: Anorexia
SMQs:
Write-up: Received 1 injection for prophylaxis & that evening exp loss of appetite;

VAERS ID:60486 (history)  Vaccinated:1993-05-18
Age:6.0  Onset:1993-05-23, Days after vaccination: 5
Gender:Male  Submitted:1993-05-27, Days after onset: 4
Location:New Jersey  Entered:1993-11-03, Days after submission: 160
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: EBU930855
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1123A221 LL
Administered by: Private     Purchased by: Private
Symptoms: Infection, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recvd vax & 23MAY93 following 2nd inject exp fifth disease (erythema infectiosum); pt was seen by MD; did not receive treatment; sx have not subsided;

VAERS ID:61343 (history)  Vaccinated:1993-06-25
Age:6.0  Onset:0000-00-00
Gender:Female  Submitted:1993-07-09
Location:Illinois  Entered:1993-11-03, Days after submission: 117
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: EBU931012
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM849A40IMLA
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recvd vax & exp hive-like rash;

VAERS ID:57237 (history)  Vaccinated:1993-10-18
Age:6.0  Onset:1993-10-19, Days after vaccination: 1
Gender:Female  Submitted:1993-11-05, Days after onset: 17
Location:Minnesota  Entered:1993-11-09, 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
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: MN93055
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES2B41155 IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES346928 PO 
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: fever, vomiting began 1AM on OCT93 & cont throughout the day total of 11 times;

VAERS ID:57292 (history)  Vaccinated:1993-08-09
Age:6.2  Onset:1993-08-10, Days after vaccination: 1
Gender:Female  Submitted:1993-08-15, Days after onset: 5
Location:California  Entered:1993-11-12, Days after submission: 89
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Mantoux 9AUG93;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: CA93096
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3489864IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1507V1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES067K3PO 
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Diarrhoea, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: fever to 104 10AUG93; fever to 100 w/poor appetite & diarrhea 11AUG93;

VAERS ID:57306 (history)  Vaccinated:1993-11-05
Age:6.2  Onset:1993-11-05, Days after vaccination: 0
Gender:Female  Submitted:1993-11-08, Days after onset: 3
Location:Maine  Entered:1993-11-12, 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: Pedi-rynatin, Theopholin, slo bid;
Current Illness: maybe?
Preexisting Conditions: asthmatic
Diagnostic Lab Data: NA
CDC Split Type: ME93050
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH49382173IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Hyperhidrosis, Muscle twitching, Somnolence, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt dizzy, lethargic, difficulty in waking up, twitching, cold sweats, hives on arms;

VAERS ID:57374 (history)  Vaccinated:1993-07-26
Age:6.0  Onset:1993-07-27, Days after vaccination: 1
Gender:Female  Submitted:1993-07-28, Days after onset: 1
Location:Arkansas  Entered:1993-11-15, Days after submission: 110
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Septra;
Current Illness: NONE
Preexisting Conditions: erythromycin-diarrhea;
Diagnostic Lab Data: NONE
CDC Split Type: AR9355
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3489824IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0680M3PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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: pt recvd vax 27JUL93 w/rash, t99; pt devel quarter size red & raised wheals on face, arms, neck & trunk; no wheezing or SOB; rt arm red & swollen @ inject site w/rest of arm from shoulder to wrist whealed up;

VAERS ID:57520 (history)  Vaccinated:1993-09-15
Age:6.1  Onset:1993-09-15, Days after vaccination: 0
Gender:Male  Submitted:1993-09-16, Days after onset: 1
Location:Arkansas  Entered:1993-11-19, Days after submission: 64
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp fever site react @ 5 y/o w/DTP #2;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: AR9369
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3489832IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0686C2PO 
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Arthralgia, Crying, Injection site hypersensitivity, Injection site oedema, 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), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt recvd vax woke up 11PM crying, screaming, c/o extreme pain gerneralized fever $g101, vomiting started p/APAP which was given Q4 @ 2AM fever $g103; pt had redness & swelling @ inject site & advised MD call/visit;

VAERS ID:57545 (history)  Vaccinated:1993-11-09
Age:6.3  Onset:1993-11-09, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:California  Entered:1993-11-19
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: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3359314SCLA
Administered by: Private     Purchased by: Private
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: local react lt deltoid 7PM; redness, swelling 7cm x 11cm over 24 hrs period;

