National Vaccine
Information Center

Your Health. Your Family. Your Choice.
MedAlerts Home
  Read the MedAlerts Blog Subscribe to the MedAlerts Blog 

Found 596268 cases in entire database

Case Details (Sorted by Age)

This is page 2684 out of 5963

Result pages: prev   2585 2586 2587 2588 2589 2590 2591 2592 2593 2594 2595 2596 2597 2598 2599 2600 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2614 2615 2616 2617 2618 2619 2620 2621 2622 2623 2624 2625 2626 2627 2628 2629 2630 2631 2632 2633 2634 2635 2636 2637 2638 2639 2640 2641 2642 2643 2644 2645 2646 2647 2648 2649 2650 2651 2652 2653 2654 2655 2656 2657 2658 2659 2660 2661 2662 2663 2664 2665 2666 2667 2668 2669 2670 2671 2672 2673 2674 2675 2676 2677 2678 2679 2680 2681 2682 2683 2684 2685 2686 2687 2688 2689 2690 2691 2692 2693 2694 2695 2696 2697 2698 2699 2700 2701 2702 2703 2704 2705 2706 2707 2708 2709 2710 2711 2712 2713 2714 2715 2716 2717 2718 2719 2720 2721 2722 2723 2724 2725 2726 2727 2728 2729 2730 2731 2732 2733 2734 2735 2736 2737 2738 2739 2740 2741 2742 2743 2744 2745 2746 2747 2748 2749 2750 2751 2752 2753 2754 2755 2756 2757 2758 2759 2760 2761 2762 2763 2764 2765 2766 2767 2768 2769 2770 2771 2772 2773 2774 2775 2776 2777 2778 2779 2780 2781 2782 2783   next


VAERS ID:158605 (history)  Vaccinated:2000-06-26
Age:6.0  Onset:2000-07-04, Days after vaccination: 8
Gender:Female  Submitted:2000-07-05, Days after onset: 1
Location:Georgia  Entered:2000-08-08, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: environmental allergies
Diagnostic Lab Data: NONE
CDC Split Type: GA00078
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.00720SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 7/4/00, the pt''s arm started itching after swimming in the ocean at the injection site. It was an area the size of a dime. It is red, swollen and the size of a 1/2 dollar. Treatment was cold compresses and Benadryl.

VAERS ID:158636 (history)  Vaccinated:1999-07-29
Age:6.0  Onset:1999-07-30, Days after vaccination: 1
Gender:Male  Submitted:1999-08-01, Days after onset: 2
Location:Montana  Entered:2000-08-08, Days after submission: 373
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: Allergic rhinitis and asthma
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4623554IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1985H SCRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES801E6 PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt had fever, red and swollen deltoid on 7/30/99. Fever was gone on 7/31/99 and swelling less.

VAERS ID:158640 (history)  Vaccinated:2000-07-21
Age:6.0  Onset:2000-07-21, Days after vaccination: 0
Gender:Female  Submitted:2000-07-21, Days after onset: 0
Location:Texas  Entered:2000-08-08, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0538J1SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1452J0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site mass, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The pt experienced injection site redness, swelling, and a small lump.

VAERS ID:158793 (history)  Vaccinated:2000-07-27
Age:6.0  Onset:2000-07-28, Days after vaccination: 1
Gender:Female  Submitted:2000-08-01, Days after onset: 4
Location:New York  Entered:2000-08-14, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0137BA4IMLA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P12323SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0399K1SCRA
Administered by: Other     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: The pt experienced redness/warmth over the left arm area about 12 hours with increased in redness and swelling until evaluated 36 hours later. Advised ice to area and hydrocortisone cream.

VAERS ID:158919 (history)  Vaccinated:1998-01-23
Age:6.0  Onset:2000-07-24, Days after vaccination: 913
Gender:Male  Submitted:2000-08-07, Days after onset: 14
Location:New Hampshire  Entered:2000-08-16, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00081647
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0802E0SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt developed chickenpox.

VAERS ID:159047 (history)  Vaccinated:2000-08-15
Age:6.0  Onset:2000-08-15, Days after vaccination: 0
Gender:Female  Submitted:2000-08-18, Days after onset: 3
Location:Georgia  Entered:2000-08-22, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0440K0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever/redness and swelling at vaccine site within 12 hours of administration.

VAERS ID:159158 (history)  Vaccinated:1995-10-18
Age:6.0  Onset:2000-08-17, Days after vaccination: 1765
Gender:Female  Submitted:2000-08-24, Days after onset: 7
Location:California  Entered:2000-08-25, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: URI
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES4F611493IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0790130SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0423B0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Chickenpox disease, post vax. Had vaccine 10/18/1995 and had chickenpox on 8/17/00.

VAERS ID:159266 (history)  Vaccinated:2000-08-16
Age:6.0  Onset:2000-08-18, Days after vaccination: 2
Gender:Female  Submitted:2000-08-27, Days after onset: 9
Location:Arkansas  Entered:2000-08-29, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: milk intolerance
Diagnostic Lab Data: CXR - no results available, urine, labs
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0313BA2IMLA
HIBV: HIB (HIBTITER)PFIZER/WYETH622363A2IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R13462SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0583K1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Anorexia, Confusional state, Ear pain, Headache, Lethargy, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: The fever started 2 days post vax and went as high as 107. The fever lasted 4 days and the pt complained of a headache, sore arm, was confused, lethargic, anorexia, and complained of left ear pain. The pt went to the ER. The pt is currently on antibiotics.

VAERS ID:159294 (history)  Vaccinated:2000-08-21
Age:6.0  Onset:2000-08-21, Days after vaccination: 0
Gender:Female  Submitted:2000-08-22, Days after onset: 1
Location:Missouri  Entered:2000-08-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: daily vitamin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM921A24IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R050723IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1714J1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Fall, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 7-10 hours post vax pt experienced nausea, fever 102.2. Pt was weak and fell to knees - did not pass out.

VAERS ID:159418 (history)  Vaccinated:2000-08-15
Age:6.0  Onset:2000-08-17, Days after vaccination: 2
Gender:Female  Submitted:2000-08-18, Days after onset: 1
Location:Michigan  Entered:2000-09-06, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Children''s Tylenol
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES7389AA4IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R050623IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0126J1SCRL
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt complained of left leg redness and swelling of thigh area. No pain and not warm to the touch. Pts advised to treat with Children''s Motrin and apply ice to affected area. Also advised to seek medical attention if symptoms worsen.

VAERS ID:159448 (history)  Vaccinated:2000-08-23
Age:6.0  Onset:2000-08-23, Days after vaccination: 0
Gender:Female  Submitted:2000-08-31, Days after onset: 8
Location:Massachusetts  Entered:2000-09-07, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: same reaction;MMR II;;4.00;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4733340IMRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 11 x 9 cm dark red, tender, warm, itchy, slightly indurated rash. Reaction was around injection site on right deltoid. Resolved in 72 hours with Benadryl.

VAERS ID:159458 (history)  Vaccinated:2000-08-15
Age:6.0  Onset:2000-08-16, Days after vaccination: 1
Gender:Female  Submitted:2000-08-22, Days after onset: 6
Location:New Hampshire  Entered:2000-09-07, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM941A23IMLA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3199A22IMLA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R12502SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left arm swelling 7.5 inches (6" from deltoid to elbow); right arm size 6.5 inches.

