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Case Details (Sorted by Age)

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VAERS ID:169720 (history)  Vaccinated:1999-10-03
Age:18.0  Onset:1999-10-03, Days after vaccination: 0
Gender:Female  Submitted:2002-06-19, Days after onset: 990
Location:D.C.  Entered:2001-05-09, Days after submission: 406
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: Allergic to certain detergents
Diagnostic Lab Data: N/A
CDC Split Type: U200000032
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES7126AA0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Malaise, Nausea, Paraesthesia, Pyrexia, Rash, Vertigo
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (narrow), Hypersensitivity (narrow)
Write-up: It was reported that an 18 year old female received a Menomune A/C/Y/W-135 vaccination on 10/3/99. Reportedly, 4 hours, post vax, the pt developed vertigo, nausea, tingling in her arm, malaise, fever and her arm became swollen with a red rash. The pt was given Benadryl and Tylenol as treatment. The pt reportedly, recovered from the experience. *F/UP report on 3/4/03: From correspondence received at manufactorer on 2/22/00, add''l PT history info was provided. F/UP #1 (6/19/02): During internal auditing of all files, it was deemed necessary to amend the report by updating the Adverse Event Coding (Added Fever and Paresthesia).

VAERS ID:169722 (history)  Vaccinated:2000-02-08
Age:18.0  Onset:2000-02-08, Days after vaccination: 0
Gender:Female  Submitted:2000-03-17, Days after onset: 38
Location:Tennessee  Entered:2001-05-09, Days after submission: 417
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: Codeine allergy
Diagnostic Lab Data:
CDC Split Type: U2000001010
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES7363AA0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Bradycardia, Hypoventilation, Syncope vasovagal
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: It was reported that an 18 year old female received a Menomune A/C/Y/W-135 vaccination on 2/8/00. Reportedly, the pt experienced a vasovagal reaction, post vax. BP-120/60, P-52, R-16. Resolution of symptoms after elevation of legs, ammonia ampule inhalant and ingestion of orange juice. The pt completely recovered from this experience.

VAERS ID:169724 (history)  Vaccinated:2000-02-10
Age:18.0  Onset:2000-02-10, Days after vaccination: 0
Gender:Female  Submitted:2000-04-12, Days after onset: 61
Location:New Jersey  Entered:2001-05-09, Days after submission: 392
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: U2000001030
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES7363AA SCLA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Blood pressure increased, Heart rate increased, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow)
Write-up: It was reported that an 18 year old female pt received a Menomune A/C/Y/W-135 vaccination on 02/10/00 at 14:30 and felt fine and left the office. The pt returned at 18:00, complaining of general weakness, nausea, chest tightness, hives and itching. The pt did not experience shortness of breath, BP-left 140/84-100-20; right 150/84-100-20. Treatment of Benadryl 50mg per oral was given. At 18:30, the pt''s BP was left 140/84-100-20, right 150/84-100-20. The pt reportedly recovered from this experience. From correspondence received, it was reported that the pt did not experience chest tightness, hives and itching as previously reported, however, did experience diaphoresis.

VAERS ID:169730 (history)  Vaccinated:2000-03-23
Age:18.0  Onset:2000-03-25, Days after vaccination: 2
Gender:Male  Submitted:2000-05-03, Days after onset: 38
Location:Tennessee  Entered:2001-05-09, Days after submission: 371
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: CBC and Chemistry panel-both normal.
CDC Split Type: U2000002540
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA178AA0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: It was reported that a pt received a Menomune A/C/Y/W-135 vaccination and sometime, post vax, the pt developed a headache, fever and possible viral symptoms. Additional information is being requested. From correspondence received, it was reported on 3/25/00, the pt developed a fever (100F-101F), chills and pain in the head. Pt went to the ER at 19:30. A fever of 99F persisted until 3/29/00. The pt reportedly, recovered from this experience. Doctor dx''d idiosyncratic reaction to vaccine or an "exagena normal response" and nothing to be concerned about.

VAERS ID:169731 (history)  Vaccinated:2000-01-21
Age:18.0  Onset:0000-00-00
Gender:Male  Submitted:2003-02-12
Location:Colorado  Entered:2001-05-09, Days after submission: 644
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: Dx''d with an Arachnoid Cyst which was discovered after an accident 6 years ago.
Diagnostic Lab Data:
CDC Split Type: U200000255
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA178AA SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Condition aggravated, Cyst, Dementia, Headache
SMQs:, Dementia (narrow), Noninfectious encephalopathy/delirium (broad)
Write-up: It was reported that an 18 year old male pt was dx''d with an Asymptomatic Arachnoid Cyst, 6 years ago, discovered by chance after an accident. This cyst was smaller at the time and did not need any intervention. Reportedly, the pt received a Menomune A/C/Y/W-135 vaccination on 1/21/00 and several weeks later, the pt developed severe headaches, rating a 10 on a scale of 1 to 10. Neurologist saw pt and had a MRI done which showed the Arachnoid Cyst was enlarged. Vioxx and Biofeedback was tried, which seemed to help slightly but headaches have continued. A Neurosurgeon has suggested possible surgery. From correspondence *received at manufacturer on 5/1/00,* it was reported that the pt continues to be treated with a non-steroidal anti-inflammatory. As of 4/12/00, the pt''s headaches have subsided. He is scheduled for a return visit in 6/00 to the Neurologist. *F/UP report on 3/4/03: Amendments in the narrative and add''l PT and responsible MD info was also provided. (also added adverse event coding Aggravation Rx).*

VAERS ID:169735 (history)  Vaccinated:2000-06-12
Age:18.0  Onset:2000-06-13, Days after vaccination: 1
Gender:Female  Submitted:2001-01-10, Days after onset: 211
Location:Connecticut  Entered:2001-05-09, Days after submission: 118
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: U2000004880
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA230AA SC 
Administered by: Private     Purchased by: 0
Symptoms: Headache, Injection site reaction, Malaise, Mononucleosis syndrome, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: It was reported that an 18 year old female received a Menomune A/C/Y/W-135 vaccination on 6/12/00. Reportedly, on 6/13/00, the pt developed a headache, fever, general malaise and a mild local reaction. Recovery status unknown. Further information requested. From additional correspondence received on 7/12/00, it was reported that on 6/15/00, the pt was dx''d with mono. Reportedly, the pt recovered from this experience. No further information is expected, case is closed.

VAERS ID:169738 (history)  Vaccinated:2000-06-27
Age:18.0  Onset:2000-06-28, Days after vaccination: 1
Gender:Male  Submitted:2001-01-10, Days after onset: 196
Location:Maine  Entered:2001-05-09, Days after submission: 118
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD-Tubersol 5 TU/Aventis Pasteur LTD/251811
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U2000005360
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA231AA SC 
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: It was reported that an 18 year old male pt received a Menomune A/C/Y/W-135 vaccination and a PPD-Tubersol skin test on 6/27/00. Reportedly, on 6/28/00, the pt developed a temperature of 100F and dizziness. A physician did not evaluate the pt. Further information requested. From correspondence received on 8/8/00, it was reported that the pt recovered from this experience. No further information is expected, this case is closed.

VAERS ID:169739 (history)  Vaccinated:2000-07-07
Age:18.0  Onset:2000-07-08, Days after vaccination: 1
Gender:Female  Submitted:2002-06-18, Days after onset: 710
Location:Minnesota  Entered:2001-05-09, Days after submission: 405
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: U200000581
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA198AA0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Dyskinesia, Eye movement disorder, Fatigue, Hearing impaired, Movement disorder, Nausea, Nystagmus, Pallor, Paralysis, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Akathisia (broad), Dyskinesia (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: It was reported that a female patient received a Menomune A/C/Y/W-135 vaccination on 07/07/00 at 2:00 PM. Reportedly 30 hours after the injection the patient became severely nauseated, pale and developed shaking and jerking of her arms and legs, eyes were open but rolling, no loss of bladder or colon. When the patient came to she could see but not hear, could sit up but couldn''t move legs. The patient experienced muscle fatigue for the rest of the day. Patient recovered from this experience and was okay the following day. From additional correspondence received on 10/10/00, the county were the vaccine was administered was provided. No further info is expected, this case is closed. *F/UP report 3/4/03: ....It was deemed necessary to amend the report by updating the adverse event coding - added Pallor, Nystagmus, Paralysis.*

VAERS ID:169740 (history)  Vaccinated:2000-06-02
Age:18.0  Onset:2000-06-13, Days after vaccination: 11
Gender:Male  Submitted:2000-07-31, Days after onset: 48
Location:Pennsylvania  Entered:2001-05-09, Days after submission: 282
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: U2000005850
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA230AA SC 
Administered by: 0     Purchased by: 0
Symptoms: Abscess
SMQs:
Write-up: It was reported that an 18 year old male pt received a Menomune A/C/Y/W-135 vaccination on 6/2/00. Reportedly, on 6/13/00, the pt developed a possible sterile abscess, no specifics provided. Further information requested.

