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Case Details (Sorted by Age)

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VAERS ID:213702 (history)  Vaccinated:2003-10-27
Age:20.0  Onset:2003-10-29, Days after vaccination: 2
Gender:Female  Submitted:2003-11-13, Days after onset: 15
Location:Montana  Entered:2003-12-09, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control Pills
Current Illness: Vomiting flu bug
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1093AA4IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Flu shot 10/27. On 10/29 rash on back. Took Benadryl cleared up went away.

VAERS ID:213746 (history)  Vaccinated:2003-11-24
Age:20.0  Onset:2003-12-02, Days after vaccination: 8
Gender:Male  Submitted:2003-12-03, Days after onset: 1
Location:Texas  Entered:2003-12-09, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770  
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Feeling hot, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Left deltoid erythematous with increased warmth for 2 days. Left axillary node tenderness for two days. Treatment: Cephalexin 500mg PO BID for 10 days. Ibuprofen 800mg PO BID for 10 days.

VAERS ID:214254 (history)  Vaccinated:2003-12-08
Age:20.0  Onset:2003-12-17, Days after vaccination: 9
Gender:Female  Submitted:2003-12-19, Days after onset: 2
Location:Virginia  Entered:2003-12-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Dermatitis bullous, Injection site erythema, Nausea, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: This is a 20 y/o ? black active duty military member who received her primary smallpox vaccination on 12/08/03. She states that she progressed fine through the first week after her vaccination and did not develop any viremic symptoms. On 12/15/03 she reported with her fellow soldiers to immunizations to have a 7-day wound check. She stated that the medic told her it looked great and was "just exactly how it is supposed to look". She told me that the medic pressed all around the outside edges of the site. He was wearing gloves, however patient states that she never saw him change gloves between patients and "there were a lot of us". On 12/17/03, she removed the bandage and states that the area under the gauze part of the bandage was "red and blistered". She also began having viremic symptoms of fever, chills and nausea at this time. Her viremic symptoms last approximately 4 days.

VAERS ID:214295 (history)  Vaccinated:2003-12-01
Age:20.0  Onset:2003-12-01, Days after vaccination: 0
Gender:Male  Submitted:2003-12-02, Days after onset: 1
Location:North Carolina  Entered:2003-12-23, 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: Pt just recovered from recent mild post-comevesion syndrome from motor vehicle accident.
Diagnostic Lab Data: Physical exam
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0803SCLA
Administered by: Military     Purchased by: Military
Symptoms: Headache, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Approximately 2 hours after receiving Anthrax vaccine, pt had severe headache, body ache, vomiting that evening and the next morning.

VAERS ID:214350 (history)  Vaccinated:2003-11-15
Age:20.0  Onset:2003-12-17, Days after vaccination: 32
Gender:Male  Submitted:2003-12-28, Days after onset: 11
Location:Massachusetts  Entered:2003-12-24, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Asthma, OCD Medical records sttes abnormal thinking as pre-existing problem. msv
Diagnostic Lab Data: Discharge summary states CSF abnormal. msv Medical records state lab test abnormal. msv
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1139AA0 LA
Administered by: Private     Purchased by: Other
Symptoms: CSF test abnormal, Guillain-Barre syndrome, Hyporeflexia, Injury, Laboratory test abnormal, Myasthenic syndrome, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (narrow), Accidents and injuries (narrow), Hostility/aggression (broad), Demyelination (narrow)
Write-up: Guillain Barre syndrome. Hospitalized at hospital. Still no reflexes in ankles and knees bilaterally. Discharge summary states paresthesia, pain. msv Medical records state myasthenia, accidental injury. msv

VAERS ID:214487 (history)  Vaccinated:2003-12-15
Age:20.0  Onset:2003-12-16, Days after vaccination: 1
Gender:Male  Submitted:2003-12-18, Days after onset: 2
Location:Washington  Entered:2003-12-30, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0811SC 
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Oedema peripheral, Pain, Skin disorder
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 12/16/03 noted localized pain at 0500. At 1200 developed redness, tightness in the skin developed around around 1700 and swelling of the arms and itching. There has been progression of the swelling and erythema to below the elbow since 12/17/03. 12/18/03 has erythema measuring 25cm.

VAERS ID:214517 (history)  Vaccinated:2003-10-25
Age:20.0  Onset:2003-10-30, Days after vaccination: 5
Gender:Male  Submitted:2003-11-15, Days after onset: 16
Location:Minnesota  Entered:2003-12-30, Days after submission: 45
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: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Contusion, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)
Write-up: 5 days after TB test, throbbing pain in left forearm, unable to lift due to increased pain. NO swelling or redness at injection site. 3 inch bruise noted on 11/09, went to provider on 11/10.

VAERS ID:214909 (history)  Vaccinated:2004-01-02
Age:20.0  Onset:2004-01-13, Days after vaccination: 11
Gender:Male  Submitted:2004-01-14, Days after onset: 1
Location:New Jersey  Entered:2004-01-14
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: pending CBC, monospot, and RPR
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS235A41IMUN
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.06663N0SCUN
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130IDLA
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURERU0991AA1IMUN
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUB421AA0SCUN
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Rash maculo-papular, Thermal burn
SMQs:, Anaphylactic reaction (broad), Accidents and injuries (narrow), Hypersensitivity (narrow)
Write-up: 2 days of widespread symmetrical pink maculopapular eruption w/ pruritus and burning; started on ankles and has spread to feet, lower legs, hands, wrists, forearms, and sparsely on back and abdomen; includes palms and soles

VAERS ID:215018 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:2002-11-18
Gender:Female  Submitted:2004-01-09, Days after onset: 417
Location:Georgia  Entered:2004-01-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The pt had no relevant medical history, concurrent medical conditions or concurrent medications. There were no known drug allergies.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0387770A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5299A4  LA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Fatigue, Headache, Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: A nurse reported the occurrence of an injection site rash in 20-year-old female who received hepatitis B vaccine recombinant (Engerix-B) for prophylaxis. The pt had no relevant medical history, concurrent medical conditions or concurrent medications. There were no known drug allergies. On an unspecified date, the pt received an injection of hepatitis B vaccine recombinant (Engerix-B) 20 mcg in the left arm (lot #ENG5299A4). On 11/18/2002, the pt developed chills. On 11/21/2002, the pt experienced fatigue, and developed an injection site rash. On an unspecified date, the pt experienced a headache. All events were experienced post-vaccination. The injection site rash resolved on 11/22/2002 while all the other events resolved by 11/25/2002. The reporter considered the events to be related to Engerix-B administration.

VAERS ID:215030 (history)  Vaccinated:2002-11-26
Age:20.0  Onset:2002-12-02, Days after vaccination: 6
Gender:Female  Submitted:2004-01-09, Days after onset: 403
Location:New Jersey  Entered:2004-01-16, 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:
Current Illness: UNK
Preexisting Conditions: The pt''s medical history, concurrent conditions and concurrent medications were unknown.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0390040A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 0  
Administered by: Private     Purchased by: Other
Symptoms: Fatigue, Malaise, Pharyngolaryngeal pain
SMQs:
Write-up: A nurse reported the occurrence of a sore throat in a 20-year-old female who was vaccinated with hepatitis B vaccine recombinant (Engerix-B) for prophylaxis. The pt''s medical history, concurrent conditions and concurrent medications were unknown. The reporting nurse stated that on 11/26/2002, the pt received her 1st Engerix-B injection. On 12/02/2002, the pt''s mother called the physician''s office to report that the pt was experiencing a sore throat and was "rundown". As of 12/20/2002, the outcomes of the events were unknown.

VAERS ID:215137 (history)  Vaccinated:2003-07-24
Age:20.0  Onset:2003-07-24, Days after vaccination: 0
Gender:Unknown  Submitted:2004-01-09, Days after onset: 169
Location:Florida  Entered:2004-01-16, 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:
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0418250A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5371A40  
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: This case was reported by a health professional and described the occurrence of fever in a 20 year old pt who received hep B vaccine recombinant (Engerix B) for prophylaxis. The pt''s medical history, concurrent conditions, and concurrent medications were not reported. On 7/24/03, the pt received the first dose of Engerix B (5371A4). In the afternoon or evening of 7/24/03, the pt developed a fever. She was febrile when seen by the physician on 7/25/03.

VAERS ID:215164 (history)  Vaccinated:2003-09-22
Age:20.0  Onset:2003-09-22, Days after vaccination: 0
Gender:Female  Submitted:2004-01-09, Days after onset: 109
Location:Oregon  Entered:2004-01-16, 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: UNK
Current Illness: UNK
Preexisting Conditions: The reporter indicated that another pt at this facility experienced the same events following receipt of Engerix-B. See report A0427394A.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0428127A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5390A40  
Administered by: Other     Purchased by: Other
Symptoms: Fatigue, Headache, Influenza like illness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: This case was reported by a nurse and described the occurrence of headache in a female pt in her twenties who received hepatitis B vaccine recombinant (Engerix-B) injection for prophylaxis. On 09/22/03 the pt received the 1st dose of Engerix-B. On that date, she also received a tuberculin skin test. Approximately four hours post-immunization, on 09/22/03, the pt experienced headache, fatigue, fever and flu-like symptoms. The events resolved by 09/24/03.

VAERS ID:215269 (history)  Vaccinated:2003-12-29
Age:20.0  Onset:2004-01-09, Days after vaccination: 11
Gender:Female  Submitted:2004-01-13, Days after onset: 4
Location:Kansas  Entered:2004-01-21, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4030013  LA
Administered by: Military     Purchased by: Military
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: Macular papular truncal rash

VAERS ID:215276 (history)  Vaccinated:2003-12-29
Age:20.0  Onset:2004-01-09, Days after vaccination: 11
Gender:Male  Submitted:2004-01-13, Days after onset: 4
Location:Kansas  Entered:2004-01-21, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130 LA
Administered by: Military     Purchased by: Military
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: Macular papular truncal rash

VAERS ID:215280 (history)  Vaccinated:2003-12-29
Age:20.0  Onset:2004-01-09, Days after vaccination: 11
Gender:Male  Submitted:2004-01-13, Days after onset: 4
Location:Kansas  Entered:2004-01-21, 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130 LA
Administered by: Military     Purchased by: Military
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: Macular papular truncal rash.

