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Found 500133 cases where Symptom is Immune system disorder or Immunodeficiency or Immunoglobulins decreased or Lymphadenopathy

Case Details (Sorted by Age)

This is page 304 out of 501

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VAERS ID:220397 (history)  Vaccinated:2004-01-22
Age:21.0  Onset:2004-01-29, Days after vaccination: 7
Gender:Female  Submitted:2004-05-17, Days after onset: 108
Location:Unknown  Entered:2004-05-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: DENIES
Preexisting Conditions: NONE
Diagnostic Lab Data: Diagnostic evaluation revealed ANA SCR positive at $g/+1:160, ANA titer borderline at 1:80, ESR normal at 8, RF negative, CRP 3.48. WBC 7.4, H/H 12/36, Plat 304. Sickle cell trait neg, STD: neg, RPR neg. Routine right and left hand x-rays were normal with no evidence of inflammatory arthropathy. MRI of left hand reports unremarkable except for minimal subcutaneous edema involving the dorsum of the hand (area of pain pt c/o). MRI right hand reports no evidence of erosive arthritis.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0801SCLA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300131 RA
Administered by: Military     Purchased by: Military
Symptoms: Antinuclear antibody, Hypoaesthesia, Hypokinesia, Injection site pain, Injection site swelling, Laboratory test abnormal, Lymphadenopathy, Muscular weakness, Musculoskeletal stiffness, Oedema peripheral, Pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: Patient is a 21-year-old who received her first Anthrax and primary Smallpox vaccination on 22 January 2004. She demonstrates that she received her Anthrax in the LEFT tricep and Smallpox vaccination in her RIGHT deltoid. She initially reports mild swelling and pain at each injection site but no substantial swelling or erythema occurring 7-10 days after her vaccinations. Approximately 1 to 1 « weeks after immunizations, upon waking she noticed mild swelling in both her hands and wrists that ached with movement. Associated symptoms included axillary lymphandenopathy, left greater than right, stiffness in neck, posteriorly and laterally, and difficulty removing rings from her hands. She was given her second Anthrax vaccination on 23Jan04. She again demonstrates vaccine given in the right tricep. Her previous symptoms persisted causing her to report to sick call on 2 February 2004 where she was advised that she was experiencing a mild reaction to immunizations and was prescribed Indocin 25mg 1-2 every 12 hours. Her symptoms continued as a constant ache that never stopped. The ache varied in intensity from 3-4/10 to 7/10 (today). Movement, lifting, prolonged use of hands and arms triggers feelings of weakness, numbness and tingling that reportedly extended to her elbows, limiting her ability to work on board ship. She was medi-vaced for further evaluation and treatment.

VAERS ID:220614 (history)  Vaccinated:1999-03-11
Age:21.0  Onset:2003-04-21, Days after vaccination: 1502
Gender:Female  Submitted:2004-05-14, Days after onset: 389
Location:Unknown  Entered:2004-05-18, 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: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: serum varicella zoster, 04/21/03, negat, "no immunity"
CDC Split Type: WAES0304USA02590
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a RN concerning a 21 y/o female pt with no relevant medical history who on 28Jan1999 and 11Mar1999 received a first and second dose of varicella virus vaccine live (lot number unk), respectively. There was no illness at the time of vaccination. There was not concomitant medication. On 21Apr2003, a titer for varicella was completed and results were negative (results previously reported as "no immunity". It was also noted that there were no "problems" with the vaccine and no side effects. Unspecified medical attention was sought. No further information is expected.

VAERS ID:221237 (history)  Vaccinated:2004-05-12
Age:21.0  Onset:2004-05-12, Days after vaccination: 0
Gender:Female  Submitted:2004-05-12, Days after onset: 0
Location:Virginia  Entered:2004-05-21, 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: NONE
Current Illness: NONE
Preexisting Conditions: Allergy to Decadron;
Diagnostic Lab Data: NONE
CDC Split Type: VA04016
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5466A40IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Muscle spasms, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Pt received Hep B Aelurt dose #1. No dyspnea. Reports hives (generalized), lightheadedness, and cramps several hours later. Questions allergic reaction to Hep B: To take Benadryl.

VAERS ID:221794 (history)  Vaccinated:2004-01-07
Age:21.0  Onset:2004-01-20, Days after vaccination: 13
Gender:Female  Submitted:2004-05-14, Days after onset: 114
Location:Texas  Entered:2004-05-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: height: 65 inches. body temp: 1/20/04: 104fever, 1/21/04: 101.2fever, 01/22/04: afebrile. body weight: 200
CDC Split Type: WAES0401USA01585
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0570N0SC 
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Pyrexia, Tenderness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from an occupational health registered nurse concerning a 21 year old black female patient care assistant with no allergies, no history of chicken pox and no medical history on 07JAN2004 was vaccinated subcutaneously in the left arm with a 0.5ml first dose of varicella virus vaccine live. There was no concomitant medication. On the night of 20JAN2004 the patient stated her temp was as high as 104F. On 21JAN2004 the patient was seen in the office with a fever of 101.2F and a sore, swollen, hard and slightly red, 2-3 diameter area (silver dollar size) around the injection site. There were no lesions at the time of report. The patient was advised to take acetaminophen (Tylenol) for an elevated temperature and discomfort, apply warm compresses to her left upper arm for discomfort and was then sent home. She was instructed not to return to work until she was afebrile. No diagnostic lab tests were performed. On 22JAN2004 the patient reported to the occupational health clinic prior to work. She was afebrile, there was no rash or redness and there was a "little" soreness. It was reported that the patient had recovered. No product quality complaint was involved. No further information is expected.

VAERS ID:221840 (history)  Vaccinated:2003-12-16
Age:21.0  Onset:2003-12-16, Days after vaccination: 0
Gender:Female  Submitted:2004-05-14, Days after onset: 149
Location:Ohio  Entered:2004-05-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: Drug hypersensitivity;
Diagnostic Lab Data: NONE
CDC Split Type: WAES0402USA01330
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0767M SC 
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site erythema, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a RN concerning a 21 year old white female with a concurrent condition of allergy to PCN and sulfa who on 12/16/03 between 13:00 and 13:30 was vaccinated in the left deltoid SC with a first dose of varicella virus vaccine live (Lot # 643596/0767M). There was no illness at the time of vaccination. There was no adverse event following prior vaccinations. On 12/16/03, between 13:00 and 13:30 the pt immediately developed pain at the injection site and between 7-8 PM a knot developed described as "blue/red in color 1/2 of a baseball in length and 1/4 inch raised". The pt was diagnosed with cellulitis. On 12/17/03, "the next day", the pt developed more pain in the left arm. On 12/18/03, "two days after vaccination", the pt presented to her physician and she was prescribed antibiotics for 10 days. There were no diagnostic lab tests performed. On approximately 12/30/03, the pt recovered 5-6 days after the onset of symptoms. No further information is expected.

VAERS ID:222250 (history)  Vaccinated:2004-05-31
Age:21.0  Onset:2004-06-01, Days after vaccination: 1
Gender:Male  Submitted:2004-06-01, Days after onset: 0
Location:Unknown  Entered:2004-06-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0784SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site vesicles, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: One day following the vaccine, the patient developed erythema, swelling, and induration in a 4 inch diameter around the injection site. He also developed a few linear vesicles over the site. The area was tender and mildly pruritic. He was treated with atarax, antibiotics, and icepacks. He is scheduled to follow up in 1-2 days.

VAERS ID:222343 (history)  Vaccinated:2003-02-26
Age:21.0  Onset:2003-02-26, Days after vaccination: 0
Gender:Male  Submitted:2004-02-24, Days after onset: 363
Location:New Jersey  Entered:2004-06-03, Days after submission: 99
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: 03AV0013
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0720SCRA
Administered by: Military     Purchased by: Military
Symptoms: Headache, Pyrexia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: Headache and fever (99.2) after receiving vaccination, lasted about one day. Also experienced a sensation of having a swollen throat. All symptoms resolved.

VAERS ID:222358 (history)  Vaccinated:2003-09-09
Age:21.0  Onset:2003-09-10, Days after vaccination: 1
Gender:Male  Submitted:2004-02-18, Days after onset: 161
Location:Michigan  Entered:2004-06-03, Days after submission: 105
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: Environmental allergies.
Diagnostic Lab Data: NONE
CDC Split Type: 03AV0033
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0762SCLA
Administered by: Other     Purchased by: Other
Symptoms: Fatigue, Headache, Pain, Postnasal drip, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: On day following immunization he felt tired and achy. Two days after immunization he also experienced sinus drainage, slight headache and was sleepy. Treatment was rest. All symptoms have resolved.

VAERS ID:222400 (history)  Vaccinated:2003-03-09
Age:21.0  Onset:0000-00-00
Gender:Male  Submitted:2004-06-01
Location:Arizona  Entered:2004-06-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergy to Naprosyn-after taking Naprosyn for approx. 1 1/2 weeks, developed rash on torso, neck and face, difficulty swallowing and breathing, and body tremors. Evaluated at ER in July 2001.
Diagnostic Lab Data: 4/1/04, Ceruloplasmin 19.0 (18-55) 4/1/04 Copper level 790 (590-1180)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0662SCLA
Administered by: Military     Purchased by: Military
Symptoms: Cough, Feeling hot, Influenza like illness, Injection site erythema, Injection site mass, Injection site swelling, Myalgia, Pruritus, Pyrexia, Rhinorrhoea, Sinus congestion, Tenderness, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Bilateral hand tremors. Experienced tenderness surrounding vaccination site, lasting approx. 2 weeks, nickel to quarter sized knot noted at vaccination site lasting approx. 3 weeks. Experienced significant redness, swelling, pruritis, and warmth surrounding vaccination site (about the size of baseball) with onset within 3 days of vaccine and resolution by 2 weeks post vaccination. Experienced flu-like symptoms (rhinorrhea, cough, sinus pressure, generalized myalgias and possibly a fever) approx. 1 weeks following vaccine administration and lasting x 1 week.

VAERS ID:222719 (history)  Vaccinated:2004-06-15
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2004-06-15
Location:Kansas  Entered:2004-06-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5384B61IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: Vaccination expired on 06/12/2004

VAERS ID:222858 (history)  Vaccinated:2002-02-27
Age:21.0  Onset:2002-02-28, Days after vaccination: 1
Gender:Female  Submitted:2003-01-08, Days after onset: 314
Location:Arizona  Entered:2004-06-18, Days after submission: 526
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OVCON 30
Current Illness: NONE
Preexisting Conditions: Asthma, Seasonal Allergies
Diagnostic Lab Data: NONE
CDC Split Type: PCRN02AV0002
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV048B1SCRA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelling from Elbow to armpit, red, very itchy Large local reaction, bottom of arm swelled up.

VAERS ID:223139 (history)  Vaccinated:0000-00-00
Age:21.0  Onset:2003-09-01
Gender:Female  Submitted:2004-05-28, Days after onset: 270
Location:Unknown  Entered:2004-06-22, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Serum measles IgG 09/??/03 negative titer.
CDC Split Type: WAES0309USA02007
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received on 18-Sep-2003 from a registered nurse concerning an approximately 21 year old female who at 15 months of age and at 9 years of age was vaccinated with MMR vaccine live. In early September 2003 at a visit, the patient had a negative titer for measles. The reporter considered the event as vaccine failure. Subsequently, the patient was revaccinated at that visit. The patient reportedly had no untoward effects." Additional information has been requested.

VAERS ID:223204 (history)  Vaccinated:2004-06-17
Age:21.0  Onset:2004-06-18, Days after vaccination: 1
Gender:Female  Submitted:2004-06-18, Days after onset: 0
Location:Missouri  Entered:2004-06-23, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5563A41IMLA
Administered by: Public     Purchased by: Private
Symptoms: Rash maculo-papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: No treatment needed. Vaccine administered at 15:00 on 06/17/04. Awoke in AM with spots mostly on back and abdomen on 06/18/04. Itching client self prescribed hydrocortisone. Client reporter this to Health Department, when ask if it looked like a rash, client stated more like spots.

VAERS ID:223271 (history)  Vaccinated:2003-10-08
Age:21.0  Onset:2004-01-12, Days after vaccination: 96
Gender:Female  Submitted:2004-05-28, Days after onset: 136
Location:Unknown  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: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: Serum immunoglobulin G (01/12/04): less, negative;
CDC Split Type: WAES0401USA01731
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0878M1  
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 21 year old female pt with a unknown medical history who in October 1983 received a dose of MMRII (lot # not reported). On 10/08/03 the pt was vaccinated with a second dose of MMRII (lot # reported as either 643954/0878M or 644151/1002M). On 01/12/04 the pt''s IgG levels were less than 10 which are considered negative by the testing lab. Unspecified medical attention was sought. Additional information has been requested.

VAERS ID:223398 (history)  Vaccinated:2004-06-24
Age:21.0  Onset:2004-06-24, Days after vaccination: 0
Gender:Female  Submitted:2004-06-25, Days after onset: 1
Location:Hawaii  Entered:2004-06-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 10mg. x 2 months
Current Illness:
Preexisting Conditions: Allergy to Amoxicillin, Bactrim, Ceclor, Each caused a rash.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS805A60IMRA
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUE172AA0SCLA
Administered by: Unknown     Purchased by: Private
Symptoms: Arthralgia, Lacrimation increased, Pruritus, Throat tightness, Tremor
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Lacrimal disorders (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Developed whole body itching about ten hours after shots. Next morning, about 20 hours after shots, had sore joints, watery eyes, tightness in throat, feels shaky, tremorous. Treated with Zyrtec 10mg. p.o. No pharyngeal edema on exam. Lungs clear. Eyes watery. No rash noted.

VAERS ID:223421 (history)  Vaccinated:2004-06-16
Age:21.0  Onset:2004-06-20, Days after vaccination: 4
Gender:Male  Submitted:2004-06-25, Days after onset: 5
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
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020071   
Administered by: Military     Purchased by: Military
Symptoms: Injection site pustule, Pruritus, Rash pustular, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 4 days after the SPV was administered, the patient noticed another lesions located on his neck. The next day, he also noticed 2 small lesions on the opposite upper arm. He complains of pruritus, however, he denies any fever, chills, myalgias, headache, fatigue, vomiting, nausea, vomiting, shortness of breath, chest pains, visual changes. The lesions at time of exam had progressed to the pustule stage and were at the same stage as the primary vaccination site.

VAERS ID:223736 (history)  Vaccinated:2003-02-21
Age:21.0  Onset:2003-02-25, Days after vaccination: 4
Gender:Female  Submitted:2004-07-07, Days after onset: 497
Location:North Carolina  Entered:2004-07-07
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
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0650SCUN
Administered by: Military     Purchased by: Military
Symptoms: Dysphagia, Dyspnoea, Eye swelling, Hypersensitivity, Pruritus, Rash, Similar reaction on previous exposure to drug, Skin hyperpigmentation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Anthrax #1 21 Feb 2003 States that 4 days after her first Anthrax Vaccine she broke out in a rash that started on her abdomen and over a period of 2-3 days it had spread to both her legs and arms. Describes the itchy rash as being flat small circular hyperpigmented areas about the size of a pencil head surrounded by a hypopigmented halo. Denies any changes in shampoos, body sprays, deodorants, soaps, detergents, or foods. States that she was overseas at the time and went to the ER for care. They treated her for a local allergic reaction to a new product even though she denied the use of any new products. Anthrax #2 10 Mar 2003 States that rash was not resolved when they decided to give Anthrax #2. Two days after receiving the vaccination the rash spread up her neck to her face. She states that the itching was so bad that she could not function. The rash was so bad that her eyes were swollen shut, she was unable to swallow and had difficulty breathing. States that she went to the ER where she was placed her on steroids, antihistamines and Motrin. She states that the rash did not start to clear until she was on the medication for 5 days. States that she could not work for the first three days. Anthrax #3 7 Nov 2003 States that with this vaccination she broke out with small flat bumps on her legs again but they seemed to have resolved in one day. States that she only used lotion on these. Denies any fever, headache, muscle or joint pain with any of the three vaccinations. She is currently due for Anthrax #4.

VAERS ID:223777 (history)  Vaccinated:0000-00-00
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2004-07-06
Location:Arkansas  Entered:2004-07-08, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CBC, Strep Screen
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Headache, Laryngospasm, Myalgia, Pain, Pharyngolaryngeal pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Temp 101.8 7/6/04 (Inoculated for yellow fever on 07/01/04) x2days Body ache, Headache- Pain level 9 on 1-10 scale Sore throat, throat swollen (7/1/04 fever decreased feeling better)

VAERS ID:223907 (history)  Vaccinated:2004-06-06
Age:21.0  Onset:2004-06-17, Days after vaccination: 11
Gender:Female  Submitted:2004-07-02, Days after onset: 15
Location:Florida  Entered:2004-07-13, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0808N1SCRA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1185A2IMLL
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Seen at woman''s clinic: Left arm swollen and red x 2 weeks. RN called us. She recommended warm compresses and Motrin (Phone NIS: unable to contact pt for more information).

VAERS ID:224030 (history)  Vaccinated:2004-07-10
Age:21.0  Onset:2004-07-10, Days after vaccination: 0
Gender:Male  Submitted:2004-07-12, Days after onset: 2
Location:New York  Entered:2004-07-16, 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:
Diagnostic Lab Data:
CDC Split Type:
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1020AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Erythema, Influenza like illness, Injection site pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Flu-like symptoms ; fever, chills, injection site pain and redness. 8 hours after administration of vaccines.