VAERS ID:159750 (history)  Vaccinated:1998-05-01
Age:6.0  Onset:1998-06-08, Days after vaccination: 38
Gender:Male  Submitted:2000-09-14, Days after onset: 829
Location:California  Entered:2000-09-15, Days after submission: 1
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? Yes
Previous Vaccinations: pityriasis rosea rash~Hep B (Recombivax HB)~2~7.00~In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC-critical value, HBSAG-neg, HBC IGM antibody-neg
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1287H2  
Administered by: Private     Purchased by: Private
Symptoms: Aplastic anaemia, Laboratory test abnormal, Pancytopenia
SMQs:, Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic erythropenia (narrow), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 25 days post vax, the pt was hospitalized with CBC critical values. Dx with pancytopenia. Follow up 10/13/2000: "This event is due to the cumulative effects of a series of 3 Hep B vaccines. 1st vaccine: No noticeable adverse effects. 2nd vaccine: 1 week later, diagnosis pityriasis rosea rash. 3rd vaccine: 25 days later-hospitalized CBC critical values"

VAERS ID:159751 (history)  Vaccinated:2000-06-01
Age:6.0  Onset:2000-06-22, Days after vaccination: 21
Gender:Male  Submitted:2000-09-07, Days after onset: 77
Location:California  Entered:2000-09-15, Days after submission: 8
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1451J0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Epistaxis, Platelet count decreased, Thrombocytopenic purpura
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Developed ITP 3 weeks after vax. Had severe epistaxis and platelet count of 10k. Hospitalized and treated with IVIG.

VAERS ID:159798 (history)  Vaccinated:2000-09-01
Age:6.0  Onset:2000-09-01, Days after vaccination: 0
Gender:Female  Submitted:2000-09-07, Days after onset: 6
Location:Michigan  Entered:2000-09-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: spinal tap
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION2610113IMLA
Administered by: Public     Purchased by: Public
Symptoms: Musculoskeletal stiffness, Pain, Photophobia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Symptoms of temperature of 104, stiff neck, sore legs and arms, and photophobia. Taken to ER where physician did a spinal tap. Physician then decided the symptoms were a reaction to the vaccine the pt had received earlier in the day. Medical director recommended an antibody level for 9/11/00 and not to have pt receive the last vaccine.

VAERS ID:159817 (history)  Vaccinated:2000-08-29
Age:6.0  Onset:2000-08-29, Days after vaccination: 0
Gender:Female  Submitted:2000-09-05, Days after onset: 7
Location:Wyoming  Entered:2000-09-15, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to PCN
Diagnostic Lab Data:
CDC Split Type: WY0008
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0009K3IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1860J0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: No text provided.

VAERS ID:159875 (history)  Vaccinated:2000-06-26
Age:6.2  Onset:0000-00-00
Gender:Male  Submitted:2001-07-17
Location:Nevada  Entered:2000-09-19, Days after submission: 301
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00090390
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER    
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1713J0  
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0065K0  
Administered by: Other     Purchased by: Other
Symptoms: Convulsion, Coordination abnormal, Delirium, Nervous system disorder, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: The pt developed a "brain reaction", ataxia, collapsed and was hospitalized. The pt sought unspecified medical attention. Additional information has been requested. Follow-up info received on 09/10/2001 states the pt has chronic seizure disorder, neurological disorder, and partial brain damage. The follow-up info from a registered nurse indicated that the pt was vaccinated on 06/26/2000 with one dose of varicella virus vaccine live. Concomitant therapy included MMR, DTP, polio vaccines. she reported that she did not have any info on an adverse event post vaccination on this pt. She stated that their office only does immunizations and well baby care. She noted that it is possible that the mother may have taken the pt to another pediatrician for care, but their office was never notified of any adverse event post vaccination. She reported that she did not have the lot numbers of the vaccines that the child had received; she would need to put in a request for that day of immunizations to be pulled from the warehouse for the lot number info. Additional info has been requested.

VAERS ID:159907 (history)  Vaccinated:2000-08-14
Age:6.0  Onset:2000-08-14, Days after vaccination: 0
Gender:Male  Submitted:2000-08-30, Days after onset: 16
Location:Washington  Entered:2000-09-19, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Chronic eczema
Diagnostic Lab Data:
CDC Split Type: WA001675
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.P0168 SCLA
Administered by: Private     Purchased by: Public
Symptoms: Anxiety, Dyspnoea, Headache, Injection site hypersensitivity, Injection site pain, Nausea, Pallor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Abrupt onset pollor, headache, nausea, SOB, anxiety, red/ tender at site 10-15 min post injection. Treatment elevate cover. Pulse 0, resp increased, redness at site.

VAERS ID:159918 (history)  Vaccinated:2000-08-16
Age:6.0  Onset:2000-08-17, Days after vaccination: 1
Gender:Female  Submitted:2000-09-19, Days after onset: 33
Location:Missouri  Entered:2000-09-20, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Augmentin
Current Illness: Otitis Media
Preexisting Conditions: hereditary spherocytosis
Diagnostic Lab Data: blood culture-neg, CRP-wnl
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4726534IMLA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R14894 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0582481SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Next day post vax, the pt''s left arm was red, swollen, and hot to the touch. Admitted to hospital and received antibiotics by IV.

VAERS ID:160063 (history)  Vaccinated:2000-08-01
Age:6.0  Onset:2000-08-01, Days after vaccination: 0
Gender:Male  Submitted:2000-08-17, Days after onset: 16
Location:Texas  Entered:2000-09-25, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ;VARIVAX;1;2.08;In Sibling
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: TX00114
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1866J0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Pruritus, 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: At 10:30 pt had localized reaction at varicella injection site, within 1 minute of injection. Child complained of itching and had a 1cm papule/hive with itching and redness observed. Hive increased to 1.5cm with no other reactions noted. Ice was applied, 25mg Diphenhydramine HCL, Benadryl PO given. After 45 minutes, hives decreased to less than 1/2cm and no other reaction noted.

VAERS ID:160246 (history)  Vaccinated:2000-09-22
Age:6.0  Onset:2000-09-22, Days after vaccination: 0
Gender:Male  Submitted:2000-09-25, Days after onset: 3
Location:Virginia  Entered:2000-10-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to Gentamycin, Diazalin
Diagnostic Lab Data: NONE
CDC Split Type: VA00034
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM2941A2 IMLA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0151K IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0257K SCRA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Pain
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Child complained of aching in left arm. Mother gave child one spoonful of liquid Tylenol. Redness on left arm occurred 9/22/00 evening. On 9/23/00, the pain in the left arm decreased. No pain in arm today.

VAERS ID:160372 (history)  Vaccinated:2000-08-18
Age:6.0  Onset:2000-08-19, Days after vaccination: 1
Gender:Female  Submitted:2000-08-21, Days after onset: 2
Location:Indiana  Entered:2000-10-06, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: IN200035
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM921A24IMRL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P138023 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0258F1SCLL
Administered by: Other     Purchased by: Private
Symptoms: Ecchymosis, Gait disturbance, Injection site hypersensitivity, Injection site oedema
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Grandmother brought child in and the right thigh was red and swollen at the site of injection. It is red all over the thigh with a quarter sized bruise at injection site. The pt experienced limping. Use Benadryl and cold compresses if needed. By the next day, the child was doing much better. After a few days the child was ok.