VAERS ID:215479 (history)  Vaccinated:2002-11-05
Age:20.0  Onset:2002-11-05, Days after vaccination: 0
Gender:Female  Submitted:2003-03-01, Days after onset: 116
Location:North Carolina  Entered:2004-01-22, Days after submission: 327
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: UA, Strep screen, CBC, CmP-all done on 11/8/02 and results were within normal limit.
CDC 'Split Type': U200201150
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR    
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEUR    
Administered by: Other     Purchased by: Other
Symptoms: Headache, Musculoskeletal stiffness, Myalgia, Nausea, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: It was reported that a 20 year old female pt received Fluzone and Menomune at approximately 3:30pm on 11/5/02. The pt reportedly felt well prior to receiving vaccinations. At 8:30pm on 11/5/02, the pt experienced onset of slight headaches and slight stiff neck with muscular aching but without joint pain. The pt felt nauseated without vomiting, no nuchal rigidity but complained of slight pain with head flexion. The pt also experienced slight tenderness at upper arm. The reporter spike with pt by phone on 11/11/02 and she was asymptomatic by 11/9/02. Th pt was not on any other medications at time of vaccination and had no previous history of any medical conditions or allergies.

VAERS ID:215626 (history)  Vaccinated:2003-12-18
Age:20.0  Onset:2003-12-21, Days after vaccination: 3
Gender:Male  Submitted:2004-01-10, Days after onset: 20
Location:Unknown  Entered:2004-01-27, Days after submission: 17
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: VIRAL SYNDROME
Preexisting Conditions: CLEFT LIP/PALLET;
Diagnostic Lab Data: CSF: c/w viral meningitis; CRP: $g20;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 2IM 
Administered by: Military     Purchased by: Military
Symptoms: Convulsion, Influenza like illness, Meningitis, Thinking abnormal
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Generalised convulsive seizures following immunisation (narrow)
Write-up: Flu like symptoms followed by mental status changes, then seizures.

VAERS ID:215674 (history)  Vaccinated:2004-01-05
Age:20.0  Onset:2004-01-13, Days after vaccination: 8
Gender:Female  Submitted:2004-01-20, Days after onset: 7
Location:Wisconsin  Entered:2004-01-28, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV081 SCRA
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES765751   
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSH8AB238A6   
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200711 LA
Administered by: Military     Purchased by: Military
Symptoms: Rash papular
SMQs:
Write-up: Small papules on stomach, bachial neck

VAERS ID:215680 (history)  Vaccinated:2003-12-05
Age:20.0  Onset:2003-12-06, Days after vaccination: 1
Gender:Female  Submitted:2004-01-20, Days after onset: 45
Location:North Carolina  Entered:2004-01-28, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1129AA0IMLA
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETHU0991AA1IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: A lump formed in the shot area with a soft spot in the center.

VAERS ID:216088 (history)  Vaccinated:2003-12-09
Age:20.0  Onset:2003-12-09, Days after vaccination: 0
Gender:Female  Submitted:2003-12-16, Days after onset: 7
Location:Florida  Entered:2004-02-05, 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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQWYE587312DEC03
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE, INC./WYETH LABORATORIES, INC500019B IN 
Administered by: Other     Purchased by: Other
Symptoms: Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Information regarding Flumist was received from a healthcare professional regarding a 20 year old female pt who experienced nausea, vomiting, and headache. At 20 years of age, the pt received a dose on 12/9/03. On 12/9/03, approximately one hour post vaccination, the pt experienced nausea, vomiting, and a headache. The pt still had a headache about four hours after vaccine administration. No additional info was available at the date of this report.

VAERS ID:216229 (history)  Vaccinated:2003-12-11
Age:20.0  Onset:2003-12-11, Days after vaccination: 0
Gender:Female  Submitted:2004-02-06, Days after onset: 57
Location:California  Entered:2004-02-06
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: latex allergy
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1293AA0SCUN
Administered by: Public     Purchased by: Unknown
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: Patient administered flu shot. Kept under observation because of history of latex allergy. After 10 minutes, concern of tightness in throat and was seen by doctor.

VAERS ID:216369 (history)  Vaccinated:2004-01-27
Age:20.0  Onset:2004-02-05, Days after vaccination: 9
Gender:Male  Submitted:2004-02-11, Days after onset: 6
Location:Utah  Entered:2004-02-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: The lab is currently testing cultures from the lesions. Results are expected 11 Feb 04 or 12 Feb 04.
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710IDLA
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Cow pox, Discomfort, Lymphadenopathy, Pain, Rash maculo-papular, Rash pustular, Skin ulcer
SMQs:, Hypersensitivity (narrow)
Write-up: 5 Feb 04 pt describes body aches, generalized pustular, and maculopapular rash on his torso, groin and arm. He has a red streak from the vaccination site on his l upper arm and painful swollen lymph nodes in the l axilla. The rash was evaluated in ER, 7 and 8 Feb 04 and was thought to have generalized vaccinia. The rash has improved over time. The discomfort has decreased and the rash is macular in nature. The largest area is 1 cm in diameter. The lesions don''t join each other. Pt states he is feeling much better today and has gone back to work.

VAERS ID:217119 (history)  Vaccinated:2004-02-11
Age:20.0  Onset:2004-02-22, Days after vaccination: 11
Gender:Female  Submitted:2004-03-01, Days after onset: 8
Location:Kansas  Entered:2004-03-01
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: n/a
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0815IMRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300131IMLA
Administered by: Military     Purchased by: Military
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: macular papular truncal rash

VAERS ID:217109 (history)  Vaccinated:1999-02-20
Age:20.0  Onset:1999-02-20, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:2004-03-02
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: red dyes
Diagnostic Lab Data:
CDC 'Split Type': BERNA20030047
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TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER015090160  
Administered by: Other     Purchased by: Military
Symptoms: Agitation, Anaphylactic reaction, Diarrhoea, Face oedema, Nausea, Pharyngeal oedema, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal allergic conditions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Anaphylactic Reaction (Anaphylactic reaction, Anaphylactic reaction) Face oedema (Face oedema, Face oedema). Throat swelling (throat swelling, Oropharyngeal swelling). Case Discription: This 20 year old male patient was vaccinated with Vivotif Berna vaccine (Lot No. 015090.16) on 20 FEB 1999 at 09.30 am. Two hours later the patient developed nausea and diarrhoea and 10-12 hours he experienced itchiness, increased agitation, facial edema and closing throat swelling. At Emergency room visit the patient was given Benadryl (diphenhydramine) 25 mg peroral. Because of recurrence of the closing throat swelling the patient returned to the Emergency room and received Epinephrin (adrenaline) and Benadryl (diphenhydramine) 50 mg p.o. The symptoms resolved within 3 days. This case was forwarded by the FDA, VAERS No. 120863

VAERS ID:217410 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2004-02-24
Location:Texas  Entered:2004-03-09, Days after submission: 14
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: PPT: 49.0
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0702SC 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURX01100IM 
Administered by: Military     Purchased by: Military
Symptoms: Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: Uterine/vaginal spotting (blood) within 24 hours of receiving 2 Anthrax vaccines 1-2 weeks apart. No previous history.

VAERS ID:217419 (history)  Vaccinated:2004-02-17
Age:20.0  Onset:2004-02-19, Days after vaccination: 2
Gender:Female  Submitted:2004-02-20, Days after onset: 1
Location:Virginia  Entered:2004-03-09, 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: Orthotricyclen;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': VA04004
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU0842AA5IMRA
Administered by: Public     Purchased by: Public
Symptoms: Hypoaesthesia, Injection site pain, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Per mother: client developed fever of 103.6 and arm numbness 2 days after administration. Declined going to MD ER, has no insurance. Took Tylenol only. On third day no fever and moderate soreness in arm going about normal daily activities.

VAERS ID:217768 (history)  Vaccinated:2004-03-01
Age:20.0  Onset:2004-03-09, Days after vaccination: 8
Gender:Male  Submitted:2004-03-12, Days after onset: 3
Location:Kansas  Entered:2004-03-15, Days after submission: 3
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: Pt. has Hepatitis C.
Diagnostic Lab Data: Hepatitis C Virus abnormal on 24 Feb 04
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YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUB501AA0SCLA
Administered by: Military     Purchased by: Military
Symptoms: Hepatitis C virus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt. states he had 3 bumps under left eye on Tues. and bumps under right eye Wed. morning. Pt. went to clinic Wed. morning and discovered bumps on chest and back. No fever no nausea, vomiting or diarrhea, no itching.

VAERS ID:217924 (history)  Vaccinated:2003-12-12
Age:20.0  Onset:2003-12-12, Days after vaccination: 0
Gender:Female  Submitted:2004-03-05, Days after onset: 84
Location:New York  Entered:2004-03-18, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: GENERAL PHYSICAL CONDITION NORMAL. The patient has no known drug allergies; concurrent medical conditions were not reported.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0443029A
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSHAB235A40  
Administered by: Other     Purchased by: Private
Symptoms: Cyanosis, Influenza like illness, Pain, Paraesthesia, Peripheral coldness, Pyrexia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Peripheral coldness, Paraesthesia, Cyanosis, Pyrexia, Influenza like illness, Pain. This case was reported by a nurse practitioner and described the occurrence of cold, tingling, blue extremities in a 20-year old female patient who received hepatitis inactivated and hepatitis B recombinant vaccine (Twinrix). The patient had no known drug allergies and was healthy at the time of administration of Twinrix. On 12 December 2003, the patient received the first dose of Twinrix (lot HAB235A4). At an unspecified time following administration of Twinrix, on 12 December 2003, the patient developed cold, tingly, bluish extremities, a feverish feeling, flu-like symptoms, and achiness. That same day, she was seen at the student health service. As of 12 December 2003, the events were unresolved.