VAERS ID:224069 (history)  Vaccinated:2003-03-12
Age:21.0  Onset:2003-03-26, Days after vaccination: 14
Gender:Male  Submitted:2004-07-16, Days after onset: 477
Location:Unknown  Entered:2004-07-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Normal Values 06/22/03 06/27/03 07/07/03 07/16/03 12/10/03 CKMB .18-4.2 0.58 Troponin I 0-0.15 <0.15 <0.15 CPK 55-170 70 355 Glucose 70-120 100 BUN 8-21 12 Creat. 0.7-1.3 0.9 K+ 3.6-5.2 4.1 NA+ 137-148 140 CL- 98-108 103 CO2 22-33 28 CA 8.4-10.5 9.3 AST 15-46 23 LDH 313-618 483 ESR 0-15 6 Cholesterol 100-199 178 HDL 29-67 54 WBC 4.5-10.8 4.6 3.3 3.7 2.8 RBC 4.70-6.20 4.81 4.97 4.81 4.71 Hgb 13.5-17.50 12.8 13.2 12.7 12.5 Hct 40.0-54.0 38.0 39.7 38.0 37.0 Plat 140-440 378 335 232 250 Lymph 20-45 44 44.90 41 Mono 0-12 11 15.60 12 EBN <0.90 4.81 EB VC IGG 0.00-0.90 6.77 EB VC IGM 0.00-0.90 0.14 RF Negative Negative ANA SCR Negative 1:80 Speckled RPR Nonr
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Arrhythmia, Chest pain, Dehydration, Dizziness, Dyspnoea, Hypoxia, Laboratory test abnormal, Oedema peripheral, Pharyngolaryngeal pain, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad)
Write-up: This is a 21-year-old male who was in his usual health when he received his primary smallpox vaccination on 03/12/2003. Approximately 2 weeks after receiving vaccination notice swelling in bilateral ankle with no change in respect to duty or posture. He noticed that the swelling was progressing to his knees bilateral approximately 1 month of vaccination. He had difficulty getting in to his rack on board , which was underway at this time. He reported to medical at approximately 1 month after receiving the vaccination, after developing chest pain (8/10) with out associated shortness of breath. He states he had a sore throat and fever at this time as well. He was told to drink plenty of water, given Motrinr, and returned to work. Approximately 1-2 days after initial onset of chest pain (10/10), again reported to medical. He was again sent back to work. When he attempted to climb 3 flights of ladders, became short of breath (5/5) and he became dizzy. He was again sent to medical, where he was given intravenous hydration. He was told that his heartbeat was irregular at that time. He was given a diuretic and Motrinr and was again released. After 3 months had lapsed and his symptoms he was flown from the ship to a hospital. At the hospital, was given medication, had a chest xray and an echocardiogram completed. He was hospitalized for 1 week. He was transferred home via MAC flight. During the flight developed chest pain (10+/10) but did not become short of breath. He was transferred to medical center via bus. At hospital he continued to have chest pain and shortness of breath. He was placed on oxygen and placed on bed rest. He was there for 24 hours and then was sent to another hospital via commercial flight. He was admitted for 24 hours and then placed on medical hold from late June to Early September 2003. He then transferred to his current duty station. He states that he has not experienced any further chest pains or shortness of breath since his discharge.

VAERS ID:224341 (history)  Vaccinated:2004-07-12
Age:21.0  Onset:2004-07-13, Days after vaccination: 1
Gender:Female  Submitted:2004-07-19, Days after onset: 6
Location:Massachusetts  Entered:2004-07-26, 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:
Diagnostic Lab Data:
CDC Split Type:
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RAB: RABIES (IMOVAX)AVENTIS PASTEURX05810IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Vaccinated 7/12/04 , 1:45pm. Almost 12 hours later, developed fever, vomiting, dizziness. About 10-12 hours later the fever and vomiting were gone; dizziness was gone the following day.

VAERS ID:224516 (history)  Vaccinated:2004-06-16
Age:21.0  Onset:2004-06-16, Days after vaccination: 0
Gender:Male  Submitted:2004-06-22, Days after onset: 6
Location:Unknown  Entered:2004-07-29, Days after submission: 37
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: NONE
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0801SC 
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40366130  
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUB501AA SC 
Administered by: Unknown     Purchased by: Military
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Bilateral urticaria

VAERS ID:224539 (history)  Vaccinated:0000-00-00
Age:21.0  Onset:2004-06-25
Gender:Male  Submitted:2004-06-27, Days after onset: 2
Location:Unknown  Entered:2004-07-30, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Bx done: erythema multiforme.
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4030013   
Administered by: Military     Purchased by: Military
Symptoms: Cow pox, Diarrhoea, Erythema multiforme, Pruritus, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: 21 year old male who was vaccinated 8 days prior to admission (on 26June) to hospital started to have rash appear on body (on chest, upper arms, and thighs). Rash appear small in size and scattered and itchy. Pt admitted for observation to r/o generalized vaccinia. Derm and VIG Pt conferred a mild case. VIG is not indicated. Benadryl 25ml PO ever 6 hours prn, itching. Nurse follow up on 10/25/04 states: "Final diagnosis confirmed as erythema multiforme minor. Diarrhea was also another symptom."

VAERS ID:224644 (history)  Vaccinated:2004-07-14
Age:21.0  Onset:2004-07-15, Days after vaccination: 1
Gender:Male  Submitted:2004-07-16, Days after onset: 1
Location:South Carolina  Entered:2004-08-03, Days after submission: 18
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 BIOSOLUTIONSFAV0844  
Administered by: Military     Purchased by: Unknown
Symptoms: Erythema, Oedema, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Erythema, edema and itching to LUE. Tx''d with Benadryl 25mg q 4-6 PRN itchy and Motrin 800mg TID x 3d

VAERS ID:224665 (history)  Vaccinated:0000-00-00
Age:21.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Unknown  Entered:2004-08-03
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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TTOX: TETANUS TOXOID (NO BRAND NAME)SANOFI PASTEURU1019AA  LA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURX0521  LA
Administered by: Military     Purchased by: Military
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Clear water like bumps on both left and right of my arms. Wiped them off and they popped.

VAERS ID:224746 (history)  Vaccinated:2003-04-10
Age:21.0  Onset:2003-04-11, Days after vaccination: 1
Gender:Female  Submitted:2004-07-30, Days after onset: 476
Location:Florida  Entered:2004-08-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES0306USA00199
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0541M1IM 
Administered by: Private     Purchased by: Other
Symptoms: Fatigue, Headache, Injection site erythema, Injection site inflammation, Injection site pain, Injection site warmth, Nausea, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up:

VAERS ID:224893 (history)  Vaccinated:2004-07-20
Age:21.0  Onset:2004-07-31, Days after vaccination: 11
Gender:Female  Submitted:2004-08-04, Days after onset: 4
Location:California  Entered:2004-08-04
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: None
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4030013 IDGM
Administered by: Military     Purchased by: Military
Symptoms: Infection transmission via personal contact, Pruritus, Skin ulcer, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Patient was not vaccinated. Her husband received smallpox vaccine about two weeks prior to her ER visit of 03 August 04. The husband used tweezers to debride the smallpox vaccination site. The patient subsequently used the same tweezers to pluck her pubic hair. On 31 July 04 the patient states she developed lesions in her pubic area. At her ER visit, the physician noted one macerated pustular lesion in her pubic area. She was treated with Zyrtec for itching.

VAERS ID:225279 (history)  Vaccinated:2004-02-05
Age:21.0  Onset:2004-02-06, Days after vaccination: 1
Gender:Male  Submitted:2004-08-09, Days after onset: 184
Location:Louisiana  Entered:2004-08-10, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5447A62IMRA
Administered by: Other     Purchased by: Private
Symptoms: Hyperhidrosis, Injection site erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Received HBV #3 on 2/5/04. No reaction until 2/6/04 when he noticed redness around injection site, on 2/8/04 became diaphoretic and experienced perfuse itching which lasted about 1 hour. No treatment reported to clinic on 8/9/04 9AM.

VAERS ID:225293 (history)  Vaccinated:0000-00-00
Age:21.0  Onset:2003-07-31
Gender:Female  Submitted:2004-08-06, Days after onset: 372
Location:Tennessee  Entered:2004-08-11, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Premature birth
Diagnostic Lab Data: Ultrasound within normal limits; Beta-human chorionic confirmed pregnancy
CDC Split Type: WAES0302USA00317
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Medication error, Unintended pregnancy
SMQs:, Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received form a registered nurse through a pregnancy registry concerning an approximately 21 year old white female with no concurrent conditions and a history of one previous pregnancy (pre-term birth at 36 weeks) and no history of birth defects, stillbirth, or miscarriage who was vaccinated with a dose of varicella virus vaccine live. The reporter indicated that the patient was now pregnant and may have been pregnant at the time of vaccination. The patient was not tested for varicella antibodies before vaccination. It was noted that no other medications were used during pregnancy. The patient''s last menstrual period was on 12/20/02 and her estimated delivery date was 9/26/03. A pregnancy test confirmed pregnancy. Unspecified medical attention was sought. Follow up information was received from the registered nurse who indicated that in April 2003, the patient had a routine ultrasound at 21 weeks that was within normal limits. The patient had no local reaction at the vaccination site and no varicella or herpes zoster symptoms post vaccination. On 7/31/03, the patient gave birth to a live born normal male infant weighing 3 pounds and 11 ounces at 30.5 weeks from her last menstrual period. There were no congenital anomalies. Complications included immature lungs. The patient was hospitalized for five weeks requiring mechanical ventilation, a feeding tube, and a heart monitor. The patient improved and was discharged from the hospital on a heart monitor. It was noted that this was done more for the mother''s peace of mind than due to the patient''s health status. The patient had a fine recovery with a good outcome. There were no other complications during pregnancy or labor. There were no infections or illnesses during pregnancy. The infant had no feature of congenital varicella zoster syndrome. No further information is expected.

VAERS ID:225300 (history)  Vaccinated:2004-01-06
Age:21.0  Onset:2004-01-30, Days after vaccination: 24
Gender:Male  Submitted:2004-08-05, Days after onset: 187
Location:Maryland  Entered:2004-08-11, Days after submission: 6
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 148 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: 5FEB CXR: Left lung collapse. Radiographic findings suggestive of left main stem bronchus obstruction (possibly by mucous plug). 24MAR04 CXR: 1. Interval Advancement of Dobbhoff tube tip, now within the gastric. 2. Continued probable atelectasis int he lateral aspect of the left lung base. 02FEB04 @2209
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSHAB238B60  
Administered by: Military     Purchased by: Military
Symptoms: Anxiety, Asthenia, Atelectasis, Bronchial obstruction, Depression, Difficulty in walking, Dyspnoea, Enzyme abnormality, Faecal incontinence, Glaucoma, Guillain-Barre syndrome, Hypoaesthesia, Lung disorder, Movement disorder, Nervous system disorder, Neuralgia, Sensory disturbance, Throat tightness, Urinary incontinence
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Glaucoma (narrow), Cardiomyopathy (broad), Demyelination (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (broad)
Write-up: Guillain Barre Syndrome post Twinrix. Immediately after the injection he "felt like it went straight to the base of my neck and down the spine, felt like a worm." He reports he asked the vaccinator "am I supposed to feel like this?" 24 days later on 30JAN04 he reports his "back became numb and I had a sensation in my legs and was weak. " The next day these sxs continued as well as he developed numbness in the hands and feet bilaterally and had difficulty walking Also his "throat felt tight" but denied shortness of breath. On 2FEB04 he presented to the emergency room and was admitted to the ICU for Guillain-Barre syndrome. On admission he denied any recent hx of URI, diarrhea, fever or chills. The initial problem list included generalized weakness, autonomic instability and transaminitis. Sxs quickly progressed to complete immobility although he was fully alert and responded to yes an no question with a slight squeezing of the left hand. On 5FEB he was intubated secondary to an aspiration episode. He had a gastrostomy tube insert4ed. He received 5 treatments of IVIG with little improvement. He remained intubated in the ICU for several weeks with telemetry, sequential compression devices, tube feeding and UE peripheral IVs. Eventually he was extubated and made slow progress toward regaining mobility. On hospital day 45 physical medicine and rehabilitation was consulted to assist in pt''s rehabilitation. He then began intensive physical therapy, occupation therapy and speech therapy. At the time he had diffuse neuropathic pain and had become incontinent of urine and stool. He was unable to ambulate and had developed glaucoma following extensive steroid use. He developed a reactive depression with insomnia, anxiety and depressed mood. He was receiving DVT prophylaxis. He continued to improve and was discharged from the hospital on 5JUN04 and allowed 30 days convalescent leave. At the time of this writing his hands are numb to temperature and light pressure. Fine motor movement is improving and he is able to ambulate a few steps independently. He has full sensation in the thighs but it is markedly reduced below the knees. he has constant throbbing neuropathic pain in the lower extremities and frequent feelings "like an electric shock or on fire". His bladder control had returned and bowel function is improving. He is pending medical board separation form the military. Per the follow up report-Spoke to SM. Has greatly improved. Is walking now with a cane, no longer wheelchair bound. Has neuropathic pain in feet only, no longer in legs. Feet are painful only with contact, not continuosly. Still has numbness in fingertips, but no longer in hands. His smile is asymmetrical. Bowel and bladder function has returned to normal. Is receiving care. Is medically retired from the military and received 50% disability. VA claim still pending. Is applying to school now to acquire new skills.

VAERS ID:225757 (history)  Vaccinated:2004-08-03
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:2004-08-24
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: HCG negative 5/10; HCG negative 6/16; HCG positive 8/12.
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130SCLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURX04810IMLA
Administered by: Military     Purchased by: Military
Symptoms: Laboratory test abnormal, Medication error, Unintended pregnancy
SMQs:, Normal pregnancy conditions and outcomes (narrow)
Write-up: Patient vaccinated for smallpox 8/3/04 due to impending deployment. Patient tested positive for HCG 8/12/04. No adverse consequence to date. Note: HCG on 5/11, 6/16/04.

VAERS ID:225800 (history)  Vaccinated:2004-08-02
Age:21.0  Onset:2004-08-03, Days after vaccination: 1
Gender:Male  Submitted:2004-08-06, Days after onset: 3
Location:Kentucky  Entered:2004-08-24, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Nausea, vomiting, diarrhea, myalgias

VAERS ID:225867 (history)  Vaccinated:2004-08-13
Age:21.0  Onset:2004-08-14, Days after vaccination: 1
Gender:Female  Submitted:2004-08-16, Days after onset: 2
Location:Missouri  Entered:2004-08-25, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: mitral valve prolapse - outdoor allergies
Diagnostic Lab Data:
CDC Split Type: MO200438
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1186AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site swelling, Nausea, Tachycardia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 08/13/04 Received Td, 08/14/04 arm sore, p.m. got knot, 6pm swelled, red, 08/15/04 3 am Tachycardia, nausea (does have a mitral valve prolapse) no emesis. arm throbbed and hurt all the way over. Sun pm swelling down, 08/16/04 right arm red but not swollen.

VAERS ID:225965 (history)  Vaccinated:2003-10-15
Age:21.0  Onset:2003-10-15, Days after vaccination: 0
Gender:Female  Submitted:2004-08-27, Days after onset: 317
Location:Virginia  Entered:2004-08-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denies any illness
Preexisting Conditions: none
Diagnostic Lab Data: none performed
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 4SCUN
Administered by: Military     Purchased by: Military
Symptoms: Dermatitis atopic, Injection site erythema, Injection site swelling, Lymphadenopathy, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: This 21-year-old member received her 4th anthrax vaccination on October 15, 2003, while stationed overseas. She reports the vaccination site was red and swollen around the upper arm. The rash began to her arms within 30-45 minutes after receiving shot then slowly spread over her body over the next 3-4 days. She describes the rash as "feeling like sandpaper", with pruritis and some axillary lymphadenopathy for one week. She denied any fever, nausea, vomiting, diarrhea, muscle fatigue or weakness, paresthesia, or headaches. She sought out medical care 3-4 days later as the rash continued to spread and was given a shot of Benadryl. She was diagnosed with "atopic dermatitis after anthrax shot" and instructed in the use a hydrocortisone cream to the rash until resolution. Her rash lasted approximately 7-10 days. She reports no further rashes or scarring noted as of August 27, 2004. She denies any past history of a similar reaction, any recent illness, exposure to new substances, or bites while overseas.

VAERS ID:226092 (history)  Vaccinated:2004-08-30
Age:21.0  Onset:2004-08-30, Days after vaccination: 0
Gender:Female  Submitted:2004-08-31, Days after onset: 1
Location:Nevada  Entered:2004-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax, Zoloft, Wellbutrin
Current Illness: None
Preexisting Conditions: Bipolar disorder and panic anxiety disorder
Diagnostic Lab Data: Blood
CDC Split Type:
Vaccination
Manufacturer
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Dose
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RAB: RABIES (RABAVERT)CHIRON CORPORATION3340112IMLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Bone pain, Chest pain, Chills, Disorientation, Dizziness, Dyskinesia, Headache, Heart rate increased, Hypersensitivity, Hyperventilation, Injection site pain, Muscle spasms, Myalgia, Nausea, Paraesthesia, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dyskinesia (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Osteonecrosis (broad), Hypersensitivity (narrow)
Write-up: 10:00 am on Aug. 31 my last of the rabies series was administered. At approx. 8:00 pm that same night I began to feel the following side effects: *soreness at site of administration *nausea *chills *tingling in legs *dizziness *disorientation *weakness *jerky movements and muscle spasms *severe chest pain *excessive heart rate *throbbing headache that made my eyes sore and hard to keep open *hyperventilation and wheezing *severe pain in my muscles and bones, particularly my spine and ankles I went to the emergency department at approx. 10:30pm where I was diagnosed with a severe allergic reaction and medicated with an injection of Antivan. Because I had to turn in all my copies of the vaccines I received to my school, I can only indicate what ones I know were administered, not exact types or manufacturers. However, the Health Department should have on file everything I received this month.