VAERS ID:160380 (history)  Vaccinated:2000-09-19
Age:6.0  Onset:2000-09-20, Days after vaccination: 1
Gender:Female  Submitted:2000-09-21, Days after onset: 1
Location:New Hampshire  Entered:2000-10-06, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NH0018
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM958A20IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0585K0SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0768K0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt experienced a fever, right arm swelling, redness and warmth to the touch. On 9/22/00, the pt''s fever has decreased and the pt is much better.

VAERS ID:162124 (history)  Vaccinated:0000-00-00
Age:6.0  Onset:0000-00-00
Gender:Male  Submitted:2000-05-17
Location:Virginia  Entered:2000-10-10, Days after submission: 146
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ5556408MAY2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES467674 IM 
Administered by: Other     Purchased by: Other
Symptoms: Lymphadenopathy, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Subsequently, pt developed a large swollen gland under his arm and an extensive rash approximately 2 inches round.

VAERS ID:162144 (history)  Vaccinated:2000-04-26
Age:6.0  Onset:0000-00-00
Gender:Unknown  Submitted:2000-08-04
Location:Illinois  Entered:2000-10-10, Days after submission: 67
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: 53330303
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4676740IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES  PO 
Administered by: Other     Purchased by: Other
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: A nurse reported that a 6 year old received the first dose of Acel-Immune, as well as Orimune and MMR vaccines on 04/26/00 and subsequently, developed a rash on the upper right arm, site of Acel-Immune administration. This is 1 of 2 patients from this facility who experienced an adverse event following receipt of Acel-Immune lot 467-674.

VAERS ID:160555 (history)  Vaccinated:1995-10-03
Age:6.0  Onset:2000-10-03, Days after vaccination: 1827
Gender:Male  Submitted:2000-10-05, Days after onset: 2
Location:New Jersey  Entered:2000-10-16, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0443B0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt developed chickenpox.

VAERS ID:160580 (history)  Vaccinated:1995-11-17
Age:6.0  Onset:2000-10-04, Days after vaccination: 1783
Gender:Male  Submitted:2000-10-05, Days after onset: 1
Location:Pennsylvania  Entered:2000-10-16, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: viral pharyngitis
Preexisting Conditions: hx of asthma and allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS3779113IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0445B0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Rash papular
SMQs:, Lack of efficacy/effect (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt had Varivax vaccine on 11/17/1995 and was exposed two weeks ago and started with papules over body on 10/4/00. Seen in MD''s office on 10/4/00. Sister has chicken pox also. The pt is expected to recover.

VAERS ID:160631 (history)  Vaccinated:1995-09-20
Age:6.0  Onset:2000-10-10, Days after vaccination: 1847
Gender:Male  Submitted:2000-10-12, Days after onset: 2
Location:Arizona  Entered:2000-10-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Rash pustular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Post vax, multiple pustulants on back and arms.

VAERS ID:160661 (history)  Vaccinated:2000-09-06
Age:6.0  Onset:2000-09-07, Days after vaccination: 1
Gender:Female  Submitted:2000-09-26, Days after onset: 19
Location:Washington  Entered:2000-10-18, 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:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0417K0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Rash papular
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Per pt''s mom''s report, reddish, pruritic rash appeared on right upper arm, outer aspect, on 9/7/00 or 9/8/00; initially, right deltoid area, then extended from approx. just below shoulder to just above elbow. No other local or systemic signs or symptoms. Seen by RN (vaccine administrator) on 9/13/00; papular, pinkish-white rash right, upper, outer arm; according to mother, rash almost completely gone on 9/17/00. Recommended treatment with ice, calamine lotion and diphenhydramine. Temperature was 98.2F on 9/13/00.

VAERS ID:160791 (history)  Vaccinated:2000-10-03
Age:6.0  Onset:2000-10-05, Days after vaccination: 2
Gender:Male  Submitted:2000-10-05, Days after onset: 0
Location:Ohio  Entered:2000-10-23, Days after submission: 18
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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0497K IM 
Administered by: Public     Purchased by: 0
Symptoms: Unevaluable event
SMQs:
Write-up: No data provided.

VAERS ID:160927 (history)  Vaccinated:1995-10-31
Age:6.0  Onset:2000-10-10, Days after vaccination: 1806
Gender:Female  Submitted:2000-10-17, Days after onset: 7
Location:California  Entered:2000-10-25, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Varivax given on 10/31/1995 and 1 week later, developed chickenpox. Now with chickenpox again.

VAERS ID:161037 (history)  Vaccinated:2000-10-12
Age:6.0  Onset:2000-10-12, Days after vaccination: 0
Gender:Male  Submitted:2000-10-21, Days after onset: 9
Location:Michigan  Entered:2000-10-27, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0403AA4IMLL
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4749380IMRL
Administered by: Private     Purchased by: Other
Symptoms: Myalgia, Oedema, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Post vax, the pt developed swelling, fever, and achiness.

VAERS ID:162873 (history)  Vaccinated:1997-10-08
Age:6.0  Onset:1997-10-08, Days after vaccination: 0
Gender:Male  Submitted:2000-07-19, Days after onset: 1015
Location:Georgia  Entered:2000-10-30, Days after submission: 103
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: bronchospasm NOS, hypersensitivity NOS
Diagnostic Lab Data: UNK
CDC Split Type: HQ7195012JUN2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  IM 
Administered by: Private     Purchased by: Other
Symptoms: Hypersensitivity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A mother reported that her 6 year old son received an injection of Flu-Shield (1997-1998 Formula) in September, 1997. Within 20 minutes, post vax, he developed generalized hives. He recovered.

VAERS ID:161130 (history)  Vaccinated:2000-08-30
Age:6.0  Onset:2000-09-06, Days after vaccination: 7
Gender:Female  Submitted:2000-09-12, Days after onset: 6
Location:Colorado  Entered:2000-10-31, Days after submission: 49
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: CO00018
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1463J0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration, Skin nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Mom reports "hard, red lump" at injection site, 7 days, post vax. Noticed several other similar lumps on unvaccinated arm, leg and trunk. Saw MD and was treated with Benadryl. Mom reports lumps are resolving, 12 days, post vax.

VAERS ID:161157 (history)  Vaccinated:2000-10-16
Age:6.0  Onset:2000-10-16, Days after vaccination: 0
Gender:Female  Submitted:2000-10-17, Days after onset: 1
Location:California  Entered:2000-10-31, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CA000112
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3329A21IMLA
Administered by: Public     Purchased by: Public
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Mother called at clinic, after 1 hour post vax, said that child had vomited once, a large amount. Mother states it might be the cookies that she ate at lunchtime. Checked on the child at 17:00 and mother stated she feels better. On 10/17/00, rechecked the child and she had no problems, per mom.

VAERS ID:161269 (history)  Vaccinated:1996-06-17
Age:6.0  Onset:2000-10-27, Days after vaccination: 1593
Gender:Female  Submitted:2000-10-27, Days after onset: 0
Location:Pennsylvania  Entered:2000-11-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Amoxicillin
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0392B0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Cough, Drug ineffective, Infection, Pruritus
SMQs:, Anaphylactic reaction (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Began today with about 50 pox/lesions with itching. Afebrile. Had a deep and dry cough.