VAERS ID:218079 (history)  Vaccinated:2004-03-01
Age:20.0  Onset:2004-03-10, Days after vaccination: 9
Gender:Male  Submitted:2004-03-22, Days after onset: 12
Location:Washington  Entered:2004-03-22
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:
Diagnostic Lab Data:
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4030013 IDLA
Administered by: Military     Purchased by: Military
Symptoms: Bacterial infection, Cellulitis, Erythema, Feeling hot, Lymphangitis, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness on left arm increased over last 3-4 days with streaking. 1 cm blistered area surrounded by edma and warmth 5-6 cm in diameter with a lymphangitic streak extending 8 cm medially towards the axilla. Seen at civillian ED, diagnosed with bacterial cellulitis and treated with 3gm IV Unasyn and Augemntin 875mg 1 b.i.d x10 days.

VAERS ID:218154 (history)  Vaccinated:2004-03-19
Age:20.0  Onset:2004-03-21, Days after vaccination: 2
Gender:Male  Submitted:2004-03-23, Days after onset: 2
Location:Pennsylvania  Entered:2004-03-25, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Malaise, Nausea, Muscle aches
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 1IMLA
Administered by: Military     Purchased by: Military
Symptoms: Malaise, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: 20 year old white male received first Anthrax vaccine in 3/19/2004. Patient developed malaise, muscle aches, nausea 3/21/04.

VAERS ID:218563 (history)  Vaccinated:2004-02-19
Age:20.0  Onset:2004-04-01, Days after vaccination: 42
Gender:Female  Submitted:2004-04-03, Days after onset: 2
Location:Virginia  Entered:2004-04-03
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: Urine hCG + on 4/1/04
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710SCLA
Administered by: Military     Purchased by: Military
Symptoms: Unintended pregnancy
SMQs:, Normal pregnancy conditions and outcomes (narrow)
Write-up: 20 y/o F was vaccinated with SPV on 2/19/04, after denying the possibility of pregnancy on her screening form and listing LMP as 2/2/04. Positive vaccine take documented on 2/25/04. On 4/1/04, pt presented for pregnancy testing after not having another period since 2/2/04. Urine hCG was positive. Pt has had no complications to date. She currently plans to terminate the pregnancy, but this decision was not based on having had SPV. She has been educated & counseled regarding SPV in pregnancy, and encouraged to submit products of conception for research purposes if she terminates.

VAERS ID:218647 (history)  Vaccinated:2003-04-03
Age:20.0  Onset:2003-10-30, Days after vaccination: 210
Gender:Male  Submitted:2003-10-30, Days after onset: 0
Location:Nevada  Entered:2004-04-07, Days after submission: 159
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: Evaluated by ER physician. Clinical diagnosis.
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0713SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site induration, Injection site oedema, Injection site vesicles
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt developed erythema, edema and induration at the vaccine site this was followed by vesiculation.

VAERS ID:218832 (history)  Vaccinated:2004-04-05
Age:20.0  Onset:2004-04-05, Days after vaccination: 0
Gender:Female  Submitted:2004-04-08, Days after onset: 3
Location:California  Entered:2004-04-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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RAB: RABIES (IMOVAX)AVENTIS PASTEURW14190IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURX01100IMLA
Administered by: Public     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: Client received rabies travel vaccinations for trip on Monday, April 5th, 2004. The rabies vaccine Imovax Lot # W1419-3 was given. This lot was recalled on April 5th. The recall information was received after the vaccination was given. The client was contacted on Tuesday, April 6th, 2004 and informed of the recall and suggested treatment was discussed. Client came in for HRIG and Imovax post exposure treatment on Wednesday, April 7, 2004. No signs or symptoms of any adverse effects were noted on history and physical exam and client signed agreement to receive prophylactic treatment as perscribed.

VAERS ID:219228 (history)  Vaccinated:2003-12-15
Age:20.0  Onset:2003-12-15, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Maryland  Entered:2004-04-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: Systemic lupus erythematosus.
Diagnostic Lab Data: UNK
CDC 'Split Type': HQWYE9022524DEC03
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE, INC./WYETH LABORATORIES, INC  IN 
Administered by: Private     Purchased by: Private
Symptoms: Medication error, Nasal congestion
SMQs:
Write-up: Information regarding Flumist (2003-2004 Formula) (influenza virus vaccine, live intranasal (2003-2004 Formula) (influenza virus vaccine, live intranasal (2003-2004 formula) nasal solution (frozen) was received from a healthcare professional regarding a 20-year-old female patient with systemic lupus erythematosus, who experienced nasal irritation and nasal dryness. The patient received a dose on 15-Dec-2003. Medical History: The patient''s concurrent illness includes systemic lupus erythematosus (not currently receiving medication for Lupus). Product Details: Indication for Flumist (2003-2004 Formula) was immunization. Product was administered on 15-Dec-2003. Dose regimen was 1 dose (intranasal). Concomitant Therapy: Concomitant therapy included tetanus and diptheria toxoids (manufacturer unknown) administered on 16-Dec-2003. Event Details: On 15-Dec-2003, subsequent to Flumist administration, the patient experienced nasal irritation (nasal passage irritation), including dryness (nasal dryness). The reported wanted to know if the patient was at risk for any specific complications due to the fact that she has a history of lupus. The patient''s rhematologist is upset that FluMist was given to a patient with lupus (medication error). No additional information was available at the time of this report.

VAERS ID:219230 (history)  Vaccinated:2003-12-01
Age:20.0  Onset:2003-12-20, Days after vaccination: 19
Gender:Male  Submitted:2004-01-19, Days after onset: 30
Location:Ohio  Entered:2004-04-19, Days after submission: 90
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: Nasopharyngitis; Rhinorrhoea
Diagnostic Lab Data: Test Name: Chest X-raay 12/21/2003, results: negative for pneumonia.
CDC 'Split Type': HQWYE909224DEC03
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE, INC./WYETH LABORATORIES, INC  IN 
Administered by: Other     Purchased by: Other
Symptoms: Bacterial infection, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Information regarding Flumist (2003-2004 Formula) (influenza virus vaccine, live intranasal (2003-2004 Formula) (influenza virus vaccine, live intranasal (2003-2004 formula) nasal solution (frozen) was received from a mother (a nurse) regarding her 20-year-old son who felt sick immediately following Flumist and later developed a fever. At 20 years of age, the patient received a dose the week of 08-Dec-2003. Medical History: The patient had a slight cold and little runny nose before receiving Flumist. Product Details: Indication for Flumist (2003-2004) was immunization. Product was administered the week of 08-Dec-2003 at health center. Dose regimen was 1 dose (intranasal). Concomitant Therapy: Patient was not taking concomitant therapy. Event Details: the patient "felt sick" immediately following Flumist administration. On 20-Dec-2003, he reported "feeling terrible", developing a fever of 102.6, which increased to 104.4 on the night of 21-Dec-2003. He was treated with Tylenol (acetaminophen) and Advil (ibuprofen), but the fever continued to rise. On the evening of 21-Dec-2003, he was taken to the emergency room at the hospital. He was prescribed Avelox (moxifloxacin) for a possible bacterial infection, and sent home. As of 23-Dec-2003, he was beginning to feel better. Test results: On 21-Dec-2003, chest x-ray results were negative for pneumonia. No additional information was available at the time of this report.

VAERS ID:219256 (history)  Vaccinated:2003-12-10
Age:20.0  Onset:2003-12-12, Days after vaccination: 2
Gender:Female  Submitted:2004-01-14, Days after onset: 33
Location:New Jersey  Entered:2004-04-19, Days after submission: 95
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQWYE773616DEC03
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE, INC./WYETH LABORATORIES, INC  IN 
Administered by: Other     Purchased by: Other
Symptoms: Periorbital oedema, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: Orbital Oedema; Pyrexia/Fever. Information regarding Flumist (2003-2004 formula) nasal solution (frozen)) was received from a healthcare professional regarding a 20 year old female patient who experienced peri-orbital edema and fever. At 20 years of age, the patient received a dose on 10-Dec-2003. The patient experienced peri-orbitla edema on 12-Dec-2003. Treatment included zyrtec (certirizine hydrochloriede) but this "did not help". On 17-Dec-2003, the patient developed a "low grade" fever/pyrexia. No additional information was available at the time of this report.

VAERS ID:219325 (history)  Vaccinated:2004-04-12
Age:20.0  Onset:2004-04-12, Days after vaccination: 0
Gender:Female  Submitted:2004-05-03, Days after onset: 21
Location:Virginia  Entered:2004-04-20, 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:
Current Illness: NONE
Preexisting Conditions: History of allergies but no known drug allergies. 28Apr04 Environmental allergies, no egg allergy.
Diagnostic Lab Data:
CDC 'Split Type': 200401463
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HEPA: HEP A (VAQTA)MERCK & CO. INC.6477011165N   
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURW0460   
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURW0909   
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUB492AA   
Administered by: Public     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: From initial information received on 4/14/04 from a health care professional regarding an adverse event occurring in the USA, it was reported that a 20 year old female patient received a Yellow Fever vaccination, lot number UB492AA, a TYPHIM vaccination, lot number W0909, an IPOL vaccination, lot number W0460 and a VAQTA vaccination, lot number 1165N (no routes and sites of administration reported), on 4/12/04. Two hours after receiving the vaccination the patient broke out with hives on her face, neck and upper lip. She denied having dyspnea or tightness in chest. She went to the emergency room where she was given IV Benadryl and decadron. The hives resolved in minutes after receiving the medication. No other information was provided. The patient recovered from this event. From additional information received on 28Apr04 from a telephone contact with the reporter, it was reported that the pt had environmental allergies, but no egg allergies. It was also reported that this pt had received previous doses of every vaccine except for the Yellow Fever vaccine. The pt recovered. No additional information is expected, this case is considered closed.