VAERS ID:226224 (history)  Vaccinated:2004-08-27
Age:21.0  Onset:2004-09-04, Days after vaccination: 8
Gender:Male  Submitted:2004-09-05, Days after onset: 1
Location:Missouri  Entered:2004-09-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NEGATIVE.
Preexisting Conditions: NONE
Diagnostic Lab Data: RPR PENDING. EXPECTED TO BE NEGATIVE.
CDC Split Type:
Vaccination
Manufacturer
Lot
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Chills, Lymphangitis, Myalgia, Pruritus, Rash papular
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: PAPULAR RASH ON BILATERAL HANDS, PALMS, FEET, SOLES, ELBOW, BACK, FACE BEGINNING DAY 7 AFTER VACCINATION. AFEBRILE BUT MYALGIAS REPORTED. NO HEADACHE OR NEUROLOGIC SYMPTOMS. MAJOR TAKE AT VACCINATION SITE WITH LYMPHANGITIS AND CELLULITIS. TREATMENT: KEFLEX 250 MG PO QID FOR 7 DAYS, ZYRTEC 10 MG PO QDAY PRN FOR ITCHING, TYLENOL 650 MG PO Q4HRS PRN CHILLS/MYALGIAS.

VAERS ID:226225 (history)  Vaccinated:2004-08-25
Age:21.0  Onset:2004-09-04, Days after vaccination: 10
Gender:Male  Submitted:2004-09-05, Days after onset: 1
Location:North Carolina  Entered:2004-09-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE.
Preexisting Conditions: NONE.
Diagnostic Lab Data: CBC, PT, PTT, INR, CHEM 8 NORMAL, CK ELEVATED, WBC 12.3, UA WNL, D-DIMER.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH   RA
Administered by: Military     Purchased by: Military
Symptoms: Blood creatine phosphokinase increased, Leukocytosis, Medication error, Oedema peripheral, Skin discolouration, Skin necrosis, Tenderness, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Severe cutaneous adverse reactions (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: BILATERAL ANKLE SWELLING WITH PURPLISH DISCOLORATION AND TENDERNESS. EXTENDS MIDCALF TO MIDFOOT. SATELLITE PATCHES. 3+ PITTING EDEMA AND BOGGINESS. ELEVATED WBC. NO CALF TENDERNESS. NO HISTORY OF VASCULITIS, DVT, OTHER. OTHERWISE HEALTHY AND ATHLETIC. MAJOR TAKE AT VACCINE SITE. HE REPORTS 7 JABS FOR PRIMARY VACCINATION: SHOULD HAVE BEEN 3, UNLESS HIS RECALL IS INCORRECT.

VAERS ID:226228 (history)  Vaccinated:2004-08-31
Age:21.0  Onset:2004-09-02, Days after vaccination: 2
Gender:Female  Submitted:2004-09-06, Days after onset: 4
Location:Unknown  Entered:2004-09-06
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: acne, mild
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0861SCRA
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Approximately 3 days after anthrax #2, developed approx 5 cm rash in local area; itch requiring benadryl.

VAERS ID:226307 (history)  Vaccinated:2004-05-21
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2004-08-17
Location:Unknown  Entered:2004-09-08, Days after submission: 22
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: There is anterior fusion of T10 and T11 vertebra bodies. S4 and S5 vertebral elements are relatively hypoplastic. There is a lobular soft tissue mass projecting posterior to the lower sacrum and buttocks. There is no calcification within this. The bowel gas pattern is normal. The lung bases are clear. Multiple vertebral anomalies as described.
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0721SC 
Administered by: Military     Purchased by: Military
Symptoms: Foetal growth retardation, Medication error, Unintended pregnancy
SMQs:, Foetal disorders (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Had AVA #2 about the time of conception. Term infant born with fetal Sacral Teratoma and multiple Vertebral and rib abnormalities.

VAERS ID:226414 (history)  Vaccinated:2004-08-23
Age:21.0  Onset:2004-08-25, Days after vaccination: 2
Gender:Male  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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU0991AA   
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site mass, Medication error, Pruritus
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 50mmx40mm erythema with 10mm area of induration. Mild itchy.

VAERS ID:226424 (history)  Vaccinated:2004-08-23
Age:21.0  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: Othocyclen
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU0991AA ID 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site induration, Injection site pain, Medication error, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: In error: Administered 0.1 ml Td ID instead of PPD. Left forearm with 10 mm area of induration noted 48 hours past injection. Painful to touch 4 days after injection pain subsided: induration decreased.

VAERS ID:226511 (history)  Vaccinated:2004-08-06
Age:21.0  Onset:2004-08-09, Days after vaccination: 3
Gender:Male  Submitted:2004-08-22, Days after onset: 13
Location:New Mexico  Entered:2004-09-10, Days after submission: 19
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CK critically elevated at 12175 (norm is 55-170);
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0864SCRA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Blood creatine phosphokinase increased, Chills, Headache, Muscle spasms, Pyrexia, Rhabdomyolysis
SMQs:, Rhabdomyolysis/myopathy (narrow), Neuroleptic malignant syndrome (narrow), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad)
Write-up: CHEST SPASMS; 104 FEVER; HEADACHE; APPROX 3 DAYS AFTER VACCINATION IN ICU FOR 3 DAYS; RHABDOMYOSIS. Nurse follow up on 10/20/04 states: "Hospital d/c summary reviewed. Final diagnoses were rhabdomyolysis and dehydration. Shivering and fatigue."

VAERS ID:226522 (history)  Vaccinated:2004-09-11
Age:21.0  Onset:2004-09-12, Days after vaccination: 1
Gender:Female  Submitted:2004-09-12, Days after onset: 0
Location:Iowa  Entered:2004-09-13, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Duricef abx
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0853SCRA
Administered by: Military     Purchased by: Military
Symptoms: Feeling hot, Injection site swelling, Tenderness, Vaccine positive rechallenge
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Local swelling at injection site (right arm) . Warm to touch, tender

VAERS ID:226549 (history)  Vaccinated:2004-09-02
Age:21.0  Onset:2004-09-02, Days after vaccination: 0
Gender:Male  Submitted:2004-09-02, Days after onset: 0
Location:Massachusetts  Entered:2004-09-13, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Codeine allergy
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: Dysphagia
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)
Write-up: Difficulty swallowing x 20min after vaccination. Benadryl, 50mg PO.

VAERS ID:226670 (history)  Vaccinated:2004-08-23
Age:21.0  Onset:2004-08-25, Days after vaccination: 2
Gender:Female  Submitted:2004-09-01, Days after onset: 7
Location:New York  Entered:2004-09-15, 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 prn, Allegra prn, Orthotrycyclen
Current Illness: NONE
Preexisting Conditions: Sports induced asthma; allergic rhinitis
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU0991AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Injection site induration, Medication error, Pruritus, Tenderness
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 80 mm x 40 mm area of erythema with 10 mm induration central. Tender, itches 4 days post injection erythema, induration decreased. Symptoms subsided.

VAERS ID:226774 (history)  Vaccinated:1970-08-06
Age:21.0  Onset:1970-08-10, Days after vaccination: 4
Gender:Male  Submitted:2004-09-14, Days after onset: 12454
Location:Unknown  Entered:2004-09-20, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Rash on feet and groin area.
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Blindness, Injection site oedema, Lacrimation increased, Pain, Photophobia, Pruritus, Pyrexia, Rash, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow)
Write-up: Excessive rash over most of the body. Swelling of glands under the arms and groin area. Vision problems, very irritating when exposed to sunlight or electrical lights. Vision worsened in right eye from 20/30 to 20/200 within 5 months. Smallpox: all deporting shots to leave country was given on 08/06. Knowledge of all-unknown. I had a reaction to a vaccination for smallpox while I was in the military. It was given to me by medics on 08/06/1970. Symptoms were swelling, pain, temperature, splotch type rash, itchy and watery eyes. I was treated for the swelling and rash first. After 4 days of treatment for these problems I was then refined to quarters with no use of any type of light-just total darkness for 2 days. Eventually all the rash and swelling went away. At this time I acknowledged to the military that I was having vision problems. There was no available optometrist at the base where I was stationed. I came home in 09/1970. I then was sent to another country. Between 10/1970 and 01/1971 I noticed a distinct problem with having to squint all the time because the sun or bright lights hurt my eyes severely. At this time I went to the optometrist and found my eye sight to be 20/100 already. By 02/1971 my eye sight had gone to 20/200. This being in my right eye only. My left eye is still 20/20. Glasses were issued by the military at this time. By 975 glasses for the vision in the right eye could not be fitted. I''m blind in this eye today. I never filed a complaint to the military until 02/02. I have talked to numerous optomologists and optometrists and they suggest or agree that I may have a weak or weaker eye, being the right eye. This is all after fact or a matter of opinion. If there is any information available on the effects of a reaction to Smallpox vaccination that could have caused this problem I would greatly appreciate hearing about it. I would like to hear a response on this or advise on what you think.

VAERS ID:226931 (history)  Vaccinated:2004-04-18
Age:21.0  Onset:2004-04-18, Days after vaccination: 0
Gender:Male  Submitted:2004-09-22, Days after onset: 157
Location:New Jersey  Entered:2004-09-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: GI upset
Preexisting Conditions: None
Diagnostic Lab Data: None available Medical records state abnormal lab tests.
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0ID 
Administered by: Military     Purchased by: Military
Symptoms: Cardiac disorder, Chest pain, Dehydration, Diarrhoea, Laboratory test abnormal, Myocarditis, Throat tightness, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow)
Write-up: This is a 21- year-old who developed a stomach virus on 16 April 2004. He reports that he had emesis and diarrhea and became dehydrated. He presented for deployment immunizations on 17 April. He was told that since he had been sick the day before he couldn't get his smallpox vaccination, but was given his anthrax vaccination. Prior to getting to receiving the anthrax he reported to the individuals providing immunizations that he has “a pain in the lower chest/upper abdomen area”. He described the pain as “gas build up” lasting about 15 minutes that occurred only twice, once at 0300 on 04/17 and 04/18. He rated it at 2/10. He felt that this was due to the vomiting he had done the day before. On 18 April he reported for and received his smallpox vaccination at 0900 hrs. He worked his usual work, completed 8-hour shift. At approximately 1700 he states that it felt like something was stuck in his throat with accompanying chest pain 2/10. His pain progressed over the next one hour to a 7/10 and felt like he was “being squeezed”. He denies any shortness of breath. His pain was changed with position or activity. He reported to the Emergency Department at Hospital. He did not see a physician until approximately 2100. He underwent chest xray and laboratory work done. He was told he was being admitted for “deterioration around the heart”. He states that his chest pain was reach its worse point on Monday 04/19/2004 at which time he received morphine and oxygen. He remained in the hospital until 22 April 2004 at which time released without restrictions. On 26 April 2004, he presented for medical clearance. MD saw him. He states he had his vitals check and auscultation of his heart and lungs done. He was then cleared for full duty and placed on deployment status. He deployed on 04 June 2004. Medical record states myocarditis.

VAERS ID:226935 (history)  Vaccinated:2001-02-10
Age:21.0  Onset:0000-00-00
Gender:Male  Submitted:2004-09-17
Location:Unknown  Entered:2004-09-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1IM 
Administered by: Military     Purchased by: Military
Symptoms: Unevaluable event
SMQs:
Write-up: Antiphospholipid antibody syndrome after Hep B. (also states received several AVA but no documentation).

VAERS ID:226978 (history)  Vaccinated:2004-09-21
Age:21.0  Onset:2004-09-21, Days after vaccination: 0
Gender:Male  Submitted:2004-09-23, Days after onset: 2
Location:Unknown  Entered:2004-09-24, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0870SCLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt felt itchy 10 to 20 min after shot and noticed rash and redness 2 to 3 hours later rash on upper arms, chest, back and neck. Benadryl 50mg IM, Prednisone 10mg po 60/60-40/40-20/20-10/10, Hydroxyzine 25mg 1 tab every 6 hours.

VAERS ID:227204 (history)  Vaccinated:2004-08-30
Age:21.0  Onset:2004-08-30, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:2004-09-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0793 LA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Afebrile with posterior upper left arm area of erythema and swelling approximately 4 x 6 cm. + Fluctuant. From at shoulder and elbow. Distally NVI.

VAERS ID:227507 (history)  Vaccinated:2004-09-15
Age:21.0  Onset:2004-09-15, Days after vaccination: 0
Gender:Female  Submitted:2004-09-29, Days after onset: 14
Location:Wisconsin  Entered:2004-10-08, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Nausea, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: N/V, dizziness, shakiness, several hours after Anthrax vaccination.

VAERS ID:227583 (history)  Vaccinated:2004-08-19
Age:21.0  Onset:2004-09-11, Days after vaccination: 23
Gender:Female  Submitted:2004-10-10, Days after onset: 29
Location:Unknown  Entered:2004-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: seasonal allergies
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130IDLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Rash maculo-papular, Rash pruritic, Rash pustular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt complaint of itchy ''bumps'' after vaccination. Initially she thought they were bug bites and she scratched them. Distributed on arms, shoulders, chest and face. Pt feels they look like bug bites and itch, but for a longer period. Maculo-papular lesions. Slightly erythematous. Not confluent. Appearance consistent with nonviral pustulosis.

VAERS ID:227930 (history)  Vaccinated:2004-07-24
Age:21.0  Onset:2004-07-26, Days after vaccination: 2
Gender:Male  Submitted:2004-07-28, Days after onset: 2
Location:Texas  Entered:2004-10-19, Days after submission: 83
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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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710 RA
Administered by: Military     Purchased by: Military
Symptoms: Cough, Headache, Pharyngolaryngeal pain, Tenderness
SMQs:, Anaphylactic reaction (broad)
Write-up: Headache, sore, itchy throat, coughing.

VAERS ID:228042 (history)  Vaccinated:2004-09-01
Age:21.0  Onset:2004-09-12, Days after vaccination: 11
Gender:Female  Submitted:2004-09-15, Days after onset: 3
Location:Unknown  Entered:2004-10-21, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0870IM 
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720SC 
Administered by: Military     Purchased by: Military
Symptoms: Pain, Pyrexia, Rash erythematous, Rash macular, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Patient presented with a painful erythematous macular/patchy rash on bilateral lower extremities from knees down. Peeling skin on plantar surface both feet. Positive fever. Discharge summary states tinnitis pedis, pain. msv

VAERS ID:228048 (history)  Vaccinated:2004-09-29
Age:21.0  Onset:2004-10-09, Days after vaccination: 10
Gender:Male  Submitted:2004-10-10, Days after onset: 1
Location:Unknown  Entered:2004-10-21, Days after submission: 11
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: No lab available: deployed location
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0 LA
Administered by: Military     Purchased by: Military
Symptoms: Lymphadenopathy, Rash, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash: sore trunk, swollen lymph nodes. Treated with Tylenol, Benadryl and Calamine.

VAERS ID:228188 (history)  Vaccinated:2002-08-07
Age:21.0  Onset:2002-08-07, Days after vaccination: 0
Gender:Male  Submitted:2002-08-23, Days after onset: 16
Location:Oregon  Entered:2004-10-26, Days after submission: 795
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: 3 consecutive CT Scans to ensure cerebral bleed had ceased.
CDC Split Type: OR200248
Vaccination
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5270A40IMLA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU0367AA5IMLA
Administered by: Public     Purchased by: Public
Symptoms: Cerebral haemorrhage, Injury, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic cerebrovascular conditions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: 3-8 minutes after receiving Td and Hepatitis B shots, client left clinic room to lobby to pay bill (20-30 feet). He passed out with warning and fell straight backwards, suffering a severe blow to the back of his head. He was taken per ambulance to hospital where diagnosis was concussion with cerebral bleed.

VAERS ID:228256 (history)  Vaccinated:2004-10-15
Age:21.0  Onset:2004-10-19, Days after vaccination: 4
Gender:Female  Submitted:2004-10-26, Days after onset: 7
Location:Unknown  Entered:2004-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: URI type sx for 3 weeks
Preexisting Conditions: denied
Diagnostic Lab Data: CBC ordered- WBC 9.6 with relative shift
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0860SCRA
HEP: HEP B (FOREIGN)MERCK & CO. INC.1167M1IMUN
HEPA: HEP A (VAQTA)MERCK & CO. INC.1068N1IMUN
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETHUNK0IDLA
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURERUNK IMUN
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURERUNK IMUN
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Decreased appetite, Diarrhoea, Dizziness, Fatigue, Headache, Injection site erythema, Myalgia, Nausea, Vaccination complication, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Pt developed diarrhea 4 days post vaccination, emesis, nausea, slight headache, tenderness in axilla, fatigue, some dizziness/weakness, also with erythema and satellite lesions around smallpox vaccination site, diminished appetite.

VAERS ID:228340 (history)  Vaccinated:2004-10-22
Age:21.0  Onset:2004-10-23, Days after vaccination: 1
Gender:Male  Submitted:2004-10-27, Days after onset: 4
Location:Alaska  Entered:2004-10-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness at time of vaccine
Preexisting Conditions: No other conditions.
Diagnostic Lab Data:
CDC Split Type: AK200461
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0853SCLA
Administered by: Military     Purchased by: Military
Symptoms: Contusion, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt received shot number 4 of the Anthrax series in his left arm, vaccine site sore to the touch, looks like it is bruised (size of hafl dollar), Received shot 22 Oct 04, First time patient had a reaction. Color of site yellow, blue and purple. No other vaccines given this day or 4 weeks prior.

VAERS ID:228399 (history)  Vaccinated:2004-10-26
Age:21.0  Onset:2004-10-26, Days after vaccination: 0
Gender:Male  Submitted:2004-10-28, Days after onset: 2
Location:New York  Entered:2004-10-28
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: SHELLFISH
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURX01100IMRA
Administered by: Military     Purchased by: Military
Symptoms: Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: PT C/O NAUSEA AND H/A APPROX. 1HR AFTER ADMINISTRATION OF TYPHOID VACCINE.

