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Case Details (Sorted by Age)

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VAERS ID:226547 (history)  Vaccinated:2004-08-16
Age:17.0  Onset:2004-08-18, Days after vaccination: 2
Gender:Male  Submitted:2004-08-26, Days after onset: 8
Location:North Dakota  Entered:2004-09-13, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: ND0414
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPH: DTAP + HIB (TRIHIBIT)AVENTIS PASTEURU08736C3IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site inflammation, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Very swollen, inflamed red left upper arm deltoid area-advised ice (intermittent), children''s Motrin for anti inflammatory, Cortaid for itching (topical) or Benadryl.

VAERS ID:226687 (history)  Vaccinated:2004-08-27
Age:17.0  Onset:2004-09-02, Days after vaccination: 6
Gender:Male  Submitted:2004-09-08, Days after onset: 6
Location:Missouri  Entered:2004-09-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PCN, Sulfa, Keflex
Diagnostic Lab Data: check with ER
CDC Split Type: MO200445
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSA753A90IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abnormal behaviour, Jaundice, Pyrexia
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad)
Write-up: Parent states on phone that pt has fever, personality changes, and is yellow, 09/02/04. Instructed to go to ER. Mom stated felt personality changes started in pm on 08/27/04.

VAERS ID:226645 (history)  Vaccinated:2004-07-27
Age:17.0  Onset:2004-07-27, Days after vaccination: 0
Gender:Female  Submitted:2004-09-09, Days after onset: 44
Location:Kentucky  Entered:2004-09-15, 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: Depo Provera 150mg IM on 07/27/04;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5514A20IMRA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1000AA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Pruritus, Rash
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 07/28/04: Grandmother called, child spent the night with a friend while at friends house, broke out in a rash on back. Itching and states "trouble breathing last night". Child is still at friends house called her grandmother who called nurse. Counselor and phone # for CDC. Take Benadryl as needed. Deny distress at this time. Client took Benadryl (next day), rash stayed 2 days, no other symptoms.

VAERS ID:226709 (history)  Vaccinated:2004-09-10
Age:17.0  Onset:2004-09-10, Days after vaccination: 0
Gender:Male  Submitted:2004-09-10, Days after onset: 0
Location:Massachusetts  Entered:2004-09-16, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic to beef and pork.
Diagnostic Lab Data: Pt was Dx''d from Hospital ED 2 hours later.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1215N0IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0963N1IMRA
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD1143IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0072N0SCRA
Administered by: Other     Purchased by: Public
Symptoms: Cough, Erythema, Face oedema, Hypersensitivity, Loss of consciousness, Nasal congestion
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)
Write-up: 4 vaccines administered. Pt fainted after last vaccine. Reclined on cot, ice to face, BP=12/74, P:76 R=20. Recovered, color good, alert, oriented after 5 min. 8:10 forehead, reddened and swollen lips and nose swollen. Frequent congested cough. 911 called for possible allergic reaction, Epi-pen 0.3mg admin 8:15.

VAERS ID:227012 (history)  Vaccinated:2004-07-30
Age:17.0  Onset:2004-07-31, Days after vaccination: 1
Gender:Female  Submitted:2004-09-17, Days after onset: 48
Location:Arizona  Entered:2004-09-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: N/A
CDC Split Type: AZ0407
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5540A20IMLA
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURUE122AA0IMRA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1025AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dysphonia, Pharyngolaryngeal pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Immunized at approx. 8am 7/30/04. By 8pm c/o sore throat. Lost voice by 12am & episodes of uncontrolled shaking w/out loss of consciousness x 15 min at approx. 2am. Took two 200mg ibuprofen w/ relef in 5 min. No fever or headache. More tremors but improved w/ ibuprofen. Did not seek medical care.

VAERS ID:227249 (history)  Vaccinated:2004-09-21
Age:17.0  Onset:2004-09-21, Days after vaccination: 0
Gender:Male  Submitted:2004-09-24, Days after onset: 3
Location:Florida  Entered:2004-10-01, 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: Zoloft 150mg, every morning
Current Illness:
Preexisting Conditions: Migraines,depression
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0182P  LA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1020AA  RA
Administered by: Public     Purchased by: Unknown
Symptoms: Contusion, Injury, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Approximately 20 minutes after receiving vaccines, pt and guardian building where he passed out hurting face on pavement. Contusions on upper lip bruised chin and hands. Blunt trauma to frontal dentition no signs of breakage follow up 10/6/04. Sent to ER. Left before being seen. BP 105/59 P63.

VAERS ID:227533 (history)  Vaccinated:2004-10-01
Age:17.0  Onset:2004-10-01, Days after vaccination: 0
Gender:Female  Submitted:2004-10-04, Days after onset: 3
Location:Virginia  Entered:2004-10-08, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Pineapple upside down cake give same symptoms.
Diagnostic Lab Data: NONE
CDC Split Type: VA04035
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0310N0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 20 minutes after hep B, started itching developed raised bumps on neck, back, side. Denies edema, dyspnea, h/a.

VAERS ID:227652 (history)  Vaccinated:2004-10-08
Age:17.0  Onset:2004-10-08, Days after vaccination: 0
Gender:Male  Submitted:2004-10-12, Days after onset: 4
Location:North Carolina  Entered:2004-10-13, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5598A90IMLA
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURX08280SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1036N0SCRA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1011AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0588P0SCRA
Administered by: Public     Purchased by: Unknown
Symptoms: Dizziness, Hypotension, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: OV 10/8/04 for school vaccines. No record of previous vaccination. Immediately after last vaccine pt became lightheaded and pallor. Pt''s condition continued to get progressively worse on observation. Attempted to obtain blood pressure and couldn''t. 911 was called and Benadryl 50mg IM was administered along with Epinephrine 0.5ml IM at 10:52AM per agency standing order by RN. EMS arrived and pt was taken by ambulance to ER.

VAERS ID:229064 (history)  Vaccinated:2004-11-08
Age:17.0  Onset:2004-11-08, Days after vaccination: 0
Gender:Male  Submitted:2004-11-09, Days after onset: 1
Location:Texas  Entered:2004-11-09
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: prematurity, his of heart surgery
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0472P2IMLA
HEPA: HEP A (VAQTA)MERCK & CO. INC.0222P0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0590P0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Dyspnoea, Hyperhidrosis, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: At approximately 5:42pm, the client stated he felt short of breath after last vaccine administered (hep A). The client stood up and took a few steps then stated that he felt dizzy and short of breath. Instructed client to sit in the chair located in the hallway. The client then became diaphoretic and very pale. Instructed client to put his head between his knees. Blood pressure taken 100/50, pulse 50. Benadryl 0.5cc IM to RA given at approximately 5:50pm. At a few minutes till 6:00pm, the client stated that he felt better. B/P re-taken 104/82, pulse 68. Client''s normal facial color returned and he left the office at 6:00 pm according to his mother. At 7:00 pm, mother was called to follow up on son''s condition. Mother stated that he had eaten supper and that he felt just fine. Mother stated that she would "keep an eye on him through the night and that she would let us (office staff / nurses) know if any other problems occurred.

VAERS ID:229730 (history)  Vaccinated:2004-09-25
Age:17.0  Onset:2004-09-29, Days after vaccination: 4
Gender:Female  Submitted:2004-11-29, Days after onset: 61
Location:New York  Entered:2004-11-29
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
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0993N0SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Pyrexia, Rash, Rhinitis
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Patient developed rash, fever, cough and coryza on 09/29/04. Rash last 5 days. On 10/23/04 Measles IgG 2.12; Measles IgM 160.

VAERS ID:229876 (history)  Vaccinated:2004-11-18
Age:17.0  Onset:2004-11-18, Days after vaccination: 0
Gender:Female  Submitted:2004-11-24, Days after onset: 6
Location:Minnesota  Entered:2004-11-30, 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
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5497A91IMLA
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURX10402SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1034N1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Fatigue, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Complaints of low grade fever (99F), dizziness and fatigue, headache approximately 3.5 hours after receiving immunizations. Continues to complain of same symptoms on 11/24/04. Has been attending school; not ill enough to stay home or see doctor.

VAERS ID:230029 (history)  Vaccinated:2004-11-11
Age:17.0  Onset:2004-11-12, Days after vaccination: 1
Gender:Male  Submitted:2004-11-27, Days after onset: 15
Location:Missouri  Entered:2004-12-06, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advair BID, Albuterol PRN for RAD
Current Illness: NONE
Preexisting Conditions: Allergic Rhinitis; Well controlled mild intermittent RAD.
Diagnostic Lab Data: Increased CBC; Negative BC; No organism recovered; Cellulitis with no abscess or septicemia. Medical Record received on 1/3/2005 states pt did not experience cellulitis.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1458AA0 RA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0287P0 LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Laboratory test abnormal, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Patient given flu vaccine 11/11/04. Within 24-36 hours, erythema/induration, fever. Initially observed with supportive care. Next 24-48 hours, continued fever, increased spread of erythema, induration - indicative of cellulitis. Medical Record received on 1/3/2005 states vomiting.

VAERS ID:230108 (history)  Vaccinated:2004-11-17
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2004-12-01
Location:Montana  Entered:2004-12-07, 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
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE, INC./WYETH LABORATORIES, INC500338P0IN 
Administered by: Private     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: Pt was given Flumist and was pregnant. Pt did not tell me she was prior to vaccination.

VAERS ID:231222 (history)  Vaccinated:2004-12-07
Age:17.0  Onset:2004-12-07, Days after vaccination: 0
Gender:Female  Submitted:2004-12-16, Days after onset: 9
Location:New York  Entered:2004-12-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Zantac, MTV, Celebrex, Folic Acid, Calcium
Current Illness: gastritis, asthma, RA
Preexisting Conditions: Allergy, Amoxicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU152AAB  LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0529P1 RA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient received vaccine 12/7/04 am. Developed swelling and redness right arm around injection site that evening. Went to ER and placed on Keflex. Then on 12/8 area getting bigger went to walk in clinic Keflex. Discharged , prednisone started.