VAERS ID:169741 (history)  Vaccinated:2000-07-29
Age:18.0  Onset:2000-08-01, Days after vaccination: 3
Gender:Female  Submitted:2002-06-17, Days after onset: 685
Location:Pennsylvania  Entered:2001-05-09, Days after submission: 404
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U200000634
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA199AA SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Nausea, Pain, Pharyngolaryngeal pain, Pyrexia, Viral infection
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: It was reported that an 18 year old female pt received a Menomune A/C/Y/W-135 vaccination on 7/29/00. Reportedly, on 8/1/00, the pt developed a sore throat, a temperature of 101F, nausea and general aches. The pt was evaluated by a physician and was dx''d with a viral illness and her symptoms per the Adverse Event report, were not related to the vaccine. From additional correspondence received on 10/4/00, it was reported, "As per our telephone conversation of 9/26/00, this form was never started. Once this individual had gone to her physician, it was determined that she had a viral infection, which had nothing to do with the vaccine. Upon talking with our director and pharmacist in charge, it was determined that this was not an event to be reported." This case is closed. *F/UP report on 3/4/03: Viral infection added as adverse event coding*

VAERS ID:169744 (history)  Vaccinated:2000-08-30
Age:18.0  Onset:0000-00-00
Gender:Female  Submitted:2001-12-27
Location:Ohio  Entered:2001-05-09, Days after submission: 232
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: U200000723
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESDA178AA SCRA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Myalgia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: It was reported that a female pt (twin A) received a MENOMUNE vaccination on 8/30/00. Reportedly, sometime after the vaccination, the pt developed vomiting, headache, dizziness and muscle aches for 3 days. Further information requested. F/UP report on 3/4/03: From add''l info received on 1/22/01, add''l responsible MD, PT and Lab info were provided. Reportedly, there were no other medications, illnesses at time of vax or pre-existing conditions. No further info was provided. This case is closed.

VAERS ID:169745 (history)  Vaccinated:2000-08-30
Age:18.0  Onset:0000-00-00
Gender:Female  Submitted:2001-12-28
Location:Ohio  Entered:2001-05-09, Days after submission: 233
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: U200000724
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA184AA0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Myalgia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: It was reported that a female pt (twin b) received a MENOMUNE A/C/Y/W-135 vaccination on 8/30/00. Reportedly, sometime after the vaccination, the pt developed vomiting, headache, dizziness and muscle aches for 3 days. Further information requested. F/UP report on 3/4/03: From follow-up info received on 1/22/01, add''l PT, vax administrator, responsible MD, lab data, PT illness at time & medical history were provided. There were reportedly no other PT medications. There were no adverse events reported for previous vax''s. This case is closed.

VAERS ID:169746 (history)  Vaccinated:2000-05-26
Age:18.0  Onset:2000-06-02, Days after vaccination: 7
Gender:Female  Submitted:2000-11-07, Days after onset: 158
Location:Tennessee  Entered:2001-05-09, Days after submission: 182
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: U2000008030
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES  SCUN
Administered by: Other     Purchased by: Private
Symptoms: Migraine
SMQs:
Write-up: It was reported that an 18 year old female pt received a Menomune A/C/Y/W-135 vaccination on 5/26/00. Reportedly, the pt developed migraine headaches, 1 week, post vax. From additional information received on 1-DEC-2000, additional information for the Reporter, Vaccine Administrator and Responsible Physician were received. The patient''s recovery status was reported as unknown.

VAERS ID:170173 (history)  Vaccinated:2001-04-25
Age:18.0  Onset:2001-04-25, Days after vaccination: 0
Gender:Male  Submitted:2001-05-07, Days after onset: 12
Location:California  Entered:2001-05-23, Days after submission: 16
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: Pollen allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0072AA IMRA
Administered by: Other     Purchased by: Public
Symptoms: Pain
SMQs:
Write-up: Sore arm when I sleep at night. It has been almost 2 weeks, since I had the TD shot. I took acetaminophen (2) and ice. Now advised to take ibuprofen and use warm compresses.

VAERS ID:170754 (history)  Vaccinated:2000-03-20
Age:18.0  Onset:2000-03-20, Days after vaccination: 0
Gender:Male  Submitted:2001-05-30, Days after onset: 435
Location:Unknown  Entered:2001-06-01, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00041510
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Pharyngolaryngeal pain, Pyrexia, Rash, Viral infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a consumer concerning his 17 yr old son with no known allergies who on 20-MAR-2000 was vaccinated with one dose of measles virus vaccine live and mumps virus vaccine live and rubella virus vaccine live (second generation). It was reported that since the time of vaccination, the pt was sick with a sore throat and fever. Unspecified medical attention was sought. Additionally, it was noted that on 15-APR-2000 the pt broke out what a Dr termed a viral rash. The pt was on antibiotic and antihistamine therapy; however, it was not clarified if they were concomitant therapies or treatment medications. Additional info has been requested.

VAERS ID:171576 (history)  Vaccinated:1999-09-13
Age:18.0  Onset:2000-07-30, Days after vaccination: 321
Gender:Male  Submitted:2001-05-15, Days after onset: 289
Location:Indiana  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WAES00070898
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0717J0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Herpes zoster
SMQs:
Write-up: Information has been received concerning a pt who was vaccinated on 09/13/99 with his first dose of varicella vaccine. On 07/03/00 the pt''s mother notified the physician''s office to report that her son had 18 pox.

VAERS ID:171658 (history)  Vaccinated:2000-08-07
Age:18.0  Onset:2000-08-17, Days after vaccination: 10
Gender:Female  Submitted:2001-05-15, Days after onset: 271
Location:Indiana  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00082000
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.6323841728J0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Rash, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Post vax, the patient developed a "lesion rash". The patient sought unspecified medical attention. Follow up information from the physician indicated that the patient broke out with 2 or 3 lesions about 10 days after vaccination. It was reported that the physician did not consider this to be an adverse experience. No further information is expected.

VAERS ID:171689 (history)  Vaccinated:0000-00-00
Age:18.0  Onset:0000-00-00
Gender:Female  Submitted:2001-05-15
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00090075
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Post vax, the patient developed redness at the injection site. The patient sought unspecified medical attention. Follow up information from the health care facility indicated that the patient received another shot with no problems. It was reported that the reporter "didn''t remember the name of the patient". No further information is expected.

VAERS ID:172083 (history)  Vaccinated:2001-01-02
Age:18.0  Onset:2001-01-17, Days after vaccination: 15
Gender:Female  Submitted:2001-05-15, Days after onset: 117
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Amoxicillin allergy, cephalexin allergy, codeine allergy, drug allergy, meperidine allergy, sulfonamide allergy
Diagnostic Lab Data:
CDC Split Type: WAES01011825
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Skin ulcer, Viral infection
SMQs:
Write-up: On 01/17/2001, in the evening, the patient developed a very mild rash, maybe 8 lesions, that appeared to be chickenpox. The patient sought medical attention. Additional information has been requested.

VAERS ID:170606 (history)  Vaccinated:2001-05-16
Age:18.0  Onset:2001-05-26, Days after vaccination: 10
Gender:Male  Submitted:2001-05-29, Days after onset: 3
Location:Ohio  Entered:2001-06-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: PCN, dust, animals (cat & dogs) ?
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5151A21IMRA
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.VA359AA0SCLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR11210IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 5/29/01 pt called with C/O hives on back and sometimes back of legs. Appeared about 3 days ago. Has taken nothing to relieve symptoms. Advised pt to try Benadryl cream topically or oral Benadryl. If symptoms increase see PMD or call.

VAERS ID:170721 (history)  Vaccinated:2001-06-02
Age:18.0  Onset:2001-06-02, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:Maryland  Entered:2001-06-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD placed also on 6/2/01
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0164L SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1885K SCLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Vaccines administered @ 12:00, after checking out and going home pt returned and reported hives on both upper and lower extremities @ 12:45 (no swelling of lips, tongue, throat) administered benadryl 25mg IM, PO benadryl 25mg Q6 x 2 days. No further problem.

VAERS ID:170722 (history)  Vaccinated:2001-05-15
Age:18.0  Onset:2001-05-19, Days after vaccination: 4
Gender:Female  Submitted:2001-05-22, Days after onset: 3
Location:Mississippi  Entered:2001-06-08, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type: MS01018
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1381K1SCRL
Administered by: Public     Purchased by: Other
Symptoms: Pyrexia, Rash, Tenderness
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 5/19/01 rash developed on Rt leg - extended from ankle to mid calf. rash sore to touch had elevated temp of 102.7, the increased temp lasted until 5am. Continue to have rash on Rt leg.

VAERS ID:171078 (history)  Vaccinated:2001-06-01
Age:18.0  Onset:2001-06-01, Days after vaccination: 0
Gender:Female  Submitted:2001-06-04, Days after onset: 3
Location:Tennessee  Entered:2001-06-11, 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: PPD/Pasteur/C0619AA/ID/LFA
Current Illness: NONE
Preexisting Conditions: Pt is grossly obese
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0105K1SCLA
Administered by: Private     Purchased by: Other
Symptoms: Chest pain, Dyspnoea, Headache, Myalgia, Neck pain, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Immediately, post vax, pt left the building and waited in car. Sharp pain started in heart, up neck and down right arm, up into head and down all through arm and fingers of right side. Felt breathing difficult. Felt like was going to die. Lasted 5-10 minutes. Muscles were sore over whole body for the rest of the day with accompanying headache.