VAERS ID:228584 (history)  Vaccinated:2004-10-04
Age:21.0  Onset:2004-10-06, Days after vaccination: 2
Gender:Female  Submitted:2004-11-01, Days after onset: 26
Location:Unknown  Entered:2004-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0865IMLL
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: MACULARPAPULAR RASH ALL OVER BODY (ARMS, LEGS, BACK, NECK, AND CHEST) ITCHINESS AND REDNESS. WENT TO CLINIC 06OCT04 GIVEN CREAM ARISTOCORTA 2X A DAY. 12OCT04 GIVEN CREAM TRIAMCINOLONEACETONIDE 2X A DAY/ZYRTEC PILLS. 18OCT04 GIVEN CREAM ACTICIN ONE TIME A DAY LEAVE ON FOR 10-12HOURS, RUB ALL OVER BODY, THEN WASH OFF (PERMETHRIN) HYDROXINE PILLS FOR ICHING/TWICE A DAY, ONE/TWO PILLS (ATARAX). 20OCT04 GIVEN PRENEZONE PILLS 20MG TAPERED OFF 60MG FOR DAYS 1-2 60MG/DAYS 3-4 40MG/DAYS 5-6 20MG/DAYS 7-8 1/2 TAB/HYDROXINE (ATARAX) 25MG TWICE A DAY/TWO TO THREE PILLS. 28OCT04 GIVEN PRENEZONE PILLS 20MG TAKEN ONCE A DAY/HYDROXINE 25MG/TWO TO THREE PILLS TWICE A DAY 01NOV04. 20MG PRENEZONE TAPER OFF OVER 2 WEEKS IN NOVEMBER(2st-19th). 60MG DAYS 1-3. 40MG DAYS 4-12. 20MG DAYS 13-19 CREAM FLUOCINONIDE .05% 15 GRAMS TWICE A DAY HYDROXINE (ATARAX) 25MG 2x A DAY (TWO OR THREE PILLS)

VAERS ID:229001 (history)  Vaccinated:2004-10-19
Age:21.0  Onset:2004-10-29, Days after vaccination: 10
Gender:Male  Submitted:2004-11-01, Days after onset: 3
Location:Virginia  Entered:2004-11-09, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0820IMRA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1501AA0IMRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
Administered by: Military     Purchased by: Unknown
Symptoms: Cow pox
SMQs:
Write-up: Disseminated vaccinia Benadryl 25mg

VAERS ID:229228 (history)  Vaccinated:2004-11-04
Age:21.0  Onset:2004-11-05, Days after vaccination: 1
Gender:Female  Submitted:2004-11-08, Days after onset: 3
Location:North Carolina  Entered:2004-11-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Migraine headaches
Diagnostic Lab Data: Not available; hospitalized at another location.
CDC Split Type:
Vaccination
Manufacturer
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0988NN SCRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 21 year old female with a history of splenectomy 3/03 overseas. On 11/4/04 she received a SC injection of pneumococcal polyvalent vaccine 0.5ml in right upper arm. She subsequently developed pain, redness, swelling in the extremity which required hospitalization. Temperature to 101-102 degrees F. Follow up 01/26/05: I have no specific details as to treatment as this occurred in a different location as previously reported. Patient has recovered.

VAERS ID:229387 (history)  Vaccinated:2004-11-16
Age:21.0  Onset:2004-11-18, Days after vaccination: 2
Gender:Female  Submitted:2004-11-18, Days after onset: 0
Location:Pennsylvania  Entered:2004-11-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Orthotricycline
Current Illness: none
Preexisting Conditions: Ibuprofen allergy
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS802B60IMRA
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.0005P SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0657P0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 1 and 1/2 inch of erythema at site. No warmth, no induration, minimally tender.

VAERS ID:229618 (history)  Vaccinated:2004-11-04
Age:21.0  Onset:2004-11-13, Days after vaccination: 9
Gender:Male  Submitted:2004-11-23, Days after onset: 10
Location:Unknown  Entered:2004-11-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: None
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURV1048BA0IMRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130IDLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cow pox, Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: Multiple maculopapular lesions on trunk and upper extremeties. Consistent with generalized vaccinia.

VAERS ID:229657 (history)  Vaccinated:2004-11-08
Age:21.0  Onset:2004-11-17, Days after vaccination: 9
Gender:Male  Submitted:2004-11-24, Days after onset: 7
Location:Washington  Entered:2004-11-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC/UA/CHEM PENDING
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Unknown
Symptoms: Hypersensitivity, Purpura, Rash, Rash macular
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow)
Write-up: PT WAS SEEN IN ER 8 DAYS AFTER IMM W/ RASH/ REFERRED TO CLINIC NEXT DAY. PRESUMED ALLERGIC RXN TO TYLENOL COLD RX AND WAS TREATED W/ SOLUMEDROL AND ORAL PREDNISONE AND LORATADINE. I SAW PT FIRST, 16 DAYS POST IMMUNIZATION (SMALL POX) AND HE WAS IMPROVING BUT STILL HAD PURPURA ON LEGS/NON HEMMORHAGIC/NON BLANCHING/ AND COALESCED SALMON COLORED MACULAR RASH TO REMAINDER OF BODY, THAT DOES NOT BLANCH. PT FEELING WELL, NO FURTHER TX. WILL DO CBC/UA/CHEM TODAY AND HE WILL FOLLOW UP NEXT WEEK.

VAERS ID:229816 (history)  Vaccinated:2003-11-20
Age:21.0  Onset:2004-02-20, Days after vaccination: 92
Gender:Female  Submitted:2004-11-30, Days after onset: 284
Location:Virginia  Entered:2004-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denies
Preexisting Conditions: proteinuria with entrance physical otherwise healthy
Diagnostic Lab Data: Laboratory: Normal Values 14 Jun 2004 @ 0629 12 May 2004 @1546 22 April 2004 @1254 21 April 2004 @1435 15 April 2004 @1423 05 Mar 2004 @1046 WBC 7.5 9.3 RBC 4.07 4.21 Hgb 10.5 10.5 Hct 30.6 31.3 Plat 169 191 Pt 14.2 PTT 30.0 Serum Albumin 3.5 3.8 Glucose 88 80 114 65 (L) PO4 4.1 4.9 (H) BUN 34 (H) 26 24 Creat. 3.3 (H) 3.1 (H) 3.0 K+ 4.4 4.5 4.3 NA+ 139 142 142 CL- 103 107 106 CO2 24 21(L) 25 CA 7.7 (L) 8.0 (L) 7.9 (L) Anion gap 11 14 11 ANA Borderline 1:80 Positive $g/= 1:160 Cholesterol 227(H) Trig 167 HDL 45 LDL 149 VLDL 33 RPR Nonreactive HIV Negative Urine Creat 90 Urine Protein 5564 24 Hour UA P
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 0 UN
Administered by: Military     Purchased by: Military
Symptoms: Abdominal distension, Chest pain, Dysmenorrhoea, Headache, Laboratory test abnormal, Menstruation irregular, Nausea, Renal failure, Vaccine positive rechallenge, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Fertility disorders (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad)
Write-up: This 22 year old received her first anthrax vaccination on November 20, 2003. She advised the corpsman of irregularities in her menstrual cycle and she tested negative for pregnancy. She stated she was feeling “sick” prior to and for seven days post vaccination with nausea and vomiting 2-3 times a day around lunchtime. She stated food made her vomit which resulted in sharp epigastric substernal chest pain. The pain worsened while lying flat requiring her to stand up or lean forward for relief. This pain was centered mid chest right $g left on a 6/10 scale that lasted for a few seconds. She reported to medical and was advised this was a possible stress reaction. She denied any myalgia, arthralgia, fevers, headaches, rashes, or any breathing problems. She required no medication to relieve her discomfort as it resolved spontaneously. She stated she received her second anthrax vaccination on January 27, 2003. However, DEERS records the second vaccination as December 5, 2003 and the third vaccination on December 19, 2003. She stated she was ill with similar symptoms as anthrax #1 but they were worse, again lasting for one week. She reported the nausea and vomiting occurred after lunch with an “increase in stomach fullness”. She reported 20-30 minutes after eating she felt hungry as if she had not eaten. She denied any specific food group or position change as recreating this discomfort. She slept easily at night. She also reported a sharp spasmodic headache at 7/10 that lasted for a few minutes three times a day while “cranking” (KP duty). These headaches would resolve spontaneously. She reported to medical and completed a full lab evaluation that revealed “kidney failure.” Her menstrual cycle began February 20, 2004 lasting 3 days. She was referred to the GYN clinic for further evaluation of “dysmenorrhea secondary to kidney failure”. In February 2004 she was preparing for deployment with the Regional Support Group (RSG). Further medical evaluation prompted evaluation for lupus and ultimately sent to a kidney specialist in March 2004 for renal failure. Review of her past medical problems revealed proteinuria during a pre-enlistment physical in January 2003 and a positive PPD while in boot camp (June 5, 2003) with implementation of INH therapy in July 2003.

VAERS ID:229847 (history)  Vaccinated:2004-11-18
Age:21.0  Onset:2004-11-18, Days after vaccination: 0
Gender:Female  Submitted:2004-11-30, Days after onset: 12
Location:Unknown  Entered:2004-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1459AA IMLA
Administered by: Military     Purchased by: Military
Symptoms: Cough, Dysphonia, Heart rate increased, Ocular hyperaemia, Pharyngeal oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Glaucoma (broad), Hypersensitivity (narrow)
Write-up: Blood shot eyes, swollen throat, change in voice, elevated pulse, all within 10 min of coughing episode. 50 mg Benadryl po, 60 mg Prednisone po, Transport to ER.

VAERS ID:229853 (history)  Vaccinated:2004-10-19
Age:21.0  Onset:2004-10-28, Days after vaccination: 9
Gender:Male  Submitted:2004-11-01, Days after onset: 4
Location:Virginia  Entered:2004-11-30, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0820IMRA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1501AA0 RA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETHY0200720IDLA
Administered by: Military     Purchased by: Military
Symptoms: Cow pox, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 21 y/o male report with rash across chest/ stomach/ neck. Received small pox vaccine 19OCT2004. Disseminated vaccinia.

VAERS ID:230582 (history)  Vaccinated:2004-11-02
Age:21.0  Onset:2004-11-02, Days after vaccination: 0
Gender:Female  Submitted:2004-11-03, Days after onset: 1
Location:Tennessee  Entered:2004-12-09, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: TN04064
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS093AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Rec''d Hep B #1 at approx 2:00PM, 11/2/04. Reports had rash to fever at 8:00PM same day, went to ER rec''d Benadryl, steroid shot.

VAERS ID:231149 (history)  Vaccinated:2004-12-06
Age:21.0  Onset:2004-12-08, Days after vaccination: 2
Gender:Female  Submitted:2004-12-10, Days after onset: 2
Location:Virginia  Entered:2004-12-15, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: depoprovera q 3 months
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: VA04045
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION3350110IMRA
Administered by: Public     Purchased by: Public
Symptoms: Hypoaesthesia, Myalgia, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Patient stated that symptoms of muscle aching in back of neck, shoulder and then left arm region around 2pm 12/8/04. At that time, she began to have numbness of left arm 9vaccine was given in right arm). This numbness continued but was going away by afternoon of 12/9/04.

VAERS ID:231157 (history)  Vaccinated:2004-03-03
Age:21.0  Onset:2004-03-21, Days after vaccination: 18
Gender:Female  Submitted:2004-03-25, Days after onset: 4
Location:Georgia  Entered:2004-12-15, Days after submission: 265
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Neg TB skin test 3/16/04
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: GA04052
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU0844AA1 LA
Administered by: Public     Purchased by: Public
Symptoms: Blister, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Skin: Linear vesicles on hands, arms and under breasts + urticarial rash and LMP 3/20/04. Ed: Launder all clothing in hot water. Prescription given.

VAERS ID:231242 (history)  Vaccinated:2000-05-17
Age:21.0  Onset:2001-12-21, Days after vaccination: 583
Gender:Male  Submitted:2004-12-13, Days after onset: 1088
Location:D.C.  Entered:2004-12-17, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Echo: Impression - normal 2D echo. No pericardial effusion. 8/23/04: ECG was significant for PR depression and a concave ST elevation in several leads congruent with pericarditis. CXR impression - low lung volumes. No evidence of acute disease in the chest 10/5/03. EKG with ST elevations 10/7/03. Echo: Impression - moderate pericardial effusion with right atrial free wall collapse 10/8/03. Echo: Impression - moderate pericardial effusion (fibrinous strands seen in pericardial space). Right atrial diastolic free wall collapsed persists. Preserved systolic function LVEF 50-55% 10/18/04. EKG: Normal sinus. 95 bpm. No ST elevation. Flipped T1. V2-V6. CXR: cardiomegaly bilateral effusion (L$gR). CT Chest: Impression - Large pericardial effusion w
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0443SC 
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Contusion, Cough, Dyspnoea, Electrocardiogram abnormal, Headache, Injection site pain, Injection site swelling, Laboratory test abnormal, Palpitations, Pericardial effusion, Pericarditis, Pyrexia, Tachycardia
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad)
Write-up: History of recurrent pericarditis since 2001. Awaiting complete medical records; noted from 2002-2003 show approximately 6 episodes of pericarditis and at least 1 episode of pleural effusion. Patient was healthy prior to 2001. After receiving his anthrax vaccines, patient does not recall experiencing significant local or systemic symptoms. He does recall a moderate amount of swelling and tenderness surrounding vaccine sites, and on at least one occasion, he experienced some bruising at the vaccine site. The vaccine sites remained tender for about a week. Prior to November 2001, patient was in his usual good state of health. In November 2001, while stationed overseas, patient recalls being at work and couldn''t breathe...heart was racing...felt like it was going to pound out of my chest. He sought medical evaluation where a chest x-ray and ECG were done and he was diagnosed with pericarditis. He was prescribed Motrin and then released. He took the Motrin for 3-4 days and the chest pain had completely resolved by 1 week after treatment. He experienced a second episode of chest pain after returning home. Patient is not sure of the details, but believes it was around September 2002. The third episode was in early January 2003. He began noting the bottom of my ribs were sore...my heart started racing again so on the following day he went to the clinic. This time his ECG was normal and he was released. The next day the pain became worse and he began experiencing shortness of breath. He was given NSAIDS and a 2 week profile for light duty and no PT. He was seen by internal medicine on 1/27/03 and it was felt that the previous recurrent pericarditis episodes were secondary to partial treatment and he was treated with a 2 week course of Indocin 25mg TID and a continued profile for 2 months. He was asymptomatic between February and July 2003. A note from the cardiology clinic on 3/24/03 noted that patient was exercising at his own pace without problems and that there were no subjective findings or findings on physical exam or ECG suggesting recurrence of pericarditis. The next episode was in late August 2003, when he experienced chest pain (not relieved with NSAIDS or Lortab) and shortness of breath. Patient sought evaluation at the emergency room. He was then admitted for pericarditis. He had a fever of 104 with this episode. He was again treated with Indocin and Cardiology recommended no PT for 6 months. His next admission was in October 2003 with a diagnosis of recurrent pericarditis, which required pericardiocentesis. His echo showed a moderate pericardial effusion and his ECGs were reported to have ST elevations. He was discharged after about 5-7 days, and then readmitted within 10 days of discharge. His present symptoms included sharp anterior chest pain, shortness of breath, and a nonproductive cough. That admission included the diagnosis of recurrent pericarditis and bilateral pleural effusions. He was treated with Indocin and Colchicine. Patient has had no recurrence of symptoms in over 1 year. He describes the chest pain as usually being left-sided and usually a stabbing type pain. The pain intensity was usually a level 10 on a pain scale of 0-10. He noted that the chest pain was worse when laying down, and decreased when leaning forward or when walking. When chest pain and shortness of breath were at their worst, he had to sleep sitting up. He usually experienced shortness of breath and the sensation of his heart beating hard and fast with minimal activity. He also experienced headaches with some episodes of chest pain, but headaches have never persisted. He denies any peripheral edema or irregular heart rates. Prior to 2001, patient denies any previous episodes of chest pain, shortness of breath, or heart disease. He denies any symptoms of infection prior to initial episode of pericarditis. He has undergone cardiology evaluation and care since 2002.

VAERS ID:231239 (history)  Vaccinated:2004-12-08
Age:21.0  Onset:2004-12-17, Days after vaccination: 9
Gender:Male  Submitted:2004-12-19, Days after onset: 2
Location:Unknown  Entered:2004-12-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denies
Preexisting Conditions: denies
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 2IMUN
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130IDLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Pruritus, Skin ulcer, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pt noted itching in R inguinal area approx 12/17/04. Vaccinated with smallpox 12/08/04. Erythematous and lesion consistent with autoinoculation.

VAERS ID:231667 (history)  Vaccinated:2004-12-22
Age:21.0  Onset:2004-12-28, Days after vaccination: 6
Gender:Male  Submitted:2004-12-29, Days after onset: 1
Location:Unknown  Entered:2004-12-28, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200721IDLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Vaccination complication
SMQs:
Write-up: 20 y/o cauc male primary vaccination with smallpox on 2004Dec22. Patient states that he removed dressing and stopped covering up site for last 3 days. 2 days ago patient noticed multiple vesicles around primary vaccination site which have spread throughout upper left arm. Patient has been wearing long sleeves since immunization and denies close contacts, sharing sheets/bedding/bed. Denies any other vesicles or any sob, cp, n/v, ha, neck stiffness.

VAERS ID:232078 (history)  Vaccinated:0000-00-00
Age:21.0  Onset:2004-12-01
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:2005-01-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MEDI0002636
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500356P IN 
Administered by: Military     Purchased by: Military
Symptoms: Headache, Medication error, Pharyngolaryngeal pain
SMQs:
Write-up: This is a non-serious spontaneous case from a healthcare professional in the USA reporting that a medical support member had ACCIDENTAL EXPOSURE to FLUMIST while vaccinating military personnel. The reporter determined the events to be unrelated to FLUMIST administration. This case is submitted according to the VAERS accelerated reporting agreement for FLUMIST. An unidentified medical support member developed headache and scratchy throat after accidental exposure during FLUMIST administration. Investigation into these events resulted in no definitive reason why the FLUMIST was responsible for these symptoms. The reporter determined the events to be unrelated to FLUMIST vaccination. Further information has been requested. Follow up - This is a non-serious spontaneous case from a healthcare professional reporting that a medical support member had ACCIDENTAL EXPOSURE to FLUMIST while vaccinating military personnel. The reporter determined the events to be unrelated to FLUMIST administration. This case is submitted according to the VAERS accelerated reporting agreement for FLUMIST. An unidentified medical support member developed headache and scratchy throat after accidental exposure during FLUMIST administration. Investigation into these events resulted in "no definitive reason" why the FLUMIST was responsible for "these symptoms." HEPA filters were put into the environment and since then, nobody has gottensick. The patient has recovered. The reporter believes military personnel that were vaccinated with FLUMIST were already sick and hence may have caused the individuals administering FLUMIST to have headache and scratchy throat. The reporter will not give patient identifiers regarding this patient. The reporter determined the events to be unrelated to FLUMIST vaccination. Additional information received on 05Jan05 and 19Jan05 incorporated into above narrative.