VAERS ID:232086 (history)  Vaccinated:2005-01-05
Age:17.0  Onset:2005-01-05, Days after vaccination: 0
Gender:Female  Submitted:2005-01-06, Days after onset: 1
Location:Tennessee  Entered:2005-01-10, 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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0273N1SC 
Administered by: Other     Purchased by: Public
Symptoms: Lymphadenopathy, Pharyngolaryngeal pain, Pyrexia, Tenderness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever 99, sore throat, lymph node tenderness 2-3 hours after MMR

VAERS ID:232543 (history)  Vaccinated:2005-01-05
Age:17.0  Onset:2005-01-05, Days after vaccination: 0
Gender:Male  Submitted:2005-01-13, Days after onset: 8
Location:Unknown  Entered:2005-01-19, 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:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: ME05002
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURERUE255AA0SC 
Administered by: Private     Purchased by: Private
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Tingling, numbness on the side vaccine was given

VAERS ID:232739 (history)  Vaccinated:2004-07-16
Age:17.0  Onset:2004-07-16, Days after vaccination: 0
Gender:Male  Submitted:2004-12-23, Days after onset: 160
Location:Unknown  Entered:2005-01-24, Days after submission: 32
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: dog bite in Peru
Diagnostic Lab Data: Hemoglobin , liver function test , ESR , Billirubin , Urine Protein , EBV , CMV
CDC Split Type: EM20040458
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION3340110  
Administered by: Other     Purchased by: Other
Symptoms: Fatigue
SMQs:
Write-up: A 17 year old male patient experienced fatigue after receiving post exposure treatment with RabAvert following a dog bite while traveling to Peru. The patient received 5 doses of RabAvert, the first dose on 07/16/2004 and the last dose on 08/13/2004. During and after the entire rabies vaccine series the patient was very fatigued, sleeping 12 hours a day during summer vacation and continued to be very fatigued after returning to school. Laboratory tests revealed a billirubin of 4.1 mg/dl and urine protein of 100 mg/dl. The patient had no other associated symptoms. The patient reportedly had grown over four inches during the summer and liked to sleep 12 hours a day. At the time of this report the patient continued to be fatigued and the billirubin remained elevated. Epstein Barr Virus and Cytomegalovirus test results were both negative. The patient was sxheduled to see a liver specialist.

VAERS ID:232889 (history)  Vaccinated:2005-01-21
Age:17.0  Onset:2005-01-22, Days after vaccination: 1
Gender:Male  Submitted:2005-01-25, Days after onset: 3
Location:New York  Entered:2005-01-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: MUSCLE SPASTICITY;DTP (no brand name);1;2;In Patient
Other Medications: BABY ASPIRIN
Current Illness: NONE
Preexisting Conditions: PENICILLIN, AMPICILLIN, AUGMENTIN, LORABID, ZITHROMAX, DOXICYCLIN SLEEP APNEA
Diagnostic Lab Data: EKG, XRAYS, BLOOD TESTS
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Atrial fibrillation, Chest pain, Diarrhoea, Dizziness, Heart rate irregular, Nausea, Pyrexia, Shoulder pain, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow)
Write-up: 1.FEVER AND ABDOMINAL PAIN WITHIN 18 HOURS- MOTRIN, CHARCOAL CAPSULE 2.PAIN FROM RIGHT SHOULDER TO ELBOW AND ARMPIT AND BACK RADIATING FROM CHEST WITHIN 24 HOURS 3.WHEEZING, LIGHT HEADEDNESS, NAUSEA, LOOSE BOWELS WITHIN 24 HOURS- ALBUTEROL INHALER, REST 4. CHEST PAIN, IRREGULAR HEARTBEAT, ATRIAL FIBRILLATION-WITHIN 48 HOURS- WENT TO ER- TOLD TO REST

VAERS ID:232947 (history)  Vaccinated:2005-01-13
Age:17.0  Onset:2005-01-14, Days after vaccination: 1
Gender:Female  Submitted:2005-01-14, Days after onset: 0
Location:New Mexico  Entered:2005-01-26, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEUR 5 RA
Administered by: Other     Purchased by: Public
Symptoms: Headache, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 12 hours after injection patient experienced severe shot site pain, temporal headache, backache and nausea. Non Focal PE: No lymphadenopathy

VAERS ID:233408 (history)  Vaccinated:2005-01-31
Age:17.0  Onset:2005-02-01, Days after vaccination: 1
Gender:Female  Submitted:2005-02-02, Days after onset: 1
Location:New York  Entered:2005-02-04, 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: PPD - Skin Test - Adventis - Lot # C1707AA - Intra-dermal - left forearm.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.1239N IMRA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1354AA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever - feeling of Malaise - began 24 hours after administration of vaccine. Responded to Tylenol.

VAERS ID:233442 (history)  Vaccinated:2000-02-08
Age:17.0  Onset:0000-00-00
Gender:Male  Submitted:2005-02-01
Location:Unknown  Entered:2005-02-07, 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: UNK
Diagnostic Lab Data: Diagnostic urinalysis 30mg/d (protein); Sjogren''s antigen normal; Smith antigen normal; Plasma alanine: 226 U/L; Plasma creatinine 2,406 U/L; Plasma TSH normal; Serum antimitochondrial normal; Serum anti-SCI 70 test normal; Serum aldolase 22.2 IU/L; Serum Epstein-Barr VCA negative; Serum Epstein-Barr VCA positive; Serum Borrelia negative; Serum 5-nucleotidase normal; Ribonucleoprotein normal; Prothrombin time normal; Urine immunoglobulin A normal; Serum rheumatoid factor normal; Serum HIV-1 detuned EIA negative; Serum hepatitis C negative; Serum antithyroid normal; Serum antismooth muscle normal; Serum antiparietal cell normal; Serum ANA normal; Plasma phosphorus normal; Plasma aspartate 22 U/L; Erythrocyte normal; VDRL negative; APTT norma
CDC Split Type: WAES0501PRI00001
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Private     Purchased by: Unknown
Symptoms: Blood creatinine increased, Laboratory test abnormal, Muscular weakness, Myalgia, Polymyositis, Pruritus, Pyrexia, Rash maculo-papular, Vaccine positive rechallenge
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Tumour lysis syndrome (broad)
Write-up: Information has been received from a literature article concerning a 17 year old male who on 1/00 was vaccinated with hepatitis B vaccine recombinant. After the first vaccination, the patient developed weakness of the legs. Seventeen days later, the patient received a second dose of the vaccine. Seventeen days after the second injection of the vaccine, low grade fever, a pruritic maculopapular rash appeared and weakness of the legs recurred. The patient was initially treated with topical diphenhydramine cream 1% thrice daily and received IV fluids in order to induce a good urine flow. He was discharged five days after admission. The day of discharge, the total creatinine kinase was 2,271 U/L, and leg weakness persisted. Four weeks later, he had recovered full strength of his lower extremities, the rash had disappeared, and the enzymes had normalized. Administration of the third dose of hepatitis B vaccine was thought unadvisable. Subsequently, the patient recovered from generalized myalgia, low grade fever, and pruritic maculopapular rash on thighs, abdomen, and arms. No further information is available. It has been noted that the patient was hospitalized. The article mention polymyositis. A copy of the published article is attached as further documentation of the patient''s experience.

VAERS ID:233758 (history)  Vaccinated:2004-04-19
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2005-02-09
Location:Georgia  Entered:2005-02-14, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Therapy unspecified
Current Illness:
Preexisting Conditions: Pregnancy NOS (LMP unk)
Diagnostic Lab Data: Ultrasound results not provided.
CDC Split Type: WAES0404USA02578
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1099N SC 
Administered by: Other     Purchased by: Other
Symptoms: Medication error, Unintended pregnancy
SMQs:, Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a RN through a pregnancy registry concerning a 17 year old female who on 19Apr04 was vaccinated SC with a 0.5mL dose of varicella virus vaccine live (lot #647267/1099N). Concomitant vaccination on the same day included a dose of hep B virus vaccine rHBsAg (manufacturer unk). The reporter indicated that the pt knew she was pregnant at the time of vaccination but did not disclose that information at the time because she had an abortion scheduled for 20Apr04. The pt changed her mind and did not have the abortion. She was also treated for chlamydia and received antibiotics that were not safe for her pregnancy. The name of the drug was not available. Unspecified medical attention was sought and no treatment was required. IT was noted that therapy with varicella virus vaccine live was discontinued. A product quality complaint was not involved. Follow up information was received from a RN who indicated that on 17Nov04 at 40 weeks from her LMP, the pt gave birth to a normal female infant weighing 10 pounds and 7 ounces. There were no complications, infections, or illness during pregnancy. Diagnostic tests during pregnancy included an ultrasound (results not provided). Complications during labor included a cesarean section due to failure to progress. There was no feature of congenital varicella zoster syndrome. Upon internal review, failure to progress was determined to be an other important medical event (OMIC). Information received on 29Apr04 contained the following adverse experience: Chlamydia (onset unk). No further information is expected.

VAERS ID:234063 (history)  Vaccinated:2005-02-19
Age:17.0  Onset:2005-02-19, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:2005-02-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER30004330PO 
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Mother states patient took first dose of oral typhoid at 8 AM and waited 1 hour to eat, then exactly 2 hours after dose became nauseated and had abdominal cramping. Denies any fever or diarrhea. Felt better the evening of 02/20/05.

VAERS ID:234270 (history)  Vaccinated:2005-02-14
Age:17.0  Onset:2005-02-16, Days after vaccination: 2
Gender:Female  Submitted:2005-02-18, Days after onset: 2
Location:Michigan  Entered:2005-02-23, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singulair
Current Illness: No
Preexisting Conditions: Allergy to Tree nuts
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0383P  LA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives 56 hours after administered on torso. Disappeared 4 hours after Benadryl. Hives again 80 hours after administration - again resolved with Benadryl.