VAERS ID:171154 (history)  Vaccinated:2001-04-16
Age:18.0  Onset:2001-04-20, Days after vaccination: 4
Gender:Female  Submitted:2001-05-05, Days after onset: 15
Location:Michigan  Entered:2001-06-13, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: geographic tongue
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3139A2 IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0163K1SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES367AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Fungal infection, Malaise, Pain, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Patient developed muscle aches in arms, shoulders and left leg. Hands were sore to write with. On 6/5/01, patient got a fungus in the mouth and became very tired. She developed a strange illness at school and then slept 2 days. After 5 weeks, she was still very tired and receiving treatment for oral fungus.

VAERS ID:171159 (history)  Vaccinated:2001-06-04
Age:18.0  Onset:2001-06-04, Days after vaccination: 0
Gender:Female  Submitted:2001-06-04, Days after onset: 0
Location:Virginia  Entered:2001-06-13, 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: Parkdale PPD, lot #01231P
Current Illness: Anemia
Preexisting Conditions: Allergy to peanuts and shellfish
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UA394AA0SC 
Administered by: Public     Purchased by: Other
Symptoms: Cold sweat, Dizziness, Mydriasis, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Five minutes after patient received vaccine, she felt faint and vomited. Pupils were dilated, and she was cold and clammy.

VAERS ID:171397 (history)  Vaccinated:2001-05-25
Age:18.0  Onset:2001-05-25, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Virginia  Entered:2001-06-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: fever, seizures;UNK. PERTUSSIS;;.25;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: had possible seizures with the pertussis vaccine, allergy to Ceclor
Diagnostic Lab Data:
CDC Split Type: VA01015
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UA230AA0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Headache, Hearing impaired, Similar reaction on previous exposure to drug, Visual acuity reduced
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad)
Write-up: On 5/29/01 the pt developed a headache following the receipt of the meningococcal vaccine 4 days prior. The pt complained of not being able to hear, or see, was dizzy. She then was sent to the ER. Told was reaction to "shot".

VAERS ID:172015 (history)  Vaccinated:2001-06-01
Age:18.0  Onset:2001-06-03, Days after vaccination: 2
Gender:Male  Submitted:2001-06-12, Days after onset: 9
Location:Nebraska  Entered:2001-06-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Blood and urine test done 1st time negative. Test repeated bacteria reported in urine.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1281K1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Dizziness, Headache, Infection, Laboratory test abnormal, Nausea, Pyrexia, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Pt received MMR on 6/1/01. Grandmother stated on 6/3/01 pt complained of headache, temp 101-102 and nausea. On 6/4/01 there were light red raised areas on the neck and shoulders, loss of appetite, nausea, low grade temp and a headache. On 6.6.01 grandmother took child to Dr. The child was unable to see routine doctor. While seeing Dr, blood test and urine were done. The results to the blood and urine test were negative, and the doctor could not give reason for condition. On 6/8 child had red raised areas on neck, shoulders, back, chest, and arms. Blood & urine test were done again, urine came back positive with bacteria. Dizzy, headache and red spots remain. Pt taken to ER Dr diagnosed measles.

VAERS ID:172029 (history)  Vaccinated:2001-05-04
Age:18.0  Onset:2001-05-05, Days after vaccination: 1
Gender:Female  Submitted:2001-05-17, Days after onset: 12
Location:California  Entered:2001-06-19, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Monodox for acne
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, STS
CDC Split Type: CA010054
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5158A21IMLA
Administered by: Other     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Student reports noticing rash on back and chest 1 day after receiving 2nd Hep B injection. No symptoms after 1st injection. 5/17/01 T 98.7, BP 100/60, P 72

VAERS ID:172432 (history)  Vaccinated:2001-06-05
Age:18.0  Onset:2001-06-05, Days after vaccination: 0
Gender:Male  Submitted:2001-06-05, Days after onset: 0
Location:California  Entered:2001-06-26, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Previous head injury in 8/00 and was seen by a neurologist for 3 months.
Diagnostic Lab Data: BP 142/80; P-92
CDC Split Type: CA010065
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1424K IMLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0377AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Blood pressure increased, Cold sweat, Disorientation, Headache, Injury, Pallor, Tachycardia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypertension (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Client was found by a PHN outside the clinic beside his truck on the ground with emesis beside him. On assessment, found a lump on the back of his head about the size of a quarter with a small scrape on his left elbow. Able to move all extremities with full ROM. Pt is awake, able to tell his name but disoriented, unable to tell where he is and what happened. He''s pale, cold and clammy and diaphoretic. Assisted back into the clinic and walked without difficulty. Ice pack applied over the back of his head. Supervisor called paramedics and notified mother. Still complained of a severe headache until paramedics came.

VAERS ID:172451 (history)  Vaccinated:2001-05-07
Age:18.0  Onset:2001-05-14, Days after vaccination: 7
Gender:Female  Submitted:2001-05-16, Days after onset: 2
Location:Pennsylvania  Entered:2001-06-26, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PA0142
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1265K0IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1381K1SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0375AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt had MMR vaccine for school on 5/7/01. On 5/16/01, presented to office with macular papular and itchy rash of chest and abdomen.

VAERS ID:172474 (history)  Vaccinated:2001-06-18
Age:18.0  Onset:2001-06-18, Days after vaccination: 0
Gender:Female  Submitted:2001-06-18, Days after onset: 0
Location:Indiana  Entered:2001-06-26, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aventis Pasteur TB test, lot #C0824AA, placed in right forearm
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1032K0IMLA
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UA312AA0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Anxiety
SMQs:
Write-up: Patient experienced anxiety after receiving vaccines.

VAERS ID:172865 (history)  Vaccinated:2001-06-12
Age:18.0  Onset:2001-06-16, Days after vaccination: 4
Gender:Female  Submitted:2001-06-27, Days after onset: 11
Location:Michigan  Entered:2001-07-03, 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: Desogen
Current Illness: NONE
Preexisting Conditions: previous reaction to Dialudid and reaction to DTP as a child.
Diagnostic Lab Data: CBC, ESR, TSH and Liver panel
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UA303AA  RA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Joint stiffness, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: The pt experienced arthralgia to the elbows, hands and knees occurring 4 days post vax. Pain and stiffness was worse when placing pressure on joints. Itching of hands and feet. No fever or other symptoms.

VAERS ID:172936 (history)  Vaccinated:2001-06-19
Age:18.0  Onset:2001-06-21, Days after vaccination: 2
Gender:Male  Submitted:2001-06-28, Days after onset: 7
Location:New York  Entered:2001-07-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 20mg QD
Current Illness: NONE
Preexisting Conditions: Hypertension
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA360AA0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Grand mal convulsion, Postictal state
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: Grand mal seizure for 45 seconds and 30 minutes post-ictal. First seizure. Obviously no proof of causality.

VAERS ID:173098 (history)  Vaccinated:2001-06-29
Age:18.0  Onset:2001-07-03, Days after vaccination: 4
Gender:Male  Submitted:2001-07-05, Days after onset: 2
Location:Louisiana  Entered:2001-07-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: LA010701
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0367AA0IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0165L1SCLA
Administered by: Public     Purchased by: 0
Symptoms: Lymphadenopathy, Pain
SMQs:
Write-up: Mother called clinic on 7/5/01, stating that the child was taken to doctor with complaint of "a swollen gland under the arm that shots were given in and complained of pain in the area". Child was placed on antibiotics.

VAERS ID:173259 (history)  Vaccinated:2001-06-04
Age:18.0  Onset:2001-06-08, Days after vaccination: 4
Gender:Female  Submitted:2001-07-10, Days after onset: 32
Location:Maryland  Entered:2001-07-13, Days after submission: 3
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic to Sulfa
Diagnostic Lab Data: VQ Scan/CT of chest, abdomen, pelvis and U/S of pelvis; CBC; Chem Panel; Urine Cx.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.LA410AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Chest pain, Hypotension, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: On 6/8/01 PM, pt had sudden onset of severe right upper chest pain; was taken to ER and developed hypotension, severe abdominal pain and vomiting. She was Rx''d with dopamine IV antibiotic fluids and transferred to ICU. In 10 to 12 hours, weaned off pressors; fever resolved and discharged home on po antibiotics after 3 day stay.

VAERS ID:173603 (history)  Vaccinated:2001-07-06
Age:18.0  Onset:2001-07-13, Days after vaccination: 7
Gender:Male  Submitted:2001-07-17, Days after onset: 4
Location:Nevada  Entered:2001-07-25, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Laceration
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESUO386AA IM 
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: One week post vax, pt called complaining of continued muscle aches and fatigue.