VAERS ID:57560 (history)  Vaccinated:1993-10-26
Age:6.0  Onset:1993-10-26, Days after vaccination: 0
Gender:Female  Submitted:1993-10-26, Days after onset: 0
Location:Arizona  Entered:1993-11-22, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type: AZ9332
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES2B410064IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1289W1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3529424PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax & devel immediate redness & wheal above inject site of MMR; no c/o discomfort; ice pack to inject site; MD notified & DPH given; slight swelling inject site;

VAERS ID:57656 (history)  Vaccinated:1993-11-02
Age:6.1  Onset:1993-11-07, Days after vaccination: 5
Gender:Male  Submitted:1993-11-18, Days after onset: 11
Location:Iowa  Entered:1993-11-23, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: early lt OM rx Suprax 2 tsp
Preexisting Conditions: down''s synd w/endocardial cushion defect repair of ASD lesion;
Diagnostic Lab Data: EEG-abn;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES3549350IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0860W0IMLL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3549644PO 
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Electroencephalogram abnormal
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: focal motor seizures five days post vax; EEG was consistent w/sz disorder; no prior hx of sz;

VAERS ID:57764 (history)  Vaccinated:1993-10-19
Age:6.4  Onset:1993-10-20, Days after vaccination: 1
Gender:Male  Submitted:1993-10-21, Days after onset: 1
Location:Wisconsin  Entered:1993-11-29, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WI93076
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1095A42 RA
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: devel hives on 21OCT93 p/receiving vax on 19OCT93; used calamine lotion and baking soda bath x 2;

VAERS ID:57817 (history)  Vaccinated:1993-07-21
Age:6.8  Onset:1993-07-22, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Ohio  Entered:1993-11-30
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: cerebralpalsy, hx sx;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES27410924IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.055591 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES681K4PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Apnoea, Condition aggravated, Convulsion, Cyanosis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow), Hypoglycaemia (broad)
Write-up: pt suffered a sz the day p/the vax; pt turned blue, stopped breathing per mom; brought to ER & recvd 02 and was observed;

VAERS ID:58093 (history)  Vaccinated:1993-10-29
Age:6.0  Onset:1993-10-29, Days after vaccination: 0
Gender:Female  Submitted:1993-11-18, Days after onset: 20
Location:Pennsylvania  Entered:1993-12-09, Days after submission: 21
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: PA93174
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1185V1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: w/in 5 mins of vax pt exp red rash devel over upper rt arm; inject site was hot, no itching, no resp discomfort; ice pact immed applied @ clinic;

VAERS ID:58141 (history)  Vaccinated:1993-09-21
Age:6.2  Onset:1993-09-21, Days after vaccination: 0
Gender:Female  Submitted:1993-09-24, Days after onset: 3
Location:Alaska  Entered:1993-12-13, Days after submission: 80
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: AK93026
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES3J410613IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3609432PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Insomnia, Pyrexia, Screaming
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5inch red & swollen area to lt deltoid; fever of 104, cried all noc p/vax; woke up once per hr; 2 nights p/vax missed 3 days of school; given APAP;

VAERS ID:63784 (history)  Vaccinated:1993-02-19
Age:6.7  Onset:1993-02-19, Days after vaccination: 0
Gender:Female  Submitted:1993-02-24, Days after onset: 5
Location:Puerto Rico  Entered:1994-01-03, Days after submission: 313
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: congenital defect of the lt hip;
Diagnostic Lab Data: mom refers that aseptic measures were not done by nurse prior to inject; pt was hospitalized for cellulitis lt thigh @ inject site;
CDC Split Type: PR9310
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3379015 LL
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0679B5PO 
Administered by: Public     Purchased by: Public
Symptoms: Injection site inflammation, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: during the afternoon of the day vax was administered 19FEB93, pt started to have t38C; during the following day pt had inc pain & inflammation in the area; on the 3rd day pt was eval by MD & referred to hosp;

VAERS ID:58841 (history)  Vaccinated:1993-11-04
Age:6.1  Onset:1993-11-05, Days after vaccination: 1
Gender:Female  Submitted:1993-11-23, Days after onset: 18
Location:Washington  Entered:1994-01-06, Days after submission: 44
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:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: WA93983
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES3J410633IMRA
Administered by: Public     Purchased by: Public
Symptoms: Chills, 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: 6 hrs following vax pt had teeth chattering, t103, vomitted APAP given; 4AM pt had t103 & vomitted & chattering teeth again;