VAERS ID:234283 (history)  Vaccinated:2004-08-02
Age:17.0  Onset:2004-09-11, Days after vaccination: 40
Gender:Female  Submitted:2005-02-22, Days after onset: 164
Location:Louisiana  Entered:2005-02-23, 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: 4/00 Verapamil ER 180mg daily 9/03 Lexapro 20mg BID
Current Illness: None
Preexisting Conditions: NKA 04/2000 DX Hypertension 09/2003 DX Depression
Diagnostic Lab Data: See above (#7) for mother''s statement of testing.
CDC Split Type:
Vaccination
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0333P0IMLA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1020AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Benign intracranial hypertension, Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad)
Write-up: 2/22/05-Mother in the Health Unit to complete VAERS form due to the following sequence of events after receiving the Hepatitis B vaccine series. Her mother states that she was previously diagnosed w/ high blood pressure, depression, and she is extremely overweight. Dates and information recorded as given by mother: 8-2-04 Patient received #1 Hep B Pedi/Adol at 1:30pm. The injection site was left arm, given IM. 9-11-04 Patient complained of severe headache and pressure on the right side of her head. 9-13-04 Patient received #2 Hep B at 2:00pm. The injection site was left arm given IM. 9-14-04 Patient complained of severe headache & pressure on right side of head. Seen at Clinic. NP ordered MRI of brain. Results of MRI abnormal. Ordered MRI of pituitary gland. Results-cyst on pituitary gland. Refer to neurologist. Ordered EEG-abnormal: diagnosed w/ Pseudotumor Cerebri. Spinal tap-pressure mildly elevated. 2nd opinion concurred w/ diagnosis of Pseudotumor Cerebri. In October 2004(?) Patient started having blurred vision along with severe headaches & pressure on right side of head. 11-19-04-seen by neuro ophthalmologist. He stated symptoms psychosomatic-ordered meds for headache, which decreased headache pain after 1 month. Vision remains 20/200 in both eyes; no corrective lens has been ordered since the eye doctor thinks these symptoms are temporary. Patient is home schooled. 12-13-04 3rd Hep B @ 10:30AM, left arm. Patient is on following meds: Verapamil ER 180mgs daily, Lexapro 20mg BID, Diamox 500mg TID, Topamax 100mg HS, Furaset PRN-headache. She found information on line of other people w/ Pseudotumor Cerebri that believe their condition was caused by Hep B vaccine.

VAERS ID:234356 (history)  Vaccinated:1970-01-01
Age:17.0  Onset:1970-01-01, Days after vaccination: 0
Gender:Male  Submitted:2005-02-26, Days after onset: 12840
Location:Idaho  Entered:2005-02-26
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: High fever, sweats, stomach nausea, extreme fatigue
Preexisting Conditions: none related
Diagnostic Lab Data: See medical records and "C" file.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
BCG: BCG (NO BRAND NAME)UNKNOWN MANUFACTURER    
CHOL: CHOLERA (NO BRAND NAME)UNKNOWN MANUFACTURER    
DTPIHI: DT+IPV+HIB+HEPB (NO BRAND NAME)UNKNOWN MANUFACTURER    
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER    
PLAGUE: PLAGUE (USP)GREER LABORATORIES, INC.    
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Military     Purchased by: Military
Symptoms: Angiopathy, Bronchitis, Chills, Dyspnoea, Gastrointestinal disorder, Hypertension, Lung disorder, Pneumonia, Pyrexia, Viral infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Repeated pneumonia, multiple bronchitis, and mono-nucleosis, gastro-intestinal distress, fevers, chills, hospitalization. Life long: yearly pneumonias resistant to inoculation, annual and bi-annual bronchitis, symptoms of COPD and chronic breathing problems not associated with asthma. Chronic fatique. Cardio-Vascular degeneration, high blood pressure, and events and tendancy toward vascular dissection.

VAERS ID:234398 (history)  Vaccinated:2005-02-24
Age:17.0  Onset:2005-02-26, Days after vaccination: 2
Gender:Female  Submitted:2005-02-28, Days after onset: 2
Location:Kansas  Entered:2005-02-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None. Benadryl or Clariton during allergy season.
Current Illness: Nasal congestion, no fever. Had the "flu" per aunt last week. No fever since 2/21/05.
Preexisting Conditions: General allergies. Not allergic to eggs.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0241P0IMLA
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUE352AA0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest discomfort, Dizziness, Pain, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: After the shot that day had a sore arm where both YF and Hep A were given; extended up into her neck. No fever. Two days after the shot she noticed some hives located between her shoulder blades which have since changed locations in different areas on her trunk or arms. Has been taking Benadryl. Today c/o her chest getting tight, a little dizzy. Her grandmother was taking her to the ER for treatment at the time of the call by her aunt and mother to the HD.

VAERS ID:234533 (history)  Vaccinated:2005-02-15
Age:17.0  Onset:2005-02-15, Days after vaccination: 0
Gender:Male  Submitted:2005-02-15, Days after onset: 0
Location:Wisconsin  Entered:2005-03-02, 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: Tegretol, Augmentin
Current Illness: Mild sinus symptoms
Preexisting Conditions: E Coli meningitis with hydrocephalus UP shunt, Seizures
Diagnostic Lab Data: Labs: CBC, CMP, Tegretol level normal
CDC Split Type:
Vaccination
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0768P0SCLA
Administered by: Private     Purchased by: Unknown
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)
Write-up: Patient had 3 seizures in the 2 hours after vaccine. He does have a known seizure disorder and he required no other medication to stop the 1 to 3 minute seizures. His office visit was prolonged by 2 hours.

VAERS ID:234876 (history)  Vaccinated:2004-11-16
Age:17.0  Onset:2004-11-17, Days after vaccination: 1
Gender:Male  Submitted:2004-11-18, Days after onset: 1
Location:Colorado  Entered:2005-03-11, Days after submission: 113
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
HEPA: HEP A (VAQTA)MERCK & CO. INC.0123P1IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0271P1SCRL
Administered by: Other     Purchased by: Unknown
Symptoms: Feeling hot, Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness and increased temp at injection site.

VAERS ID:235012 (history)  Vaccinated:2004-09-01
Age:17.0  Onset:2004-09-01, Days after vaccination: 0
Gender:Female  Submitted:2005-03-07, Days after onset: 187
Location:Unknown  Entered:2005-03-15, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0410USA03890
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Information has been received from a registered nurse concerning a 17 year old female who in 09/04, was vaccinated with a first dose of hepatitis B virus vaccine rHBsAg (yeast). Four to five hours post vaccination she developed a fever, malaise and dizziness that lasted up to 48 hours. Subsequently the patient "felt fine". Medical attention was not sought. There was no product quality complaint involved. Additional information has been requested.

VAERS ID:235446 (history)  Vaccinated:2005-02-23
Age:17.0  Onset:2005-02-24, Days after vaccination: 1
Gender:Female  Submitted:2005-03-16, Days after onset: 20
Location:Arizona  Entered:2005-03-25, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergy to PCN and Eggs
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0815P IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient began with complaints of pain on 02/24/2005 at approximately 20:00(10:00) By 02/25/2005 at 7:00 left deltoid hot, red and swollen. MD notified and diphenhydramine 50mg PO started by Dr x48 hours. Ice packs given.

VAERS ID:236222 (history)  Vaccinated:0000-00-00
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2005-01-25
Location:Unknown  Entered:2005-04-18, Days after submission: 82
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The pt''s concurrent medications and medical conditions were not reported.
Diagnostic Lab Data: SPECT, unspecified date: "focally diminished cortical brain activity".
CDC Split Type: A0527185A
Vaccination
Manufacturer
Lot
Dose
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Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Disturbance in attention, Dizziness, Fatigue, Fibromyalgia, Gait disturbance, Headache, Hypoaesthesia, Insomnia, Laboratory test abnormal, Migraine
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: This case was reported by a lawyer and described the occurrence of loss of concentration in a 17 year old female pt who received lyme disease vaccine recombinant (Lymerix) injection for prophylaxis. A physician or other health care professional has not verified this report. On an unspecified date, the pt received Lymerix. At an unk time after receiving Lymerix, the pt experienced fatigue, migraine headaches, myalgias, arthralgias, dizziness, gait disturbances, insomnia, numbness, loss of concentration, cognitive problems and fibromyalgia type symptoms with a SPECT (single photon emission computerized tomography) scan showing focally diminished cortical brain activity. Time to onset, treatment, and outcome were not reported.

VAERS ID:236226 (history)  Vaccinated:0000-00-00
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2005-01-25
Location:Unknown  Entered:2005-04-18, Days after submission: 82
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The pt''s concurrent medication and medical conditions were not reported.
Diagnostic Lab Data: UNK
CDC Split Type: A0527192A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Disturbance in attention, Fatigue, Headache
SMQs:, Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad)
Write-up: This case was reported by a lawyer and described the occurrence of loss of concentration in a 17 year old female pt who received lyme disease vaccine recombinant (Lymerix) injection for prophylaxis. A physician or other health care professional has not verified this report. On an unspecified date, the pt received Lymerix. At an unk time after receiving Lymerix, the pt experienced fatigue,arthralgias, headaches, and loss of concentration. Time to onset, treatment, and outcome were not reported.

VAERS ID:236555 (history)  Vaccinated:2005-04-14
Age:17.0  Onset:2005-04-14, Days after vaccination: 0
Gender:Female  Submitted:2005-04-15, Days after onset: 1
Location:South Carolina  Entered:2005-04-25, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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RAB: RABIES (RABAVERT)CHIRON CORPORATION3350112IMRA
Administered by: Private     Purchased by: Other
Symptoms: Anxiety, Asthenia, Dyspnoea, Heart rate increased, Hypoaesthesia, Tenderness
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)
Write-up: vaccine administered 04/14/05-9:00 AM. 3:30 PM- numbness, tingling in tips of fingers radiating to mid forearm of arm vaccine was administered (left). 6:00 PM- playing soccer, noticed heavy feeling in arm and breathing difficulty. Seen in ER. 04/15/05- numbness and tingling still present in left hand and fingers to the wrist. In ER pt with rapid heart rate. Care advice: Referred pt to be seen in MD office in AM When called mom back she stated that child told her that her chest feels like something heavy is on it. Mom is concerned and took to ER nearby. ER: General: Somewhat anxious-appearing lady but in no distress. Vital signs: BP 102/60, P 82/ regular, R 18 unlabored, O2 sat 100% on room air, T 97.7. HEENT: mouth moist with clear throat. Neck: Supple non-tender, Lungs: Clear to ascultation and percussion, Heart: regular rate and rhythm, no murmurs or gallops. Chest: some slight tenderness over back and chest wall. Extremeties: some slight decreased sensation of left hand and slight decreased grip. Some slight tenderness over left shoulder and arm area. Abdomen: soft, flat, nontender. Neurologic: normal. Probable reaction to rabies vaccine. Advised to drink plenty of fluids, and Eat well. Get some rest tonight and touch base with MD in office tomorrow, this is who is administering vaccine and they can decide if they need to proceed on with this. If not improving by tomorrow morning need to see her MD, If it gets much worse tonight, instructed to go to the ER.