VAERS ID:173618 (history)  Vaccinated:2000-07-03
Age:18.0  Onset:2000-07-17, Days after vaccination: 14
Gender:Female  Submitted:2001-02-04, Days after onset: 202
Location:Hawaii  Entered:2001-07-25, Days after submission: 170
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: Allergy to penicillin/sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1359H1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Choking, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Pt developed subjective, transient choking sensation x 1 episode 2 wks post vax. Pt also had difficulty breathing per mother. Pt was not seen or treated by MD.

VAERS ID:173661 (history)  Vaccinated:2001-07-17
Age:18.0  Onset:2001-07-17, Days after vaccination: 0
Gender:Male  Submitted:2001-07-18, Days after onset: 1
Location:Massachusetts  Entered:2001-07-27, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Adhesive tape; tincture of benzoin
Diagnostic Lab Data: Blood Sugar - 150, EKG - sinus bradycardia (50-54)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UA357AA0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Hyperglycaemia, Sinus bradycardia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: The patient experienced a syncopal episode 30-40 minutes post vax. The ER findings showed a normal physical exam. The patient is to follow up with non-invasive cardiology. It is not known if there is any causal agent with the vaccine.

VAERS ID:173704 (history)  Vaccinated:2001-07-19
Age:18.0  Onset:2001-07-19, Days after vaccination: 0
Gender:Female  Submitted:2001-07-23, Days after onset: 4
Location:Pennsylvania  Entered:2001-07-30, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUB016AB0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt developed hives within 24 hours of vaccine.

VAERS ID:173889 (history)  Vaccinated:2001-07-05
Age:18.0  Onset:2001-07-13, Days after vaccination: 8
Gender:Male  Submitted:2001-08-02, Days after onset: 20
Location:Maryland  Entered:2001-08-03, Days after submission: 1
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: Urine protein 4+; Albumin 1.8; Cholesterol 312
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM5224D90IMLA
Administered by: Private     Purchased by: Private
Symptoms: Blood cholesterol increased, Nephrotic syndrome, Proteinuria
SMQs:, Acute renal failure (broad), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Lipodystrophy (broad), Chronic kidney disease (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad)
Write-up: Nephrotic Syndrome on prednisone and responding well.

VAERS ID:173934 (history)  Vaccinated:2000-05-16
Age:18.0  Onset:2000-05-17, Days after vaccination: 1
Gender:Female  Submitted:2001-07-30, Days after onset: 439
Location:Wisconsin  Entered:2001-08-07, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00070168
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0044J0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Nausea, Pruritus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: The day after vaccination, the pt woke up with a two inch diameter lump in the injection site area. The pt experienced itching and was nauseated the entire day. The nausea resolved by the next evening and the itching continued for the 2 or 3 days post vaccination. The pt is recovered and did not experience any other symptoms or rxn''s.

VAERS ID:173993 (history)  Vaccinated:2001-06-22
Age:18.0  Onset:2001-06-24, Days after vaccination: 2
Gender:Male  Submitted:2001-07-19, Days after onset: 25
Location:Virginia  Entered:2001-08-07, Days after submission: 19
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: VA01024
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UA408AA0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Vertigo
SMQs:, Vestibular disorders (narrow)
Write-up: Post vax, the patient experienced dizziness that lasted 3 weeks. The patient was diagnosed with vertigo, no fever. Possible contributing factors are the patient was in a soccer game on 06/19/2001 or 06/21/2001 and was hit at the ear area and had a "bump". Also, 9-10 days before the vaccine, the patient swam in the ocean with a high bacteria level.

VAERS ID:174037 (history)  Vaccinated:2001-07-30
Age:18.0  Onset:2001-07-30, Days after vaccination: 0
Gender:Male  Submitted:2001-08-02, Days after onset: 3
Location:New York  Entered:2001-08-08, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUB030AB0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Photophobia, Vomiting
SMQs:, Acute pancreatitis (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: Pt had a severe headache, photophobia and vomiting which occurred several hours, post vax. Temperature was 97.8F, "able to miss fever", was toxic looking. Symptomatic treatment with Tylenol prn and rest.

VAERS ID:174095 (history)  Vaccinated:2001-07-26
Age:18.0  Onset:2001-07-30, Days after vaccination: 4
Gender:Female  Submitted:2001-08-06, Days after onset: 7
Location:New Jersey  Entered:2001-08-09, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U2001009140
Vaccination
Manufacturer
Lot
Dose
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Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES  SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Back pain, Headache, Meningitis, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: From telephone contact with reporter, it was stated that an 18 year old female pt received a Menomune A/C/Y/M-135 vaccination on 7/26/01. On 7/30/01, the pt developed backache and headache. On 8/1/01, the pt developed headache, backache and nausea. On 8/2/01, the pt went to a pediatrician''s office; at 14:00, pt was violently throwing up. Pt was admitted to the hospital on 8/3/01 and dx''d with viral meningitis. Pt was released on 8/4/01. From FOLLOW-UP correspondence received on 11/02/2001, it was reported that the patient recovered from this experience. Additional patient vaccine, the correct adverse event onset date and responsible physcian information was also proivided. This case is closed.

VAERS ID:174176 (history)  Vaccinated:2001-07-06
Age:18.0  Onset:2001-07-07, Days after vaccination: 1
Gender:Female  Submitted:2001-07-24, Days after onset: 17
Location:Georgia  Entered:2001-08-10, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Unspecified adverse event;UNK. PERTUSSIS;1;1.50;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: GA01070
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0268AA3IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Injection site erythema, Injection site mass, Injection site pain, Injection site swelling
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: Pt developed increased swelling and redness in left arm from shoulder to elbow the day after TD vaccine. She was unable to move her arm due to soreness. She took Benadryl. She still has a hard knot at injection site but swelling has decreased, after 6 days.

VAERS ID:174458 (history)  Vaccinated:2001-07-10
Age:18.0  Onset:2001-07-17, Days after vaccination: 7
Gender:Female  Submitted:2001-07-27, Days after onset: 10
Location:California  Entered:2001-08-20, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: E-mycin for acne.
Current Illness: Lymph Adenopathy - node in neck.
Preexisting Conditions:
Diagnostic Lab Data: Elevated liver function, elevated Bilirubin.
CDC Split Type:
Vaccination
Manufacturer
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HEPA: HEP A (VAQTA)MERCK & CO. INC.0477L1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Decreased appetite, Diarrhoea, Eye disorder, Laboratory test abnormal, Rash
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: This patient had abdominal pain, decreased appetite, diarrhea, elevated liver function tests, and elevated bilirubin, eyes slightly yellow, rash after injection. Seen 13 days after injection, had lab work.

VAERS ID:174634 (history)  Vaccinated:2000-03-16
Age:18.0  Onset:2000-05-08, Days after vaccination: 53
Gender:Male  Submitted:2001-08-08, Days after onset: 457
Location:Iowa  Entered:2001-08-24, Days after submission: 16
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 20 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Spinal Tap; EEG
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2919A20IMLA
Administered by: Private     Purchased by: Private
Symptoms: Aseptic necrosis bone, Cerebellar syndrome, Coordination abnormal, Nervous system disorder, Sinus congestion, Tooth disorder
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Osteonecrosis (narrow)
Write-up: Pt was about to graduate from high school. Pt had college form to fill out, re: health status. Hepatitis B vaccine was suggested. Pt received 1st injection 3/16. 2nd-4/17/2000. In May 2000, pt was admitted to the hospital with acute cerebritis that required steroid therapy.The steroid therapy ultimately lead to aseptic necrosis of hips . Pt had had dental surgety and had draining sinuses. 60 DAY FOLLOW UP STATES: Pt has not recovered. Ataxia. Post vaccination cerebellitis started 04/10/2000.

VAERS ID:174710 (history)  Vaccinated:2001-08-14
Age:18.0  Onset:2001-08-21, Days after vaccination: 7
Gender:Male  Submitted:2001-08-21, Days after onset: 0
Location:Unknown  Entered:2001-08-27, 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: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5144A2 IM 
Administered by: 0     Purchased by: 0
Symptoms: Feeling abnormal, Nausea
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Post vax, the patient experienced nausea and "feels bad".

VAERS ID:174744 (history)  Vaccinated:2001-08-01
Age:18.0  Onset:2001-08-01, Days after vaccination: 0
Gender:Female  Submitted:2001-08-09, Days after onset: 8
Location:Minnesota  Entered:2001-08-28, Days after submission: 19
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: U/A, CBC - WNL
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UA395AA0 LA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Musculoskeletal stiffness, Otitis media, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: This patient had a fever of 104 - 102 over the course of one week. Also having headache and stiff neck first 2-3 days. On day 9 diagnosed with Right otitis media.

VAERS ID:174802 (history)  Vaccinated:2001-08-14
Age:18.0  Onset:2001-08-14, Days after vaccination: 0
Gender:Female  Submitted:2001-08-20, Days after onset: 6
Location:Indiana  Entered:2001-08-29, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5144A20IMLA
Administered by: Other     Purchased by: 0
Symptoms: Dizziness, Pain, Tongue disorder
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad)
Write-up: The patient complained of dizziness, pain in the left arm, thick tongue, and feeling faint within an hour post vaccination.