VAERS ID:232092 (history)  Vaccinated:2004-12-21
Age:21.0  Onset:2004-12-21, Days after vaccination: 0
Gender:Female  Submitted:2004-12-21, Days after onset: 0
Location:Texas  Entered:2005-01-10, Days after submission: 20
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: TX04095
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVA059AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chest pain, Hypoaesthesia, Injection site pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Heaviness in left arm/chest. Numbness in fingers. Soreness at site area.

VAERS ID:232330 (history)  Vaccinated:2001-11-09
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2002-10-10
Location:Unknown  Entered:2005-01-14, Days after submission: 827
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: PJP200100414
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cyanosis, Peripheral coldness
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: A report was received from a health professional on 12Nov01 concerning a 21 year old female pt who experienced cyanosis of the left hand fingers 3,4 and 5 after receiving Fluvirin (batch E02101HA) on 09Nov01. The pt left hand fingers (3,4 and 5) turned blue and were cool touch. She was able to detect sensation. The event was increasing and decreasing in intensity and was ongoing at the time of reporting. There was insufficient information to determine the reporter''s causality assessment.

VAERS ID:232426 (history)  Vaccinated:2000-03-07
Age:21.0  Onset:2000-03-13, Days after vaccination: 6
Gender:Male  Submitted:2005-01-18, Days after onset: 1772
Location:Unknown  Entered:2005-01-18
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: PEANUTS AND WASP STINGS
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0473SC 
Administered by: Military     Purchased by: Military
Symptoms: Face oedema, Oedema peripheral, Pruritus, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 03/07/2000, within one week of receiving his 4th vaccine developed hives, one side of his face, lips was swollen and he had hives in axilla, back and abdomen. He sought medical care and was told to keep diary of foods, soaps and other contact items. He was prescribed Benadryl which did not help. Within a week he went back to Medical and was prescribed Zyrtec, which had no affect on his symptoms. His hive episodes would last 8-10 hours and then resolve to only reoccur in a few hours to a few days. He notes that his hands would itch and swell and within a 10-30 minutes to a day. He was deployed in November 2002. He received your 5th vaccine in theater. Within a week he had a “Serious” breakout. He states he developed swelling of face, hands, feet, and hives over his trunk. He was given Benadryl in the field. He took the Benadryl and Zyrtec together. He had these episodes approximately ever 3 days. He notes that his hands continued to itch regardless of his intervention. In January 2003, he was seen in theater by an physician. He prescribed Allegra 180mg and Zantac 150 mg and he was instructed to take them at the same time. This would relieve his symptoms for 23 hours. After 23 hours the symptoms would come back with a vengeance, much worse than before. He was instructed to once a month stop taking the medicine and see if his symptoms return. He continued to take the medications until February 2004. When he came off the medication, his hands started itching and his feet started swelling. He restarted the Allegra by itself. By April 2004, his symptoms had mostly resolved. He continues to have some swelling of his feet and itchy hands. He received his 6th anthrax vaccine in August 2003. Again within a week he developed hives and urticaria as described in his previous vaccinations. He states that before and after his deployment he told the physician who attended him that he had all the above symptoms; however he was told he was fine and would receive his vaccination and deploy as scheduled. He was told he could not see an allergist because he was leaving to soon. Currently he is symptom free. The military wants to give him his annual anthrax booster when the injunction is lifted. He is concerned that his symptoms will once again return and escalate.

VAERS ID:232682 (history)  Vaccinated:2005-01-06
Age:21.0  Onset:2005-01-08, Days after vaccination: 2
Gender:Male  Submitted:2005-01-14, Days after onset: 6
Location:Florida  Entered:2005-01-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABA015BA1IMLL
Administered by: Other     Purchased by: Private
Symptoms: Migraine
SMQs:
Write-up: Pt received Twinrix2 on 1/6/05. Received phone call from pt on 01/12/05; client states he had been having migraine headaches since 1/8/05 or for the last five days. Has been self medication with OTC remedies. Recommended client see his family doctor for evaluation. Received Twinrix 1 on 12/9/04 with no ill effects.

VAERS ID:232736 (history)  Vaccinated:2004-08-11
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2004-12-23
Location:Connecticut  Entered:2005-01-24, Days after submission: 32
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: Need for prophylactic vaccination and inoculation against rabies (preexposure to rabies vaccination); allergies to sulfa and raspberries
Diagnostic Lab Data:
CDC Split Type: EM20040432
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: A 21 year old female pt experienced fever and vomiting after pre exposure vaccination with RabAvert. The pt received RabAvert IM on 04Aug04 and 11Aug04. Her allergies included sulfa and raspberries. Her past medical history and concomitant medications were unspecified. Approx 24 hours after receiving RabAvert on 11Aug04, the pt complained of 2 episodes of vomiting and a fever of 101.2F that persisted for 12 to 24 hours. No further details were provided.

VAERS ID:233038 (history)  Vaccinated:2004-05-11
Age:21.0  Onset:2004-06-09, Days after vaccination: 29
Gender:Male  Submitted:2005-01-16, Days after onset: 221
Location:Illinois  Entered:2005-01-28, Days after submission: 12
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 175 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI; Spinal Tap; UA; Blood work. Discharge Summary received on 2/16/2005 states LP abnormal, MRI of cervical spine and brain abnormal.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS    
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Acute disseminated encephalomyelitis, Arthralgia, Brain stem syndrome, CSF test abnormal, Constipation, Encephalitis, Fatigue, Gait disturbance, Headache, Laboratory test abnormal, Memory impairment, Myelitis, Paralysis, Urinary incontinence, Urinary retention, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad)
Write-up: Paralysis from chest down 6/9/04. Unable to void or move bowels; headache/vomiting. Diagnosed on 6/12/04 with lesions on brain stem and spinal cord from immunizations: ADEM. Treated with high dose IV Solu-Medrol and physical therapy. Discharge Summary received on 2/16/2005 states knee pain, neck discomfort, numbness and weakness in extremities, tingling in hands, low-grade temperature, mild imbalance, muscle strain, and abnormal gait. Follow up 02/05/05:the report was unable to obtain lot number for vaccine 1, manufacturer and lot number for vaccine 2, manufacturer and lot number for vaccine 3, lot number for vaccine 4, and lot number and manufacturer for vaccine 5. Continues with chronic fatigue, urinary retention and incontinence joint pain (knees, hips, back, neck) balance disturbance chronic constipation, sleep disturbance (o/t pain) short term memory difficulty. My life has completely charged since immunization and I am concerned as the military is still giving the same immunizations knowing they cause these effects. At age 21 I am officially retired from a productive life. Per the follow up report-Patient is currently experiencing continous pain throughout body, fatigue, sleep interruption, short term memory loss, at time balance is affected. But the worst is that patient has no control of bladder and bowels. Since immunizations patient has no control of bladder. Currently having Botox injections every 6 months. Training bladder to render it. Completely paralyzed. Patient must catherize himself 4-6 times a day. The pain and sleep deprival does not allow patient to work or go to school.

VAERS ID:233063 (history)  Vaccinated:2005-01-26
Age:21.0  Onset:2005-01-27, Days after vaccination: 1
Gender:Female  Submitted:2005-01-31, Days after onset: 4
Location:Kansas  Entered:2005-01-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ortho evra patch (birth contol)
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER 1 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Face oedema, Nausea, Oedema peripheral, Pain, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: The vaccine was given on campus on the 26th of January 2005. The next day client experienced hives she took Benadryl for this. On Friday 28th she woke up with swollen hands and went to the campus health office. She was later seen by the family physican. He prescribed Prednisone. On the 29th she awoke with swollen hands and feet and hives and pain and discomfort and nausea & later the evening experienced swollen lips. The swelling did subside by the 30th of January however she is still experiencing hives over most of her body. She is still using Benadryl and Prednisone.

VAERS ID:233244 (history)  Vaccinated:2005-01-09
Age:21.0  Onset:2005-01-19, Days after vaccination: 10
Gender:Male  Submitted:2005-01-20, Days after onset: 1
Location:Maine  Entered:2005-02-01, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130 LA
Administered by: Military     Purchased by: Other
Symptoms: Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: On 01/19/05, I noticed red bumps covering my back and chest, around 25 or 30 of them.

VAERS ID:233328 (history)  Vaccinated:1991-01-20
Age:21.0  Onset:1991-01-20, Days after vaccination: 0
Gender:Male  Submitted:2005-02-02, Days after onset: 5127
Location:Unknown  Entered:2005-02-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Received all predeployment shots in December 1990. Deployed to Gulf.
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Unable to locate as Military is unable to locate records.
CDC Split Type:
Vaccination
Manufacturer
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 1IMRA
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Chest pain, Cough, Diarrhoea, Diplopia, Dizziness, Dysphagia, Dyspnoea, Gastrointestinal disorder, Hallucination, Hyperhidrosis, Lacrimation increased, Migraine, Muscle spasms, Muscle twitching, Muscular weakness, Nausea, Salivary hypersecretion, Vision blurred, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Lacrimal disorders (narrow), Ocular motility disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Reactions after receiving Vaccine A (Anthrax Shot) in the middle of the desert. nausea diarrhea double vision dizziness shortness of breath Reactions after receiving Pyridostigmine Bromide Pills. Severe Chest Pain and tightness of chest Trouble Breathing and shortness of breath Gastrointestinal upset, nausea, vomiting Abdominal cramps and diarrhea Increased salivation and tearing Increased sweating Muscle cramps Muscle twitching Muscle weakness Migraine Headaches Hallucinations Cough Blurry Vision Problems with swallowing food and water Problems with Balance Botulinum Toxoid Vaccine received in arm. Was still experienceing same signs associated with Anthrax vaccine. Botulinum Toxoid Vaccine seemed to intensify these symptoms. Received and took 1991 pink Malaria Pill/vaccine for several weeks.

VAERS ID:234082 (history)  Vaccinated:2002-11-15
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2003-08-22
Location:Unknown  Entered:2005-02-22, Days after submission: 550
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug Not reported
Current Illness:
Preexisting Conditions: No risk factors reported
Diagnostic Lab Data:
CDC Split Type: PJP200200791
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: A report received from a health care professional on 11/15/02, concerning a female vaccinee who was inadvertently administered 9.5 ml of Fluvirin on 11/15/02. No adverse symptoms were reported. There was insufficient information to determine the reporter''s causality assessment. Update (1) 01/07/03: A follow up report from a health care professional which indicated that the vaccinee was 20 years of age. The vaccinee inadvertently self administered 9.5 ml of Fluvirin. The vaccinee did not experience any adverse reactions.

VAERS ID:234127 (history)  Vaccinated:2002-11-15
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2003-08-22
Location:Unknown  Entered:2005-02-22, Days after submission: 550
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug Not Reported
Current Illness:
Preexisting Conditions: No risk factors reported.
Diagnostic Lab Data:
CDC Split Type: PJP200200864
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE35732HA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: A report was received from a health care professional on 11/22/02, concerning a group of vaccinees less than 4 years old of unknown demography who inadvertently received Fluvirin from approximately 11/07/02 onwards. There were no reported adverse events. There was insufficient information to determine the reporter''s causality assessment. Update (1) 12/10/02: A follow up report was received on 12/10/02, indicating that a 21 month old female vaccinee was inadvertently administered Fluvirin intramuscularly on 11/15/02. the vaccinee experienced no adverse reactions. Cross reference: PJP200200848, PJP200200849, PJP200200850, PJP200200851, PJP200200852, PJP200200853, PJP200200854, PJP200200855, PJP200200856, PJP200200857,PJP200200858, PJP20020859, PJP200200860, PJP200200861, PJP200200862, PJP200200863, PJP200200805, PJP200200865, PJP200200866, PJP200200867, PJP200200868, PJP200200869, PJP200200870, PJP200200871, PJP200200872, PJP200200873, PJP200200874, PJP200200875, PJP200200876 andPJP200200877.

VAERS ID:234181 (history)  Vaccinated:2005-02-02
Age:21.0  Onset:2005-02-02, Days after vaccination: 0
Gender:Female  Submitted:2005-02-08, Days after onset: 6
Location:North Carolina  Entered:2005-02-22, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC and UA
CDC Split Type: NC05018
Vaccination
Manufacturer
Lot
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Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION3380111IMRA
Administered by: Public     Purchased by: Private
Symptoms: Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Temperature of 101 degrees, chills and muscle aches for 24 to 36 hours. Not treated with medication.

VAERS ID:234475 (history)  Vaccinated:2004-04-16
Age:21.0  Onset:2004-04-19, Days after vaccination: 3
Gender:Female  Submitted:2005-02-22, Days after onset: 309
Location:Utah  Entered:2005-03-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: 04AV00607SP
Vaccination
Manufacturer
Lot
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV080 SCRA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Student received second dose of AVA 4/16/04 in the immunization clinic. On 04/19/04, reported back to nurse with the following symptoms: Right arm red, swollen and warm to touch. Clinic nurse sent her to the affiliated urgent care center where she was treated. She returned to the clinic 04/20/04 and the affected arm was much improved.

VAERS ID:234632 (history)  Vaccinated:2005-01-26
Age:21.0  Onset:2005-01-27, Days after vaccination: 1
Gender:Male  Submitted:2005-02-01, Days after onset: 5
Location:Delaware  Entered:2005-03-07, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500356P0IN 
Administered by: Military     Purchased by: Military
Symptoms: Pharyngitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow)
Write-up: Patient has pharyngitis, treated with Entex and Amoxicillin.

VAERS ID:234734 (history)  Vaccinated:2004-10-18
Age:21.0  Onset:2004-10-29, Days after vaccination: 11
Gender:Male  Submitted:2004-10-29, Days after onset: 0
Location:Unknown  Entered:2005-03-09, Days after submission: 131
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: NONE
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0820SCRA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1457AA0IMRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETHY0200720 LA
Administered by: Military     Purchased by: Military
Symptoms: Cow pox, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Multiple erythematous lesions on chest and back. Generalized vaccinia. Treated with claritin.

VAERS ID:234864 (history)  Vaccinated:2003-09-15
Age:21.0  Onset:2003-12-01, Days after vaccination: 77
Gender:Male  Submitted:2005-03-12, Days after onset: 467
Location:Unknown  Entered:2005-03-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0780IMRA
Administered by: Military     Purchased by: Military
Symptoms: Memory impairment
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad)
Write-up: Severe memory problems; short term memory significantly decreased; frequent loss of thoughts and events which are recent; unable to recall significant information; must write thoughts or tasks down immediately to remember the majority of items to be accomplished. Symptoms have mildly increased after continued Anthrax series. Physician recommended completion of this form.

VAERS ID:235034 (history)  Vaccinated:2005-03-04
Age:21.0  Onset:2005-03-14, Days after vaccination: 10
Gender:Male  Submitted:2005-03-16, Days after onset: 2
Location:Unknown  Entered:2005-03-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130IDLA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Headache, Injection site erythema, Injection site induration, Injection site pustule, Joint stiffness, Malaise, Myalgia, Nausea, Pyrexia, Tenderness
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), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: ROBUST TAKE. Fevers, (temp 103.1) chills, headache, malaise, myalgia, nausea, local stiffness, induration, tenderness, 10 x 28 cm erythema at vaccine site c 1 cm Jennerian pustule. Lost a day of work.