VAERS ID:236740 (history)  Vaccinated:2005-04-20
Age:17.0  Onset:2005-04-21, Days after vaccination: 1
Gender:Male  Submitted:2005-04-28, Days after onset: 7
Location:Maryland  Entered:2005-04-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Accutane
Current Illness:
Preexisting Conditions: Right side Hemiplegia, Acne
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1493AC IMLA
Administered by: Private     Purchased by: Private
Symptoms: Lymphadenopathy, Pain
SMQs:
Write-up: Aching all over. Swollen nodes.

VAERS ID:237029 (history)  Vaccinated:2005-04-28
Age:17.0  Onset:2005-04-28, Days after vaccination: 0
Gender:Male  Submitted:2005-04-29, Days after onset: 1
Location:Virginia  Entered:2005-05-05, 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
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0180P0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Loss of consciousness, Pallor, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Few second episode (unwitnessed except by mother of pt) of shaking head "blackout", neg LOC, pallor, 5 minutes after vaccination received.

VAERS ID:237406 (history)  Vaccinated:2005-04-18
Age:17.0  Onset:2005-04-18, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:2005-05-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depoprovera inj 2/18/05
Current Illness: NONE
Preexisting Conditions: Heart murmur, PIH
Diagnostic Lab Data: Lump CTA, A/P airway patent, no erythema, an obvious rash at vaccine site.
CDC Split Type: TX05030
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0858P1IMLA
Administered by: Private     Purchased by: Public
Symptoms: Feeling hot, Injection site erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: 10 min after injection pt c/o itchiness left arm around injection site upon inspection area at injection site was hot, red, spreading to entire upper arm. Sp O2=98% on room air. Vistan 50mg IM given 17:00, no itching, resting comfortably at 17:15.

VAERS ID:237564 (history)  Vaccinated:2004-03-30
Age:17.0  Onset:2004-04-23, Days after vaccination: 24
Gender:Male  Submitted:2004-07-15, Days after onset: 83
Location:Massachusetts  Entered:2005-05-19, Days after submission: 308
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Augmentin
Current Illness:
Preexisting Conditions: None. The patient received the vaccine as part of a post-exposure series following an animal bite. The type of animal was not specified and it was not reported whether it was tested for rabies.
Diagnostic Lab Data:
CDC Split Type: 200401854
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)AVENTIS PASTEUR 1  
Administered by: Public     Purchased by: Unknown
Symptoms: Diarrhoea, Headache, Migraine, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: From initial information received on 5/10/04 from the patient''s parent regarding an adverse event occurring in the USA, it was reported that a 17 year old male patient received his first dose of post-exposure IMOVAX RABIES on 3/27/04 and a second dose of IMOVAX RABIES on 3/30/04. Lot numbers, routes and sites of administration were not reported. 24 days after receipt of his second dose, the patient developed symptoms of headache, which progressively worsened to migraine, nausea, vomiting, and diarrhea. Reportedly, the symptoms lasted seven to ten days. Per mother, the patient is to see a physician for assessment, upon which either the physician or the mother will submit a report. Per recall, the patient is to receive three more doses of the vaccine. The patient''s recovery status was not reported. From additional information received on 7/9/04, it was reported that the patient received the vaccines following an animal bite. The type of animal was not specified and it was not reported whether it was tested for rabies. He received the IMOVAX RABIES vaccination in an emergency room and was started on Augmentin on 3/30/04 by another physician. The lot numbers were not provided. It was not reported whether the patient continued the series or whether he recovered from these adverse events.

VAERS ID:237682 (history)  Vaccinated:2005-05-13
Age:17.0  Onset:2005-05-13, Days after vaccination: 0
Gender:Female  Submitted:2005-05-20, Days after onset: 7
Location:Ohio  Entered:2005-05-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: None known
Current Illness: None known
Preexisting Conditions: Allergic to dandellions and probable seasonal allergies
Diagnostic Lab Data: Unknown. I have not received the records from Hospital
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUE500AA0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dyspnoea, Paraesthesia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: About one hour after receiving the yellow fever vaccine pt developed paresthesias of her lips, facial and neck hives and difficulty breathing. She was at the local health department when this occurred and was then transferred via emergency squad to hospital. She was observed over night in their facility and received anti-histamines and steroids and made an excellent recovery.

VAERS ID:237887 (history)  Vaccinated:0000-00-00
Age:17.0  Onset:2004-04-13
Gender:Female  Submitted:2005-05-16, Days after onset: 398
Location:North Dakota  Entered:2005-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Body temp 99F low grade fever
CDC Split Type: WAES0404USA02018
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Pyrexia, Viral infection
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Information has been received from a nurse concerning her 17 year old daughter who in 1996 was vaccinated with a dose of varicella virus vaccine live. Subsequently, the pt developed chicken pox. On 13Apr04 the pt began to develop lesions described as a rash mainly on the torso with 100 total lesions, perhaps 50 on the front and 50 on her back. She also had a very low grade fever of about 99 degrees. She missed school for one week, but now has recovered and is doing well. No treatment or doctor visit was necessary. No product quality complaint was involved. No additional information is expected.

VAERS ID:238087 (history)  Vaccinated:2005-05-12
Age:17.0  Onset:2005-05-12, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Utah  Entered:2005-05-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cipro
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURU1589AA0 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Feeling hot, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Complained of itching and warmth of upper body. No wheezing, shortness of breath, or skin eruptions noted. Benadryl 50mg given PO stat.

VAERS ID:238660 (history)  Vaccinated:2005-05-27
Age:17.0  Onset:2005-05-27, Days after vaccination: 0
Gender:Female  Submitted:2005-05-31, Days after onset: 4
Location:Alabama  Entered:2005-05-31
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: Drug allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURUE329AA0SCRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1144N1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Chest discomfort, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: 5/27/05 0930 vaccine received. 1000 Increased SOB and tight chest. 1030 ER and medicated.

VAERS ID:238668 (history)  Vaccinated:2005-05-25
Age:17.0  Onset:2005-05-26, Days after vaccination: 1
Gender:Male  Submitted:2005-05-26, Days after onset: 0
Location:Connecticut  Entered:2005-05-31, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION3498011   
Administered by: Private     Purchased by: Private
Symptoms: Chills, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Temp= 100 F, nausea and chills. Temp at 1:00PM=100

VAERS ID:238724 (history)  Vaccinated:2004-09-14
Age:17.0  Onset:2004-09-20, Days after vaccination: 6
Gender:Male  Submitted:2005-05-16, Days after onset: 238
Location:Pennsylvania  Entered:2005-06-01, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra; Prilosec
Current Illness:
Preexisting Conditions: Gastroesophageal reflux disease; Acne; Overweight; Drug Hypersensitivity
Diagnostic Lab Data: NONE
CDC Split Type: WAES0410USA04382
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0281P0SC 
Administered by: Private     Purchased by: Private
Symptoms: Injection site vesicles, Musculoskeletal stiffness, Rash, Tenderness
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Information has been received from a physician concerning her son a 17 year old male who is overweight, has gastroesophageal reflux disease, acne, and is allergic to sulfamethoxazole (+) trimethoprim, and amoxicillin who 9/19/04 was vaccinated SC in his right deltoid with a first dose of varicella virus vaccine live (lot # 648313/0281P). Concomitant therapy included omeprazole and fexofenadine hydrochloride. Subsequently, the patient experienced a stiff neck and a rash on his forearm. It was reported that the rash did not appear to be varicella. The patient''s stiff neck cleared up in six days. Unspecified medical attention was sought. Subsequently, the patient recovered. There was no product quality complaint involved. Follow up information from a healthcare professional indicated that on 9/20/04, the patient experienced a stiff neck that was tender to touch, a rash on his forearm, blisters at site of vaccination and his right arm hurt. Subsequently, the patient recovered. The physician stated that she did not see the patient, his mother is a physician and reported this to her on 10/28/04. The patient was advised to get titer and possibly eliminate the need for a second immunization. No further information is available.

VAERS ID:238817 (history)  Vaccinated:2004-08-11
Age:17.0  Onset:2004-08-13, Days after vaccination: 2
Gender:Female  Submitted:2005-05-16, Days after onset: 276
Location:Michigan  Entered:2005-06-01, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Irritable bowel syndrome; Asthma
Diagnostic Lab Data: UNK
CDC Split Type: WAES0408USA01423
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0886N0SC 
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Pruritus, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse practitioner concerning a 16 year old white female student with irritable bowel syndrome and asthma who on 8/11/04, at 16:50, was vaccinated SC in the upper arm with the first dose of varicella virus vaccine live (lot # 647093/0886N). There was no illness at the time of vaccination. The NP reported that on 8/13/04 the patient developed several small, itchy, red vesicular lesions on both arms (patient called clinic on 8/16/04 to reported event). The NP indicated that no other symptoms were noted. At the time of this report, the patient was recovering. Additional information has been requested.

VAERS ID:239917 (history)  Vaccinated:2004-08-16
Age:17.0  Onset:2004-09-13, Days after vaccination: 28
Gender:Male  Submitted:2005-06-26, Days after onset: 286
Location:Unknown  Entered:2005-06-03, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: On 9/13/04: serum alanine-59; serum aspartate-41; serum immunoglobulin08 M-IgM for hepatitis A was positive.
CDC Split Type: WAES0409USA01450
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.648219/0024P   
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic enzyme abnormal, Infection
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Info has been received from a physician concerning a 17 year old male who on 8/16/04, was vaccinated with hepatitis A virus vaccine inactivated (lot 648219/0024P). On 9/13/04, the pt "came back to the office" with "minimal right upper quadrant pain". The pt also had "slightly elevated" liver enzymes (SGOT=41; SGPT=591 and IgM for hepatitis A was also positive. Unspecified medical attention was sought. No product quality complaint involved. Follow-up reported that the pt was "diagnosed with infectious mononucleosis, therefore increased LFT''s cannot be attributed to vaccine (hepatitis A virus vaccine inactivated". Follow-up information from the physician stated that the pt "had mononucleosis and she does not think (the hepatitis A virus vaccine inactivated) had anything to do with the adverse event/elevated liver enzymes". No further info is expected.