VAERS ID:174893 (history)  Vaccinated:2001-07-03
Age:18.0  Onset:2001-07-04, Days after vaccination: 1
Gender:Female  Submitted:2001-07-12, Days after onset: 8
Location:Arizona  Entered:2001-08-31, Days after submission: 50
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
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Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1388K1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Face oedema, Flushing, Nausea, Pharyngeal oedema, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: On 07/05/01, this patient''s mother reports the patient was experiencing, dizziness, nausea, skin flushed, and warm to touch. This began the next day 07/04/01 after MMR was taken. On 07/09/01, this mother reports the child was seen in the ER on Saturday 07/07/01 with swollen lips, areas of the throat and mouth swollen, and rash on her arms. The ER gave her steroids and Benadryl.

VAERS ID:174900 (history)  Vaccinated:2001-07-13
Age:18.0  Onset:2001-07-13, Days after vaccination: 0
Gender:Female  Submitted:2001-07-16, Days after onset: 3
Location:Virginia  Entered:2001-08-31, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA410AA0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Ear pain, Neck pain, Pyrexia, Swelling, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Pt developed swelling of right jaw, pain in right ear and neck, wheezing and fever. She denies any rash.

VAERS ID:175077 (history)  Vaccinated:2001-07-13
Age:18.0  Onset:2001-07-18, Days after vaccination: 5
Gender:Female  Submitted:2001-08-07, Days after onset: 20
Location:Colorado  Entered:2001-09-06, Days after submission: 30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations: unspecified;Td, Adsorbed, Adult (Mfr not specified);1;15.00;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CSF Fluid-neucleated 17; Diff: Poly-71, lymphs-24, glucose-48, protein-54
CDC Split Type: CO01012
Vaccination
Manufacturer
Lot
Dose
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Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UB036AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: CSF test abnormal, Dizziness, Headache, Hyperventilation, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: The pt experienced a fever on 7/13/01 which continued until 7/16/01. On 7/18/01 developed a severe debilitating headache. Pain was on "top" of head. Pain was so bad it caused the pt to hyperventilate and become very dizzy.

VAERS ID:175117 (history)  Vaccinated:2001-08-22
Age:18.0  Onset:2001-08-22, Days after vaccination: 0
Gender:Female  Submitted:2001-08-24, Days after onset: 2
Location:New Hampshire  Entered:2001-09-06, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergy to shellfish
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5208A22IMLA
Administered by: Private     Purchased by: Public
Symptoms: Dyspnoea, Fatigue, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: After injection started with rash on chest and felt tired with chills and feverish. Complained of back pain with increased shortness of breath by afternoon. Seen in ED around 6:30 PM on 8/23/01.

VAERS ID:175132 (history)  Vaccinated:2001-08-24
Age:18.0  Onset:2001-08-26, Days after vaccination: 2
Gender:Female  Submitted:2001-08-28, Days after onset: 2
Location:Pennsylvania  Entered:2001-09-06, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sore throat and fever
Preexisting Conditions: Asthma
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUB058AA0SCLA
Administered by: Public     Purchased by: 0
Symptoms: Chest discomfort, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt developed extensure urticaria and chest tightness.

VAERS ID:175144 (history)  Vaccinated:2001-07-27
Age:18.0  Onset:2001-07-27, Days after vaccination: 0
Gender:Female  Submitted:2001-08-23, Days after onset: 27
Location:North Carolina  Entered:2001-09-06, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tetracycline
Current Illness:
Preexisting Conditions: Tetracycline for acne
Diagnostic Lab Data:
CDC Split Type: NC01075
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0004L1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pharyngeal oedema, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: Hep-B vaccine given on 7/27/01 at approx. 14:00 and by 17:00, the pt began itching. Total body rash followed. By 22:00, the pt had swelling in her throat. Treated with Adrenaline and Depo-Medrol injection, oral Benadryl and Prednisone and improved in 3 days.

VAERS ID:175207 (history)  Vaccinated:2001-08-16
Age:18.0  Onset:2001-08-16, Days after vaccination: 0
Gender:Male  Submitted:2001-08-23, Days after onset: 7
Location:Texas  Entered:2001-09-10, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergy to shrimp and "pollens". Pt gave a history of rash and breathing difficulty after shrimp is eaten.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UB040AA0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Blood pressure decreased, Cold sweat, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Likely, all a vasovagal event, but his symptoms were quite prolonged. Within about 20 seconds, post vax, while standing, pt fainted briefly. He came to and was sitting down and then fainted again after BP cuff deflated. We laid the pt down. BP was 90/60, then 108/60 after 2 minutes; then 130/80, 3 minutes later. No airway compromise or rash. Pt was scared and had cool and clammy extremities for about 45 minutes. O2 sats were more than 98%. Pt had full recovery and no medicines were administered.

VAERS ID:175378 (history)  Vaccinated:2001-08-30
Age:18.0  Onset:2001-08-30, Days after vaccination: 0
Gender:Female  Submitted:2001-09-06, Days after onset: 7
Location:Ohio  Entered:2001-09-14, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metronidazole (flagyl)
Current Illness: Trichomonas Vaginitis
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5173A22 LA
Administered by: Public     Purchased by: Public
Symptoms: Ageusia, Eye disorder, Facial palsy, Nervous system disorder
SMQs:, Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: The patient is an 18 year old who originally got a TB shot and a Hepatitis B shot a couple of days ago and since then she has had loss of taste on half of her tongue and her eyes are not closing right. Her face is all twisted and her mouth is twisted. The patient shows classic signs of Bell''s Palsy on the right side of her face, loss of taste on half of her tongue and a seventh nerve distribution.

VAERS ID:175501 (history)  Vaccinated:2001-09-04
Age:18.0  Onset:2001-09-06, Days after vaccination: 2
Gender:Female  Submitted:2001-09-11, Days after onset: 5
Location:Connecticut  Entered:2001-09-19, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UB043AC0SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0375AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Grand mal convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Father called to report that his daughter had a grand mal seizure on 9/6/01 and he brought her to ER. She was discharged late PM. Follow-up being done with another doctor; a neurologist.

VAERS ID:175777 (history)  Vaccinated:2001-08-10
Age:18.0  Onset:2001-08-10, Days after vaccination: 0
Gender:Female  Submitted:2001-09-05, Days after onset: 26
Location:Pennsylvania  Entered:2001-09-27, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of migraine headaches since the age of 13.
Diagnostic Lab Data: NONE
CDC Split Type: PA0155
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEUR017AB0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Fatigue, Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: On 8/10/01 at 19:00, pt vomited until 8/11/01 in the AM and then she had an onset of a headache, nausea, fever and fatigue. Symptoms continued on an intermittent basis. On 8/23/01, pt seen by PMD and put on Inderal and Vioxx for 1 month. Pt is to see PMD on 9/7/01 for evaluation. On 9/5/01, mother reports that headaches continue. Other symptoms have resolved.

VAERS ID:175974 (history)  Vaccinated:2001-09-21
Age:18.0  Onset:2001-09-23, Days after vaccination: 2
Gender:Male  Submitted:2001-09-26, Days after onset: 3
Location:California  Entered:2001-10-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Joint swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Pt developed swollen and painful joints and hives.

VAERS ID:176098 (history)  Vaccinated:2001-09-20
Age:18.0  Onset:2001-09-20, Days after vaccination: 0
Gender:Female  Submitted:2001-09-20, Days after onset: 0
Location:Montana  Entered:2001-10-05, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MT0117
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0049L1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Crying, Hypoaesthesia, Injection site oedema, Joint range of motion decreased, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Arthritis (broad)
Write-up: Pt was at Boyfriend''s house the afternoon of 09/20/2001. She fell asleep and then woke up crying approximately 2:30-3am. Stated her left arm felt like "dead weight" was achy and slightly swollen and could barely lift up her arm. Pt has taken Tylenol IHN recommended continue Tylenol and ice intermittently and to call Health Department to see how doing. On 09/24/2001 called patient and she stated arm felt better by Friday evening (09/21/2001).

VAERS ID:176366 (history)  Vaccinated:2001-08-02
Age:18.0  Onset:2001-08-02, Days after vaccination: 0
Gender:Male  Submitted:2001-08-02, Days after onset: 0
Location:Michigan  Entered:2001-10-16, Days after submission: 75
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: Peanut allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURUB030AB SCRA
Administered by: Private     Purchased by: Private
Symptoms: Eye swelling, Rash papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Popular raised rash on limbs, hives, eye swelling 2 hours post injection.

VAERS ID:176467 (history)  Vaccinated:2001-08-17
Age:18.0  Onset:2001-09-01, Days after vaccination: 15
Gender:Female  Submitted:2001-10-12, Days after onset: 41
Location:Maryland  Entered:2001-10-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: SGOT=1119; SGPT= 987
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA277AC0IM 
Administered by: Private     Purchased by: Private
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: Two weeks post vax, the patient presented with complaint of fever, myalgias, and nausea.

