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VAERS ID: 25021 (history)  
Age: 32.0  
Gender: Female  
Location: Florida  
Vaccinated:1990-06-08
Onset:1990-06-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RUB: RUBELLA (MERUVAX II) / MERCK & CO. INC. 2359R / - - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Arthralgia, Bradycardia, Chills, Hypotension, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: /p receiving vaccine developed headache, sorejoints, chills, sternal chest pain, low grade fever, low blood pressure & low heart rate, chills again, relief lasted about 2-2.5 hrs. I have not found the low B/P & HR documented.


VAERS ID: 25022 (history)  
Age: 0.2  
Gender: Female  
Location: Maryland  
Vaccinated:1990-04-26
Onset:1990-04-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271911 / - - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Agitation, Injection site reaction, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever 102 F. local adenopathy, screaming episode & local reaction


VAERS ID: 25023 (history)  
Age:   
Gender: Male  
Location: Pennsylvania  
Vaccinated:1989-10-23
Onset:1989-12-07
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: receiving gold therapy for rhematiod arthritis
Current Illness: URI
Preexisting Conditions: rhematoid arthritis
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt has URI prior to onset of Guillian-Barre symptoms. He has rheumatoid arthritis & was receiving gold therapy concurrently. He was given the flu vaccine on 23Oct89


VAERS ID: 25024 (history)  
Age:   
Gender: Unknown  
Location: New Hampshire  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4898197 / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Injection site reaction, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore edema on arms massive redness from top of shoulder to elbows. More than the usual expected reaction. Just started using the DT two weeks ago. All reactions during this period 6 out of 30 patients.


VAERS ID: 25025 (history)  
Age:   
Gender: Unknown  
Location: Florida  
Vaccinated:0000-00-00
Onset:1990-01-10
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9J01133 / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: treated with Hydroxazine
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: rash, pruritus


VAERS ID: 25026 (history)  
Age: 1.0  
Gender: Male  
Location: Washington  
Vaccinated:1990-01-12
Onset:1990-01-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 229974 / - - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 9A11092 / - - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 244970 / - - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Died? Yes
   Date died: 1990-01-14
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: child found dead in bed 14Jan90. Had full check up 12Jan90 with immunizations DPT/HIB/Oral Polio


VAERS ID: 25027 (history)  
Age: 1.0  
Gender: Female  
Location: New York  
Vaccinated:1990-05-29
Onset:1990-05-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1022S / - - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever 102.5 F, rash


VAERS ID: 25028 (history)  
Age: 2.0  
Gender: Male  
Location: Tennessee  
Vaccinated:1989-05-24
Onset:1990-06-24
   Days after vaccination:396
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 8L01022 / - - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Meningitis
SMQs:, Noninfectious meningitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? Yes
   Date died: 1990-06-25
   Days after onset: 1
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt admitted with H-Flu meningitis on 24Jun90. Pt expired on 25Jun90. Pt received HIB vaccine at 18 months of age.


VAERS ID: 25029 (history)  
Age: 0.5  
Gender: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:1990-04-02
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9M01012 / - RL / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: p/ receiving DPT #2 infant developed fever 103.4 for 4 days and extreme lethargy


VAERS ID: 25030 (history)  
Age: 66.0  
Gender: Female  
Location: New York  
Vaccinated:1989-12-01
Onset:1989-12-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01202 / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Encephalitis, Guillain-Barre syndrome, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (narrow), Demyelination (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Lisinopril 20mg, Verapamil 120mg, HCTZ 25mg, Thyrolar
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Mylagias occurred within 3 days of immun. Seen on 4 additional occasions for continued pain & increasing eye/temporal pain. Considered poss. meningoencephalitis due to vaccine. Admit to hosp for Guillain-Barre Synd. on 15Feb90.


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