VAERS ID:59248 (history)  Vaccinated:1994-01-05
Age:6.2  Onset:1994-01-05, Days after vaccination: 0
Gender:Female  Submitted:1994-01-15, Days after onset: 10
Location:Missouri  Entered:1994-01-25, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: BP 88/60, P120, R16;
CDC Split Type: MO94004
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1273W0SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES3589501PO 
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3569030IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Pruritus, Tachycardia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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 vax while leaving & standing @ doorway c/o SOB, itching & had apparent blotching hives on face, neck, upper arms & chest; MD notified & epi & DPH given;

VAERS ID:59283 (history)  Vaccinated:1993-11-04
Age:6.4  Onset:1993-11-12, Days after vaccination: 8
Gender:Male  Submitted:1993-12-15, Days after onset: 33
Location:Nebraska  Entered:1994-01-26, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp adverse rxn in 1988 @ 18 mos w/DTP #2;
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergic to pertussis
Diagnostic Lab Data:
CDC Split Type: NE9328
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0118W0 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0677F2PO 
Administered by: Public     Purchased by: Public
Symptoms: Lymphadenopathy, Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: rash started 11-12 pruritic-febrile usually AM & PM; rash over entire body, enlarged cervical nodes; lungs clear; APAP for fever; rash improved over time;

VAERS ID:59313 (history)  Vaccinated:1993-12-03
Age:6.6  Onset:1993-12-03, Days after vaccination: 0
Gender:Female  Submitted:1993-12-29, Days after onset: 26
Location:Kansas  Entered:1994-01-27, Days after submission: 29
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: apnea monitor first 6months of life according to grandma
Diagnostic Lab Data: lab work done @ ER on 4DEC93;
CDC Split Type: KS93066
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES3C510254 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1506V1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0691H3PO 
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Malaise, Pyrexia, Stupor, Tremor, Urinary incontinence
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Child feverish w/in 1 hr of immun; 5AM pt did not feel well; was incontinent; became non-responsive; had convulsions; to ER; lab work nl; released 10AM w/orders for APAP q4hrs; 03JAN94 pt has shaking type vibration of whole body, 0-3 x/day;

VAERS ID:61569 (history)  Vaccinated:1993-09-02
Age:6.0  Onset:1993-09-02, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Illinois  Entered:1994-02-03
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: no relevant data;
CDC Split Type: WAES93090157
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.0710W   
Administered by: Other     Purchased by: Other
Symptoms: Malaise, Syncope, Urinary incontinence
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 2SEP93 & 4 mins p/inject, passed out & was unconscious for about 15 seconds; pt urinated while unconscious; subsequently regained consciousness & was listless; No further details were provided;

VAERS ID:59741 (history)  Vaccinated:1993-12-06
Age:6.3  Onset:1993-12-07, Days after vaccination: 1
Gender:Male  Submitted:1993-12-08, Days after onset: 1
Location:Alaska  Entered:1994-02-08, Days after submission: 62
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: AK94003
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES3B510202IMLA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site oedema, Injection site pain, Pyrexia, Vasodilatation, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: area of inject on lt deltoid had sl swelling & redness next day; area red & tender to touch; mom treated w/hot/cold packs; taken to ER dx cellulitis; running fever of 99 w/vomiting;

VAERS ID:59838 (history)  Vaccinated:1993-12-08
Age:6.2  Onset:1993-12-08, Days after vaccination: 0
Gender:Male  Submitted:1993-12-14, Days after onset: 6
Location:Georgia  Entered:1994-02-14, Days after submission: 62
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: nebulizer PRN for asthma;
Current Illness: NONE
Preexisting Conditions: asthma;
Diagnostic Lab Data: NONE
CDC Split Type: GA93233
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES3529152IMLA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0686M2PO 
Administered by: Public     Purchased by: Public
Symptoms: Muscle twitching, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 8DEC93 pt started running fever; day p/vax had vomiting p/meals & drinking fluids for the wole day; also had jerking of legs, arms & eyes twitching;

VAERS ID:59899 (history)  Vaccinated:1994-01-25
Age:6.7  Onset:1994-01-26, Days after vaccination: 1
Gender:Male  Submitted:1994-02-01, Days after onset: 6
Location:Florida  Entered:1994-02-15, Days after submission: 14
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: mom denies any illness
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: FL94007
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES3J410611IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.G02101SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0061W1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Pyrexia
SMQs:, 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: day 1 following vax rt arm edematous, red, hard & painful to elbow; t101 for 4 days; warm compresses applied; taken to MD x2; given DPH, duracef & Motrin;