VAERS ID:176508 (history)  Vaccinated:2001-09-26
Age:18.0  Onset:2001-10-06, Days after vaccination: 10
Gender:Female  Submitted:2001-10-12, Days after onset: 6
Location:New York  Entered:2001-10-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1388K1SCLA
Administered by: Other     Purchased by: 0
Symptoms: Lymphadenopathy, Petechiae, Pharyngolaryngeal pain, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Post vax on 10/06/2001 the patient developed a fever, sore throat, and swollen glands. On 10/11/2001 the patient developed a petichael rash on her face and neck.

VAERS ID:176858 (history)  Vaccinated:2001-10-11
Age:18.0  Onset:2001-10-11, Days after vaccination: 0
Gender:Female  Submitted:2001-10-23, Days after onset: 12
Location:Texas  Entered:2001-10-30, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Right eye swelling
Preexisting Conditions: UNK
Diagnostic Lab Data: Vitals 108/56 Pulse 70-16 No fever
CDC Split Type: TX01159
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0675AB0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Eyelid oedema, Hypotension, Hypoventilation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: Pt received Fluzone at 10:15am. Returned an hour later with swollen right eyelid (upper and lower). No repiratory distress, pain or itching. Awake and alert. Benadry 50mg elixir given and ice pack applied to right eye. No fever.

VAERS ID:176885 (history)  Vaccinated:2001-09-12
Age:18.0  Onset:2001-09-12, Days after vaccination: 0
Gender:Female  Submitted:2001-10-22, Days after onset: 40
Location:South Dakota  Entered:2001-10-30, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergic to chlorine.
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5189A20IM 
Administered by: Private     Purchased by: Public
Symptoms: Feeling hot, Heart rate increased, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad)
Write-up: Pt described rapid heart, tingling fingers and lips, "warm spots on skin". No SOB or swelling. This incident was not witnessed by health care professionals and pt did not seek medical attention.

VAERS ID:176902 (history)  Vaccinated:2001-10-04
Age:18.0  Onset:2001-10-04, Days after vaccination: 0
Gender:Male  Submitted:2001-10-04, Days after onset: 0
Location:Illinois  Entered:2001-10-30, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tuberculin PPD
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: IL01042
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5159A20IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0361AA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Cold sweat, Eye movement disorder, Loss of consciousness, Petit mal epilepsy, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: The patient experienced cold, clammy perspiration, became unconscious with rolling of eyes upward and petit mal seizures for a few seconds. The patient regained consciousness and was seen in the ER. The patient was diagnosed with syncope due to shots.

VAERS ID:177258 (history)  Vaccinated:2001-08-22
Age:18.0  Onset:2001-08-22, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2001-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0516L1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt developed local erythema and swelling on injection site after Varivax #2.

VAERS ID:177367 (history)  Vaccinated:2001-10-02
Age:18.0  Onset:2001-10-02, Days after vaccination: 0
Gender:Female  Submitted:2001-10-13, Days after onset: 11
Location:Wisconsin  Entered:2001-11-07, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5255A60 RA
Administered by: Other     Purchased by: Private
Symptoms: Bacterial infection, Chest pain, Dyspnoea, Fatigue, Feeling hot, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Vaccine administered at 4pm and approximately two hours post vaccination, pt experienced "generalized warmth". Next morning, experienced "generalized muscle weakness, fatigue and chest soreness." "It was hard to breathe." No site reaction. Went to MD who referred her to vaccine administrator. Dx''d with strept, 2 days later, on 10/5/01.

VAERS ID:177412 (history)  Vaccinated:2001-09-25
Age:18.0  Onset:2001-09-25, Days after vaccination: 0
Gender:Female  Submitted:2001-10-30, Days after onset: 35
Location:Minnesota  Entered:2001-11-08, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Slight abdominal cramping for 2 months, not at this time.
Preexisting Conditions: Slight abdominal cramping for 2 months, intermittent.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5235A40IMRA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Two hours after vaccine administered, pt experienced severe left lower quadrant pain/cramping a 7 on a scale of 1-10 with 10 being the worst pain. Pain lasted 1 hour, pt laid down, fell asleep.

VAERS ID:177828 (history)  Vaccinated:2001-11-05
Age:18.0  Onset:2001-11-05, Days after vaccination: 0
Gender:Female  Submitted:2001-11-08, Days after onset: 3
Location:Wisconsin  Entered:2001-11-16, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergic to penicillin.
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0591EA0IMRA
Administered by: Private     Purchased by: Other
Symptoms: Chest pain, Feeling hot, Injection site pain, Migraine, Nasal congestion, Neck pain, 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), Cardiomyopathy (broad), Arthritis (broad)
Write-up: The patient experienced a migraine headache, fever, stuffiness, felt hot and her head, neck and chest aches. The patient''s right arm is sore at the site of injection. The patient had nausea and vomited on 11/06 and remained ill until 11/08.

VAERS ID:177909 (history)  Vaccinated:2001-06-22
Age:18.0  Onset:2001-08-24, Days after vaccination: 63
Gender:Male  Submitted:2001-09-30, Days after onset: 37
Location:New York  Entered:2001-11-19, Days after submission: 50
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vit C 500 mg qd
Current Illness: NONE
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5175C92IMRA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia
SMQs:, Guillain-Barre syndrome (broad)
Write-up: Generalized Weakness, lodd ofL.E.function, Hospitalized 08/26/01, dx with GBS

VAERS ID:178050 (history)  Vaccinated:2001-08-20
Age:18.0  Onset:2001-08-20, Days after vaccination: 0
Gender:Male  Submitted:2001-09-25, Days after onset: 36
Location:Alaska  Entered:2001-11-21, Days after submission: 57
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: Elevated WBC, Negative throat culture.
CDC Split Type: AK200166
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5187A20IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM678A20IM 
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Fatigue, Leukocytosis, Pain, Pharyngolaryngeal pain, Pyrexia, Somnolence
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: The patient experienced a fever, extreme tiredness, slept 24 hours, has pain, sensitivity to touch, sore throat and abdominal pain.

VAERS ID:178196 (history)  Vaccinated:2001-10-18
Age:18.0  Onset:2001-10-18, Days after vaccination: 0
Gender:Female  Submitted:2001-11-08, Days after onset: 21
Location:Alaska  Entered:2001-11-26, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: EKG; Cat Scan; Blood work
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5189A22IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM688A21IMLA
Administered by: Private     Purchased by: Other
Symptoms: Heart rate decreased, Loss of consciousness
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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Spoke with pt''s mom and she said that the pt received the Hep-B #3 and Hep-A #2 at 14:50. Her sister found the pt in the bathroom passed out with weak pulse at 16:30. EMS took her to the ER. Pt was discharged to home.

VAERS ID:178202 (history)  Vaccinated:2001-11-20
Age:18.0  Onset:2001-11-21, Days after vaccination: 1
Gender:Female  Submitted:2001-11-23, Days after onset: 2
Location:Florida  Entered:2001-11-26, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUB016AB SCLA
Administered by: Other     Purchased by: Other
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: One day post vax, pt had macular/papular rash all over arms and legs.

VAERS ID:178571 (history)  Vaccinated:2001-11-16
Age:18.0  Onset:2001-11-16, Days after vaccination: 0
Gender:Female  Submitted:2001-11-16, Days after onset: 0
Location:Tennessee  Entered:2001-12-04, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: Temp 98.6; BP 120/80; pulse 76
CDC Split Type: TN01062
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0744L1SCRA
Administered by: Other     Purchased by: Other
Symptoms: Eye swelling, Injection site swelling, Nasal congestion
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt developed swelling at injection site, puffiness under eyes and a stuffy nose. Symptoms lasted for 2 hours.

VAERS ID:178575 (history)  Vaccinated:2001-10-29
Age:18.0  Onset:2001-10-30, Days after vaccination: 1
Gender:Male  Submitted:2001-10-30, Days after onset: 0
Location:Tennessee  Entered:2001-12-04, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: TN01060
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1026K0IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0742L0SC 
Administered by: Public     Purchased by: Public
Symptoms: Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: One day post vax, pt awoke with severe headache and fever. Reporter was unsure of degree of temperature but states it went up and down. Tylenol and Advil were given. Pt referred to clinic.

VAERS ID:178688 (history)  Vaccinated:2001-11-26
Age:18.0  Onset:2001-11-28, Days after vaccination: 2
Gender:Female  Submitted:2001-11-29, Days after onset: 1
Location:Delaware  Entered:2001-12-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Diagnostic Lab Data: MRI of upper right arm-showed cellulitis below the skin; WBC-24.1; BP-decreased; Resp-increased
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU0679CA0SCRA
PPV: PNEUMO (PNU-IMUNE)PFIZER/WYETH4722090SCRA
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Hypotension, Injection site erythema, Respiratory rate increased, Skin ulcer, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: On 11/28/01 at 12:30, the pt was seen at a local ER. Right upper arm with 2 punctures with red lesion at area around injection site. Pt was treated with antibiotics and stayed overnight.