VAERS ID:161371 (history)  Vaccinated:1999-11-11
Age:6.0  Onset:2000-10-29, Days after vaccination: 353
Gender:Female  Submitted:2000-10-30, Days after onset: 1
Location:Florida  Entered:2000-11-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1034J0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt experienced outbreak of less than 50 lesions. Onset 10/29/00 and was itchy.

VAERS ID:161736 (history)  Vaccinated:1997-02-13
Age:6.0  Onset:2000-10-30, Days after vaccination: 1355
Gender:Male  Submitted:2000-10-31, Days after onset: 1
Location:Florida  Entered:2000-11-09, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0782D SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Chickenpox .

VAERS ID:161888 (history)  Vaccinated:1996-02-21
Age:6.0  Onset:2000-11-06, Days after vaccination: 1720
Gender:Female  Submitted:2000-11-07, Days after onset: 1
Location:Pennsylvania  Entered:2000-11-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1125B0IMRL
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt given varivax vaccine on 2/21/96 and now, 4 years later, has developed varicella on 11/6/00.

VAERS ID:163289 (history)  Vaccinated:0000-00-00
Age:6.0  Onset:0000-00-00
Gender:Female  Submitted:1999-11-22
Location:Indiana  Entered:2000-11-14, Days after submission: 358
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: Amoxil allergy
Diagnostic Lab Data:
CDC Split Type: 19990306351
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Public     Purchased by: Other
Symptoms: Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On the day of vax, the pt experienced a temperature of 101 and a headache. the symptoms were treated with Tylenol. The most recent information received reports the symptoms as resolved.

VAERS ID:161974 (history)  Vaccinated:2000-10-27
Age:6.0  Onset:2000-10-28, Days after vaccination: 1
Gender:Female  Submitted:2000-11-06, Days after onset: 9
Location:Tennessee  Entered:2000-11-15, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Bilateral ear tubes
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0415AA3IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt was given injection at 15:30 on Friday. On Saturday at 16:00, injection site was the size of a baseball, red, hot and itching. Was given 1 1/2 tsp Benadryl and inflammation was gone the next morning.

VAERS ID:162199 (history)  Vaccinated:2000-10-16
Age:6.0  Onset:2000-10-16, Days after vaccination: 0
Gender:Female  Submitted:2000-10-18, Days after onset: 2
Location:Ohio  Entered:2000-11-20, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: OH0046
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM939A22IMRA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3198A22IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R12512SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0253K1SCLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Vaccine given 10/16/00 AM. At 5 PM same day pt developed a fever of 104 F and swelling and erythema right upper arm and pain down to right hand X 2 days. On 10/18/00 fever 101 F. Motrin given for pain and fever. Follow up on 10/20/00 fever gone but still slight erythema and soreness.

VAERS ID:162382 (history)  Vaccinated:1994-02-14
Age:6.0  Onset:0000-00-00
Gender:Female  Submitted:2000-11-10
Location:California  Entered:2000-11-21, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: immune system blood test, metabolic test, hair analysis, stool analysis, EEG, NRS, polypeptide testing, heavy metal screening
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM61149 IMRA
Administered by: Private     Purchased by: Public
Symptoms: Autism, Constipation, Convulsion, Immune system disorder, Mental retardation severity unspecified, Speech disorder, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: The pt''s parent states that child had too many vaccination upon her birth, which greatly compromised her immune system. She started having head tremor at age of 5 to 6 months of age which caused her regression. She developed severe developmental delays plus seizure disorder and autism. 60 day follow-up states the pt is non-verbal and badly constipated.

VAERS ID:162596 (history)  Vaccinated:2000-11-14
Age:6.0  Onset:2000-11-15, Days after vaccination: 1
Gender:Male  Submitted:2000-11-17, Days after onset: 2
Location:Michigan  Entered:2000-11-27, 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: Lotrisone
Current Illness: localized dermatitis on left neck
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4725500IMRA
Administered by: Public     Purchased by: Other
Symptoms: Hypokinesia, Injection site erythema, Injection site pain, Injection site swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: One day post vax, the pt noted an erythematous, slightly raised tender to touch area on the right lateral arm at the injection site. Decreased movement of arm, pain and missed school. The pt also had an elevated temp as well. The area increased in sized until 11/16/00. On 11/17/00 was seen by MD. The area was approximately 7.5 cm x 7.0 cm.

VAERS ID:162676 (history)  Vaccinated:2000-11-09
Age:6.0  Onset:2000-11-21, Days after vaccination: 12
Gender:Male  Submitted:2000-11-22, Days after onset: 1
Location:Iowa  Entered:2000-11-28, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Digoxin, ASA
Current Illness: NONE
Preexisting Conditions: pulmonary atresia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH41082133IMLL
Administered by: Private     Purchased by: Private
Symptoms: Herpes zoster, Infection
SMQs:
Write-up: The pt experienced shingles on the right arm 11 days post vax.

VAERS ID:162709 (history)  Vaccinated:2000-11-04
Age:6.0  Onset:2000-11-05, Days after vaccination: 1
Gender:Male  Submitted:2000-11-06, Days after onset: 1
Location:Iowa  Entered:2000-11-28, Days after submission: 22
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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAMA939A24IMRA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3199A22IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R06683SCRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1722J1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The child developed a red, swollen area at the injection site, approximately 2 1/2 - 4 inches around (per patients mother''s report). Denies pain or discomfort. Lasted 3-4 days.

VAERS ID:163030 (history)  Vaccinated:1997-01-08
Age:6.0  Onset:2000-11-01, Days after vaccination: 1393
Gender:Female  Submitted:2000-11-10, Days after onset: 9
Location:Nebraska  Entered:2000-12-04, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NE005
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0388B0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Drug ineffective, Infection, Pyrexia
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 11/1/00, child developed 3 areas on back, family initially dx''d as mosquito bites but by the 2nd, child now quite febrile. Had 6 on abdomen, few on back of leg and 10 on back. On Saturday, 150+ in mouth, ears, head, back, face and still febrile. Mom treated with oatmeal bath and by 11/10/00 were scabbed over.

VAERS ID:163053 (history)  Vaccinated:2000-11-14
Age:6.0  Onset:2000-11-14, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Michigan  Entered:2000-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0414BB0IMRL
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4749380IMLL
Administered by: Private     Purchased by: Private
Symptoms: Difficulty in walking, Injection site pain
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypoglycaemia (broad)
Write-up: Post vax, the pt developed severe pain at injection site, could not walk the next day. .

VAERS ID:163075 (history)  Vaccinated:2000-10-18
Age:6.0  Onset:2000-10-22, Days after vaccination: 4
Gender:Female  Submitted:2000-10-30, Days after onset: 8
Location:Texas  Entered:2000-12-05, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: TX00148
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SCLL
Administered by: Public     Purchased by: 0
Symptoms: Injection site oedema, Injection site pain, Injection site rash, Injection site vesicles, Injection site warmth, Rash maculo-papular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3 in diameter rash around injection site. Warm, tender, swollen, red macular Papular rash. Three small blisters.