VAERS ID:219412 (history)  Vaccinated:2004-04-14
Age:20.0  Onset:2004-04-16, Days after vaccination: 2
Gender:Female  Submitted:2004-04-22, Days after onset: 6
Location:Iowa  Entered:2004-04-22
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: NKMA
Diagnostic Lab Data: See #7
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0817N1SCLA
Administered by: Unknown     Purchased by: Public
Symptoms: Pharyngolaryngeal pain, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: MMR was recieved on 4/14/04, on 4/16/04 pt developed a slight sore throat. On 4/17/04 developed bumps on her palms, the next day they spread to her feet and knees. C/o itch. Saw MD on 4/19/04. TC on 4/19/04 was normal, CBC unremarkable. Placed on Zyrtec and Triamcinolone Cream. Was to have F/U on 4/21/04 but she rescheduled for 4/26/04

VAERS ID:219813 (history)  Vaccinated:2004-04-16
Age:20.0  Onset:2004-04-21, Days after vaccination: 5
Gender:Unknown  Submitted:0000-00-00
Location:Connecticut  Entered:2004-05-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zantac; Prozac;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Vaccine administered 04/16/04
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1134N1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Skin ulcer
SMQs:
Write-up: Lesions under right armpit, wrist and 2 spots on back.

VAERS ID:221088 (history)  Vaccinated:2003-08-19
Age:20.0  Onset:2003-08-19, Days after vaccination: 0
Gender:Female  Submitted:2004-05-14, Days after onset: 269
Location:California  Entered:2004-05-20, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0309USA01517
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 20 year old female who on 19-Aug-2003 was vaccinated with a dose of varicella virus vaccine live. Subsequently, the patient developed a rash. Unspecified medical attention was sought. No additional information was provided. No product quality complaint was involved. Additional information has been requested.

VAERS ID:221193 (history)  Vaccinated:2003-03-01
Age:20.0  Onset:2003-09-30, Days after vaccination: 213
Gender:Female  Submitted:2004-05-14, Days after onset: 227
Location:Texas  Entered:2004-05-20, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES 0310USA01848
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Blister, Drug ineffective, Infection, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Hypersensitivity (broad)
Write-up: Information has been received from a physician concerning a female medical assistant in her mid 20''s who in January 2003, and in March or April 2003 was vaccinated with a first and second dose kof varicella virus vaccine live. On 30-Sep-2003 the patient developed chicken pox. She said that she felt awful and itchy and had one blister on her arm the first day. She counted about 6-10 blisters overall. She still has a couple red marks which she stated are scars. Unspecified medical was sought and no treatment was required. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested.

VAERS ID:221350 (history)  Vaccinated:2003-11-12
Age:20.0  Onset:2003-11-16, Days after vaccination: 4
Gender:Male  Submitted:2004-05-14, Days after onset: 179
Location:Maryland  Entered:2004-05-21, 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:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: dermatological 11/24/03: pending
CDC 'Split Type': WAES0311USA02597
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0671N1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse practitioner concerning a "normal, healthy" 20 year old black male hospital employee with no significant medical history including no immunosuppression and no known recent exposure to varicella or other viruses, who on 12NOV2003 was vaccinated with a second dose of varicella virus vaccine live as part of his employment. Concomitant vaccination on the same day included a dose of hepatitis B virus vaccine. There was no other concomitant medication. On 01OCT2003 the pt was vaccinated with a first dose of variccella virus vaccine live. On 16NOV2003 the pt reported that he began to develop a rash. The pt was seen in employee health the following day. At that time, the nurse practitioner reported that the pt had approximately five lesions on his back, five on the trunk, and 10 in the "folds of his arm" (side unspecified). The lesions were described as macular/papular, but not vesicular. The reporter indicated that if there were any vesicles, they were extremely small/minimal, and she was not really able to discern if there was fluid in any of the lesions. The patient also reported that the lesions were itchy, but had no other complaints at the time. Diphenhydramine hydrochloride, benadryl, was prescribed. He was ordered to stay home from work until the lesions resolved/ crusted over if applicable. The pt had been ordered not to work in the hospital since his rash began on 16NOV2003. The pt was scheduled to be seen again on 24NOV2003. The nurse practitioner indicated that she would like to submit a specimen to the varicella zoster virus identification program if possible but ws not sure if she would have any viable specimens on 24NOV2003. On 24NOV2003 the nurse practitioner saw the patient in the office and indicated that his rash was macular/papular and she could not obtain any specimens. the reporter stated that the initial rash started just four days after the second vacciation. It was noted that the rash was resolving, however, a new macular/papular rash was developing on t

VAERS ID:221410 (history)  Vaccinated:2004-05-17
Age:20.0  Onset:2004-05-17, Days after vaccination: 0
Gender:Female  Submitted:2004-05-20, Days after onset: 3
Location:Michigan  Entered:2004-05-24, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: PCN Codeine
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1025AA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Dyspnoea, Muscle spasms, Pharyngeal oedema, Pharyngitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (narrow), Dystonia (broad), Oropharyngeal infections (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Td booster given at 2:30PM 05/17/04 at Drs office that evening pt c/o muscle spasms and swollen throat. Taken to ER. Dx: Reaction to Td. Vaccin. 5/19/04 taken back to ER with c/o trouble breathing . Dx: acute pharangitis

VAERS ID:221446 (history)  Vaccinated:2003-10-02
Age:20.0  Onset:2003-10-03, Days after vaccination: 1
Gender:Male  Submitted:2004-01-20, Days after onset: 109
Location:D.C.  Entered:2004-05-24, Days after submission: 124
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': 200302239
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1014M1SCRA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU091AA IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Dyskinesia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad)
Write-up: From initial information received on 03/Oct/2003 from health care professional regarding an adverse event occurring in the USA, it was reported that a 20-year-old male patient received a dose of Td vaccine, lot number U0991AA, administered intra-muscularly in the left deltoid and his second dose of Measles, mumps and rubella vaccine, lot number 1014M, administered subcutaneously in the right arm on 02/Oct/2003 at 2:00 PM. On 03/Oct/2003 at 9:30 AM, the patient had a temperature of 101 degrees and jerky movements of the entire body. The patient recovery status was not reported.

VAERS ID:221535 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:2003-12-22
Gender:Female  Submitted:2004-05-14, Days after onset: 143
Location:Unknown  Entered:2004-05-24, Days after submission: 10
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:
Diagnostic Lab Data: Diagnostic laboratory 12/22/03 negative titer.
CDC 'Split Type': WAES0312USA02458
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a registered nurse concerning a female health care student in her early twenties who in 2001 was vaccinated with a first and second dose of varicella virus vaccine live. The reporter indicated that the patient now shows a negative titer. No medical attention was sought. A product quality complaint was not involved. Additional information has been requested.

VAERS ID:221541 (history)  Vaccinated:2003-01-03
Age:20.0  Onset:2003-12-22, Days after vaccination: 353
Gender:Female  Submitted:2004-05-14, Days after onset: 143
Location:Tennessee  Entered:2004-05-24, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: serum varicella zoster, 12/22/03, negative titer.
CDC 'Split Type': WAES0312USA02727
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS  IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.6430830572M0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a RN concerning a 20 year old adult white female with no known drug allergies who on 03Jan03 and 10Feb03 was vaccinated SC in the left arm with the first and second doses of varicella virus vaccine live. There was no known illness at the time of vaccination. Concomitant therapy that day included a dose of (ENGERIX B) administered IM in the right deltoid. No further information is expected.

VAERS ID:221547 (history)  Vaccinated:1999-03-22
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2004-05-14
Location:Ohio  Entered:2004-05-24, Days after submission: 10
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: Diagnostic Laboratory, inconclusive low titer to Varicella
CDC 'Split Type': WAES0401USA00056
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a physician concerning a 20 year old female employee who on 16Feb1999 and 22Mar1999 was vaccinated with a first and second dose of varicella virus vaccine live. One lot number was reported to be 628694/1663H, however the dose corresponding to this lot number was not specified. It was reported that the pt had an inconclusive low titer to varicella despite the two dose and that there was a vaccine failure. Unspecified medical attention was sought. No product quality complaint was involved. Additional information has been requested.

VAERS ID:222089 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2004-05-21
Location:Unknown  Entered:2004-05-27, 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: UNK
Current Illness:
Preexisting Conditions: Rhinitis allergic; Dermatitis atopic
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0310USA01494
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 20 year old male with rhinitis allergic and atopic dermatitis who was vaccinated with one dose of hepatitis A virus vaccine inactivated. Within a few hours of vaccination, the patient experienced urticaria. The physician reported that the patient now develops urticaria upon exertion/exercise. Unspecified medical attention was sought. There was no product quality complaint involved. Additional information has been requested.

VAERS ID:222286 (history)  Vaccinated:2002-10-21
Age:20.0  Onset:2002-10-26, Days after vaccination: 5
Gender:Male  Submitted:0000-00-00
Location:Nebraska  Entered:2004-06-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Elevated white count
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: 9x13 cm area of redness where injection given, pain increased, fever.

VAERS ID:222321 (history)  Vaccinated:2004-05-12
Age:20.0  Onset:2004-05-12, Days after vaccination: 0
Gender:Male  Submitted:2004-05-26, Days after onset: 14
Location:Wisconsin  Entered:2004-06-03, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU0836AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pain
SMQs:
Write-up: 2 hours after shot (1-2 pm) severe left arm pain.

VAERS ID:222431 (history)  Vaccinated:2004-06-02
Age:20.0  Onset:2004-06-02, Days after vaccination: 0
Gender:Female  Submitted:2004-06-07, Days after onset: 5
Location:California  Entered:2004-06-07
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: HCG Positive
CDC 'Split Type':
Vaccination
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 0SCUN
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0IDUN
Administered by: Military     Purchased by: Military
Symptoms: Laboratory test abnormal, Medication error, Skin ulcer, Unintended pregnancy
SMQs:, Normal pregnancy conditions and outcomes (narrow)
Write-up: Service member inadvertently received smallpox and anthrax vaccinations on 6/2/04 during pregnancy. States that she did not have a smallpox briefing but did receive educational brochures and completed the screening form.States that she had a pregnancy test on 5/25/04 but did not receive the results until 6/3/04. States that she had to go to a different base to have the pregnancy test done and sometimes the results take longer to get back.States that she did not have any problems with the vaccinations up to this point. Denies any rashes, flu-like symptoms, pruritus, chest pain, and shortness of breath or fever. No numbness or tingling in extremities. No lesions other than SPV site. Referred to OB provider. Scheduled to be seen on 6/7/04.