VAERS ID:239321 (history)  Vaccinated:2005-06-02
Age:17.0  Onset:2005-06-02, Days after vaccination: 0
Gender:Female  Submitted:2005-06-02, Days after onset: 0
Location:Georgia  Entered:2005-06-07, 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
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1573AC0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Loss of consciousness, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Nausea, passed out after administration of injection.

VAERS ID:239820 (history)  Vaccinated:2005-06-09
Age:17.0  Onset:2005-06-09, Days after vaccination: 0
Gender:Female  Submitted:2005-06-09, Days after onset: 0
Location:Indiana  Entered:2005-06-14, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 06/09/2005;Hep B (unknown mfr);1;13;In Sibling
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB030AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Dizziness, Nausea, Pallor, Visual disturbance
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Dizziness, nausea, paleness, chills, dark spots in vision. Water, cool packs to head/neck, sitting position.

VAERS ID:239867 (history)  Vaccinated:2005-05-05
Age:17.0  Onset:2005-05-07, Days after vaccination: 2
Gender:Female  Submitted:2005-06-13, Days after onset: 37
Location:Pennsylvania  Entered:2005-06-14, Days after submission: 1
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: No allergies, to asthma under no current treatment.
Diagnostic Lab Data: Positive strep screen.
CDC Split Type:
Vaccination
Manufacturer
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Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSVA018BA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Infection, Lymphadenopathy, Pharyngolaryngeal pain
SMQs:
Write-up: Havrix adolescent dose administered intramuscularly in left arm on 05/15/2005. Father called on 05/07/2005 indicating she has sore throat and swollen nodes in neck since 05/06/2005, no fever. Father called 05/08/2005 - temperature 101 with worse throat pain. Sent to ER - diagnosed with strep throat, put on an antibiotic. 05/12/2005 much improved, no pain.

VAERS ID:240121 (history)  Vaccinated:2005-06-08
Age:17.0  Onset:0000-00-00
Gender:Male  Submitted:2005-06-16
Location:Massachusetts  Entered:2005-06-20, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: Not reported.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES  SC 
Administered by: Private     Purchased by: Other
Symptoms: Medication error
SMQs:
Write-up: Reporting product confusion event. Physician administering TB "vaccine" gave Prevnar by mistake. Physician reported event personally and stated "those bottles all look alike". Prevnar was given SC. Physician stated there was no adverse event.

VAERS ID:240251 (history)  Vaccinated:2005-06-15
Age:17.0  Onset:2005-06-15, Days after vaccination: 0
Gender:Male  Submitted:2005-06-17, Days after onset: 2
Location:Nebraska  Entered:2005-06-21, 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: Allegra
Current Illness: NONE
Preexisting Conditions: Allergic to pollen; takes allergy meds for that.
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1280AA5 LA
Administered by: Public     Purchased by: Public
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Breaking out on face started Wednesday night; little bumps. Hives on arms, noticed Thursday. Today, Friday, has scattered hives on arms and legs. Doctor advised Benadryl. To see doctor if continued worsening.

VAERS ID:240381 (history)  Vaccinated:2005-06-13
Age:17.0  Onset:2005-06-13, Days after vaccination: 0
Gender:Male  Submitted:2005-06-23, Days after onset: 10
Location:Colorado  Entered:2005-06-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: Allergic to antibiotic (Omnisaf)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Public     Purchased by: Private
Symptoms: Back pain, Chest discomfort, Dizziness, Neck pain, Pain, Pyrexia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Patient complaining of body aches, fever, 1000mg of Tylenol given to control fever. Everyday after vaccination had 102 degree temperature, neck and back aches and dizziness. Had tightness when breathing, no runny nose. On 4th day (Thurs) had temperature of 103.9 and seen by doctor who ruled out an ear infection and concluded vaccine was culprit. Patient was fine by Sunday.

VAERS ID:240864 (history)  Vaccinated:2005-06-16
Age:17.0  Onset:2005-06-28, Days after vaccination: 12
Gender:Female  Submitted:2005-06-30, Days after onset: 2
Location:California  Entered:2005-06-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEUR6E538AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Malaise, Pruritus, Rash, Stomach discomfort, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Rash started on chest the evening of 6/28/05, we applied topical Benedryl. She had small rash symptoms morning of 6/29/05, during the day they became progressively worse and she had hives over her chest, arms and legs, she also felt sick to her stomach. We gave her two Benedryl tablets and applied more topical Benedryl. The hives are very itchy and the welts are large. This morning 6/30, she still has the hives and not feeling very well.

VAERS ID:241090 (history)  Vaccinated:2005-06-29
Age:17.0  Onset:2005-06-29, Days after vaccination: 0
Gender:Female  Submitted:2005-07-01, Days after onset: 2
Location:Pennsylvania  Entered:2005-07-08, 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: The pt''s past medical history is significant for anaphylaxis following an insect bite and she carries an EpiPen. The pt had no illnesses at the time of vaccination.
Diagnostic Lab Data:
CDC Split Type: 2005012530
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU1657AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Rash macular
SMQs:, Hypersensitivity (narrow)
Write-up: From initial info received on 6/29/05 from a physician, regarding an adverse event occurring in the USA, it was reported that a 17 year old female pt received a dose of Menactra, lot U1657AA, IM in the left arm at 14:00 on 6/29/05. 90 minutes post vaccination, the pt developed red, blotchy patches over her elbows and knees. She was seen by a physician and treated with Benadryl 50mg per os. The pt recovered from this event.

VAERS ID:241362 (history)  Vaccinated:2005-07-12
Age:17.0  Onset:2005-07-13, Days after vaccination: 1
Gender:Female  Submitted:2005-07-15, Days after onset: 2
Location:Ohio  Entered:2005-07-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OCPs
Current Illness: none
Preexisting Conditions: Allergy reported to vicodin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1494AB0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site oedema, Lymphadenopathy, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt developed a localized erythematous, pruritic reaction at site of vaccine administration on left upper extremity. Pt noted itching and mild redness on day after administration. Area increased in size and became edematous and she noted tenderness and "bumps" in left axilla that resolved overnight. 2 days after vaccine administration she presented to the clinic for evaluation of reaction. At that time, a 5cm by 5cm area of erythema and edema was present on left upper arm. Area was soft, nontender, pruritic, without induration. There were no other signs or symptoms of allergic reaction.

VAERS ID:241681 (history)  Vaccinated:2005-07-23
Age:17.0  Onset:2005-07-23, Days after vaccination: 0
Gender:Female  Submitted:2005-07-23, Days after onset: 0
Location:Louisiana  Entered:2005-07-25, 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: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0945P0IMRA
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURX100622SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.055P0SCRA
Administered by: Public     Purchased by: Unknown
Symptoms: Pruritus, Sneezing
SMQs:, Anaphylactic reaction (narrow), Hypersensitivity (broad)
Write-up: Pt reported sneezing en route home then ears, eyes, and face started to itch. Pt left ER at 0855. Returned at 1049 for Tx. Was given Benadryl 50mg PO, itching stopped at 1125 until discharge at 1500.

VAERS ID:241682 (history)  Vaccinated:2005-03-09
Age:17.0  Onset:2005-03-11, Days after vaccination: 2
Gender:Female  Submitted:2005-03-14, Days after onset: 3
Location:Nevada  Entered:2005-07-25, Days after submission: 132
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: NV0503
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1340AA  LA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Fatigue, Pain, Pain in jaw
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Osteonecrosis (broad)
Write-up: Mom called on 03/11/2005. Patient was too ill to come to school with complaint of left arm and jaw pain. Afebrile. Taking Advil with minimal relief. Also complaint of extreme exhaustion. Phone private no, was told to seek er help if symptoms worsen. Also dizzy.

VAERS ID:241858 (history)  Vaccinated:2005-07-27
Age:17.0  Onset:2005-07-27, Days after vaccination: 0
Gender:Male  Submitted:2005-07-27, Days after onset: 0
Location:Iowa  Entered:2005-07-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trileptal, Oxcarbazepine,Dilantin
Current Illness: None
Preexisting Conditions: Seizure disorder
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1584CA0IMLA
Administered by: Unknown     Purchased by: Unknown
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)
Write-up: Seizure 5 hours 30 minutes after administration of TD (Decavac) IM.

VAERS ID:242027 (history)  Vaccinated:2005-07-12
Age:17.0  Onset:2005-07-12, Days after vaccination: 0
Gender:Female  Submitted:2005-07-20, Days after onset: 8
Location:Massachusetts  Entered:2005-08-03, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1657AA IMLA
Administered by: Private     Purchased by: Public
Symptoms: Headache, Musculoskeletal stiffness, Pain
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Approximately 12 hours after vaccine, developed stiff neck. Following day: achy all over. Within 48 hours, headache which has persisted through 07/19/2005. No fever, no rash. Positive for aseptic meningitis currently in community; illness consistent with those symptoms.

VAERS ID:242059 (history)  Vaccinated:2005-07-25
Age:17.0  Onset:2005-07-25, Days after vaccination: 0
Gender:Male  Submitted:2005-07-25, Days after onset: 0
Location:California  Entered:2005-08-03, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS628B95IMLA
Administered by: Private     Purchased by: Private
Symptoms: Medication error, No adverse drug effect
SMQs:
Write-up: In for Decavac (DT) and received DTAP, CDC called for information, watch for local reaction, do not revaccinate. Reported information to parent. Follow up information dated 8/6/05 states site assessed at 1400 on 7/26/05 no reaction at injection site.

VAERS ID:242080 (history)  Vaccinated:2005-07-28
Age:17.0  Onset:2005-07-28, Days after vaccination: 0
Gender:Male  Submitted:2005-07-29, Days after onset: 1
Location:Wisconsin  Entered:2005-08-03, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURV1572AC  LA
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad)
Write-up: Fever to 103 degrees, serum sickness type symptoms with back pain, onset 4-6 hours after vaccine.