VAERS ID:178689 (history)  Vaccinated:2001-11-26
Age:18.0  Onset:2001-11-26, Days after vaccination: 0
Gender:Male  Submitted:2001-11-26, Days after onset: 0
Location:South Carolina  Entered:2001-12-06, Days after submission: 10
Life Threatening? Yes
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
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Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.071L IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)SANOFI PASTEURT1189 IMRA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUB127AA SCLA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Chest discomfort, Dyspnoea, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Tightness in chest, SOB, wheezing and weakness after more than 20 minutes from receiving immunizations. Pt treated with SQ Epi, Solu medrol 125 and Benadryl 50 mg IV and Albuterol med treatment for 3 days.

VAERS ID:178751 (history)  Vaccinated:2001-12-04
Age:18.0  Onset:2001-12-04, Days after vaccination: 0
Gender:Female  Submitted:2001-12-06, Days after onset: 2
Location:Rhode Island  Entered:2001-12-07, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5226A91 RA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.097260 RA
Administered by: Other     Purchased by: Public
Symptoms: Injection site hypersensitivity, Pruritus, Rash maculo-papular, Vasodilation procedure
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Hypersensitivity (narrow)
Write-up: Vaccine administered 12/04/2001. Student claims injection site became reddened and intensely itchy the evening of 12/04/2001. Presented with area right upper arm 2 inches in diameter red, raised, warm to touch. Diffuse red area around this also complained of itching.

VAERS ID:179051 (history)  Vaccinated:2001-12-05
Age:18.0  Onset:2001-12-05, Days after vaccination: 0
Gender:Female  Submitted:2001-12-07, Days after onset: 2
Location:Wisconsin  Entered:2001-12-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Left deltoid swelling;Hep B (Mfr not specified);2;15.00;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5211A22 LA
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)PFIZER/WYETHUO376AA2 LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Oedema, Vasodilation procedure
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Left deltoid are warm to touch, red and minimal swelling. Reddened area was about 3 inches diameter circle. Treated with Zyrtec for 10 days and Biaxin for 10 days. (reacted to previous Hep B per pt.)

VAERS ID:179116 (history)  Vaccinated:2001-10-17
Age:18.0  Onset:2001-10-17, Days after vaccination: 0
Gender:Female  Submitted:2001-10-19, Days after onset: 2
Location:Idaho  Entered:2001-12-17, Days after submission: 59
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: ID01076
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM679A20IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Client developed "knot" to left deltoid.

VAERS ID:179303 (history)  Vaccinated:2001-10-18
Age:18.0  Onset:2001-10-25, Days after vaccination: 7
Gender:Female  Submitted:2001-10-30, Days after onset: 5
Location:California  Entered:2001-12-20, Days after submission: 51
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UB080AA0SCLA
Administered by: Other     Purchased by: Private
Symptoms: Headache, Myalgia, Pharyngolaryngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Neck muscles soreness one week after vaccine Headache,sore throat, runny nose nine days after vaccine. persistent headache eleven to twelve days after vaccine.

VAERS ID:179563 (history)  Vaccinated:2001-08-16
Age:18.0  Onset:2001-08-17, Days after vaccination: 1
Gender:Female  Submitted:2001-12-03, Days after onset: 108
Location:New York  Entered:2001-12-28, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zantac
Current Illness: UNK
Preexisting Conditions: Allergy (unspecified, not elsewhere classified) to shellfish; exposed to a bat.
Diagnostic Lab Data:
CDC Split Type: EM20011061
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION2770114IMLA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dizziness, Hyperventilation, Hypoaesthesia, Nausea, Serum sickness, Viral infection
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: A pharmacist reported that an 18 year old female experienced nausea, left-sided numbness and dizziness coincident with RabAvert post-exposure vaccine therapy. The pt was reported to have an allergy to shellfish. The pt was exposed to a bat in a cabin while camping. The pt received her 5th post-exposure RabAvert injection (all doses were reportedly given on time) in the left deltoid on 8/16/01. She experienced nausea, weakness, left-sided numbness, dizziness and was hyperventilating. There was no local reaction at the injection site. On 8/17/01, a physician in an ER dx''d her as having "hyperventilation syndrome" and possible "mild serum sickness" and felt that the pt had probable "viral syndrome". The pt also experienced numbness to her fingertips, nausea, dizziness and questionable consciousness. The pt was treated with Vistaril 50mg, IM, in the ER. As of 8/29/01, it is unknown whether the pt received any further injections of RabAvert or whether the events resolved.

VAERS ID:179754 (history)  Vaccinated:2001-10-03
Age:18.0  Onset:2001-10-03, Days after vaccination: 0
Gender:Male  Submitted:2001-10-12, Days after onset: 9
Location:Michigan  Entered:2002-01-08, Days after submission: 88
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5204A22IMRA
Administered by: Public     Purchased by: Other
Symptoms: Dizziness, Injection site pain, Malaise
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad)
Write-up: Client reports dizziness, soreness/pain at the injection site and just not feeling well.

VAERS ID:180089 (history)  Vaccinated:2001-11-21
Age:18.0  Onset:2001-11-27, Days after vaccination: 6
Gender:Female  Submitted:2002-01-15, Days after onset: 49
Location:New York  Entered:2002-01-17, 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: Insulin pump
Current Illness: NONE
Preexisting Conditions: IDDM
Diagnostic Lab Data: WBC-14.4; CBC, mono spot and antistcotol-all neg
CDC Split Type:
Vaccination
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IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURU0726AA0IM 
Administered by: Private     Purchased by: Other
Symptoms: Diarrhoea, Pruritus, Rash, Viral infection, Vomiting, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: The pt developed an itchy rash on palms and distal end of forearms, feet itchy. Erythema distal tibia area. Mild sore throat; no temperature; no cough; an episode of vomiting and diarrhea on 11/26/01. Seen on 11/28/01 with viral exanthem on feet and hands.

VAERS ID:180215 (history)  Vaccinated:2000-08-11
Age:18.0  Onset:2000-08-11, Days after vaccination: 0
Gender:Male  Submitted:2000-09-20, Days after onset: 40
Location:Florida  Entered:2002-01-22, Days after submission: 489
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: 20000278181
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0  
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Report #2000027818-1 describes knee pain in a pt who rec''d Engerix-B. This report was rec''d from a medical student and has not been verified by a physician or other HCP. Allergies and medical history, concomitant vaccines includes: measles-mumps-rubella ad diphtheria-tetanus. On 8/11/00, the pt rec''d his first dose of Engerix-B. On the evening on 8/11/00, he experienced severe knee pain which lasted that night only. As of 9/19/00, the outcome of the event is resolved.

VAERS ID:180261 (history)  Vaccinated:0000-00-00
Age:18.0  Onset:0000-00-00
Gender:Female  Submitted:2000-12-15
Location:Unknown  Entered:2002-01-22, Days after submission: 403
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ;Hep B (Engerix-B);;.00;In Sibling
Other Medications:
Current Illness:
Preexisting Conditions: Race: Caucasian; Positive Anti-Nuclear Sntibody Titer; Possible lupus Erythematosus
Diagnostic Lab Data:
CDC Split Type: 20000355441
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1  
Administered by: Other     Purchased by: 0
Symptoms: Antinuclear antibody positive, Arthralgia, Arthritis, Carpal tunnel syndrome, Hypoaesthesia, Systemic lupus erythematosus
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (narrow), Guillain-Barre syndrome (broad), Arthritis (narrow)
Write-up: Report 2000035544-1 describes carpal tunnel syndrome in an 18-year-old female who received hepatitis-B vaccine. Medical history is significant for a positive anti-nuclear antibody titer and possible lupus erythematosus. Concurrent medications were not specified. The reporter stated the the family history is significant for leg weakness, unspecified infection, arm weakness and arm numbness in this patient''s father following receipt of the hepatitis-B vaccine (see case 2000035528-1). The patient received her first injection of the hepatitis-B vaccine in July, 2000 (exact date not provided). At some later date (not specified), the patient experienced pain in all her joints and numbness in her feet. She received her second injection of the hepatitis-B vaccine in September, 2000 (exact date not provided). At some later date (not specified), she developed arthritis-like symptoms. Reportedly, a diagnosis of carpal tunnel syndrome was made. As of 06 December 2000, the outcome of the event was unknown

VAERS ID:180415 (history)  Vaccinated:2001-06-19
Age:18.0  Onset:2001-06-19, Days after vaccination: 0
Gender:Unknown  Submitted:2001-08-06, Days after onset: 48
Location:California  Entered:2002-01-24, Days after submission: 171
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: 20010155251
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5194A21IM 
Administered by: Private     Purchased by: Private
Symptoms: Lymphadenopathy, Pain, Pyrexia, Rhinorrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: On 6/19/00, the pt received her 2nd IM 0.5cc dose of Engerix-B. Following dose 2, the pt experienced flu-like symptoms consisting of body aches, gland edema, fever, and runny nose. The reporter stated that these events were moderate in intensity and possibly related to Engerix-B. They resolved on 7/2/01. On an unspecified date, the vaccinee received the 3rd dose of Engerix-B and post vax, the pt experienced unspecified flu-like symptoms. As of 7/24/01, the outcome of the 2nd episode of flu-like symptoms was unknown.