VAERS ID:235409 (history)  Vaccinated:2004-08-05
Age:21.0  Onset:2004-09-18, Days after vaccination: 44
Gender:Male  Submitted:2005-03-25, Days after onset: 188
Location:Unknown  Entered:2005-03-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denies
Preexisting Conditions: Allergies: seasonal allergies, long hair dogs, cats, all cillins, 1.Intermittent angioedema (hands, torso, lips, shoulders, joints) 2.Asthma, exercise induced (3-2004) 3.History drug induced hives, rash (Cillins) 4.Seasonal allergies including dogs, cats 5.Nearsighted, corrected w/glasses 6.Left/right wrist strains (2004) 7.Appendectomy (2004) 8.GERD 9.G6PD Positive (2001) 10.Anemic 11.Attention Deficit Disorder (ADD) (non-documented) 12.Sacrococcygeal teratoma (3 weeks of age surgically removed) 13.Fractured right 5th digit (age 13) 14.8 tattoos (3 left arm, 2 right arm, 2 chest wall, one stomach) 15.Obesity
Diagnostic Lab Data: 22 Feb 2001: Blood type A Positive, G6PD POSITIVE, Sickle Cell Negative Helicobacter pylori Ab IgG Site/Specimen 03 Feb 2005 1347 H. pylori, IgG SERUM NEGATIVE
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 2  
Administered by: Military     Purchased by: Military
Symptoms: Anaemia, Angioneurotic oedema, Arthritis, Asthma, Bursitis, Condition aggravated, Dyspnoea, Face oedema, Hypokinesia, Hypoproteinaemia, Injection site mass, Insomnia, Laboratory test abnormal, Myasthenic syndrome, Oedema peripheral, Pain, Red blood cell sedimentation rate increased, Rhinitis, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Haematopoietic erythropenia (broad), Systemic lupus erythematosus (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: IMMUNIZATION Vaccine Date Onset Date SYMPTOMS Anthrax #3 05 Aug 2004 18 Sept 2004 Nodule to right deltoid for 1 1/2 months following AVA #3 vaccination. In Sept he complained of pain in both wrists that resolved in 1-2 days as it radiated to both knuckles and fingers for 2 weeks. Complains of periodic swelling to upper lip with hive like swelling to left forehead, right chest, left back that resolves with prednisone use. History of Present Illness: This healthy 23 year old reports receiving three Anthrax (AVA) vaccination in 2002 with a fourth AVA in April-June 2003. However, his vaccination records record his first AVA as 30 Jan 2003, second AVA on 03 Mar 2003 and the third AVA on 05 Aug 2004. He reports the 05 Aug 2004 vaccination was given in the right deltoid with a resulting nodule for 1 1/2 months. There were no associated symptoms (flu, paresthesia, myalgia, arthralgia or headaches). He reports awakening on 19 September 2004 with “severe” pain to both wrists that prevented him from twisting or bending his wrists. Review of available medical records document he had been “working out and bent his wrists back bench pressing on 18 September 2004 with radiating pain into his right elbow”. He went to medical on 20 September 2004 with resolving wrist pain; however the pain was radiating into both knuckles and fingers with accompanying swelling and pain (10/10 pain scale). He complained of an inability to grip, hold objects, write, turn door knobs and that his fingers were curling. He was diagnosed with left and right wrist strains and bursitis of the right elbow. He was treated with Naprosyn. From 9-14 October 2004 he complained increased bilateral hand swelling with decreased mobility. He was re-evaluated on 14 October 2004 with a “normal exam with bilateral swelling”. Radiographic studies of his wrists/hands were normal and he was treated with Prednisone. He reports awakening on 02 November 2004 with a painful hard swollen left “latissimus muscle” after driving all night. He does lift weights 3-4 times a week, but denied any trauma, injury, weight lifting the day prior to traveling or alteration in routine. He was seen by a family physician who treated him for a swollen back muscle, “anemia and an elevated sedimentation rate” with Prednisone and an “L” named medication for hives and allergies. Allergy and Immunology examined on 24 February 2005 for persistent random episodes of angioedema to his joints, back, shoulder and lips. He denied any history eczema, respiratory distress, change in ADL, no new foods (seafood), detergents or oral/skin products. He reports hive allergy to “cillins” with no recent exposure, seasonal allergies and has a dog with known history of long hair dog-cat allergies. He was restarted on a Prednisone taper, Allegra, Zantac and emergency Epinephrine Pen use was reviewed and supplied. He is for follow up in two weeks. As of 01 March 2005, he reports sleep deprivation and or insufficient sleep as the only known triggers for this swelling. He continues to exhibit periodic “hive like swelling” to his forehead along the hairline, the left lateral latissimus muscle, and his right anterior chest wall when not taking Prednisone. He reports the swelling occurs 2-3 times a week depending on his activity. He was also evaluated by Rheumatology for “recurrent episodes of questionable angioedema treated with prednisone” on February 24, 2005. He reported “frequent episodes of swelling of various areas of his body (lips, back and hands) that were vague in nature, severity and frequency.” His last occurrence was January 31, 2005 where he was seen in the ER (no records available). Laboratory studies obtained on 13 December 2004 showed a positive ANA 1:320 homogenous, a low hemoglobin/hematocrit (13/38), normal TSH, a negative Rheumatoid Factor, low total protein at 6.2, and albumin at 3/2 otherwise normal lab. Doctor diagnosed him with questionable angioedema with lab wor

VAERS ID:235532 (history)  Vaccinated:2005-03-21
Age:21.0  Onset:2005-03-22, Days after vaccination: 1
Gender:Male  Submitted:2005-03-22, Days after onset: 0
Location:New Mexico  Entered:2005-03-29, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020072  LA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURX0862  RA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Joint range of motion decreased, Pain
SMQs:, Arthritis (broad)
Write-up: Pt received small pox vaccine on 03/21/2005. Pt came into clinic at about 9:45 on 03/22/2005 complaining of severe arm pain from the shoulder to the elbow he said that it hurts to bend the elbow and he couldn''t raise his arm above his head.

VAERS ID:235554 (history)  Vaccinated:1990-09-01
Age:21.0  Onset:0000-00-00
Gender:Male  Submitted:2005-03-29
Location:Georgia  Entered:2005-03-29
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Multiple sclerosis
SMQs:, Optic nerve disorders (broad), Demyelination (narrow)
Write-up: I have a rare form of Multiple Sclerosis.

VAERS ID:235653 (history)  Vaccinated:2005-03-29
Age:21.0  Onset:2005-03-29, Days after vaccination: 0
Gender:Female  Submitted:2005-03-29, Days after onset: 0
Location:Washington  Entered:2005-04-01, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0625P SCLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Hyperhidrosis, Injection site erythema, Nausea, Rash macular
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Hypo-, diaphoretic, nauseated, blotchy redness at injection site. All resolved within one hour after Benadryl 25mg IM. Received follow up care by MD at CWU Student Health Center.

VAERS ID:235686 (history)  Vaccinated:2005-02-16
Age:21.0  Onset:2005-03-09, Days after vaccination: 21
Gender:Male  Submitted:2005-04-04, Days after onset: 25
Location:Washington  Entered:2005-04-04
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
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720 RA
Administered by: Military     Purchased by: Military
Symptoms: Rash, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 22 year-old male with skin rash X 3 weeks found only on anterior trunk from the umbilicus to his pubic area. The lesions are non-pruritic without erythema, no pain, no discharge associated with these lesions. Patient reports the lesions appeared just a few at a time and are spreading downward toward his genitalia. He reports the lesions appeared 7-14 days after receiving smallpox vaccine. 20-30 individual pustular lesions along anterior trunk down into pubic hair area without surrounding erythema, scale, or drainage. Lesions appear to be post-vaccinia follicular pustulosis.

VAERS ID:235798 (history)  Vaccinated:2005-02-28
Age:21.0  Onset:2005-02-28, Days after vaccination: 0
Gender:Female  Submitted:2005-04-05, Days after onset: 35
Location:Unknown  Entered:2005-04-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: B0375714A
Vaccination
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Lot
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5399C6 IM 
Administered by: Other     Purchased by: Other
Symptoms: Angina pectoris, Anxiety, Chest pain, Feeling abnormal, Headache, Sleep disorder
SMQs:, Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)
Write-up: This case was reported by a regulatory authority (Ref: 1505331001) and described the occurrence of pressing pain in the cardiac area in a 21 year old female patient receiving Hepatitis B vaccine (Engerix B) injection for prophylaxis. On 02/28/05 the patient received Hepatitis B vaccine (IM) at 1 ml. The same day, after vaccination the patient developed pain in cardiac area, anxiety, sleep disorder, bad feeling and headache. On 03/03/05, the events resolved. This case was assessed as medically serious by GSK. The regulatory related to authority reported that the events were almost certainly related to vaccination with Hepatitis B vaccine. Further information has been requested. (OMIC)

VAERS ID:235820 (history)  Vaccinated:2005-01-26
Age:21.0  Onset:2005-02-02, Days after vaccination: 7
Gender:Female  Submitted:2005-02-04, Days after onset: 2
Location:Delaware  Entered:2005-04-06, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500356P IN 
Administered by: Military     Purchased by: Military
Symptoms: Epistaxis, Headache, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: Sinus pain, Nosebleeds, Headache

VAERS ID:235999 (history)  Vaccinated:2005-04-09
Age:21.0  Onset:2005-04-09, Days after vaccination: 0
Gender:Female  Submitted:2005-04-11, Days after onset: 2
Location:North Carolina  Entered:2005-04-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None apparent
Preexisting Conditions: None noted
Diagnostic Lab Data:
CDC Split Type:
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB052AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anaphylactic shock
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)
Write-up: Following Hepatitis B vaccine she immediately went in to aniphylactic shock.

VAERS ID:236243 (history)  Vaccinated:2005-04-11
Age:21.0  Onset:2005-04-11, Days after vaccination: 0
Gender:Female  Submitted:2005-04-14, Days after onset: 3
Location:Illinois  Entered:2005-04-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient received a second dose of Hepatitis A vaccine, lot # AHAVA031BR, administered in the left deltoid on 3/29/05. She has no pre-existing allergies or medical conditions. She did not have any illnesses and was taking no other medications at the time of vaccination.
Diagnostic Lab Data: NONE
CDC Split Type: 200500727
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JEV: JAPANESE ENCEPHALITIS (JE-VAX)AVENTIS PASTEUREJN216B0 LA
RAB: RABIES (RABAVERT)CHIRON CORPORATION3400110 RA
Administered by: Public     Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: From initial information received on 4/12/05 from a health care professional regarding an adverse event occurring in the USA, it was reported that a 21 year old female patient received her first dose of JE-VAX, lot # EJN216B, administered in the left deltoid and a first dose of RABAVERT, lot # 340011, administered in the right deltoid on 4/11/05 at 3:30 PM. The routes of administration were not reported for either product. Five and half hours later, at 9:00 PM on 4/11/05, the patient complained of numbness and tingling in her face, neck, lips, and chest. She also complained of shortness of breath. She was seen in a student health center and was treated with an Epipen, which relieved her chest pain and shortness of breath. She was sent to the emergency room and her recovery status is currently unknown. (OMIC)

VAERS ID:236334 (history)  Vaccinated:2005-04-15
Age:21.0  Onset:2005-04-15, Days after vaccination: 0
Gender:Male  Submitted:2005-04-19, Days after onset: 4
Location:New Jersey  Entered:2005-04-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1437AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dyspnoea, Headache, Pain, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Patient indicated that approximately 2 hours after receiving the TD shot he felt achiness, headache, fever, SOB, itchiness of throat area. These symptoms intensified into the next day. The patient did not seek medical attention but reported this on Monday and was feeling fine by then.

VAERS ID:236447 (history)  Vaccinated:2005-04-14
Age:21.0  Onset:2005-04-15, Days after vaccination: 1
Gender:Female  Submitted:2005-04-18, Days after onset: 3
Location:Maryland  Entered:2005-04-22, 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:
Preexisting Conditions: allergy to bee stings
Diagnostic Lab Data:
CDC Split Type:
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HEP: HEP B (FOREIGN)MERCK & CO. INC.0826P IMRA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1215CA IMRA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Injection site induration, Injection site mass, Injection site pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: 50x35mm induration occurred after having shot on Thurs. 04/14/05. Pt states each day area got bigger and red. Soreness in area occurred also. Warm compress and massage did not help. Nothing eles follows. Lump is still.

VAERS ID:236552 (history)  Vaccinated:2005-04-01
Age:21.0  Onset:2005-04-02, Days after vaccination: 1
Gender:Female  Submitted:2005-04-21, Days after onset: 18
Location:New Mexico  Entered:2005-04-25, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Eczema
Diagnostic Lab Data:
CDC Split Type:
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TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD3000433 PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Abdominal pain, Dizziness, Fatigue, Nausea, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt took oral typhoid on 04/01/2005, 04/03/2005, and 04/05/2005- reports on 04/02/2005 felt lightheaded " slumped over at veternarian" abdominal cramps and fever. No headaches or diarrhea. Decreased appetite, stomach continues to feel queasy and fatigue. Instructed to not take last dose of oral typhoid. All symptoms resolved on 04/21/2005.

VAERS ID:236606 (history)  Vaccinated:2005-03-28
Age:21.0  Onset:2005-03-28, Days after vaccination: 0
Gender:Male  Submitted:2005-03-28, Days after onset: 0
Location:Tennessee  Entered:2005-04-26, Days after submission: 28
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: TN05017
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0960N SC 
Administered by: Other     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Developed hives 30-60 minutes after injection Benadryl 25mg PO liquid given x 1.

VAERS ID:236667 (history)  Vaccinated:2005-04-25
Age:21.0  Onset:2005-04-25, Days after vaccination: 0
Gender:Female  Submitted:2005-04-26, Days after onset: 1
Location:Utah  Entered:2005-04-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin
Current Illness:
Preexisting Conditions: Allergy to PCN, history of general anxiety ( not diagnosed, but feels like)
Diagnostic Lab Data:
CDC Split Type:
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABA026AA1IM 
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Chills, Eye irritation, Headache, Heart rate irregular, Nausea, Neck pain, Photosensitivity reaction, Pyrexia, Vomiting, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: HA, Nausea, vomiting, wheezing (short duration) irregular heart beat, fever, chills, eyes burning, cough, sensitivity to light, bones aching and sore neck.

VAERS ID:236758 (history)  Vaccinated:2005-04-25
Age:21.0  Onset:2005-04-25, Days after vaccination: 0
Gender:Female  Submitted:2005-04-29, Days after onset: 4
Location:Pennsylvania  Entered:2005-04-29
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:
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TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD3000672 PO 
Administered by: Other     Purchased by: Private
Symptoms: Abdominal pain, Diarrhoea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt c/o abdominal pain, cramps and diarrhea 3 hours ofter taking vivotif. On day 1 and day 3 of schedule of taking vivotif. She took approximately at 11 AM and SS started by 2 PM. The SS lasted x6 hours.

VAERS ID:237025 (history)  Vaccinated:2005-04-27
Age:21.0  Onset:2005-04-28, Days after vaccination: 1
Gender:Female  Submitted:2005-05-04, Days after onset: 6
Location:Georgia  Entered:2005-05-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergic to Septra
Diagnostic Lab Data:
CDC Split Type:
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM066BA IMRA
Administered by: Military     Purchased by: Unknown
Symptoms: Arthralgia, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Soreness of right arm for 2 days. diffuse joint pain, starting at knees and later at all joints. On 04/28/05.

VAERS ID:237115 (history)  Vaccinated:2004-06-21
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2005-04-20
Location:Texas  Entered:2005-05-06, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: LA050501
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER    
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Unknown
Symptoms: Medication error, Premature labour, Unintended pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: LMP 05/29/2004, EDC 03/06/2004 EGA @ time of injection 3 weeks. Delivered baby at 39 weeks, mom and baby healthy. Information from missing data report states: I have no further information. Immunization were administred by the military.

VAERS ID:237124 (history)  Vaccinated:2005-05-03
Age:21.0  Onset:2005-05-08, Days after vaccination: 5
Gender:Male  Submitted:2005-05-08, Days after onset: 0
Location:Unknown  Entered:2005-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: URI symptoms, chest and nasal congestion with rhinorrhea
Preexisting Conditions: none
Diagnostic Lab Data: EKG with mild ST elevation in all leads, otherwise normal sinus elevation. CXR with normal cardiac silouette, mild platelike atelectasis
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200721 LA
Administered by: Military     Purchased by: Military
Symptoms: Atelectasis, Chest pain, Dyspnoea, Electrocardiogram abnormal, Pharyngitis, Rhinorrhoea, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: 22 y/o male AD PV-2 who presented for 1 day of mild SOB and chest pain, especially with inspiration. He admits to 1 week of URI type symptoms including nasal and chest congestion, rhinorrhea, and post-nasal drip. Patient has just arrived overseas. He was in processed where he received small pox vaccination on 3May 2005. Patient subsequently transferred to duty station 06 May 2005. Symptoms prompted sick call visit on 09 May 2005. Treated URI symptoms with Deconamine 1 tab po q12hours, Albuterol 2 puffs q12, pericarditis treated with Indomethacin 25 mg 1 tab po tid with food x 10. Five days after receiving his 1st SPV, patient developed symptoms of chest pain, palpitations, and dyspnea. Observed overnight and treated with INDOCIN. Since then has experienced chronic CP, dyspnea and palitations

VAERS ID:237231 (history)  Vaccinated:2004-10-01
Age:21.0  Onset:2004-10-01, Days after vaccination: 0
Gender:Male  Submitted:2005-05-10, Days after onset: 221
Location:Massachusetts  Entered:2005-05-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Passed out~Measles + Mumps + Rubella (unknown mfr)~~0~In Patient
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC Split Type:
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS  IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Agitation, Confusional state, Hyperhidrosis, Hypoaesthesia, Muscle rigidity, Muscle twitching, Similar reaction on previous exposure to drug, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Due to a Department of Public Health requirement I am required to be vaccinated against Hepatitis B. On the afternoon of October 1, 2004 I went to Health Services. I was not sick that day or in the immediate past. I informed the RN that I had a reaction after receiving the MMR shot in the past. I was then administered the vaccination of in my right arm. Following the shot, I would have to say about a couple minutes later, I passed out. My body became rigid, and twitched for a short time. According to the report I was unconscious for a time. I was then taken Urgent Care in the same building where I was administered to and recovered. Not reported, but I felt agitated, and confused during this ordeal. I also was sweating. Despite, recovering I did not feel very well for the remainder of the day or for the following week. My arm and hand felt numb as well for that time. Since then, I have refused the vaccination in which I have been told I need an exemption from my provider or I will not be able to receive my college transcript after graduating. Against MY choice not to receive this vaccination the health services and the state for that matter are jepordizing my status and what I when I graduate. The state nor does the school have any right to force me to put anything I do not want to receive in my body. Unfortunately, it appears that beleive they can get away with forced immunization. It will not happen with me. I thought you should be made aware of this reaction, since this vaccine has been an issue as of late. Thank you and hope my report of the reaction can help.

VAERS ID:237304 (history)  Vaccinated:2005-04-07
Age:21.0  Onset:2005-04-16, Days after vaccination: 9
Gender:Female  Submitted:2005-05-12, Days after onset: 26
Location:Maine  Entered:2005-05-12
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: EKG and CXR negative
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720 LA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Dyspnoea, Pericarditis, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad)
Write-up: Pt had chest pain and shortness of breath approximately 10 days after vaccine administration. Pt was evaluated at an ER and diagnosed with pericarditis. Pt was treated symptomatically and symptoms resolved without sequelae. Follow up exam unremarkable. In addition, pt had questionable satellite lesions which resolved spontaneously.