VAERS ID:242260 (history)  Vaccinated:2004-10-15
Age:17.0  Onset:2004-10-17, Days after vaccination: 2
Gender:Female  Submitted:2005-07-29, Days after onset: 285
Location:Texas  Entered:2005-08-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Clarinex, Yasmin, Lexa pro, Flonase, Advair, trazodone hydrochloride
Current Illness: Fever, General body pain, sore throat
Preexisting Conditions: Drug hypersensitivity, Asthma, Rhinitis allergic
Diagnostic Lab Data: ultrasound 10/22/2004 subcutaneous edema, no abscess, LAB TESTS: hemoglobin 11.7 g/dl low, lymphocyte count 24.6% low, platelet count 463T/mm3 high, body temp 104, WBC count 12.9 K/mm3 high, hematocrit 34.1% low, urine specific gravity 1.00
CDC Split Type: WAES0410USA03048
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1496AA IM 
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0490P1IM 
Administered by: Private     Purchased by: Private
Symptoms: Blood sodium decreased, Cellulitis, Haematocrit decreased, Haemoglobin decreased, Hypokinesia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Laboratory test abnormal, Lymphocyte morphology abnormal, Platelet count increased, Pyrexia, Scrotal oedema, Tenderness, Urine abnormality, White blood cell count increased
SMQs:, Angioedema (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Malignant lymphomas (broad), Proteinuria (broad)
Write-up: Initial and follow up information has been received from a registered nurse and a physician concerning a 16 year old white female student with a cefaclor (Ceclor) allergy, asthma and allergic rhinitis who on Oct 15 2004, at 1:15pm, was vaccinated IM in the left deltoid with a second dose of pneumococcal 23v polysaccharide vaccine (lot 649696/0490P). Concomitant vaccination, at the same time, on Oct 15 2004 included a dose of influenza virus split virion 3v vaccine inactivated (Fluzone) (lot U1496AA), also administered IM in the left deltoid. Additional concomitant therapies include desloratadine (Clarinex), drospirenone (+) ethinyl estradiol (Yasmin), escitalopram oxalate (Lexa pro), trazodone hydrochloride, fluticasone propionate (Flonase), and fluticasone propionate (+) salmeterol xinafoate (Advair)(250/50 mcg). On Oct 17 2004 the patient called the office to report a red and tender reaction at the injection site with was 3 x 6 inches. The patient was treated with ice packs and ibuprofen (Motrin) for the pain, The patient called again on Oct 18 2004 and reported a 104 degree fever and swelling and redness at the injection site of 7 x 4 inches (also reported as 10x20 centimeters). It was also reported that it was very painful and she was unable to move her arm, symptoms were not relieved by ibuprofen and ice. The patient came to the office ans was given acetaminophen (+) hydrocodone bitartrate (Vicodin) and ice packs for the pain. As of Oct 19 2004 the inject site was still painful and red, but it was reported that she was recovering. She was given naproxen (Naprosyn) for the pain, It was also reported that th patient was prescribed cephalexin (Keflex) for suspected cellulitis and referred to the emergency room for evaluation of suspected myoglobinuria, which was ruled out. The patient was seen in the hospital emergency room on Oct 22 2004 and had a left upper extremity ultrasound, which indicated subcutaneous edema and no abscess. The following diagnostic laboratory tests were performed on Oct 22 2004 and repor

VAERS ID:242600 (history)  Vaccinated:2004-11-04
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2005-07-29
Location:Colorado  Entered:2005-08-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Body temp low grade temperature
CDC Split Type: WAES0501USA00103
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0513P  UN
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Fatigue, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Information has been received from a physician concerning a female between the age of 14-50, who on Nov 04 2004 was vaccinated with a dose of pneumococcal 23v polysaccharide vaccine (lot 649732/0513P). Subsequently, the patient experienced pain at the injection site, myalgia, arthralgia, low grade temperature and fatigue, The patients outcome was unknown. Unspecified medical attention was sought. No product quality complaint was involved. The physician requested an investigation into this lot number. Additional information has been requested. It was also reported that two other patients were vaccinated with a dose of pneumococcal 23v polysaccharide vaccine (lot 649732/0513P) and experienced adverse effects (WAES0501USA03390, WAES0501USA03391). The records of testing prior to release of this lot have been checked by Quality Assurance and found to be satisfactory. The lot complies with the standards of the Center for Biologics Evaluation and Research and was released.

VAERS ID:242629 (history)  Vaccinated:2004-12-21
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2005-07-29
Location:Unknown  Entered:2005-08-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: body temperature - low grade temperature
CDC Split Type: WAES0501USA03390
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.649732/0513P   
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Fatigue, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Information has been received from a physician concerning a 17-50 year old female who on 12/21/2004 was vaccinated with a dose of pneumococcal 23v polysaccharide vaccine (lot # 649732/0513P). Subsequently, the patient experienced pain at the injection site, myalgia, arthralgia, low grade temperature and fatigue. The patient''s outcome was unknown. Unspecified medical attention was sought. No product quality complaint was involved. The physician requested an investigation into this lot number. Additional information has been requested. It was also reported that 2 other patients were vaccinated with a dose of pneumococcal 23v polysaccharide vaccine and experienced adverse effects. The records of testing prior to release of this lot have been checked and found to be satisfactory. The lot complies with industry standards and was released.

VAERS ID:242792 (history)  Vaccinated:2005-07-11
Age:17.0  Onset:2005-07-15, Days after vaccination: 4
Gender:Male  Submitted:2005-07-27, Days after onset: 12
Location:California  Entered:2005-08-08, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 200501379
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU1643AA0SCLA
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD131 IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Headache, Medication error, Nasal congestion, Pharyngolaryngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: An initial report was received in the USA from a health care professional on 7/19/05. An 18 year old male patient experienced a fever of 103 degrees F, sore throat, nasal congestion and headache four days post vaccination after he had received a SC injection of Menactra, lot number U1641AA in the left arm and an IM injection of tetanus diphtheria, lot number TD131 in the left deltoid. The patient was prescribed Motrin and Tylenol and his fever was decreased to 101 degrees F. A CBC was done on 7/15/05 but results were not provided. The Menactra vaccine was administered incorrectly as SC instead of the IM route. It is unknown if the patient has recovered. Follow-up information received on 30-August-2005. This patient was 17 year old at the time of vaccination an the manufacturer for the tetanus diphtheria product is the Massachusetts Department of Health. The results of the CBC were provided - within normal limits. The patient did not have any significant medical history, was not on any medications and did not have any illness at the time of vaccination. The patient recovered from the adverse events.

VAERS ID:242688 (history)  Vaccinated:0000-00-00
Age:17.0  Onset:0000-00-00
Gender:Male  Submitted:2005-08-02
Location:Missouri  Entered:2005-08-10, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0132R0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Hives, tightness in throat. ER IV fluids, IV Solu-medrol, IV Benadryl, Benadryl, IV Pepcid PO, Prednisone, PO x SD, P O Zyrtec, Zantac, Nexium

VAERS ID:243031 (history)  Vaccinated:2005-08-04
Age:17.0  Onset:2005-08-05, Days after vaccination: 1
Gender:Male  Submitted:2005-08-16, Days after onset: 11
Location:Illinois  Entered:2005-08-16
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: CBC
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1675AA0IMLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Fatigue, Headache, Musculoskeletal discomfort, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: 24 hr post vaccine--felt tired with nausea & vomiting 48 hr post vaccine--temp 100 with headache 72 hr post vaccine--headache worse, generalized muscle aches 96 hr post vaccine--headache same, felt spine was enlarging, went to E.R., labs (CBC) done, sent home 7 days later--fully recovered

VAERS ID:243085 (history)  Vaccinated:2005-08-10
Age:17.0  Onset:2005-08-11, Days after vaccination: 1
Gender:Female  Submitted:2005-08-11, Days after onset: 0
Location:New Hampshire  Entered:2005-08-18, 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:
Preexisting Conditions: Allergic Rhinitis
Diagnostic Lab Data: U tox
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURA98340C0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Abdominal pain upper, Dysarthria, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Received Menactra 08/10/2005 4:30pm. Woke 08/11 at 11am with headache, nausea, stomach ache. Mom thought speech slurred. Lasted approx 30-60 min, triage RN did''t appreciate slurred speech.

VAERS ID:243109 (history)  Vaccinated:2005-08-10
Age:17.0  Onset:2005-08-10, Days after vaccination: 0
Gender:Female  Submitted:2005-08-11, Days after onset: 1
Location:Michigan  Entered:2005-08-18, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.09APR060 RA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1492AB0 LA
Administered by: Other     Purchased by: Public
Symptoms: Feeling hot, Injection site hypersensitivity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: approximately 4 x 3 inch welt at injection site, area is warm with redness

VAERS ID:243481 (history)  Vaccinated:2005-08-10
Age:17.0  Onset:2005-08-10, Days after vaccination: 0
Gender:Female  Submitted:2005-08-26, Days after onset: 16
Location:South Carolina  Entered:2005-08-26
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: SC0513
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURUE459AA0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Pharyngeal oedema
SMQs:, Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Client complained of lightheadedness/dizziness after injection, approximately 2-3 minutes duration. Cool cloth applied to forehead. About 2-3 minutes later, client complained of throat swelling. Client was placed on back and vital signs taken while 911 was called.

VAERS ID:243507 (history)  Vaccinated:2005-08-26
Age:17.0  Onset:2005-08-26, Days after vaccination: 0
Gender:Female  Submitted:2005-08-26, Days after onset: 0
Location:Texas  Entered:2005-08-29, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0219R   
Administered by: Private     Purchased by: Private
Symptoms: Unintended pregnancy
SMQs:, Normal pregnancy conditions and outcomes (narrow)
Write-up: Child came for well child exam and stated school nurse stated she needed varivax. Varivax administered that afternoon, school nurse called to inform MD. She just found out child is pregnant.

VAERS ID:243582 (history)  Vaccinated:2005-06-15
Age:17.0  Onset:2005-06-15, Days after vaccination: 0
Gender:Female  Submitted:2005-06-24, Days after onset: 9
Location:Georgia  Entered:2005-08-30, Days after submission: 67
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: GA05021
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0338P IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Heart rate increased, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: Vaccine Hepatitis B given on 06/15/2005, that PM developed hives, treated and improved 06/16/2005 PM - severe hives, ER visit, treated with steroid injection and Medrol dose pack. 06/21/2005 - Saw doctor - history included hives, paleness, increased heart rate, weakness.

VAERS ID:243608 (history)  Vaccinated:2005-06-17
Age:17.0  Onset:2005-06-17, Days after vaccination: 0
Gender:Female  Submitted:2005-06-21, Days after onset: 4
Location:California  Entered:2005-08-30, Days after submission: 70
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
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1572AC0 LA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: swelling, redness at site of injection

VAERS ID:243677 (history)  Vaccinated:2005-08-31
Age:17.0  Onset:2005-09-01, Days after vaccination: 1
Gender:Male  Submitted:2005-09-01, Days after onset: 0
Location:Michigan  Entered:2005-09-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase, Zaditor
Current Illness: None Known
Preexisting Conditions: Seasonal rag weed allergies
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1750AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Headache, nausea, dizziness, temperature 99 degrees. Symptoms began today, call if worse.