VAERS ID:163089 (history)  Vaccinated:2000-08-11
Age:6.0  Onset:2000-08-25, Days after vaccination: 14
Gender:Female  Submitted:2000-08-25, Days after onset: 0
Location:Texas  Entered:2000-12-05, Days after submission: 102
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: TX00132
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0122K0SCLL
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site reaction, Skin ulcer
SMQs:, Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Client received varicella vaccine approx 14 days ago. Father brought client in this am stated she woke up with this reaction. Client appears to have one single lesion on left thigh with pustular center and redness around approximate the size of a half dollar. Advised father to take child to private MD and have checked. He said he would.

VAERS ID:163097 (history)  Vaccinated:2000-11-20
Age:6.0  Onset:2000-11-20, Days after vaccination: 0
Gender:Male  Submitted:2000-11-28, Days after onset: 8
Location:Indiana  Entered:2000-12-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Inverted chromosome 15, FTT, Developmental delay
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40081733IMRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Pruritus, Rash, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3 days of swelling and onset of rash; 5cm X 7cm erythematous area adjacent to 2cm X 5cm erythematous area surrounding darkened injection site. No induration, warmth or signs of infection. Treated with Benadryl for itching.

VAERS ID:163741 (history)  Vaccinated:2000-09-25
Age:6.0  Onset:2000-09-27, Days after vaccination: 2
Gender:Female  Submitted:2000-12-07, Days after onset: 71
Location:Indiana  Entered:2000-12-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM921A24IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R050623 LL
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt experienced a local reaction which consisted of an 11 x 10 cm erythema to the right leg (bullous eye type" appearance flat, not raised, no swelling or induration.

VAERS ID:163784 (history)  Vaccinated:2000-11-20
Age:6.0  Onset:2000-11-20, Days after vaccination: 0
Gender:Female  Submitted:2000-12-04, Days after onset: 14
Location:South Carolina  Entered:2000-12-15, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E66350HA2IMRA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4691330SCLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Malaise, Pyrexia, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mother states son complained of pain following the vax in the right arm. The pt also experienced swell of the sight. The pt did not sleep well and did not attend school the following day. The pts arm was red from the injection site to the wrist. The pt was seen in the ER with a fever of 102. Was given antibiotics and released.

VAERS ID:163802 (history)  Vaccinated:2000-04-03
Age:6.0  Onset:2000-04-03, Days after vaccination: 0
Gender:Female  Submitted:2000-12-06, Days after onset: 247
Location:California  Entered:2000-12-15, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: aphthous ulcer on throat
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1958J0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 12 post vax, the pt experienced vomiting.

VAERS ID:163902 (history)  Vaccinated:2000-11-24
Age:6.0  Onset:2000-11-25, Days after vaccination: 1
Gender:Male  Submitted:2000-11-30, Days after onset: 5
Location:Indiana  Entered:2000-12-19, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Singulair, Vancenase AQ NS
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0422EA IMRA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES468136 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: No data provided.

VAERS ID:163920 (history)  Vaccinated:2000-11-28
Age:6.0  Onset:2000-11-29, Days after vaccination: 1
Gender:Female  Submitted:2000-12-01, Days after onset: 2
Location:California  Entered:2000-12-19, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CA000132
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0173CA3IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.12313 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1507J1SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0084K0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Noted to have reddened swollen arm. Left arm warm to touch.

VAERS ID:163925 (history)  Vaccinated:1996-04-04
Age:6.0  Onset:2000-12-01, Days after vaccination: 1702
Gender:Male  Submitted:2000-12-08, Days after onset: 7
Location:Wisconsin  Entered:2000-12-19, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES3869083IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1501B0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Chicken pox dx 12/1/00. Rash lasted 8 days and resolved without complications. .

VAERS ID:163972 (history)  Vaccinated:2000-12-07
Age:6.0  Onset:2000-12-07, Days after vaccination: 0
Gender:Male  Submitted:2000-12-07, Days after onset: 0
Location:Texas  Entered:2000-12-20, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Swelling~Influenza (Seasonal) (no brand name)~~5.00~In Patient
Other Medications:
Current Illness: Sinus infection
Preexisting Conditions: Asthma; allergy to cats
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40082094IM 
Administered by: Military     Purchased by: Military
Symptoms: Injection site pain, Injection site swelling, Injection site warmth, Similar reaction on previous exposure to drug, Unevaluable event
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen, hot and tender area on both deltoids, 8cm X 8cm left, 7cm X 6cm right. The dose was split, due to swelling elbow to shoulder with flu vaccine last year.

VAERS ID:164352 (history)  Vaccinated:0000-00-00
Age:6.0  Onset:0000-00-00
Gender:Male  Submitted:2000-12-28
Location:New Jersey  Entered:2001-01-03, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: Developmental delay NOS
Diagnostic Lab Data: UNK
CDC Split Type: HQ5142721DEC2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES  IM 
Administered by: Other     Purchased by: Other
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: A mother reported that her 6 year old son received an injection of DTP and subsequently, developed seizures. No further information was available as of the date of this report. Seizures are considered "Medically Important".

VAERS ID:164620 (history)  Vaccinated:2000-07-31
Age:6.0  Onset:2000-08-01, Days after vaccination: 1
Gender:Male  Submitted:2000-08-01, Days after onset: 0
Location:Georgia  Entered:2001-01-10, Days after submission: 162
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: GA00150
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM841A22IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P09982 SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Irritability, Pain
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)
Write-up: 7/31/00 Vax given, 8/1/00 left arm red, fevered, swollen, irriatable, 8/2/00 reported to WCHD, redness and swollen 90mm/75mm. Hurts to raise left arm advised Tylenol and warm compress.

VAERS ID:164682 (history)  Vaccinated:1995-06-05
Age:6.0  Onset:2000-12-28, Days after vaccination: 2033
Gender:Female  Submitted:2001-01-03, Days after onset: 6
Location:Pennsylvania  Entered:2001-01-11, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0417B0SCRA
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt developed chickenpox on 12/28/2000 and was seen by a doctor on 1/3/01.

VAERS ID:164905 (history)  Vaccinated:1995-12-19
Age:6.0  Onset:2000-12-26, Days after vaccination: 1834
Gender:Male  Submitted:2001-01-08, Days after onset: 13
Location:Minnesota  Entered:2001-01-18, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0437B0IMLL
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: The pt experienced chicken pox on 1/1/01 through 1/10/01.

VAERS ID:164935 (history)  Vaccinated:1995-12-27
Age:6.0  Onset:2001-01-06, Days after vaccination: 1837
Gender:Female  Submitted:2001-01-17, Days after onset: 11
Location:Massachusetts  Entered:2001-01-19, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 3IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4584352PO 
Administered by: Private     Purchased by: Public
Symptoms: Blister, Pruritus, Rash papular
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt experienced scattered vesicles and papules on chest, arms and forehead. Itching that lasted for 2 days.

VAERS ID:165851 (history)  Vaccinated:2001-01-25
Age:6.0  Onset:2001-01-25, Days after vaccination: 0
Gender:Male  Submitted:2001-02-05, Days after onset: 11
Location:New Jersey  Entered:2001-02-13, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever and swelling;UNK. DTP;;.00;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM961A24IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T00833 RA
Administered by: Private     Purchased by: Other
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pain and swelling at injection site for 72 hours. Child claimed entire arm hurt. Reaction began within 2 hours, post vax. Treated with Tylenol.