VAERS ID:180524 (history)  Vaccinated:2001-09-12
Age:18.0  Onset:2001-09-12, Days after vaccination: 0
Gender:Female  Submitted:2001-11-14, Days after onset: 63
Location:Unknown  Entered:2002-01-24, Days after submission: 71
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: Medical history, concurrent conditions, and concurrent medications were not specified.
Diagnostic Lab Data:
CDC Split Type: 20010265361
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IM 
Administered by: Public     Purchased by: Other
Symptoms: Chills, Confusional state, Headache
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Report 2001026536-1 describes confusion in an 18 yr old female who received an injection of hepatitis B vaccine recombinant (Engerix-B). Medical history, concurrent conditions, and concurrent medications were not specified. On 9/12/01, the vaccinee received her first injection of Engerix B. On 9/12/01, at an unspecified time post vaccination, the vaccinee experienced confusion, a headache and chills. She was seen in the emergency department for the events. The reporter indicated the events resolved.

VAERS ID:180706 (history)  Vaccinated:2001-11-20
Age:18.0  Onset:2001-11-27, Days after vaccination: 7
Gender:Male  Submitted:2002-01-24, Days after onset: 58
Location:Tennessee  Entered:2002-01-30, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Many blood tests; hospitalized 4 days; HIV test; Mono; Lupus; MS; STD; Leukemia and Biopsy of nodules-all neg
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE11931LA2IMLA
Administered by: Other     Purchased by: Private
Symptoms: Pain, Skin nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 1 week after flu shot the pt had complaints of severe pain in both legs and feet. Also started to have painful nodules on legs and bottom of feet. Had flu shot for the last 2 years; administered by another co. Presently on valium, prednisone and pain med. Pt was hospitalized for 4 days from another facility. Annual follow up states pt had painful nodules that developed on his legs. "Took 2 months to go away." He did not take a flu shot in 2002

VAERS ID:181172 (history)  Vaccinated:2000-09-13
Age:18.0  Onset:2000-09-14, Days after vaccination: 1
Gender:Female  Submitted:2001-01-26, Days after onset: 134
Location:Florida  Entered:2002-02-11, Days after submission: 381
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: U200000812
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3231C6   
RAB: RABIES (IMOVAX)SANOFI PASTEURR1105 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arteritis, Malaise, Nausea, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Vasculitis (narrow), Hypersensitivity (narrow)
Write-up: It was reported that a 18-year-old female patient receive rabies and hepatitis-b (unspecified) vaccinations on 13-Sep-2000. Reportedly on 14-Sep-2000, the patient experienced malaise, nausea, feeling feverish, joint stiffness, A fine rash was noted on examination of the patient on both her forearms and under both breasts. Patient was treated symptomatically with Atarax and Ibuprofen. From additional information received on 08-Dec-2000, "Reviewed, no added info at this time".

VAERS ID:181178 (history)  Vaccinated:2001-03-05
Age:18.0  Onset:2001-03-07, Days after vaccination: 2
Gender:Female  Submitted:2001-05-03, Days after onset: 56
Location:North Carolina  Entered:2002-02-11, Days after submission: 284
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: U200100527
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)AVENTIS PASTEURT022131SC 
Administered by: Public     Purchased by: Private
Symptoms: Headache, Injection site reaction, Insomnia, Myalgia, Nightmare
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: It was reported that a pt (5 of 5) received an Imovax Rabies ID vaccination on 3/5/01. Reportedly, the pt developed a headache, sore muscles, nightmares, insomnia and a local reaction, lasting 2-4 days. Further information is requested. From telephone conversation on 4/6/01, it was reported that the pt recovered from this experience. From additional correspondence received on 4/18/01, the correct vaccination date (3/5/01) and the adverse event onset date (3/7/01) were provided. Additional pt, vaccine, responsible physician and vaccine administrator information was also provided. This case is closed.

VAERS ID:181185 (history)  Vaccinated:2001-06-27
Age:18.0  Onset:2001-07-09, Days after vaccination: 12
Gender:Female  Submitted:2001-07-24, Days after onset: 15
Location:California  Entered:2002-02-11, Days after submission: 202
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U200100884
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURUA411AA SC 
Administered by: 0     Purchased by: 0
Symptoms: Headache
SMQs:
Write-up: From telephone contact with reporting physician, it was stated that an 18 year old female pt received a Menomune A/C/Y/W-135 vaccination on 6/27/01. Twelve days later, the pt complained of severe headache. She was hospitalized on 7/9/01. The pt is now at home and the headache has completely resolved.

VAERS ID:181191 (history)  Vaccinated:2000-04-26
Age:18.0  Onset:2000-04-26, Days after vaccination: 0
Gender:Female  Submitted:2001-01-28, Days after onset: 277
Location:California  Entered:2002-02-11, Days after submission: 379
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: U200100283
Vaccination
Manufacturer
Lot
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Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURUA170AA0SC 
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Loss of consciousness
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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: It was reported that an 18 year old female pt received a Menomune vaccination in the left deltoid on 04/26/2000 at 2:53pm. At approx 3:05pm the pt felt faint, walked to the nursing station and admitted to nurse about feeling bad and then loss consciousness. First aid was administered, juice and cookies. Pt spontaneously regained consciousness. Pt was monitored until recovered.

VAERS ID:181197 (history)  Vaccinated:2000-09-27
Age:18.0  Onset:2000-09-27, Days after vaccination: 0
Gender:Male  Submitted:2001-03-12, Days after onset: 166
Location:California  Entered:2002-02-11, Days after submission: 336
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:
Diagnostic Lab Data: UNK
CDC Split Type: U200100347
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEUR7188AA0SC 
Administered by: Other     Purchased by: Private
Symptoms: Chills, Headache, Hyperhidrosis, Influenza like illness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: From an initial report received on 01/04/2001, it was reported that an 18 year old male was given MEnomune vaccine on 09/27/2000. Pt reportedly "felt a little flu-like all day. 2 hours after shot give, felt "a lot worse."... head hurt/aches/cold shivers and perspired.17:45 came back to nursing station T99.6 skin warm, not perspiring 18:07 T99.7 will go home and take Tylenol or Advil for migraines and report to student health if further symptoms."

VAERS ID:181198 (history)  Vaccinated:2000-11-08
Age:18.0  Onset:2000-11-08, Days after vaccination: 0
Gender:Male  Submitted:2001-12-05, Days after onset: 392
Location:Louisiana  Entered:2002-02-11, Days after submission: 68
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: allergic to sulfa
Diagnostic Lab Data:
CDC Split Type: U200100348
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEUR7129AF0 LA
Administered by: Other     Purchased by: Private
Symptoms: Loss of consciousness
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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: From an initial report received on 01/04/2001, it was reported an 18 year old male was given a Menomune vaccination on 11/08/2000. Reportedly after receiving the Menomune vaccine the pt passed out, diaphoretic less than or equal to 10 seconds. Pt reclined supine position. Pt identified states "I have not eaten" orange juice provided, cool packs applied to face and neck. Pt instructed to take slow deep breaths. Improvement noted. Pt stated "I feel good." From additional corespondence received on 10/24/2001 no further info was provided.

VAERS ID:181199 (history)  Vaccinated:2000-11-09
Age:18.0  Onset:2000-11-09, Days after vaccination: 0
Gender:Female  Submitted:2001-03-12, Days after onset: 123
Location:New Jersey  Entered:2002-02-11, Days after submission: 336
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sulfamethoxazole for acne
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: U200100349
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEUR7346AA SCLA
Administered by: Other     Purchased by: Private
Symptoms: Back pain, Myalgia, Pain, Sluggishness
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad)
Write-up: From an initial report received on 01/04/2001, it was reported an 18 year old female pt received Menomune on 11/09/2000. "Meningitis left arm around 2pm 11/09/2000 and at 4:30pm experienced sharp back and left arm pain. Also muscular aching. Pain in lower back worse by 8pm. Called police station and they advised she go to ER. Gave Benadryl and Ibuprofen at 11:30pm. Felt better by 12:30am. Next day sluggish, but better and feels 95% with slight backache."

VAERS ID:181203 (history)  Vaccinated:2001-01-19
Age:18.0  Onset:2001-01-25, Days after vaccination: 6
Gender:Female  Submitted:2001-03-05, Days after onset: 39
Location:Texas  Entered:2002-02-11, Days after submission: 343
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: U200100444
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEUR    
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Asthenia, Chest pain, Dizziness, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: These are the symptoms of an 18 year old female pt received a Menomune vaccination on 01/19/2001. Nausea, asthenia, dizziness, myalgia, headache, abdominal pain, arthralgia, chest pain and fever (99.5 deg. F)was noted on 01/25/2001.

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