VAERS ID:222479 (history)  Vaccinated:2004-05-12
Age:20.0  Onset:2004-05-13, Days after vaccination: 1
Gender:Female  Submitted:2004-05-14, Days after onset: 1
Location:California  Entered:2004-06-08, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0181N1SCLA
Administered by: Other     Purchased by: Unknown
Symptoms: Erythema, Feeling hot
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Warmth erythema 3 1/2 X 5 cm.

VAERS ID:222690 (history)  Vaccinated:2004-05-21
Age:20.0  Onset:2004-05-28, Days after vaccination: 7
Gender:Male  Submitted:2004-06-15, Days after onset: 18
Location:Illinois  Entered:2004-06-15
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: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0  
Administered by: Unknown     Purchased by: Other
Symptoms: Erythema, Eye swelling, Influenza like illness, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 5/21/04- received primary spv- “flu-like symptoms” for the next few days. 5/28/04- noticed ”redness” on the left side of his face, corner of his left eye, and around the groin area- redness had gotten worse throughout the day. 5/30/04- notice a rash on his chest down to his waist, both ears (“inside and out”), chin, neck and around his left eye- “scattered and itchy”-“looked like poison ivy”- his left eye started to “get swollen”. 5/31/04- rashes have now spread to his right arm- pruritus worsened and his left eye became more swollen- went to the ER- given Benadryl. 6/1/04- sxs worsening- the patient was told by his Case Manager to go to the ER immediately and to obtain an emergent ophthalmology consult for his left eye. He was also instructed to contact his Case Manager from the ER and notify his CM of the name/contact number of the healthcare practitioners who were participating in his care- in the following few hours, no calls received from the patient- multiple attempts were made to contact this patient but no calls were returned- according to the healthcare practitioner who was present during the patient visit, the patient mentioned to the physician about his hiking trip on 5/28/04 and the patient also stated that he may have been exposed to poison ivy during hiking- the Medical Director of the HC has spoken with the physician who managed this patient- according to the Medical Director, the physician stated that he (the physician) “was comfortable that this patient had no ocular involvement.” On that basis, it maybe safe to assume that this is not a case of ocular vaccinia and that the patient's symptoms are not temporally associated with the receipt of the smallpox vaccine.

VAERS ID:222691 (history)  Vaccinated:2004-06-14
Age:20.0  Onset:2004-06-15, Days after vaccination: 1
Gender:Female  Submitted:2004-06-15, Days after onset: 0
Location:Indiana  Entered:2004-06-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BCP
Current Illness: None reported.
Preexisting Conditions: None reported
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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Dose
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Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS068AA0IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Swelling, Tenderness, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Client reported vomiting x2 last night. RT arm red, tender. Swelling rt side of neck and shoulder. Encouraged to see DR.

VAERS ID:223122 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2004-05-28
Location:Unknown  Entered:2004-06-22, Days after submission: 25
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: Drug hypersensitivity;
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0308USA02730
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a RN concerning a female "in her twenties", with a sulfa allergy, who was vaccinated SC on an unspecified date with a 0.5mL dose of MMRII (Lot # not reported). About two weeks post-vaccination the pt developed a rash all over her body. The pt did not seek medical attention. The pt''s outcome was reported as not recovered. Additional information is not expected.

VAERS ID:223274 (history)  Vaccinated:2004-01-16
Age:20.0  Onset:2004-01-22, Days after vaccination: 6
Gender:Female  Submitted:2004-05-28, Days after onset: 126
Location:New Jersey  Entered:2004-06-23, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Dental examination (01/23/04): negative;
CDC 'Split Type': WAES0401USA01811
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0666N   
Administered by: Private     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: Information has been received from a physician concerning a 20 year old Indian female pt with no past medical history who on 01/16/04 was vaccinated at 15:40 into the left deltoid with a dose of MMRII (Lot # 641627/0666N). There was no illness at the time of vaccination. According to the reporter, the pt was subsequently seen by a dentist for facial pain. On 01/23/04 a dentist''s exam was negative and there were no dental problems. The reporting physician questioned if this was possibly parotiditis. Further information will be provided after the pt is examined by the reporter. In follow up information from the physician, it was noted that on 01/22/04 the pt complained of headache and pain on the left side of face that goes to the left shoulder. It was unknown if the pt recovered. Additional information has been requested.

VAERS ID:223305 (history)  Vaccinated:2004-06-09
Age:20.0  Onset:2004-06-16, Days after vaccination: 7
Gender:Male  Submitted:2004-06-23, Days after onset: 7
Location:Texas  Entered:2004-06-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: none
Diagnostic Lab Data: supportive care
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH   LA
Administered by: Military     Purchased by: Military
Symptoms: Cow pox, Pruritus, Rash pustular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 06/22/04 Patient presented to our ED via ambulance. During his flight he noticed a few pustules were becoming larger and was quite itchy. He showed them to his sargent who sent him to the ED for evaluation. Presently is still here and has been seen by our ID doctor on 06/23/04 with probable generalized vaccinia.

VAERS ID:223380 (history)  Vaccinated:2004-06-21
Age:20.0  Onset:2004-06-22, Days after vaccination: 1
Gender:Female  Submitted:2004-06-24, Days after onset: 2
Location:Virginia  Entered:2004-06-24
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
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 1SCLA
Administered by: Military     Purchased by: Military
Symptoms: Discomfort, Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This 20 year-old female patient received her 2nd Anthrax Vaccination on 6/21/04. She indicates the injection was administered to her left mid-tricep region that am. Within 24 hours she noticed redness, swelling and some tenderness at the injection site. During the next 24 hours, the redness, swelling and pain worsened. She began using 800mg Motrin bid for the discomfort with some resolution of pain and swelling. She reports no adverse reaction with first anthrax, just alittle redness at the injection site. She denies weakness, numbness, problems using her left arm, paresthesia or any nodal swelling. She spoke with a nurse practitioner and was advised to come for evaluation.

VAERS ID:223420 (history)  Vaccinated:2004-06-16
Age:20.0  Onset:2004-06-24, Days after vaccination: 8
Gender:Male  Submitted:2004-06-25, Days after onset: 1
Location:California  Entered:2004-06-28, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020071   
Administered by: Military     Purchased by: Military
Symptoms: Injection site pustule, Pruritus, Rash papular, Rash vesicular, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 9 days after receiving the SPV, the pt noticed a generalized outbreak of small, red papules located over arms, torso, face, legs and palms. He complains of pruritus only. He denies fever, chills, myalgias, headache, fatigue, malaise, shortness of breath, chest pain, visual changes. The lesions have begun to form vesicles. All lesions involved with the generalized rash are of the same stage. No treatment has been given. The primary vaccine site is well into the pustule stage.

VAERS ID:223864 (history)  Vaccinated:2003-04-09
Age:20.0  Onset:2003-04-09, Days after vaccination: 0
Gender:Female  Submitted:2003-06-12, Days after onset: 64
Location:Unknown  Entered:2004-07-12, Days after submission: 396
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': 200300839
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)AVENTIS PASTEURT01330IM 
Administered by: Private     Purchased by: Other
Symptoms: Headache, Nausea, Pyrexia, Rash, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: From initial information received on 4/16/03 from a nurse regarding an adverse event occurring in the US, it was reported that a 20 year old female patient received her first dose of IMOVAX RABIES, lot number T0133, given IM in the deltoid on the evening of 4/9/03. Within half an hour after the vaccination, the patient developed tightness in her throat, a rash on her legs and hands and complained of having a fever, a headache and feeling nausea. The recovery status of this patient was not reported.

VAERS ID:223893 (history)  Vaccinated:2004-06-21
Age:20.0  Onset:2004-06-24, Days after vaccination: 3
Gender:Male  Submitted:2004-06-29, Days after onset: 5
Location:Mississippi  Entered:2004-07-13, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Spinal tap; Protein B6; GM stain; AFB; Meningitides; Group B Strep; Haemophilus influenzae; Strep pneumoniae negative; Arboverlis panel done. elevated white blood cell count, and mildly elevated CSF protein.
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1240N0 RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0953N1SCLA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1024AA0 LA
Administered by: Public     Purchased by: Public
Symptoms: CSF test abnormal, Eye pain, Headache, Laboratory test abnormal, Leukocytosis, Meningitis, Myalgia, Nausea, Nuchal rigidity, Pyrexia, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Eosinophilic pneumonia (broad)
Write-up: Onset of severe generalized headache and fever 6/21/04 at 12:00 AM. Also complained of eyes hurting, some cervical tenderness. Referred to ER and subsequently hospitalized with meningitis for 8 days. Medical diagnosis: Aseptic meningitis. Nurse follow up on 08/31/04 states: "Nausea, back stiffness, muscle pain, nuchal rigidity."

VAERS ID:223918 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2004-07-02
Location:Illinois  Entered:2004-07-13, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Unknown
Symptoms: Diarrhoea, Dizziness, Head discomfort, Injection site mass, Myalgia, Nausea, Pyrexia, Vertigo, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt had adverse drug reaction of fever, diarrhea, N/V, Myalgia, Headache, Dizziness/Vertigo and induration at site.

VAERS ID:224252 (history)  Vaccinated:2004-06-28
Age:20.0  Onset:2004-07-19, Days after vaccination: 21
Gender:Female  Submitted:2004-07-22, Days after onset: 3
Location:Oklahoma  Entered:2004-07-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Appeared healthy and no complaints of health problems. Denied allergies.
Preexisting Conditions: None known according to Mother.
Diagnostic Lab Data: Xrays, scoped and lab work according to Mother but have no access to results.
CDC 'Split Type':
Vaccination
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YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUB492AA0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Constipation, Diarrhoea, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: On 7/19/04, experienced severe abdominal pain, nausea, vomitting.In ER-numerous tests and X-rays.Inconclusive results.7/20 - back to ER - scoped and removed 5 liters of liquid from stomach according to her mother. Had been constipated and then had diarrhea. Distention of stomach is pushing against pancreas. Has been home with IV therapy and is returning to hospital today for more tests.Had Tetanus shot several days AFTER Yellow Fever immunization.