VAERS ID:243785 (history)  Vaccinated:2005-07-15
Age:17.0  Onset:2005-08-02, Days after vaccination: 18
Gender:Male  Submitted:2005-08-18, Days after onset: 16
Location:New York  Entered:2005-09-02, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: ADHD; ODD; PTSD
Diagnostic Lab Data: Abnormal EMG, Lumbar puncture w/elevated protein
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1573AC0 LA
Administered by: Private     Purchased by: Public
Symptoms: Bradycardia, CSF test abnormal, Difficulty in walking, Guillain-Barre syndrome, Laboratory test abnormal, Muscular weakness, Tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow)
Write-up: Patient diagnosed with Guillain Barre Syndrome 1 month after vaccine administration. Symptoms of muscle weakness 2 weeks prior to admission. Received medical records from hospital which reveal patient was admitted 8/16/05-8/21/05 with diagnosis of post vaccination Guillian Barre Syndrome. Symptoms included progressive muscle weakness & difficulty walking over about 2 weeks prior to admit. During hospitalization had some autonomic instability including bradycardia, tachycardia& questionable urinary problems. Treated for 5 days w/IVIG, PT/OT. Was to continue PT/OT on outpatient basis for continued but improved muscle weakness & abnormal gait.

VAERS ID:243807 (history)  Vaccinated:2005-08-17
Age:17.0  Onset:0000-00-00
Gender:Male  Submitted:2005-08-31
Location:Virginia  Entered:2005-09-06, 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: Eczema - moderate/severe
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1741AB IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Eczema, Myalgia, Skin exfoliation
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Menactra 2 weeks ago, history of Eczema at 2 week mark increased in Eczema head to toe, skin dry, papular, scaly, rash, myalgia, and chills.

VAERS ID:243912 (history)  Vaccinated:0000-00-00
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2005-09-06
Location:Tennessee  Entered:2005-09-08, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt has no known allergies. She has no significant past medical history. She was not taking any other medications and had no illnesses at the time of vaccination.
Diagnostic Lab Data: Aug 2005: Platelets 20,000 (low)
CDC Split Type: 200501728
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEUR 0SC 
Administered by: Private     Purchased by: Private
Symptoms: Anaemia, Medication error, Platelet count decreased
SMQs:, Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad)
Write-up: Initial report received from a patient''s parent on Aug 31 2005. A 17 year old female patient with no significant past medical history had received an injection of Menactra, lot number unknown, administered subcutaneously in error in June 2005. Two months later, during a routine doctor visit, a platelet count was done and was noted to be 20,000. The patient had no other symptoms. At the time of this report the patient had not recovered from this event. (OMIC) Follow-up report states: The platelet count went up to 50,000 after IVIG but then fell to 30,000 again. The patient has had no symptoms. The hematologist elected to treat with IVIG, even though the patient had no bleeding or other problems. The patient is midly anemic (hemoglobin 10), but anemia runs in the family. The patient left for college and is doing fine. She will be followed at the college. When the pediatrician finds out the name of the hematologist, she''ll call me with that contact information.

VAERS ID:243967 (history)  Vaccinated:2005-08-19
Age:17.0  Onset:2005-08-20, Days after vaccination: 1
Gender:Male  Submitted:2005-09-06, Days after onset: 17
Location:Pennsylvania  Entered:2005-09-09, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: The patient is on long term Amoxicillin for acne.
Diagnostic Lab Data:
CDC Split Type: 200501729
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1767AA  LA
Administered by: Private     Purchased by: Unknown
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Initial report received from a health care professional in the USA on Aug 31 2005. A 16 year old male patient developed bilateral itchy hives in the groin area, behind the ears and in the right axillary 24 hours after receiving the injection of Menactra, lot number U1767AA in the left deltoid on Aug 19 2005. No treatment was reported and symptoms resolved. No further information expected.

VAERS ID:244091 (history)  Vaccinated:2005-05-24
Age:17.0  Onset:2005-05-28, Days after vaccination: 4
Gender:Male  Submitted:2005-07-20, Days after onset: 53
Location:Unknown  Entered:2005-09-13, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trileptal, 02Dec02, 900 mg bid.
Current Illness:
Preexisting Conditions: The subject has a history of epilepsy, but has not had a seizure for two years. His last seizure was in Nov of 2002, which manifested with tonic clonic movements and drooling. The subject has been taking Trileptal 900mg three times daily since that time.
Diagnostic Lab Data: 29May05: Oxcarbazepine level-results pending, Urine protein 100 (ref level- neg), Urine bacteria- few (ref level), Urine drug screen neg, CT scan neg, EKG neg, The subject is to follow up with a neurologist to have an EEG and MRI. From addi
CDC Split Type: 200501033
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEUR  IM 
TDAP: TDAP (ADACEL)AVENTIS PASTEUR  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Condition aggravated, Convulsion, Coordination abnormal, Dizziness, Electroencephalogram abnormal, Gait disturbance, Hypertonia, Laboratory test abnormal, Nausea, Somnolence, Visual disturbance, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Initial report received on 01Jun05. Additional information received on 03June05 and 08Jun05. Additional information received on 13Jun05. This subject is a 17 year old male, who was seen in the ER due to dizziness and a possible seizure enrolled in study. The last dose prior to the event was given on 24May05. The subject developed dizziness and had a possible seizure four days post immunization. He also had blurred vision, nausea and vomiting, had difficulty holding his head up and became sleepy. He was seen in an ER that same day. Treatment included two litters of IV fluids and Zofran. A CT scan and EKG were negative. The subject improved and was discharged from the ER that same day. His past medical history is significant for epilepsy and he has been seizure-free for two years. The subject followed up with his pediatrician the next day and is to be seen by a neurologist on 06Jun05 and is scheduled to have an EEG and MRI. The subject recovered from these events and continued the trial. The events of dizziness and possible seizure were reported by the investigator as related to the study vaccine. From additional information received on 03Jun05 from the investigator, it was unclear what had happened. The subject was at work where he developed dizziness, double vision and lethargy. His parents picked him up and later his mother noted broad based gait and therefore took the subject to the ER. No seizure activity was observed. The subject''s previous seizure attack was a tonic-clonic generalized seizure in Nov of 2002. The neurologist pending thorough examination, including EEG, evoked the provisional diagnosis of seizure. The investigator''s differential diagnosis included non specific viral syndrome pending normal EEG results. From additional information received on 08Jun05 from the investigator, it was reported that the following findings were noted during the investigator''s telephone discussion with the neurologist: per initial evaluation by the neurologist, there were some EEG abnormalities in the left hemisphere,

VAERS ID:244551 (history)  Vaccinated:2005-08-09
Age:17.0  Onset:2005-08-17, Days after vaccination: 8
Gender:Male  Submitted:2005-08-25, Days after onset: 8
Location:California  Entered:2005-09-26, Days after submission: 32
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSVA061AA  RA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1280AA  RA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site abscess
SMQs:
Write-up: Abscess formation at immunization site right deltoid, status post incision and drainage due to cellulitis to right arm. Treated with antibiotics and daily dressing changes.

VAERS ID:244577 (history)  Vaccinated:2005-09-21
Age:17.0  Onset:2005-09-22, Days after vaccination: 1
Gender:Female  Submitted:2005-09-26, Days after onset: 4
Location:Ohio  Entered:2005-09-26
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
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1783AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Body aches, 102 temp, dizziness, headache, CPX with Motrin, Benadryl. Follow up if headaches increase or symptoms increase.

VAERS ID:244619 (history)  Vaccinated:2005-09-20
Age:17.0  Onset:2005-09-21, Days after vaccination: 1
Gender:Male  Submitted:2005-09-27, Days after onset: 6
Location:Maryland  Entered:2005-09-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sore throat
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC-NE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1769AA  LA
Administered by: Private     Purchased by: Unknown
Symptoms: Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Headache, fever, body aches.

VAERS ID:244811 (history)  Vaccinated:2005-09-19
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2005-09-26
Location:Pennsylvania  Entered:2005-10-03, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Pollen, mildew
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB030AA0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Confusional state, Hallucination, Headache, Lethargy, Pallor, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 1st 24 hours, lethargic, confused, weak, shaky, pale, hallucination. Intermittent headaches and tiredness persists.

VAERS ID:245168 (history)  Vaccinated:2005-08-31
Age:17.0  Onset:2005-08-31, Days after vaccination: 0
Gender:Male  Submitted:2005-09-01, Days after onset: 1
Location:Kansas  Entered:2005-10-11, Days after submission: 40
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Possible egg allergy
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0616P1  
Administered by: Private     Purchased by: Private
Symptoms: Anaphylactic reaction, Dysphonia, Headache
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Parkinson-like events (broad), Hypersensitivity (narrow)
Write-up: Headache, hoarseness 1 hour after 2nd half of vaccination. Given .3cc epinephrine, 1.25g Xopenex and 160 mg Depo medication and 50mg, Benadryl IM start. Observed 1 hour; no further problems. Verbal report from vaccine provider''s office staff indicates diagnosis of anaphylaxis. 1/5/06 Reviewed 1-page of office notes. They are partially illegible, but confirm symptoms and treatment and recommendation to avoid all egg-containing vaccines in future. (note: physician wrote what looked like "critical" reaction rather than anaphylaxis per se)

VAERS ID:245211 (history)  Vaccinated:2005-07-25
Age:17.0  Onset:2005-07-27, Days after vaccination: 2
Gender:Female  Submitted:2005-10-11, Days after onset: 76
Location:Connecticut  Entered:2005-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1492AB0SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hyperhidrosis, Hypoaesthesia, Hypokinesia, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt called with the following symptoms 2 days after receiving Menactra: numbness in her fingers, body aches, sweating, emesis, and difficulty moving her legs from the hips down. It lasted for a half hour and resolved with motrin. The next day she felt "foggy" and her affect was a bit off. Pt was back to baseline the following day.