VAERS ID:61578 (history)  Vaccinated:1993-04-15
Age:6.3  Onset:1993-04-15, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Maryland  Entered:1994-02-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Donnatal
Current Illness: stomach upset
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES93041083
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0137W1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pain, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt recvd vax 15APR93 & the same day pt lt arm became inflammed & warm to touch; also devel erythema & pain for eight days;

VAERS ID:60106 (history)  Vaccinated:1994-02-22
Age:6.2  Onset:1994-02-22, Days after vaccination: 0
Gender:Female  Submitted:1994-02-24, Days after onset: 2
Location:Massachusetts  Entered:1994-02-28, 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: sl runny nose
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABDT831 RA
Administered by: Private     Purchased by: Public
Symptoms: Bradycardia, Cyanosis, Somnolence, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: pt passed out/vomited post vax remained lethargic w/Peri-oral cyanosis pulse dec 60 min BP dec 70/52;

VAERS ID:62601 (history)  Vaccinated:1993-01-22
Age:6.8  Onset:1993-01-23, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:New Jersey  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amoxicillin
Current Illness: otitis media
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES93011609
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1425V0IM 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Conjunctivitis, Malaise, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt recvd vax 22JAN93 & 23JAN93 pt devel conjunctivitis; presented to MD & was treated w/eye drops; also devel a rash, fever of 103-104 & abdo pain, malaise, faitgue & felt awful; returned to MD on 26JAN93; pt treated w/unspecified meds;

VAERS ID:62658 (history)  Vaccinated:1993-02-10
Age:6.8  Onset:1993-02-10, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:California  Entered:1994-03-14
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: No relevant data;
CDC Split Type: WAES93020680
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1427V IM 
Administered by: Other     Purchased by: Other
Symptoms: Malaise, Nausea, Pyrexia
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: pt recvd vax on 10FEB93 & on same day exp fever, nausea & malaise; No further details were provided;

VAERS ID:63486 (history)  Vaccinated:1993-03-27
Age:6.2  Onset:1993-04-06, Days after vaccination: 10
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: augmentin;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES93040262
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recvd vax; 6 dys after vax; pt devel rash that was dx as viral exanthum;

VAERS ID:60700 (history)  Vaccinated:1994-02-17
Age:6.2  Onset:1994-02-20, Days after vaccination: 3
Gender:Male  Submitted:0000-00-00
Location:Minnesota  Entered:1994-03-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: congenital hip dysplasia; erbs palsy secondary to birth trauma;
Diagnostic Lab Data: NONE
CDC Split Type: MN94006
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0634W1 LL
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3 days post vax noted aprpox 30 small bumps around inject site; pt c/o itching unable to come in for visualization x 3 days; given DPh elixir;

VAERS ID:60898 (history)  Vaccinated:1993-12-11
Age:6.5  Onset:1993-12-12, Days after vaccination: 1
Gender:Female  Submitted:1994-01-01, Days after onset: 20
Location:Washington  Entered:1994-03-21, Days after submission: 79
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to milk, erthomyocin, sulfa drugs;
Diagnostic Lab Data: blood tests @ PMD & hosp
CDC Split Type: WA94997
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1557V0  
Administered by: Private     Purchased by: Public
Symptoms: Abdominal pain, Arthralgia, Hypokinesia, Nausea, Oedema, Purpura, Urinary tract infection, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: stomach ache that got worse ea day-turned into abdo cramps, nausea-vomiting went to MD; Friday purpura appeared, swelling & painful joints-Saturday couldn''t walk; swelling inc w/purpura & abdo cramps-UTI-kidney maybe involved; dx purpura He

VAERS ID:61364 (history)  Vaccinated:1994-03-14
Age:6.2  Onset:1994-03-14, Days after vaccination: 0
Gender:Male  Submitted:1994-03-18, Days after onset: 4
Location:Missouri  Entered:1994-03-31, Days after submission: 13
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: NONE
CDC Split Type: MO94016
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1273W1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Hyperventilation, Pharyngitis, Pyrexia, Rhinitis, Somnolence, Tachycardia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: same day pt slept rest of day; morning of 15MAR93 had congestion, fever of 101, sore throat, rapid heart & resp rate, vomiting; seen by MD;