VAERS ID:224270 (history)  Vaccinated:2003-04-12
Age:20.0  Onset:2003-04-13, Days after vaccination: 1
Gender:Male  Submitted:2004-07-07, Days after onset: 451
Location:D.C.  Entered:2004-07-23, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS  SC 
Administered by: Military     Purchased by: Military
Symptoms: Discomfort, Erythema, Fatigue, Feeling hot, Headache, Injection site erythema, Injection site oedema, Injection site pain, Myalgia, Skin reaction, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: After his third anthrax vaccine, given in his left triceps area on 4/12/03, he reports waking up the next am with redness, increased warmth and swelling from his shoulder to his elbow, almost the whole circumference of his upper arm. He repots that his skin was stretched tight causing significant discomfort. He called his unit for instruction and was referred to his local VA Medical Center on 4/14/03. (No records of visit available.) Patient reports that he was instructed to elevate his arm, apply ice to the affected area, and to take Ibuprofen. After 2 days, the redness, warmth and swelling began decreasing and was completely resolved within the next week. PFC also reports experiencing a mild headache, generalized muscle aches and fatigue during the first few days following receipt of his third anthrax vaccine. He denies any persistent systemic symptoms. Symptom : edema at injection site 50-120 mm Start: 4/13/2003. Symptom: erythema start: 4/13/2003 Comment: surrounding vaccine site. Symptom: Pain start: 4/13/2003 Comment: at vaccine site

VAERS ID:224318 (history)  Vaccinated:2004-07-19
Age:20.0  Onset:2004-07-19, Days after vaccination: 0
Gender:Male  Submitted:2004-07-23, Days after onset: 4
Location:New York  Entered:2004-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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RAB: RABIES (RABAVERT)CHIRON CORPORATION3300111IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Chills, Discomfort, Influenza like illness, Lymphadenitis
SMQs:
Write-up: A few hours after pre exposure rabies vaccine, (second dose of series)complained of minor lymphatic pain, under arm injection was given in. 8 hours later had chills, felt like had the flu. Then fell asleep. 48 hours still has lymphatic discomfort.

VAERS ID:224412 (history)  Vaccinated:2004-06-24
Age:20.0  Onset:2004-06-24, Days after vaccination: 0
Gender:Female  Submitted:2004-07-27, Days after onset: 33
Location:Arizona  Entered:2004-07-28, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tuberculin
Current Illness: UNK
Preexisting Conditions: The patient''s medical history was notable for visual disturbances and fatigue following administration of Vicoden. The patient''s concurrent conditions and concurrent medications were not reported. Patient wears glasses for night driving and distance vision.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0516193A
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5540A20IMLA
Administered by: Other     Purchased by: Other
Symptoms: Condition aggravated, Dizziness, Eye pain, Fatigue, Headache, Visual disturbance
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: This case was reported by a nurse and described the occurrence of vision disturbance in a 20 year old female patient who received hepatitis B vaccine recombinant. The patient''s medical history was notable for visual disturbance and fatigue following administration of Vicoden, and myopia corrected with glasses. On 6/24/04, the patient received the first dose of Engerix-B (lot ENG5540A2). On the same day, the patient received a Tuberculin skin test. At an unspecified time following the administration of Engerix-B, on 6/24/04, the patient experienced reduced visual acuity, vision disturbances characterized as haziness and feeling of pressure in both eyes, fatigue, headache, and dizziness. The patient sought medical attention, however, no lab tests or vision tests were performed. The events resolved on 6/25/04. Comment: Reduced visual acuity was assessed as medically serious (OMIC).

VAERS ID:224575 (history)  Vaccinated:2004-07-20
Age:20.0  Onset:2004-07-28, Days after vaccination: 8
Gender:Male  Submitted:2004-07-30, Days after onset: 2
Location:California  Entered:2004-07-30
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
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0800SCRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130IDLA
Administered by: Military     Purchased by: Military
Symptoms: Cow pox, Headache, Malaise, Nausea, Rash vesicular
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: 8 days after anthrax and smallpox vaccines, developed vesicular rash on trunk, neck, scalp and bilateral upper extremities. Patient was afibrile and had no other symptoms. Was see in Emergency Room and diagnosed as generalized vaccinia. He was hospitalized because he lived in an open-bay barracks and was felt to be infectious. Follow up from Hospital Discharge: headache, nausea, malaise.

VAERS ID:224690 (history)  Vaccinated:2003-12-18
Age:20.0  Onset:2003-12-18, Days after vaccination: 0
Gender:Male  Submitted:2003-12-19, Days after onset: 1
Location:South Carolina  Entered:2004-08-03, Days after submission: 227
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: NONE Treated with Prednisone
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0812SCLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUB475AA0SCLA
Administered by: Military     Purchased by: Military
Symptoms: Periorbital oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: Pt had moderate to severe periorbital swelling and truncal urticarial rash approximately 3-4 hours after receiving yellow fever (1st shot) and Anthrax #3 both left arm

VAERS ID:224942 (history)  Vaccinated:2003-11-19
Age:20.0  Onset:0000-00-00
Gender:Unknown  Submitted:2004-07-30
Location:Unknown  Entered:2004-08-05, 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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0311USA02445
Vaccination
Manufacturer
Lot
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.   UN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a RN concerning a 20 year old pt who on 11/19/03, "three days ago" was vaccinated with a dose of pneumococcal 23v polysaccharide vaccine. The pt complained of redness, pain and swelling of arm at injection site that was "getting worse". Treatment included application of hydrocortisone cream and antihistamines and there was no change in symptoms. It was noted that reporter placed the call on hold when asked for specific information and then disconnected the call. No further information is expected.

VAERS ID:225151 (history)  Vaccinated:2004-08-06
Age:20.0  Onset:2004-08-06, Days after vaccination: 0
Gender:Male  Submitted:2004-08-07, Days after onset: 1
Location:Unknown  Entered:2004-08-07
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':
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 0SCRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: nausea, diarrhea, muscle aches, fever,

VAERS ID:225264 (history)  Vaccinated:2004-07-23
Age:20.0  Onset:2004-07-26, Days after vaccination: 3
Gender:Female  Submitted:2004-07-27, Days after onset: 1
Location:Montana  Entered:2004-08-10, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol inhaler as needed;
Current Illness: NONE
Preexisting Conditions: Asthma;
Diagnostic Lab Data: 07/30/04: Telephone call to pt symptoms have resolved.
CDC 'Split Type': MT0404
Vaccination
Manufacturer
Lot
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Site
JEV: JAPANESE ENCEPHALITIS (JE-VAX)AVENTIS PASTEUREJN213A1SCLA
Administered by: Public     Purchased by: Private
Symptoms: Eyelid oedema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: On 07/27/04, pt woke up in AM with swollen right eyelid and one large hive on site of Japanese Encephalitis injection. Stated she "felt funny" going to bed on 07/26. Pt had a history of allergic reactions and has taken Claritin-hives medication with effective results. She did not want to take Benadryl. Advised pt to take Claritin-hives medication and if symptoms worsen to contact MD or if any respiratory involvement to go to the ER ASAP. Pt agreed sent pt fact sheet on Japanese Encephalitis vaccine. Per pt applied topical cortisone to site of injection to relieve itching.

VAERS ID:225431 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Unknown  Submitted:2004-08-15
Location:Washington  Entered:2004-08-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data: PCR + EM + HSV - negative
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH   UN
Administered by: Military     Purchased by: Military
Symptoms: Blister, Infection transmission via personal contact, Influenza like illness
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: Secondary Transmission Nonvaccinee Limited information available regarding vaccinee, date of vaccine, onset of symptoms, etc. Primary vaccinee is in the military and has since deployed. Reports from Health Dept. came in around October 2003. Had intimate contact with female who later devleoped flu-like symptoms, followed by the appearance of blisters on her uppper legs and genital area. Initially was told by her doctor that she had herpes, but culture came back negative. Contact changed vaccination site bandage a couple of times; admits to showering and sleeping together with site not covered.

VAERS ID:225538 (history)  Vaccinated:2004-08-13
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2004-08-17
Location:Texas  Entered:2004-08-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pregnancy
Preexisting Conditions: none known
Diagnostic Lab Data: Qualitative HCG with a positive result.
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0864SCLA
Administered by: Military     Purchased by: Military
Symptoms: Laboratory test abnormal, Medication error, Unintended pregnancy
SMQs:, Normal pregnancy conditions and outcomes (narrow)
Write-up: Patient reported to the clinic to receive her 5th Anthrax vaccine that was due in a series of 6 vaccines. The vaccine was administered after verifying that she was not allergic and had not previously had adverse reactions to vaccines or immunizations. Pregnancy was not verified beforehand. A Qualitative HCG test was ordered afterwards and the result was positive for pregnancy. The patient''s physician was notified at that time. She was seen by the doctor who counseled her about the pregnancy and advised that she would be referred offbase to begin her Obstetrical care. There has been no adverse reaction reported at this time.

VAERS ID:225760 (history)  Vaccinated:2003-12-06
Age:20.0  Onset:2003-12-07, Days after vaccination: 1
Gender:Male  Submitted:2004-08-17, Days after onset: 253
Location:Georgia  Entered:2004-08-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Aspirin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0731SCLA
Administered by: Other     Purchased by: Unknown
Symptoms: Influenza like illness
SMQs:
Write-up: Flu symptoms. Seen by private MD and strongly recommend not to get shot again.

VAERS ID:225767 (history)  Vaccinated:2004-08-09
Age:20.0  Onset:2004-08-13, Days after vaccination: 4
Gender:Female  Submitted:2004-08-17, Days after onset: 4
Location:Florida  Entered:2004-08-24, 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: Paxil
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5587A20IMRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site inflammation, Nausea, Pyrexia, Shoulder pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 8/13/04 Right shoulder pain, nausea, fever; used Aleve. 8/14/04 Seen in ER, right shoulder pain, no ecchymosis, no swelling, given sling and Vicodin PO. 8/16/04 Seen at family practice; tissue inflammation. Referred to specialist if needed.