VAERS ID:165999 (history)  Vaccinated:1997-05-23
Age:6.0  Onset:2001-01-22, Days after vaccination: 1340
Gender:Female  Submitted:2001-02-08, Days after onset: 17
Location:Minnesota  Entered:2001-02-20, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Infection and no drug effect~Varicella (Varivax)~~3.20~In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Observation
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.798302 SCRL
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Vaccine positive rechallenge
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Developed chickenpox on 4/6/98, unknown length of illness. Developed chickenpox again on 1/22/01. Supportive care.

VAERS ID:166099 (history)  Vaccinated:2001-02-13
Age:6.0  Onset:2001-02-15, Days after vaccination: 2
Gender:Female  Submitted:2001-02-16, Days after onset: 1
Location:Michigan  Entered:2001-02-22, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Cholesteatoma s/p surgery 1/9/01
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0761K0SCRL
Administered by: Private     Purchased by: Public
Symptoms: Ecchymosis, Injection site erythema, Injection site induration, Injection site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: 5 1/2cm X 4 1/2cm area of redness, induration and bruising and increased warmth.

VAERS ID:166174 (history)  Vaccinated:1995-12-11
Age:6.0  Onset:1995-12-25, Days after vaccination: 14
Gender:Male  Submitted:2001-01-29, Days after onset: 1862
Location:Georgia  Entered:2001-02-27, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: (L) OM and RAD per pediatrician''s office note.
Preexisting Conditions: RAD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0887B0SCLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0747B0SCRL
Administered by: Private     Purchased by: Private
Symptoms: Abnormal behaviour, Autism, Speech disorder
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad)
Write-up: After watching some past videos, I believe my child had a reaction to the MMR vaccine he was given on 12/11/95. By the following December of 1996, we were having his hearing tested, due to an obvious language delay. Within months, we learned he had autism. He was officially dx''d as autistic in 10/98. There was a noticeable difference in behavior by 12/25/95 and we make reference on tape of how sick he had been earlier thus making me believe now, that he had a reaction. 60 day follow-up states the pt still has autism and he has been tested for heavy metals and the level of mercury is 8.

VAERS ID:166358 (history)  Vaccinated:1996-07-30
Age:6.0  Onset:2001-02-23, Days after vaccination: 1669
Gender:Male  Submitted:2001-02-28, Days after onset: 5
Location:Georgia  Entered:2001-03-02, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1446B0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: The pt received the vaccines on 7/30/1996 and was then diagnosed with Varicella on 2/23/01. The pt was exposed 10 days prior to eruption.

VAERS ID:166659 (history)  Vaccinated:1996-08-27
Age:6.0  Onset:2001-02-19, Days after vaccination: 1637
Gender:Female  Submitted:2001-02-21, Days after onset: 2
Location:Massachusetts  Entered:2001-03-06, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0566D0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Pruritus, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 6 year old white female presents with temperature 101F-102F and spots, itching, starting on chest and back. Exposed to chickenpox, 1 week ago. Had vaccine 8/27/96. Discharged with 20 red spots 1mm X 1mm, 2mm X2mm vesicles on trunk and back, 1-2 on arms and legs approx. and 1 in vagina, itching. It is too early to tell.

VAERS ID:166670 (history)  Vaccinated:2001-01-08
Age:6.0  Onset:2001-01-08, Days after vaccination: 0
Gender:Male  Submitted:2001-02-09, Days after onset: 32
Location:Illinois  Entered:2001-03-06, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Desquamation;UNK. DTAP;2;5.00;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES4734412IMRL
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3094A22IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 1/8/01, pt received vaccines and developed erythema of extremities and subsequently, desquamation of extremities, distally. Had similar reaction with last set of IZ''s. DTAP was the only vaccine in common.

VAERS ID:166695 (history)  Vaccinated:1995-09-11
Age:6.0  Onset:2001-01-26, Days after vaccination: 1964
Gender:Male  Submitted:2001-01-30, Days after onset: 4
Location:Maryland  Entered:2001-03-07, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (PROHIBIT)CONNAUGHT LABORATORIES9F611473 LL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0871B0 LA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0433B0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Herpes zoster, Infection
SMQs:
Write-up: This child was diagnosed with shingles 01/26/01.

VAERS ID:166761 (history)  Vaccinated:2001-02-20
Age:6.0  Onset:2001-02-21, Days after vaccination: 1
Gender:Female  Submitted:2001-02-27, Days after onset: 6
Location:Michigan  Entered:2001-03-08, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: U/A - small leukocytes trace ketone. Urine culture - Neg.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4720490IMLL
Administered by: Private     Purchased by: Private
Symptoms: Periorbital oedema, Urticaria, White blood cell disorder
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haematopoietic leukopenia (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This child had hives, and facial edema (periorbital).

VAERS ID:166872 (history)  Vaccinated:1998-05-13
Age:6.0  Onset:2000-12-14, Days after vaccination: 946
Gender:Male  Submitted:2000-12-18, Days after onset: 4
Location:Pennsylvania  Entered:2001-03-09, Days after submission: 81
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: WA011720
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Public     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt had chickenpox post vaccine.

VAERS ID:166882 (history)  Vaccinated:2000-12-04
Age:6.0  Onset:2000-12-05, Days after vaccination: 1
Gender:Male  Submitted:2000-12-05, Days after onset: 0
Location:Washington  Entered:2001-03-12, Days after submission: 97
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ;DTP (unknown mfr);4;1;In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WA011709
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM922A24IMLA
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008173 IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R125123SCRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1181K1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Feeling hot, Oedema, Pain, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The patient''s left arm was swollen, warm to the touch, and painful. A temperature was noted at school and checked by the school nurse. The school nurse sent the patient home and advised the mom to contact their doctor if it continues tomorrow or worsens today. To use Tylenol for the temp and pain, Benadryl for swelling, and ice and elevation for comfort, redness and swelling. Consult with the doctor.

VAERS ID:166893 (history)  Vaccinated:2001-02-06
Age:6.0  Onset:2001-02-06, Days after vaccination: 0
Gender:Male  Submitted:2001-02-09, Days after onset: 3
Location:Virginia  Entered:2001-03-12, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular
Current Illness: Asthmatic
Preexisting Conditions: Allergic rhinitis, asthma, allergy to e-mycin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEA: MEASLES (FOREIGN)MERCK & CO. INC.1197K IMLA
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Injection site erythema, 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt seen 24 hrs post injection, L upper arm edematous, erythema and extremely tender to touch, warm to touch, pt febrile lasting 48 hrs.

VAERS ID:166896 (history)  Vaccinated:1995-07-25
Age:6.0  Onset:2001-02-18, Days after vaccination: 2035
Gender:Male  Submitted:2001-02-23, Days after onset: 5
Location:Arizona  Entered:2001-03-12, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0408B1SC 
Administered by: Private     Purchased by: 0
Symptoms: Drug ineffective, Infection, Rash papular
SMQs:, Lack of efficacy/effect (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: reports of pustulant sacks approx 20 on body.

VAERS ID:166913 (history)  Vaccinated:2001-02-15
Age:6.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Florida  Entered:2001-03-12
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: HBG-10.6; UA-WNL
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1142K0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Abnormal behaviour, Anaemia, Injection site rash
SMQs:, Haematopoietic erythropenia (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: Rash at site; behavior changes.