VAERS ID:237321 (history)  Vaccinated:2005-05-12
Age:21.0  Onset:2005-05-12, Days after vaccination: 0
Gender:Female  Submitted:2005-05-12, Days after onset: 0
Location:Georgia  Entered:2005-05-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: non response and posturing;DT Adsorbed, Ped. (no brand name);;0;In Patient
Other Medications:
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.AHBVA059BA IMLA
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1212AB IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Coma, Fatigue, Memory impairment, Posturing
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Dystonia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad)
Write-up: Non response and posturing after tetanus shot, lasting 45-60 seconds, without memory, with fatigue.

VAERS ID:237399 (history)  Vaccinated:2005-04-13
Age:21.0  Onset:2005-04-22, Days after vaccination: 9
Gender:Male  Submitted:2005-04-25, Days after onset: 3
Location:Unknown  Entered:2005-05-16, Days after submission: 21
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:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200721SCLA
Administered by: Military     Purchased by: Military
Symptoms: Conjunctivitis, Eye irritation
SMQs:, Severe cutaneous adverse reactions (broad), Corneal disorders (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: Pt present with irritation of right eye sp small pox vaccine x 9 days. Pt dx with conjunctivitis on 22Apr05. Pt treated with erythromycin opth oint. as a precautionary measure to ensure vaccinia was not transmitted from arm to eye. 25Apr05 eye is much improved.

VAERS ID:237439 (history)  Vaccinated:2004-03-24
Age:21.0  Onset:2004-04-11, Days after vaccination: 18
Gender:Female  Submitted:2005-05-12, Days after onset: 396
Location:Wyoming  Entered:2005-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pregnancy NOS ( LMP= 04/11/2004)
Diagnostic Lab Data: UNK
CDC Split Type: WAES0406USA01319
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Public
Symptoms: Abortion spontaneous, Unintended pregnancy
SMQs:, Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a physician through the manf pregnancy registry concerning a 21 year old healthy female pt who on 24Mar04 was vaccinated with a dose of varicella virus vaccine live. Concomitant vaccination on 24Mar04 included a dose of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar RA 27/3) and a dose of tetanus toxoid. The reporter stated the pt was vaccinated on 24Mar04 in another country and her LMP was 11Apr2004. The reporter noted the pregnancy was unremarkable so far. Unspecified medical attention was sought but treatment was not required. A product quality complaint was not involved. Follow up information was received from a woman in a physician''s office who reported that she had checked with the physician, who confirmed that the female pt had a miscarriage at 14 weeks gestation, on approx 19Jul04. There was no other information provided regarding the pt''s adverse experience. Additional information has been requested.

VAERS ID:237559 (history)  Vaccinated:2004-03-24
Age:21.0  Onset:2004-03-25, Days after vaccination: 1
Gender:Female  Submitted:2004-06-02, Days after onset: 68
Location:California  Entered:2005-05-19, Days after submission: 351
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Otho Tri-Cyclen
Current Illness: NONE
Preexisting Conditions: The patient has a history of irritable bowel syndrome and is allergic to amoxicillin. On 3/4/04, the patient received a first dose of Imovax Rabies, lot # W1419, a first dose of oral Typhoid vaccine, lot number 3000231, a dose of IPOD (lot # X0367), and a dose of TD ADS ADULT (lot number U1018BA). The number of previous doses of IPOL and tetanus are unknown. The patient received he
Diagnostic Lab Data: NONE
CDC Split Type: 200401687
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HEPA: HEP A (VAQTA)MERCK & CO. INC.1165M0 LA
RAB: RABIES (IMOVAX)AVENTIS PASTEUR 2  
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Diarrhoea, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: From initial information received on 4/22/04 and additional information received on 4/23/04 from a physician regarding an adverse event occurring in the USA, it was reported that a 20 year old female patient received her third dose of pre-exposure IMOVAX RABIES, lot number unknown, and a first dose of HEPATITIS A VACCINE, lot number 1165M, administered in the left deltoid on 3/24/04. The next day, on 3/25/04, the patient experienced severe abdominal cramps, nausea, and diarrhea, which lasted for five to six days. The patient reportedly recovered from this experience. The physician stated that he did not feel the patient''s adverse events were related to the vaccinations. From information received on 5/28/04 from a health professional, it was reported that all information has been received and no additional information is available at this time. No further information is anticipated, this case is considered closed.

VAERS ID:237568 (history)  Vaccinated:2003-11-21
Age:21.0  Onset:2003-11-21, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:2005-05-19
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: The patient received a first dose of IMOVAX RABIES, lot number W1419, on 11/18/03 after exposure to a rabid animal (species not specified). No adverse event was reported following the receipt of this vaccine. It was not reported whether the patient received RABIES IMMUNOGLOBULIN at that time.
Diagnostic Lab Data:
CDC Split Type: 200402075
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)AVENTIS PASTEURW14191  
Administered by: Private     Purchased by: Unknown
Symptoms: Diarrhoea, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: From initial information received on 6/7/04 from a health care professional regarding an adverse event occurring in the USA, it was reported that a 21 year old female patient received a second dose of IMOVAX RABIES, lot number W1419, on 11/21/03 as part of a post-exposure series. The route and site of administration were not reported. The same day, the patient experienced severe nausea, vomiting and diarrhea. The patient''s recovery status was not reported. The reporter of this case is the same as for case 200402074.

VAERS ID:237577 (history)  Vaccinated:2003-12-05
Age:21.0  Onset:2003-12-20, Days after vaccination: 15
Gender:Male  Submitted:2005-05-13, Days after onset: 509
Location:Unknown  Entered:2005-05-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Bronchiolitis-infancy
Diagnostic Lab Data: 24Dec03: CT chest: findings consistent with old granulomatous disease. One enlarged precarinal node is present with calcifications likely from previous granulomatous disease. No other evidence of metastatic disease is seen in the chest. 24Dec03: CT Abdomen: No specific CT evidence of lymphadenopathy or mass seen in the abdomen or pelvis. 24Dec03: Ultra Sound testicular: normal 23Dec03: CT orbits/sella/post fossa w contrast: Ill-defined subtle area of low attenuation within the posterosuperior aspect of the right globe. The extraocular compartment is normal in appearance. The differential for this finding is relatively wide but includes metastatic lesions such as from melanoma, alternatively this may represent a primary neoplastic process
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Military     Purchased by: Military
Symptoms: Blindness, Cyst, Demyelination, Encephalopathy, Eye pain, Fluid retention, Granuloma, Headache, Laboratory test abnormal, Mucous membrane disorder, Photophobia, Sinus congestion, Sinusitis, Skin ulcer, Speech disorder, Tongue oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Oropharyngeal allergic conditions (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Corneal disorders (broad), Retinal disorders (broad), Chronic kidney disease (broad), Hypersensitivity (narrow)
Write-up: Developed headaches, vision loss and eye pain. 5Dec03: Received anthrax #1, Twinrix and Influenza vaccines. 13Dec03: noticed fluid filled lesion on forefoot and a similar swelling under tongue that sometimes impaired speech. 20Dec03: Developed photophobia and throbbing headaches everywhere in head. He took Tylenol, continued full duty and did not seek medical care. He had sinus congestion at the time and these symptoms were related. 22Dec03: Awakened with headache and vision loss in right eye. Experienced aching in the eyeball itself and had acute pain in right eye when moving it. Pt was went to med center on 23Dec03 and was admitted to the inpatient service for an expedited malignancy workup. Diagnosis: right subretinal growth, likely idiopathic granuloma. Work up proved negative except for evidence of old granulomatous growth found on CT of the chest. He was also evaluated in ENT and the sulingual lesion was diagnosed as a mucocele and the lesion on the foot as a ganglionic cyst. He was started on prednisone 20mg and sent on CVL. Ophthalmology expected that his eye improve enough (if not fully) such that he will be a deployable soldier in the next 6-12 months. He continued on the prednisone for 3 weeks and his right vision improved so that he could see shapes but not details or colors. He followed up regularly with providers near his home. An MRI of the brain in Jun2004 showed Patchy white matter lesions possibly demyelinating or related to Leukoencephalopathy. Daily headaches have continued until the present. There is no pattern to them and some episodes are more severe than others. In Feb05 he returned to med center for further medical evaluation. This evaluation continues to the present.

VAERS ID:237580 (history)  Vaccinated:0000-00-00
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2005-04-22
Location:Colorado  Entered:2005-05-19, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? Yes
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
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Diabetes mellitus, Erythema, Erythema multiforme, Injection site erythema, Injection site mass, Injection site oedema, Skin disorder
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Reaction started with redness and swelling x 2-3 days. developed into a golf ball sized boil with red swelling and a white center x 1-2 weeks,. Very hard to the touch, took almost a year to go away. Skin at site is still indented. Stated pt recovered until the age of 12 when the onset of TypeI diabetes happened.

VAERS ID:237789 (history)  Vaccinated:2004-01-06
Age:21.0  Onset:2004-01-16, Days after vaccination: 10
Gender:Female  Submitted:2005-03-23, Days after onset: 432
Location:Nebraska  Entered:2005-05-23, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site reaction, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Increasing redness around injection site and into axilla. Pruritis at site.

VAERS ID:238218 (history)  Vaccinated:1993-03-10
Age:21.0  Onset:2004-03-01, Days after vaccination: 4009
Gender:Female  Submitted:2005-05-16, Days after onset: 440
Location:Pennsylvania  Entered:2005-05-26, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Serum VZV-specific 880 and then 187.
CDC Split Type: WAES0406USA00538
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Rash, Viral infection
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 21 year old female student with no medical history who on 12/14/87 and 3/10/93 was vaccinated SC with the first and second doses, respectively, of varicella virus vaccine live. There was no illness at the time of vaccination. The vaccinations were given as part of a medical research grant and yearly serum varicella zoster virus specific glycoprotein antigen based ELISA antibody titers were done through 1995. In 1993 the patient''s titer was 880 and in 1995, the titer result was 187. In the spring of 2004, the patient was diagnosed as having a serious case of varicella. Unspecified medical attention was sought and the patient required hospitalization. At the time of this report, the patient had recovered. No product quality complaint was involved. No additional information was provided. Additional information is not expected.

VAERS ID:238276 (history)  Vaccinated:2005-05-11
Age:21.0  Onset:2005-05-11, Days after vaccination: 0
Gender:Female  Submitted:2005-05-26, Days after onset: 15
Location:Michigan  Entered:2005-05-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: INHALER PRN ASTHMA
Current Illness:
Preexisting Conditions: ALLERGIC ASTHMA (MILD)
Diagnostic Lab Data: Strep test negative. Alk phos=64, SGOT=18, SGPT=7.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVBOO32BA0 LA
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUE498AA0 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Hyperhidrosis, Pain, Pharyngolaryngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: 5/11/05: Severe pain both legs, beginning about 7 hrs after vaccination. Pt is a runner. 5/12/05:Temp up to 102.5, chills, sweats, aches, severe leg pain, sore throat. Went to ER on 5/12/05. Treated for pain and fever and discharged. Was sick for about one week.

VAERS ID:239486 (history)  Vaccinated:2004-06-16
Age:21.0  Onset:2004-06-17, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Unknown  Entered:2005-06-03
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: WAES0408USA01736
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSENG5570A2   
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)SANOFI PASTEUR    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: information has been received from a manufacturer concerning a 21 year old male who was vaccinated with a does of MMR. Concomitant therapy included a first dose of Hep B in the RA and a dose of tetanus toxoid on 06/17/04 the pt

VAERS ID:239913 (history)  Vaccinated:2004-07-26
Age:21.0  Onset:2004-07-26, Days after vaccination: 0
Gender:Female  Submitted:2005-05-26, Days after onset: 304
Location:Unknown  Entered:2005-06-03, 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: Allegra
Current Illness:
Preexisting Conditions: Hypersensitivity; ragweed allergy
Diagnostic Lab Data:
CDC Split Type: WAES0408USA00301
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Medication error
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Info has been received from a physician concerning a 40 year old female physician with ragweed allergy who on 7/26/04 was vaccinated with a pediatric dose of hepatitis A virus vaccine inactivated (0.5ml), IM. Concomitant therapy included Allegra. Subsequently, the pt developed a sore shoulder. The pt recovered. Additional info has been requested.

VAERS ID:239090 (history)  Vaccinated:2005-05-17
Age:21.0  Onset:2005-05-17, Days after vaccination: 0
Gender:Male  Submitted:2005-05-18, Days after onset: 1
Location:California  Entered:2005-06-06, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NKDA
Diagnostic Lab Data: Allergic reaction to medication.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1549AA0IMGM
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB019BA0IMLA
MEN: MENINGOCOCCAL (MENOMUNE)SANOFI PASTEURUE348AA0SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0777P SCLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0371P0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Dyspnoea, Hypersensitivity, Pruritus, Swelling, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Patient broke out in hives all over his body; major itching and swelling about 30-40 minutes after receiving vaccination. Discharge summary states allergic reaction, dyspnea. msv

VAERS ID:239506 (history)  Vaccinated:2005-06-06
Age:21.0  Onset:2005-06-06, Days after vaccination: 0
Gender:Male  Submitted:2005-06-08, Days after onset: 2
Location:Missouri  Entered:2005-06-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: no
Preexisting Conditions: unknown
Diagnostic Lab Data: none PPD was also given that day with the Menactra. C2155AA Left forearm ID
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1589AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Back pain, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Patient voiced c/o body aches, back aches and joint pain for 2 days. He also states he experienced nausea and vomiting the morning of the second day.

VAERS ID:239940 (history)  Vaccinated:2004-07-01
Age:21.0  Onset:2004-07-01, Days after vaccination: 0
Gender:Female  Submitted:2004-07-19, Days after onset: 18
Location:Unknown  Entered:2005-06-10, Days after submission: 326
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: Hypotension
Diagnostic Lab Data:
CDC Split Type: 2004022920
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESBJN213A1SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain upper, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: From initial info received on 7/6/04 from a health care professional regarding an adverse event occurring in the USA, it was reported that a 21 year old female pt received her 2nd dose of JE-VAX, lot BJN213A, administered SC, in the left arm on 7/1/04. After receiving the 2nd dose at the beach by a relative, the pt reported (to this reporter who administered the 1st dose) that she experienced stomach pain, nausea and vomiting. The events resolved the same day without medical intervention. The pt recovered from these events.

VAERS ID:239760 (history)  Vaccinated:2003-04-23
Age:21.0  Onset:2003-04-23, Days after vaccination: 0
Gender:Male  Submitted:2003-06-28, Days after onset: 66
Location:New Jersey  Entered:2005-06-13, Days after submission: 716
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0760SCRA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Fatigue, Headache, Hot flush, Nausea, Oral intake reduced
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Constant HA, fatigue, joint pains and " hot flashes" since receiving 1st Anthrax vaccine on 04/23/2003. Present Illness: 23 year old active duty Military personnel. Although he admits to been afraid of needles, he states that he was in good health when he received his 1st anthrax vaccination. He has never had any px with previous vaccinations in the past. 04/23/03- Anthrax 1: pain at inj. site. "felt like i blew my triceps out. Some numbness and tingling down into right elbow that lasted about 1-2 days. This has since resolved completely. Severe HA across forehead, above eyes usually within 30-45 minutes of injection 9/10 on the pain scale. He medicated with Motrin 800 mg and the pain subsided to @ 3/10. He denies aura, photo, or photophobia, numbness, or weakness. He awoke the next morning with a dull, constant HA that improves with Motrin BID bur reoccurs daily. He also complained of sharp stabbing pains that occurred 4-8 times per day lasting several minutes that immobilized him. Whenever they occurred in both knees and his right elbow. I felt like my knees needed to be popped. He medicated with icy hot with some relief. These pains have decreased to mostly a constatnt aching pain. Two days post vaccine he began having periodic "hot flashes" startig with his hears feeling hot then sweating of his face chest and back with occassional nausea lasting 20-30 minutes. These usually occur after eating and at night. The episodes have decreased in frequency at this time.

VAERS ID:239830 (history)  Vaccinated:2005-05-26
Age:21.0  Onset:2005-05-26, Days after vaccination: 0
Gender:Male  Submitted:2005-06-09, Days after onset: 14
Location:Massachusetts  Entered:2005-06-14, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURX12444SC 
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD1065IM 
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30006871PO 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Diarrhoea, Headache
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: 5-6 hours after taking each of the first 2 typhoid capsules he suffered severe abdominal pain, diarrhea and headache occurred after the first dose; not the second. Symptoms resolved in a few hours after treatment.

VAERS ID:240054 (history)  Vaccinated:2005-05-26
Age:21.0  Onset:2005-05-27, Days after vaccination: 1
Gender:Female  Submitted:2005-06-20, Days after onset: 24
Location:Maryland  Entered:2005-06-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Orthocycline and Zertec
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURUNKNOWN0 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Contusion, Injection site erythema, Injection site oedema, Injection site pain, Injection site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling, redness, sore, warmth at injection site and then bruising at injection site. Still slighty swollen today. Saw MD at clinic for follow-up who told pt. her reaction was not unusual. The size was about 6 inches when it was at its largest.

VAERS ID:240555 (history)  Vaccinated:2003-11-24
Age:21.0  Onset:2004-01-02, Days after vaccination: 39
Gender:Female  Submitted:2005-06-17, Days after onset: 531
Location:Ohio  Entered:2005-06-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The pt''s medical history, concurrent conditions, and concurrent medications were not reported.
Diagnostic Lab Data: Hep B antibody 26Nov03 negative; Hep b antibody 02Jan04 negative.
CDC Split Type: A0443687A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 2  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This case was reported by a physician and described a 21 yr old female pt who did not respond to the hep B vaccine recombinant (Engerix B) immunization series. The pt''s medical history, concurrent conditions and concurrent medications were not reported. On 24Nov03, the pt received the third dose of Engerix B. On 26Nov03, a hep B surface antibody titre was negative. On 02Jan04, a hep B surface antibody titre was again negative.