VAERS ID:61626 (history)  Vaccinated:1994-01-04
Age:6.0  Onset:0000-00-00
Gender:Male  Submitted:1994-03-10
Location:Oregon  Entered:1994-04-06, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pt''s sibling exp leg swelling, fever x 24 hrs @ 4mos w/DTP #2;
Other Medications: NONE
Current Illness: tinia capitis
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES3L41085   
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES358941   
Administered by: Private     Purchased by: Private
Symptoms: Condition aggravated
SMQs:
Write-up: severe tinia capitis infestation starting a/immun but much worse following vax;

VAERS ID:61750 (history)  Vaccinated:1994-03-02
Age:6.3  Onset:1994-03-03, Days after vaccination: 1
Gender:Female  Submitted:1994-03-04, Days after onset: 1
Location:California  Entered:1994-04-12, Days after submission: 38
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:
Preexisting Conditions: PCN
Diagnostic Lab Data: NONE
CDC Split Type: CA94045
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES3H410354 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1289W1 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0692D3PO 
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: c/o erythematous swelling @ inject site;

VAERS ID:61975 (history)  Vaccinated:1994-03-08
Age:6.3  Onset:1994-03-09, Days after vaccination: 1
Gender:Male  Submitted:1994-03-10, Days after onset: 1
Location:Michigan  Entered:1994-04-20, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: ?pediazole allergy
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)MICHIGAN DEPT PUB HLTHTR1221A4IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1391W1SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0694A3PO 
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 9MAR93 start of erythema on lt thigh 3 1/2" x 3 1/4" diameter, induration 1 1/2" in diameter no drng; no fluctuance; non-tender; no treatment done-observe;

VAERS ID:64992 (history)  Vaccinated:1993-08-18
Age:6.4  Onset:1993-08-18, Days after vaccination: 0
Gender:Male  Submitted:1993-08-26, Days after onset: 8
Location:Pennsylvania  Entered:1994-04-25, Days after submission: 242
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:
Diagnostic Lab Data: none;
CDC Split Type: 930183902
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES342901 IMA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax & exp inject site rxn w/ redness, pain & swelling;

VAERS ID:64993 (history)  Vaccinated:1993-08-17
Age:6.0  Onset:1993-08-17, Days after vaccination: 0
Gender:Male  Submitted:1993-08-26, Days after onset: 9
Location:Pennsylvania  Entered:1994-04-25, Days after submission: 242
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: none;
CDC Split Type: 930183903
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES342901 IMA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax & exp inject site rxn; rxn included redness, pain & swelling;

VAERS ID:62234 (history)  Vaccinated:1994-04-13
Age:6.6  Onset:1994-04-14, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:North Carolina  Entered:1994-05-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type: NC94060
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES3B510204 LL
Administered by: Other     Purchased by: Public
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: lt thigh, blotchy erythema from mid-thigh to just above the knee cap; no real temp difference; no other rash; Atarax syrup given;

VAERS ID:62273 (history)  Vaccinated:1994-04-25
Age:6.0  Onset:1994-04-26, Days after vaccination: 1
Gender:Female  Submitted:1994-04-27, Days after onset: 1
Location:Washington  Entered:1994-05-02, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES3579220IMLA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.J0690 IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1161W SCRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: local react 12 cm x 15 cm induration, erythema w/vesicles;

VAERS ID:62945 (history)  Vaccinated:1994-04-27
Age:6.0  Onset:1994-04-29, Days after vaccination: 2
Gender:Male  Submitted:1994-05-02, Days after onset: 3
Location:Texas  Entered:1994-05-17, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: TX94107
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES3569184 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0072D1 LA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0699A4PO 
Administered by: Other     Purchased by: Public
Symptoms: Injection site oedema, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)
Write-up: 29APR94 called to report silver dollar size swelling on rt arm of son; 29APR94 0905 mom called MD pt had shakes; instructed to go to ER;

VAERS ID:63044 (history)  Vaccinated:1994-05-03
Age:6.3  Onset:1994-05-06, Days after vaccination: 3
Gender:Male  Submitted:1994-05-16, Days after onset: 10
Location:New York  Entered:1994-05-23, Days after submission: 7
Life Threatening? No
Died? Yes
   Date died: 1994-05-07
   Days after onset: 1
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pvt
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Autopsy-brain specimens sent for viral studies;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0178A  GM
Administered by: Private     Purchased by: Private
Symptoms: Brain oedema, Conjunctivitis, Dehydration, Encephalopathy, Otitis media, Pyrexia, Vomiting
SMQs:, Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 2 days following inject pt devel OM & conjunctivitis w/fever; treated w/Augmentin; devel vomiting & dehydration 3 days p/vax; unexputed death autopsy showed brain edema;

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