VAERS ID:166958 (history)  Vaccinated:2001-01-03
Age:6.0  Onset:2001-01-03, Days after vaccination: 0
Gender:Female  Submitted:2001-02-28, Days after onset: 56
Location:New Jersey  Entered:2001-03-12, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: NJ20016
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0322J0IM 
Administered by: Private     Purchased by: Private
Symptoms: Hypertension, Nephrotic syndrome, Oedema, Proteinuria
SMQs:, Acute renal failure (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt developed edema post vaccine, pt was hypertensive and had proteinuria. DX nephrotic syndrome.

VAERS ID:167367 (history)  Vaccinated:2000-08-10
Age:6.0  Onset:0000-00-00
Gender:Female  Submitted:2000-08-22
Location:Texas  Entered:2001-03-14, Days after submission: 204
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: U2000006430
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES0278CA IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.1346   
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0260K SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0446K SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site inflammation, Injection site reaction, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Reportedly, the pt developed a local reaction 4-inches in diameter that was warm to the touch and itchy approximately 40 hours after the vax. Further information is requested. Follow up on 10/25/02: "From follow up telephone call with the receptionist from the clinic, it was stated that they do not know a person by the name. Therefore, no further information can be obtained. This case is closed."

VAERS ID:167570 (history)  Vaccinated:0000-00-00
Age:6.0  Onset:0000-00-00
Gender:Male  Submitted:2001-03-07
Location:New Jersey  Entered:2001-03-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00091856
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Hearing impaired
SMQs:, Hearing impairment (narrow)
Write-up: Information has been received from a consumer concerning his 6 year old Caucasian son who prior to 1999 was vaccinated with the 2nd and 3rd dose of Hep-B. It was noted that the pt received the 1st dose of Hep-B (Engerix-B) prior to 1999. For the past 3 years, the reporter noticed an auditory process problem. Six months ago, the child was dx''d with auditory process disorder from a child study group at school. The father wanted to know if prior to 1999, Hep-B had thimerosal as a preservative. The pt sought unspecified medical attention. Additional information has been requested.

VAERS ID:167836 (history)  Vaccinated:2001-03-15
Age:6.0  Onset:2001-03-15, Days after vaccination: 0
Gender:Female  Submitted:2001-03-21, Days after onset: 6
Location:Kentucky  Entered:2001-03-27, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Bronchitis
Preexisting Conditions:
Diagnostic Lab Data: CT Brain Scan
CDC Split Type: KY2001021
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R14334SCLA
PNC: PNEUMO (PREVNAR)PFIZER/WYETH4733430IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0498K0SCRA
Administered by: Public     Purchased by: Other
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: The child was administered immunizations in the clinic per protocol. She was observed in the clinic 20 minutes without any adverse effects. The child and mother went to the local library where the child experienced a seizure. She was transported by ambulance to the local hospital and then transferred to another Hospital.

VAERS ID:167915 (history)  Vaccinated:1996-02-16
Age:6.0  Onset:2001-03-24, Days after vaccination: 1863
Gender:Female  Submitted:2001-03-26, Days after onset: 2
Location:Pennsylvania  Entered:2001-03-28, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1124B0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Pyrexia
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt woke up on 3/24/01 with a fever of 104. By that evening, the pt''s parents noticed pox. She now has greater than 100 pox covering her body.

VAERS ID:167979 (history)  Vaccinated:1995-08-10
Age:6.0  Onset:2001-03-23, Days after vaccination: 2052
Gender:Female  Submitted:2001-03-23, Days after onset: 0
Location:Pennsylvania  Entered:2001-03-29, 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
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0426B0SC 
Administered by: Private     Purchased by: Public
Symptoms: Pruritus, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mom called on 3/23/01 and stated child has pimple-like fluid fill blisters over body and is itchy.

VAERS ID:167983 (history)  Vaccinated:2001-02-21
Age:6.0  Onset:2001-02-22, Days after vaccination: 1
Gender:Female  Submitted:2001-02-23, Days after onset: 1
Location:Pennsylvania  Entered:2001-03-29, Days after submission: 34
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: PA0126
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0276CA3IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R149022SC 
Administered by: Public     Purchased by: Public
Symptoms: Cough, Injection site erythema, Injection site pain, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: 24 hours post vax, the pt developed a reddened area the size of a golf ball that was sore. On 2/23/01 the child was brought into the state health center because the private physician could not see the child until the following week. The pt had a temp of 98.8. Acetaminophen and fluids were advised. On 2/27/01 the mother reports the the pt has a dry wheezing cough that occurs occasionally now.

VAERS ID:168007 (history)  Vaccinated:2001-02-22
Age:6.0  Onset:2001-02-22, Days after vaccination: 0
Gender:Female  Submitted:2001-02-26, Days after onset: 4
Location:New Jersey  Entered:2001-03-30, Days after submission: 32
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: Mild allergic rhinitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5169A20IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Diarrhoea, Dysgeusia, Ear pain, Fatigue, Flatulence, Irritability, Pharyngolaryngeal pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: This child had irritability after the immunization, also sore throat, left ear pain, rash to both arms and legs. On 02/25/01, excessive gas, diarrhea, temp less than or equal to 100 degrees rectally, fatigue, abdominal pain, dysgeusia.

VAERS ID:168173 (history)  Vaccinated:1995-03-29
Age:6.0  Onset:2001-03-27, Days after vaccination: 2190
Gender:Female  Submitted:2001-03-28, Days after onset: 1
Location:Maryland  Entered:2001-04-03, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0433B0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Developed varicella on 3/27/01.

VAERS ID:168195 (history)  Vaccinated:1996-05-07
Age:6.0  Onset:2001-03-21, Days after vaccination: 1779
Gender:Female  Submitted:2001-03-27, Days after onset: 6
Location:New York  Entered:2001-04-03, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1656B SC 
Administered by: Private     Purchased by: Private
Symptoms: Pain, Pruritus, Rash, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt started with rash on back which increased overnight, presented in office on next day with 2 circular areas around size of silver dollar. Vesicular lesions which were painful and itchy. No history of varicella. no specific treatment required.

VAERS ID:168202 (history)  Vaccinated:2001-02-21
Age:6.0  Onset:2001-03-12, Days after vaccination: 19
Gender:Male  Submitted:2001-03-16, Days after onset: 4
Location:Oregon  Entered:2001-04-03, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: OR200112
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1164K0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0938K0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis bullous, Skin disorder
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt developed a generalized varicella rash all over body, with no fever and two small areas of psoriasis.

VAERS ID:168281 (history)  Vaccinated:2001-03-27
Age:6.0  Onset:2001-03-27, Days after vaccination: 0
Gender:Female  Submitted:2001-03-28, Days after onset: 1
Location:Texas  Entered:2001-04-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4753822IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site swelling, Injection site warmth, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt c/o swelling, warm to touch,and extreme pain radiating up and down L arm; fever, Pt was treated with pain medicine.

VAERS ID:168495 (history)  Vaccinated:1996-01-18
Age:6.0  Onset:2001-04-04, Days after vaccination: 1903
Gender:Female  Submitted:2001-04-04, Days after onset: 0
Location:Utah  Entered:2001-04-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1180B0IMRA
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: The pt''s younger sibling had the chicken pox 2 weeks prior to the pt breaking out. At present she has 12 lesions.