VAERS ID:225805 (history)  Vaccinated:2004-08-06
Age:20.0  Onset:2004-08-16, Days after vaccination: 10
Gender:Male  Submitted:2004-08-24, Days after onset: 8
Location:D.C.  Entered:2004-08-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Recovering from sinus infection
Preexisting Conditions: Allergic to codiene
Diagnostic Lab Data: ECG, cardiac enzymes, inflammatory markers as per Myopericarditis protocol (ECG reported as normal)
CDC 'Split Type':
Vaccination
Manufacturer
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Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710 LA
Administered by: Military     Purchased by: Military
Symptoms: Chest discomfort, Erythema, Fatigue, Injection site hypersensitivity, Injection site oedema, Injection site vesicles, Lymphadenopathy, Night sweats, Pain, Pyrexia, Swelling, Vaccination complication
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Primary smallpox vaccinee;received SPV on 8/6/03. On Day 10, awoke with chest tightness in center of chest with inhalation; rated pain as level 4/10 on pain scale of 0-10; pain resolved spontaneously after about 15 minutes. On day 11, noted erythema, mild swelling under tape adhesive. Temp 101.8. Complained of fatigue, and night sweats. Evaluated by doctor on 8/18/04, who noted left axillary lymphadenopathy and 3x3" area of well-defined, erythematous, edematous area at vaccine site; (+) vesicle and numerous small satellite lesions. "Robust take" Placed on quarters x 24 hours. Started Allegra 180mg daily and Motrin 800mg 3x/day. Called patient on 8/24/04. No recurrence of CP. Fever, fatigue and local reaction have resolved.

VAERS ID:225829 (history)  Vaccinated:2004-07-13
Age:20.0  Onset:2004-07-13, Days after vaccination: 0
Gender:Female  Submitted:2004-07-19, Days after onset: 6
Location:Louisiana  Entered:2004-08-25, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Orthotricyclen;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Testing reporting by pt: CT scan, EKG, Pregnancy Test and Drug test;
CDC 'Split Type':
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5446A42IMRA
Administered by: Public     Purchased by: Other
Symptoms: Convulsion, Eye movement disorder, Fatigue, Headache, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (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 (narrow)
Write-up: Phone call from pt on 07/14/04. Was seen in our Family Planning Medical Clinic the day before and received her 3rd HBV (the 1st of the adult formulation). Felt tired when she left the clinic about 14:30 or 15:00. Went home and had lunch. Went over to visit friends and chatted outside in the sun. Felt hot and went to porch to continue visit, felt weak and "passed out and seizured". This occurred about 18:30. Friends put her into their truck and were driving to the hospital when her eyes rolled back and she started to have more seizure activity. They became apprehensive and called 911 for assistance. Remembers waking up as the paramedics arrived and that she had a severe headache. At the hospital, continued IV and had testing done. MD interviewed friends, reviewed test results and told pt the test results were all fine and the seizure was from the shot. 07/15/04, spoke with pt midday, stated she still did not feel well. PMD had advised to seek follow up prior to leaving hospital. Reminded of options of care. Plans to go to hospital today. 15:20 spoke to a friend, states on the way to the hospital fainted twice. The hospital has requested the records from her last ER visit and they are waiting for the information now at the Medical Center.

VAERS ID:226035 (history)  Vaccinated:2004-08-23
Age:20.0  Onset:2004-08-29, Days after vaccination: 6
Gender:Male  Submitted:2004-08-30, Days after onset: 1
Location:California  Entered:2004-08-30
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: PCN, ASA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130IDLA
Administered by: Military     Purchased by: Unknown
Symptoms: Pain, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: fever,body aches,loc for about 20 min.

VAERS ID:226043 (history)  Vaccinated:2004-08-26
Age:20.0  Onset:2004-08-28, Days after vaccination: 2
Gender:Female  Submitted:2004-08-30, Days after onset: 2
Location:New York  Entered:2004-08-30
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: COMA, SEIZURES~Measles + Mumps + Rubella (unknown mfr)~1~12~In Patient
Other Medications: Benadryl;
Current Illness: NONE
Preexisting Conditions: ALLERGIC TO VACCINES, CLINIC WAS ADVISED PRIOR; Many environmental allergies;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURERMSD1179M1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Dyspnoea, Pyrexia, Rash, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: rash, fever, joint pain, rapid heart beat, hard to breathe

VAERS ID:226390 (history)  Vaccinated:2004-08-30
Age:20.0  Onset:2004-09-01, Days after vaccination: 2
Gender:Male  Submitted:2004-09-08, Days after onset: 7
Location:Unknown  Entered:2004-09-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0875SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: TWO DAYS AFTER RECEIVING ANTHRAX #6 PATIENT EXPERIENCED REDNESS AND SWELLING COVERING ENTIRE RIGHT TRICEP. NO AXILLARY LYMPHADENOPATHY, NOR STREAKING REDNESS.

VAERS ID:226421 (history)  Vaccinated:2004-08-23
Age:20.0  Onset:2004-08-25, Days after vaccination: 2
Gender:Female  Submitted:2004-09-01, Days after onset: 7
Location:New York  Entered:2004-09-09, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU0991AA   
Administered by: Other     Purchased by: Unknown
Symptoms: Erythema, Injection site induration, Medication error
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: In error: Administered 0.1 ml Td ID instead of PPD. Left forearm 20 mm x 20 mm erythema 10 mm induration.

VAERS ID:226507 (history)  Vaccinated:2004-09-07
Age:20.0  Onset:2004-09-07, Days after vaccination: 0
Gender:Female  Submitted:2004-09-10, Days after onset: 3
Location:Montana  Entered:2004-09-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: passed out after injection;Measles + Mumps (MM-Vax);2;19;In Sibling
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0326N0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cold sweat, Convulsion, Hypoxia, Loss of consciousness, Malaise, Pallor, Urinary incontinence
SMQs:, Torsade de pointes/QT prolongation (broad), Asthma/bronchospasm (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), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Administered Varivax in outer aspect of right upper arm with patient lying on floor due to reported history of passing out with injections. The patient remained on the floor after the shot and was talking to parents and RN. Approximately 2 minutes after the injection the patient stated she felt funny. While still lying on the floor, she started moaning, pulling her arms to center and neck became rigid. Her skin color was pale and clammy, she lost control of her bladder, her pulse was 60 and regular. The RN started adminsitering O2, the ambulance was called. Patient quickly was able to respond to verbal commands. Patient received O2 at 6 liter/minute for 15 minutes, her pulse remained stable at 60. The parents of the patient requested to ahve ambulance remian on stand-by and not transport patient. Patient was able to leave clinic ambulating with assistance. She was instructed to follow-up immediately with health care provider and referred to neurologist for seizures.

VAERS ID:226837 (history)  Vaccinated:2004-09-10
Age:20.0  Onset:2004-09-10, Days after vaccination: 0
Gender:Male  Submitted:2004-09-13, Days after onset: 3
Location:New York  Entered:2004-09-21, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEUR264AA0 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt developed itchy rash on right forearm approximately 6-8 hours after vaccine administration 9/10. Developed rash 9/11 with swollen oozing LL erythematous rash to face, neck, right arm. Penis/ Scrotum.

VAERS ID:226984 (history)  Vaccinated:2004-09-02
Age:20.0  Onset:2004-09-11, Days after vaccination: 9
Gender:Male  Submitted:2004-09-14, Days after onset: 3
Location:California  Entered:2004-09-24, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710 LA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Erythema, Headache, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: Headache, fever, extremely weak, red rashy spots here and there.

VAERS ID:227086 (history)  Vaccinated:2004-09-16
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2004-09-21
Location:Maryland  Entered:2004-09-28, 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:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1179N0IM 
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Hypersensitivity, Pyrexia, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Delayed hypersensitivity Rxn with large erythematous, well demarcated patch 12x6cm very tender, plus fever.

VAERS ID:227227 (history)  Vaccinated:2004-09-27
Age:20.0  Onset:2004-09-28, Days after vaccination: 1
Gender:Female  Submitted:2004-09-30, Days after onset: 2
Location:Nebraska  Entered:2004-09-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None. Doctor''s visit was for a PPD skin test needed for nursing school.
Preexisting Conditions: Sulfa
Diagnostic Lab Data:
CDC 'Split Type':
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TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER  IDLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site inflammation, Medication error, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: As a result of the accidental intradermal tentanus instead of PPD, I had to go back to the doctor''s office. I was put on Prednisone and a steroid cream because of the redness and infammation. I suffered shooting pain into my pinkie and ring finger and tingling in my hand, I believe as a result to how low the shot was givin. The "skin test" was administered two inches above my wrist. It is my belief that this should be somewhat farther from my wrist. When I went back to receive my actual test the other arm was brushed aside and no one really wanted to look at it. Whne I asked what had happened they simply said, "Oh she just grabbed the wrong thing."

VAERS ID:227246 (history)  Vaccinated:2004-09-14
Age:20.0  Onset:2004-09-14, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Wisconsin  Entered:2004-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0841SC 
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Dizziness, Nausea, Tenderness, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Nausea, vomiting, dizziness, weakness, tender at injection site. Occurred after administration of 2nd Anthrax vaccine. Other roommates bad similar symptoms.

VAERS ID:227339 (history)  Vaccinated:2004-09-29
Age:20.0  Onset:2004-09-30, Days after vaccination: 1
Gender:Female  Submitted:2004-10-04, Days after onset: 4
Location:Michigan  Entered:2004-10-04
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: Erythromycin-rash
Diagnostic Lab Data: None
CDC 'Split Type':
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MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURVB487AA0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site inflammation, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Received Meningitis shot on 09/29/04 and came to Health Services on 10/01/04 with complaint of tender, reddened arm at site of injection. No fever. NP saw student and recorded 6 cm diameter inflamed site, Right upper arm. No induration. Recommended cool compresses, Ibuprofen q 6 hours prn. To return to center if fever, pain, increase firmness to site.