VAERS ID:245259 (history)  Vaccinated:2005-10-11
Age:17.0  Onset:2005-10-12, Days after vaccination: 1
Gender:Male  Submitted:2005-10-12, Days after onset: 0
Location:California  Entered:2005-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Elevated LFT, and hyperlipidemia. Also history of hypertension
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0287R1IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1784AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Was seen in the office 10/11/05 at approximately 1500 for a well child exam. He was in good health at the time of the exam without any symptoms of illness. He was given Hepatitis A vaccine and Menactra. Approximately 12 hours later he presented to the Emergency Department with fever (103.1), chills and shaking. His CBC was slightly elevated in the ER to 11.4. His ALT was 129, however this was a known medical problem. He was discharged to home, and followed up in the PCP office in the am with mild URI symptoms and afebrile.

VAERS ID:245350 (history)  Vaccinated:2005-09-21
Age:17.0  Onset:2005-09-23, Days after vaccination: 2
Gender:Female  Submitted:2005-09-23, Days after onset: 0
Location:Texas  Entered:2005-10-13, 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: NONE
Diagnostic Lab Data:
CDC Split Type: TX05082
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0323R0 RA
Administered by: Public     Purchased by: Public
Symptoms: Feeling hot, Hypokinesia, Injection site erythema, Injection site oedema, Injection site pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Site swollen, red, warm to touch, swollen area approx 5cm. No fever c/o pain with motion.

VAERS ID:245813 (history)  Vaccinated:2005-08-15
Age:17.0  Onset:2005-08-24, Days after vaccination: 9
Gender:Male  Submitted:2005-08-26, Days after onset: 2
Location:Unknown  Entered:2005-10-20, Days after submission: 55
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
RAB: RABIES (RABIPUR)CHIRON CORPORATION9991IMRA
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEUREYN035A1SCLA
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 08/26/2005 Hives at legs, back, chest and arms, very itching 2 days ago. No difficulty in breathing. No fever, No joint pain.

VAERS ID:245837 (history)  Vaccinated:2005-09-14
Age:17.0  Onset:2005-09-14, Days after vaccination: 0
Gender:Female  Submitted:2005-10-18, Days after onset: 34
Location:Pennsylvania  Entered:2005-10-21, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.AHBRA130AA0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Several minutes after administration of vaccine, Pt had dizziness, lightheaded, pale. No treatment necessary.

VAERS ID:246123 (history)  Vaccinated:2005-10-04
Age:17.0  Onset:2005-10-17, Days after vaccination: 13
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:2005-10-26
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
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0212R SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Pruritus, Tenderness
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: She received her vaccine on 10/4/05 and on approximately 10/17 she developed a red, indurated area of skin around the administration site. Red area is approximately 3cm in diameter. This is also warm, itchy and tender.

VAERS ID:246296 (history)  Vaccinated:2005-10-06
Age:17.0  Onset:2005-10-08, Days after vaccination: 2
Gender:Male  Submitted:2005-10-11, Days after onset: 3
Location:Oregon  Entered:2005-10-28, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: 9/23/05 Varicella IgG (immune status)= non-immune.
CDC Split Type: OR200532
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1112P1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Drug ineffective, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Lack of efficacy/effect (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 6-7 cm of redness, swelling, warm to touch at injection 2 days after inoculation to present. Treat w/warm compresses, Tylenol 325mg 1-2 tabs ever 4 PRN.

VAERS ID:246298 (history)  Vaccinated:0000-00-00
Age:17.0  Onset:2005-10-02
Gender:Female  Submitted:2005-10-21, Days after onset: 19
Location:Unknown  Entered:2005-10-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: vaccinia virus culture PCR/ was positive
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Laboratory test abnormal, Skin ulcer
SMQs:
Write-up: Patient was not vaccinated but exposed to a vaccinated person who had received Smallpox vaccine, She developed a skin ulcer on her left extensor arm within 2 day of exposure. This was cultured for PCR of vcaccinia, was positive

VAERS ID:246312 (history)  Vaccinated:2005-10-19
Age:17.0  Onset:2005-10-21, Days after vaccination: 2
Gender:Male  Submitted:2005-10-25, Days after onset: 4
Location:Ohio  Entered:2005-10-28, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft, protonix, zyrtec, albuterol
Current Illness: Cough, runny nose
Preexisting Conditions: Developmental delays, GERD, allergies, strabismus, obesity Information from Medical Records states facial paralysis, asthma, GI disease and immune system disease. msv
Diagnostic Lab Data: WBC - 30.8, ESR - 19, CRP - 38.13 Information received from medical records show leukocytosis, abnormal test results, increased sed rates. msv
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0579P IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Cough, Injection site reaction, Laboratory test abnormal, Leukocytosis, Pyrexia, Red blood cell sedimentation rate increased, Rhinorrhoea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Cellulitis at injection site with temperature to 104 F. and vomiting. No other signs of infection. Admitted to hospital treated with IV antibiotics starting with Ancef, no significant clinical improvement at site, so antibiotics changed clindamycin, no improvement so changed to zosyn and vancomycin. Admitted 10/21/05, discharged 10/24/05. Medical records state cough, runny nose.

VAERS ID:246396 (history)  Vaccinated:2005-10-18
Age:17.0  Onset:2005-10-18, Days after vaccination: 0
Gender:Female  Submitted:2005-10-19, Days after onset: 1
Location:California  Entered:2005-10-31, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CA050073
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0947P0IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMAHAVA018BA0IMRA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1206BA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain upper, Diarrhoea, Dyspepsia, Fatigue, Headache, Nausea, Tenderness, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: nauseated shortly after receiving immunization. Vomited x 3 at home in evening a x2 this am. Headache, soft stools, fatigue, epigastric, tenderness and Right upper quadrant tender to deep palpation.

VAERS ID:246604 (history)  Vaccinated:2005-09-28
Age:17.0  Onset:2005-10-11, Days after vaccination: 13
Gender:Female  Submitted:2005-10-28, Days after onset: 17
Location:Virginia  Entered:2005-11-02, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES0510USA08730
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0896P0SC 
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster, Injection site vesicles, Rash vesicular, Viral infection
SMQs:, Hypersensitivity (narrow)
Write-up: Information has been received from a certified medical assistant concerning a 17 year old female who on 9/28/05 was vaccinated SC with a 0.5ml dose of varicella virus vaccine live (lot # 649274/0896P). On 10/11/05, the patient presented with a vesicular rash at the injection site that the CMA reported might have been shingles. The patient was treated with valacyclovir hydrochloride. Subsequently, the patient fully recovered. No product quality complaint was involved. The reporter considered the adverse event to be an other important medical event (OMIC). Additional information has been requested.

VAERS ID:246622 (history)  Vaccinated:2005-11-01
Age:17.0  Onset:2005-11-01, Days after vaccination: 0
Gender:Female  Submitted:2005-11-01, Days after onset: 0
Location:North Carolina  Entered:2005-11-02, Days after submission: 1
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: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUE665AA  LA
Administered by: Private     Purchased by: Private
Symptoms: Bronchospasm
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Per father approx 25 - 30 min after leaving our office. Pt developed bronchospasms requiring epinephrine per Pts father. Pts father notified us at 1pm twin sister also received vaccine with no reactions reported.

VAERS ID:246624 (history)  Vaccinated:2005-11-01
Age:17.0  Onset:2005-11-01, Days after vaccination: 0
Gender:Female  Submitted:2005-11-02, Days after onset: 1
Location:Maryland  Entered:2005-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec Zantac Midrin
Current Illness: Rhinitis due to allergy.
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data: None.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE, INC./WYETH LABORATORIES, INC500392P0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Hot flush, Nausea, Pruritus, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: At 11:45 ct. developed rash on arms, neck and inside of mouth near back of throat. Went to school nurse who told her to wash up and return to class. Rash described as itching badly, red raised spots with white bump in middle. Hot flashes no fever. Ct''s mother called writer at 3:40 PM and described SX. Writer advised her to take Benydryl (ct. states itching was somewhat relieved and rash improved) and take ct. to ED and if any breathing difficulties call 911. Ct. saw pediatrician who examined her and sent home. At 11:00 PM ct. developed severe headache and severe nausea. Pediatrician sent to local ED. Itching relieved w/ Benydryl 25 mg. at home 4:00 PM. Emergency Dept. - Ultraset for HA, Phenegren for nausea and more Benydryl. 11/2, 10:00 AM - rash resolved, slight HA, slight nausea, resting comfortably.

VAERS ID:246807 (history)  Vaccinated:2005-10-27
Age:17.0  Onset:2005-10-27, Days after vaccination: 0
Gender:Female  Submitted:2005-10-31, Days after onset: 4
Location:Georgia  Entered:2005-11-04, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Sinus Problems
Preexisting Conditions: Medical records state pharengitis. msv
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB141AA0IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0602R1SC 
TDAP: TDAP (ADACEL)AVENTIS PASTEURAPC2124AA0IM 
Administered by: Public     Purchased by: Public
Symptoms: Cough, Dyspnoea, Headache, Vomiting, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Approximately 2 hours after injections client complained of cough, vomiting which led to wheezing. Evaluated at ER and transferred with overnight stay for observation. Denied itching/hives. Medical records state dyspnea, headache. msv

VAERS ID:246992 (history)  Vaccinated:2005-08-09
Age:17.0  Onset:2005-08-09, Days after vaccination: 0
Gender:Female  Submitted:2005-11-01, Days after onset: 84
Location:Washington  Entered:2005-11-07, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB125AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Injection site pain, Joint range of motion decreased
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Painful injection site, Pt reports decreased grip affected side within one day of receiving injection. States pain throbbing. Exam find no increased local temperature, no palpable mass day after injection. Still pain with ROM 10 day later. States shoulder painful. Ortho DX tendinopathy rotator cuff probable. Final outcome of symptom progression/resolution uknown at this time.

VAERS ID:247024 (history)  Vaccinated:2005-10-16
Age:17.0  Onset:2005-10-16, Days after vaccination: 0
Gender:Male  Submitted:2005-10-20, Days after onset: 4
Location:North Carolina  Entered:2005-11-08, 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:
Current Illness:
Preexisting Conditions: Diabetes
Diagnostic Lab Data:
CDC Split Type: NC05096
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1742AA  LL
Administered by: Private     Purchased by: Private
Symptoms: Blood glucose increased, Condition aggravated, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Fever 103-104 vomiting, sugar increased to 400, all symptoms with in 4 hours time span after receiving vaccine.

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