VAERS ID:168579 (history)  Vaccinated:0000-00-00
Age:6.0  Onset:0000-00-00
Gender:Female  Submitted:2001-04-05
Location:Pennsylvania  Entered:2001-04-11, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: 0     Purchased by: 0
Symptoms: Infection
SMQs:
Write-up: This patient had varicella disease despite immunization.

VAERS ID:168731 (history)  Vaccinated:1996-04-29
Age:6.0  Onset:2001-03-17, Days after vaccination: 1783
Gender:Male  Submitted:0000-00-00
Location:North Carolina  Entered:2001-04-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1655B0SCRL
Administered by: Private     Purchased by: 0
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: The pt had the varicella vaccine on 4/29/1996. He had a varicella exposure on 3/4/01. He developed varicella on 3/17/01. Pt had varicella with $g700 lesions. Pt had at least 700 lesions.

VAERS ID:168762 (history)  Vaccinated:2001-03-23
Age:6.0  Onset:2001-03-23, Days after vaccination: 0
Gender:Female  Submitted:2001-04-09, Days after onset: 16
Location:Illinois  Entered:2001-04-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4733510IMRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt experienced a local reaction of redness and swelling the same day of receiving vax. Pt seen by physician three days post vax with redness the size of palm of hand extending downward from the injection site. Redness lasted for 5 days per parent.

VAERS ID:168781 (history)  Vaccinated:2001-03-20
Age:6.0  Onset:2001-03-21, Days after vaccination: 1
Gender:Male  Submitted:2001-03-21, Days after onset: 0
Location:Colorado  Entered:2001-04-17, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Viral infection.
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO01005
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS983A21IMLA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5176A20IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1511K1SCRA
Administered by: Public     Purchased by: Unknown
Symptoms: Flushing, Lymphadenopathy, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swollen lymph node under his right arm pit, no redness noted. Doctors appt today at 4 PM. He had a temp of 99.7 with Tylenol, flushed cheeks, and swollen tonsils. Throat culture done, no Strept, no redness, or swelling at the injection site.

VAERS ID:168943 (history)  Vaccinated:2001-04-03
Age:6.0  Onset:2001-04-03, Days after vaccination: 0
Gender:Male  Submitted:2001-04-14, Days after onset: 11
Location:California  Entered:2001-04-20, 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: NONER
Preexisting Conditions: Slight allergy to milk (cows).
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1559K0 LA
Administered by: Private     Purchased by: 0
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3 hours after the patient was given his Hepatitis A vaccine he started running a fever. The fever lasted on and off for 3 days. The highest the fever got was 104. He was given Motrin and Tylenol which did not keep the fever down.

VAERS ID:168969 (history)  Vaccinated:2001-04-05
Age:6.0  Onset:2001-04-06, Days after vaccination: 1
Gender:Male  Submitted:2001-04-06, Days after onset: 0
Location:North Carolina  Entered:2001-04-23, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: seizure;TETRAMUNE;4;1.00;In Patient
Other Medications: Trileptol, Atanol, Respiridol
Current Illness: recent sinus infection
Preexisting Conditions: partial complex epilepsy, developmental delay and behavior disorder
Diagnostic Lab Data: Na+ level - wnl (per mother)
CDC Split Type: NC01044
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LTD.U0060AA4IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T05063SCRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0177K1SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1148K0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Convulsion, Eye movement disorder, Feeling cold
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: The pt was given Motrin at 2:30pm and then received vaccines at 3:30pm. The mother gave more Motrin at 8:00pm. At 2:00am he yelled and she found him standing, cold with his eyes rolled back. The pt was taken to the hospital by ambulance. Na+ level was checked. Neurologist was called. The child continues to be afebrile. Seizures in past occurred with fever.

VAERS ID:169209 (history)  Vaccinated:2001-01-22
Age:6.0  Onset:2001-01-23, Days after vaccination: 1
Gender:Male  Submitted:2001-04-20, Days after onset: 86
Location:Missouri  Entered:2001-04-24, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 01/25/2001 - Throat Culture: Negative for Streptococcus
CDC Split Type: 20010020351
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS622C90IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 36 hours post vax, the pt developed a fine, non-pruritic, pinkish rash on his back, arms, groin and buttocks. Three days post vax, the rash began to spread to his legs and began to itch. He was seen by a physician. A throat culture was negative to Streptococcus. The pt was treated with Benadryl. The rash and itch persisted as of 01/25/2001.

VAERS ID:169097 (history)  Vaccinated:1998-06-15
Age:6.0  Onset:2001-04-17, Days after vaccination: 1037
Gender:Female  Submitted:2001-04-20, Days after onset: 3
Location:Missouri  Entered:2001-04-25, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1565E0SC 
Administered by: Private     Purchased by: Public
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Several red bumps, some with clear blister areas.

VAERS ID:169105 (history)  Vaccinated:1996-05-28
Age:6.0  Onset:2001-03-30, Days after vaccination: 1767
Gender:Male  Submitted:2001-04-19, Days after onset: 19
Location:Florida  Entered:2001-04-25, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1655B0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Mild varicella X 5-6 days.

VAERS ID:169090 (history)  Vaccinated:1996-03-07
Age:6.0  Onset:2001-04-14, Days after vaccination: 1864
Gender:Male  Submitted:2001-04-17, Days after onset: 3
Location:Pennsylvania  Entered:2001-04-26, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tine (Monovacc), Connaught, lot # K1132-2, sub Q left forearm.
Current Illness: Right otitis media 03/02/96.
Preexisting Conditions: History of otitis media.
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1129B0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This patient was exposed to his sibling with the chicken pox on 03/31/01, 30 - 40 lesions on his trunk, extremities and mouth. Afebrile.

Result pages: prev   2585 2586 2587 2588 2589 2590 2591 2592 2593 2594 2595 2596 2597 2598 2599 2600 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2614 2615 2616 2617 2618 2619 2620 2621 2622 2623 2624 2625 2626 2627 2628 2629 2630 2631 2632 2633 2634 2635 2636 2637 2638 2639 2640 2641 2642 2643 2644 2645 2646 2647 2648 2649 2650 2651 2652 2653 2654 2655 2656 2657 2658 2659 2660 2661 2662 2663 2664 2665 2666 2667 2668 2669 2670 2671 2672 2673 2674 2675 2676 2677 2678 2679 2680 2681 2682 2683 2684 2685 2686 2687 2688 2689 2690 2691 2692 2693 2694 2695 2696 2697 2698 2699 2700 2701 2702 2703 2704 2705 2706 2707 2708 2709 2710 2711 2712 2713 2714 2715 2716 2717 2718 2719 2720 2721 2722 2723 2724 2725 2726 2727 2728 2729 2730 2731 2732 2733 2734 2735 2736 2737 2738 2739 2740 2741 2742 2743 2744 2745 2746 2747 2748 2749 2750 2751 2752 2753 2754 2755 2756 2757 2758 2759 2760 2761 2762 2763 2764 2765 2766 2767 2768 2769 2770 2771 2772 2773 2774 2775 2776 2777 2778 2779 2780 2781 2782 2783   next

New Search

Link To This Search Result:
http://www.medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=2684&PERPAGE=100&ESORT=AGE


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166