VAERS ID:227524 (history)  Vaccinated:2000-06-20
Age:20.0  Onset:2001-04-02, Days after vaccination: 286
Gender:Female  Submitted:2004-10-07, Days after onset: 1284
Location:California  Entered:2004-10-07
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pregancy
Preexisting Conditions: No menstrual cycle
Diagnostic Lab Data: Auto Immune Disorder Molliscum Contagious Alopecia Agreta
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS   UN
Administered by: Military     Purchased by: Unknown
Symptoms: Foetal disorder, Medication error, Unintended pregnancy
SMQs:, Foetal disorders (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: My wife and I were stationed at a base. She was ordered to get Anthrax Shot. She told Clinic Personnel she may be pregnant. They did Blood and Urine test and told her it was negative for pregancy. She stated, her body didn''t feel right and she didn''t want the shot. The did an Ultrasound in which they said she had a cyst on her ovaries. She was informed she would be charged with disobeying a lawful order if she refused to get the shot. She accepted to take it. 2 Weeks later, the Clinic called her and related she needed to report to the Clinic ASAP because they mixed her test up with someone else and that she was indeed pregnant. They further related the Cyst was indeed the baby. I went with her in which the Medical Commander and her staff told us they wanted her to get an abortion because of the Anthrax shot. It should be noted she was approx 6 weeks pregnant at the time of the shot. We said no. First thing I did was make a copy of the Medical and shot Records. Military now says there copys are lost. (I have mine). During her 6 month check up, my civillan DR. did an ultrasound in which he says the baby had a cyst or growth on his brain stem. After his birth, they did another ultra sound which still showed the growth, and that it was still the same size. From birth to present, he was always sick. He had surgery at 2 months and had 3 inches of his intestines removed. He was admitted to the Hospital for 10 days at 8 months due to respitory problems. Whenever he got a cold he got really sick with it. My son is now 3 YOA, During this past summer, my wife and I noticed bumps on his trunk and down his left arm. The Dr said he had Molliscum Contagious. He still has abouth 50 little growths on his body. About a month later, we noticed his hair looked thinner, and it actually was falling out. A look at his scalp revealed bald spots. He was diagnosed with Alopecia areata. Furthermore, during the last month he developed a major stuttering problem. The Dr said it appears he has an Auto Immune disorder which made the Molliscum and Alpecia appear. Doing research, I noticed the Anthrax vaccine causes Auto immune disorder''s along with documented cases of Alopecia. I was wondering if my wifes shot while pregnant is causing all these problems with my child. I contacted the Military Surgeons General Office along with the CDC and they both stated there are no known cases of anyone who received the Anthrax shot while pregnant and actually had the baby. They said every noted case ended in a miscarriage. I informed them "You got a noted case now." I was informed by both of them to notify you via this report. Our Civillian Dr is currently establishing a connection between my sons numerous medical problems and the Anthrax Vaccine. He is scheduled to get another CAT scan on his skull to check the status of his growth on the brain stem. WE both found numerous cases on the internet in which people who had the anthrax shot has the same medical problems my son is having now. Any input would be greatly appreciated as I am now extremely concerned and worried about what may happen next to my son. Please contact me with any information.

VAERS ID:227600 (history)  Vaccinated:2004-09-14
Age:20.0  Onset:2004-09-14, Days after vaccination: 0
Gender:Female  Submitted:2004-09-28, Days after onset: 14
Location:New York  Entered:2004-10-11, Days after submission: 13
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
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RAB: RABIES (RABAVERT)CHIRON CORPORATION3350111IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Aphthous stomatitis, Pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Day of second dose : achiness in arm, chest and leg of side of body where vaccine administered. Several days later: developed several aphthous ulcers. Treated with ibuprofen. Pain x 2 days.

VAERS ID:227724 (history)  Vaccinated:2004-09-22
Age:20.0  Onset:2004-10-01, Days after vaccination: 9
Gender:Male  Submitted:2004-10-02, Days after onset: 1
Location:Unknown  Entered:2004-10-14, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH403003130 RA
Administered by: Military     Purchased by: Military
Symptoms: Cow pox, Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: Generalized vaccinia, diffuse maculopapular rash on torso and extremities with vaccine site as exposed for 10 day smallpox vaccine site. Treated by conservative measures. Quarters x 72 , Tylenol, Benadryl, Calamine Lotion, Rest.

VAERS ID:227834 (history)  Vaccinated:2004-10-06
Age:20.0  Onset:2004-10-14, Days after vaccination: 8
Gender:Male  Submitted:2004-10-15, Days after onset: 1
Location:Texas  Entered:2004-10-15
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: None done.
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Influenza like illness, Injection site erythema, Pyrexia, Tenderness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad)
Write-up: Increased erythema at vaccination site, Left upper arm, and slight to mild tenderness of left axilla. Patient complaining of flu like symptoms, low grade fever, lightheadedness.

VAERS ID:227842 (history)  Vaccinated:2004-07-28
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2004-10-17
Location:Unknown  Entered:2004-10-17
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':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0801SCUN
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 2IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error, Unintended pregnancy
SMQs:, Normal pregnancy conditions and outcomes (narrow)
Write-up: Pt had anthrax vaccine administered and found out she was pregnant the next day.

VAERS ID:227871 (history)  Vaccinated:2004-09-07
Age:20.0  Onset:2004-09-07, Days after vaccination: 0
Gender:Female  Submitted:2004-10-15, Days after onset: 38
Location:New York  Entered:2004-10-18, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair QSC/ 50 bid
Current Illness: NONE
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0945M SCLA
Administered by: Unknown     Purchased by: Private
Symptoms: Dizziness, Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Vomiting x 8 hours past MMR. To go next Dec for 1 more. Headache and dizziness

VAERS ID:227892 (history)  Vaccinated:2004-09-17
Age:20.0  Onset:2004-10-01, Days after vaccination: 14
Gender:Female  Submitted:2004-10-18, Days after onset: 17
Location:New York  Entered:2004-10-18
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: none
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1 UN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blister, Erythema, Pyrexia, Rash papular
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad)
Write-up: Patient received vaccine on 9/17/2004; developed red papules and vesicles on 10/1/04; afebrile. Seen in office on 10/2/04-T100.1(ax), vesicles (few) and papules over trunck, arms, legs (few). Dx made of varicella vaccine reaction. General support for fever. Home quarantine.

VAERS ID:228066 (history)  Vaccinated:2004-02-27
Age:20.0  Onset:2004-04-16, Days after vaccination: 49
Gender:Male  Submitted:2004-09-20, Days after onset: 157
Location:Virginia  Entered:2004-10-21, Days after submission: 31
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: Asthma
Diagnostic Lab Data: Persistently low platelet counts since previously normal platelet counts
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSVHA776C60IMLA
Administered by: Other     Purchased by: Public
Symptoms: Platelet count decreased, Thrombocytopenic purpura
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad)
Write-up: Developed thrombocytopenia purpura within 6 weeks of administration of vaccine.

VAERS ID:228159 (history)  Vaccinated:2004-10-20
Age:20.0  Onset:2004-10-21, Days after vaccination: 1
Gender:Female  Submitted:2004-10-22, Days after onset: 1
Location:Unknown  Entered:2004-10-22
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: None.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0873SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site induration, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, swelling of left arm. Erythema/induration measures 17.5cm up and down and 15.5cm left to right. Left arm is 2cm larger than right. Measured 14cm proximal to olecranan.

VAERS ID:228158 (history)  Vaccinated:2004-10-16
Age:20.0  Onset:2004-10-16, Days after vaccination: 0
Gender:Female  Submitted:2004-10-16, Days after onset: 0
Location:Washington  Entered:2004-10-25, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Migraines (can cause leg numbness), TMJ)
Diagnostic Lab Data: Pt with injection at 1:33PM pt with numbness/tingling left arm at 14:40. Pt with and strength and sensation on exam. Pt discharged to home, ice, pain reliever, antihistamine. If still experiencing sx in AM then pt to go to sick call. Go to ED if worse.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVA059AA2IMLA
Administered by: Military     Purchased by: Military
Symptoms: Hypoaesthesia, Hypokinesia, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pain 8/10 L shoulder to Left elbow. Numbness and Tingling Left shoulder to Left elbow inner arm. Lateral up/down movement increases pain. Grips L < R. No meds taken (aspirin based allergy: hives, breathing difficulty) No Tx.

VAERS ID:228505 (history)  Vaccinated:2004-10-24
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2004-10-24
Location:Maryland  Entered:2004-11-01, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0871SCLA
Administered by: Other     Purchased by: Military
Symptoms: Unevaluable event
SMQs:
Write-up: Pt was given 2 ANTHRAX shots within 5 minutes of each other each 0.5cc. No signs of Adverse reactions. Consulted with infectious disease LT.

VAERS ID:228792 (history)  Vaccinated:2003-02-08
Age:20.0  Onset:2003-04-16, Days after vaccination: 67
Gender:Male  Submitted:2004-10-16, Days after onset: 549
Location:D.C.  Entered:2004-11-04, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Cardiac failure congestive, Cardiomyopathy, Dyspnoea, Hepatitis, Hypoxia, Joint swelling, Oedema peripheral, Pyrexia, Skin exfoliation, Skin ulcer, Systemic lupus erythematosus
SMQs:, Cardiac failure (narrow), Hepatitis, non-infectious (narrow), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: 4/15/03 Temp 103, noted mosquito bite like lesions on back of hand. 4/16/03 Continued fever, lesions fading, hands started swelling. 4/17/03 Increased swelling of hands; new onset swelling of ankles, knees, and neck. Pain in upper abdominal quadrants radiating to back. Abdominal fullness noted. Dark urine. Seem and treated for viral syndrome with fluids and Tylenol. 4/30/03 New onset SOB. Hospitalized. Treated with antibiotics, breathing treatments, and O2. Fever and swelling continued. Evidence of CHF. Pain now localized to LUQ, with normal LFTs, elevated LFT''s. Negative for mono. Negative ANA. Symptoms gradually diminished over 3 week period. After rash on hands resolved, experienced peeling of skin on hands and elbows. Dyspnea at rest related to cardiomyopathy, improving. Hepatitis, unknown etiology, resolving. Acute onset illness/Lupus-type reaction temporally associated with multiple vaccinations. Follow up 01/27/05: Recovery status unknown, lost to follow up. Follow up 02/03/05: Recovery status unknown, lost to follow up.

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