VAERS ID:240589 (history)  Vaccinated:2003-12-19
Age:21.0  Onset:2004-02-18, Days after vaccination: 61
Gender:Female  Submitted:2005-06-17, Days after onset: 484
Location:New Hampshire  Entered:2005-06-23, 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: Oral contraceptive
Current Illness: UNK
Preexisting Conditions: Cervical cancer, colposcopy
Diagnostic Lab Data: Hepatitis B antibody on 2/18/04-4.2 mIU/mL
CDC Split Type: A0501124A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSENG5456A42IMLA
Administered by: Private     Purchased by: Private
Symptoms: Laboratory test abnormal, Medication error
SMQs:
Write-up: This case was reported by a nurse and described the occurrence of decreased antibody response in a 21 year old female pt who received Engerix-B injection for prophylaxis. The pt received immunizations with Engerix-B on 6/27/03, 8/11/03 and 12/19/03 (lots ENG5379A4, Eng5379A4 and ENG5456A4 respectively). The vaccine was administered on a 0, 2, and 6 month schedule rather than the recommended schedule of 0, 1, and 6 months. Approx. 2 months after receiving the 3rd vaccination with Engerix-B, on 2/18/04, a hepatitis B surface antibody titer measured 4.2 mIU/mL. The nurse consider the event to be related to vaccination with Engerix-B.

VAERS ID:240472 (history)  Vaccinated:2005-06-14
Age:21.0  Onset:2005-06-15, Days after vaccination: 1
Gender:Female  Submitted:2005-06-20, Days after onset: 5
Location:Missouri  Entered:2005-06-27, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTDY0794  LA
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Diarrhoea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt stated developed "loose stools" on 06/15 Not watery. No fever or other problem. Stated abdomen now cramping. Told her to follow up with her MD. PT did not call me until today.

VAERS ID:240727 (history)  Vaccinated:2005-06-20
Age:21.0  Onset:2005-06-20, Days after vaccination: 0
Gender:Female  Submitted:2005-06-27, Days after onset: 7
Location:Colorado  Entered:2005-06-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (JE-VAX)AVENTIS PASTEUREJN216B2SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Phone call from client, states she has a red, raised rash at the site of a Japanese Encephalitis injection received on 06/20/05. Stated started as red,raised area then developed a rash on her arm. Denied head aches, fever, systemic rash or resp difficulty. Declined to come to clinic for check. Encouraged to try otc Benadryl for relief of symptoms. Seek care if s/s worsen.

VAERS ID:240734 (history)  Vaccinated:2005-06-09
Age:21.0  Onset:2005-06-14, Days after vaccination: 5
Gender:Female  Submitted:2005-06-21, Days after onset: 7
Location:Unknown  Entered:2005-06-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergies to macrobid sulfa, ? Cipro
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS038AA IMRA
JEV: JAPANESE ENCEPHALITIS (JE-VAX)AVENTIS PASTEUREJN216B SCLA
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUE500AA SCRA
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Pyelonephritis, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow)
Write-up: Back paint, fever, and urinary tract infections symptoms. Urticaria over trunk of body and left arm. Sought medical attention at emergency room. Topical lotion to rash. Levaquin for pyelonephritis.

VAERS ID:240944 (history)  Vaccinated:0000-00-00
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2005-06-08
Location:Unknown  Entered:2005-07-01, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen paracetamol guaiphenesin
Current Illness: Unknown
Preexisting Conditions: The subject had no known allergies, no concurrent conditions were reported.
Diagnostic Lab Data:
CDC Split Type: A0557139A
Vaccination
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS 2  
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: This case was reported by a nurse to a sales representative and described the occurrence of injection site hives in a 21 year old female subject who was vaccinated with combined hepatitis A, hepatitis B for prophylaxis. The subject had no known allergies. Concurrent medications included Ibuprofen, Paracetamol and Guaiphensin for unspecified drug indications. On an unspecified date in 2005, on or after 01/18/2005 and on or before 05/03/2005, the subject received 3 dose of Twinrix. The site of the Twinrix administration was not provided. The same day that she received the Twinrix, on an unspecified date or after 01/18/2005 an on or before 05/03/2005, the subject experienced a hive like rash at the injection site. The injection site hives resolved on an unspecified date in 2005, on or after 01/18/2005 and on or before 05/03/2005.

VAERS ID:240976 (history)  Vaccinated:2005-06-24
Age:21.0  Onset:2005-06-27, Days after vaccination: 3
Gender:Female  Submitted:2005-06-29, Days after onset: 2
Location:Iowa  Entered:2005-07-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Seasonal allergies to pollen
Diagnostic Lab Data: NONE
CDC Split Type:
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS1116P IMLA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER  PO 
Administered by: Public     Purchased by: Private
Symptoms: Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Patient took oral typhoid dose 1 06/24/2005, early afternoon dose 2 06/26/2005 12:00pm. 06/27/2005 10AM diarrhea for few hours, vomited about 3 times. By 06/27/2005 4pm felt recovered.

VAERS ID:241151 (history)  Vaccinated:2005-06-12
Age:21.0  Onset:2005-06-19, Days after vaccination: 7
Gender:Male  Submitted:2005-06-23, Days after onset: 4
Location:Unknown  Entered:2005-07-11, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC 5.7, 13.5, 44.8, 17.1, GR 67, LY 24, MO 9.
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200721 RA
Administered by: Military     Purchased by: Military
Symptoms: Blister, Erythema, Injection site discolouration, Rash papular, Rash pruritic, Skin ulcer
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: New onset erythematous, blanchable papular lesions dorsum of right hand developing into coalescent patches on bilateral arms. Beginning 7 days after vaccination. Progressed to diffuse slightly pruritic papular lesions face, scalp, back, thighs with interspersed papulovesicular lesions dorsal forearms.

VAERS ID:241241 (history)  Vaccinated:2005-07-08
Age:21.0  Onset:2005-07-08, Days after vaccination: 0
Gender:Male  Submitted:2005-07-08, Days after onset: 0
Location:Maryland  Entered:2005-07-12, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1215CA IMLA
Administered by: Military     Purchased by: Military
Symptoms: Unevaluable event
SMQs:
Write-up: Gave pt a tetanus/diphtheria vaccination about 1030 hrs. Pt showed symptoms about 1050 hrs. Pt was given Epi (.3 u SQ left delt) at 1055 hrs. Pt was given Benadryl at 1105 hrs (50mg IM right delt). Pt was given O2 at the time. 1115 hrs pt was given 125 mg solumedrol IM in right glut. 1100 hrs pt was seen by Dr.

VAERS ID:241776 (history)  Vaccinated:2005-07-08
Age:21.0  Onset:2005-07-25, Days after vaccination: 17
Gender:Female  Submitted:2005-07-26, Days after onset: 1
Location:Hawaii  Entered:2005-07-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pregnancy
Preexisting Conditions: NKDA
Diagnostic Lab Data: + HCG on 7/25/05
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020720IDLA
Administered by: Military     Purchased by: Military
Symptoms: Medication error, Unintended pregnancy
SMQs:, Normal pregnancy conditions and outcomes (narrow)
Write-up: Pt vaccinated on 7/8/05, and denied any possibility of being pregnant at that time, she subsequently was found to be pregnant with a LMP of early MAY 05. Her pregnancy was confirmed 17 days s/p vaccination with Smallpox. Pt has had no evidence of threatened ab, and is otherwise doing well.

VAERS ID:242073 (history)  Vaccinated:2005-08-03
Age:21.0  Onset:2005-08-03, Days after vaccination: 0
Gender:Male  Submitted:2005-08-03, Days after onset: 0
Location:Massachusetts  Entered:2005-08-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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RAB: RABIES (RABAVERT)CHIRON CORPORATION3550110IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood pressure decreased, Dizziness, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Five minutes after receiving RabAvert vaccine, pt. felt light-headed and was pale. EMTs at the fire station checked the pt. BP was 88/50. Blood sugar was 103. Pt. had eaten breakfast about 4 hours before injection, and had been working outside in the very warm weather without drinking any water. After approximately a half hour, BP was normal and pt. was able to walk out of the building. He stated that he was feeling better.

VAERS ID:242403 (history)  Vaccinated:2005-07-21
Age:21.0  Onset:2005-07-22, Days after vaccination: 1
Gender:Female  Submitted:2005-08-03, Days after onset: 12
Location:Pennsylvania  Entered:2005-08-08, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illnesses at the time of vaccination.
Diagnostic Lab Data: NONE
CDC Split Type: 200501437
Vaccination
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MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1657AA0 LA
Administered by: Private     Purchased by: Unknown
Symptoms: Headache, Injection site erythema, Injection site induration, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Initial report received from a health care professional on 7/26/05. A 20 year old female patient had received a first dose of Menactra, lot number U1657AA, administered in the left deltoid on 7/21/05. One day later, she developed a severe headache and a fever of 105 degrees F. She also had a 5cm area of induration at the injection site. The patient was seen in the physician''s office on 7/26/05, where it was noted that her left deltoid was red and warm to touch. The patient was advised to use ice on the injection site and to take ibuprofen. At the time of the office visit, the patient''s headache had resolved and she was feeling better. She has since recovered from the events. (OMIC)

VAERS ID:242697 (history)  Vaccinated:2005-07-29
Age:21.0  Onset:2005-07-30, Days after vaccination: 1
Gender:Female  Submitted:2005-08-10, Days after onset: 11
Location:New Jersey  Entered:2005-08-10
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: NONE
Preexisting Conditions: Hayfever. No allergies to meds, no medical conditions.
Diagnostic Lab Data:
CDC Split Type:
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RAB: RABIES (RABAVERT)CHIRON CORPORATION3550111IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Headache, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Awoke with pounding headache, fever 102 and felt breath catch (like when you breath in cold air). Given Advil by Mother. Symptoms gone by 12p-1p.

VAERS ID:242964 (history)  Vaccinated:2005-07-19
Age:21.0  Onset:2005-07-20, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Rhode Island  Entered:2005-08-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: BCP
Current Illness: NONE
Preexisting Conditions: Pneumonia with respiratory failure 2004.
Diagnostic Lab Data: 11/18/05 Review of D/C summary - negative cultures of blood, nasal swab, and vial of Pneumovax.
CDC Split Type:
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS805A60IMGM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1675AA0IMGM
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0456P0SCGM
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1341AA4IMGM
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Erythema, Pyrexia, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Developed swelling/fever, tenderness in this area. Diagnosed with Cellulitis. Hospitalized for 3 days (left buttocks). 11/18/05 D/C summary review confirms diagnosis of cellulitis with redness and inflammation of L buttock.

VAERS ID:243239 (history)  Vaccinated:2005-08-04
Age:21.0  Onset:2005-08-04, Days after vaccination: 0
Gender:Female  Submitted:2005-08-09, Days after onset: 5
Location:Virginia  Entered:2005-08-22, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: UTI
Preexisting Conditions: Sulfa
Diagnostic Lab Data: Blood chem, urine.
CDC Split Type: VA05014
Vaccination
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RAB: RABIES (RABAVERT)CHIRON CORPORATION3410111IMRA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Asthenia, Dizziness, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Received 2 rabies vaccine in clinic at 9:30AM 8/4/05. Pt reported she became nauseous, dizzy, and had abd cramping at wk and 3 hrs later. She became pale and weak. Rescue squad was called and pt was taken to ER. Received fluids, fully recovered, discharged at 4PM.

VAERS ID:243255 (history)  Vaccinated:2000-10-01
Age:21.0  Onset:0000-00-00
Gender:Male  Submitted:2005-08-22
Location:Unknown  Entered:2005-08-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fluvoxamine; Tetracycline
Current Illness: UNK
Preexisting Conditions: Idiopathic thrombocytopenia purpura. The subject''s concurrent conditions were not reported.
Diagnostic Lab Data: IgG positive; IgM positive.
CDC Split Type: A0570908A
Vaccination
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 2  
Administered by: Other     Purchased by: Other
Symptoms: Headache, Laboratory test abnormal, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: This case was reported by a pharmacist and described the occurrence of headache in a 21 year old male subject who was vaccinated with Lyme disease vaccine recombinant for prophylaxis. Concurrent medical conditions included idiopathic thrombocytopenia purpura. Concurrent medications included Fluvoxamine and Tetracycline for unspecified drug indications. On an unspecified date in October 2000 the subject received the third dose of LYMErix. At an unspecified time after vaccination with LYMErix, on or after October 2000 and on or before 8/19/05, the subject experienced headache and fever and was hospitalized. The pharmacist reported that the subject, has positive IgG and IgM values. The outcome of the events was not provided.

VAERS ID:243370 (history)  Vaccinated:2005-08-20
Age:21.0  Onset:2005-08-21, Days after vaccination: 1
Gender:Female  Submitted:2005-08-24, Days after onset: 3
Location:New York  Entered:2005-08-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergy to strawberries.
Diagnostic Lab Data: NONE
CDC Split Type:
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MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURU1575AA SCRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site reaction, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 10 x 8 CM local reaction right posterior arm at site of Meningococcal vaccine itchy rash first noted 08/21/2005. Treated with Allegra 180MG by mouth, Benadryl 50md every 4 hours.

VAERS ID:243439 (history)  Vaccinated:2000-10-18
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2005-08-25
Location:California  Entered:2005-08-26, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: 03/27/2001 - right knee x-rays, normal right knee. 01/29/2002 - bilateral hand x-rays; normal hands. 01/31/2002 - bilateral hans x-ray; normal hands. labs 01/08/2002 - ANA screen - negative RF $g 20, Parvov B19 IGG - Negative 01/24/2002 - Lyme antibody 1.123 (Positive 1.2-9.99) 01/24/2002 - ASO 173 (0-125) TSH Sensitive 1.68 (0.49-4.67) 02/05/2002 - G6PD - Normal HAV IGM - negative HSb AG - negative HBs AB - negative HCV AB - negative
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV048B SC 
Administered by: Military     Purchased by: Military
Symptoms: Amnesia, Headache, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Fatigue, Malaise $g 60 days - thinks this has been occurring since receipt of the anthrax vaccine; never sought medical evaluation; thought it was related to work schedule. Extreme pain of site and affected arm during injection and for 24 hours following vaccine receipt. Headache, general - not sure when they started; pain from forehead to teeth; not relieved with Naprosyn, triggered/aggravated by bright lights; sometimes accompanied by nausea. Memory loss, short term started after she received anthrax vaccine, but does not recall any details.

VAERS ID:243639 (history)  Vaccinated:2005-08-15
Age:21.0  Onset:2005-08-24, Days after vaccination: 9
Gender:Female  Submitted:2005-08-31, Days after onset: 7
Location:Wisconsin  Entered:2005-08-31
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: Allergy to Sulfa
Diagnostic Lab Data: None
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40270020IDLA
Administered by: Military     Purchased by: Military
Symptoms: Headache, Injection site pain, Injection site swelling, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Presented on 8/24/05 with c/o emesis and headache and localized swelling and pain to the small pox site (L arm).

VAERS ID:243732 (history)  Vaccinated:2005-08-26
Age:21.0  Onset:2005-08-26, Days after vaccination: 0
Gender:Female  Submitted:2005-08-29, Days after onset: 3
Location:Wyoming  Entered:2005-09-01, 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: PPD
Current Illness:
Preexisting Conditions: Alcohol allergy
Diagnostic Lab Data:
CDC Split Type:
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0576R1SCLA
Administered by: Other     Purchased by: Private
Symptoms: Feeling hot, Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Hot, swollen, itchy area approx 3" diameter left arm injection site. Ran a fever and felt over the weekend (shot on 8/26).

VAERS ID:243913 (history)  Vaccinated:2005-08-31
Age:21.0  Onset:2005-08-31, Days after vaccination: 0
Gender:Female  Submitted:2005-09-07, Days after onset: 7
Location:New York  Entered:2005-09-08, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Singulair; Albuterol; Augmentin
Current Illness:
Preexisting Conditions: The patient has a history of asthma and recent urinary tract infection. At the time of the event, she had been off of prednisone for five days following a three week course of treatment. She denied any allergies or illnesses at the time of vaccination.
Diagnostic Lab Data: As per the reporter, no labs were completed. The patient''s pulse oximetry was 98%.
CDC Split Type: 200501730
Vaccination
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YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUE181AA0SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Diplopia, Dyspnoea, Headache, Ophthalmoplegia, Visual disturbance
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Ocular motility disorders (narrow)
Write-up: Initial report received from a physician on 8/31/05. A 21 year old female patient with a medical history of asthma and a recent urinary tract infection received a SC injection of YF-VAX, lot number UE181AA, on 8/31/05. 60 minutes later, the patient developed shortness of breath, a frontal headache and visual disturbances. The patient did not have respiratory distress and her pulse oximetry was 98%. The patient was treated with ibuprofen and Benadryl. She was evaluated by a physician who noted sixth nerve palsy and diplopia when the patient looks to the left. At the time of this report, the patient had not recovered from the events and was under observation. (OMIC)

VAERS ID:243989 (history)  Vaccinated:2005-06-21
Age:21.0  Onset:2005-06-22, Days after vaccination: 1
Gender:Unknown  Submitted:2005-09-08, Days after onset: 78
Location:Pennsylvania  Entered:2005-09-12, Days after submission: 4
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: UNKNOWN
Diagnostic Lab Data: UNK
CDC Split Type: WAES0508USA04672
Vaccination
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0605P UNGM
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia, Injection site swelling, Injection site warmth, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a medical assistant concerning a patient who was vaccinated with a dose of PNEUMOVAX 23 (lot # 650084/0605P). Subsequently, the patient developed a fever, heat and swelling at the injection site and had difficulty moving arm. The patient was treated with an unspecified antibiotic. Subsequently, the patient recovered. Heat and swelling at the injection site, difficulty moving arm and fever were considered to be other important medical events. Additional information has been requested.

VAERS ID:244162 (history)  Vaccinated:2005-08-24
Age:21.0  Onset:2005-09-04, Days after vaccination: 11
Gender:Male  Submitted:2005-09-10, Days after onset: 6
Location:Wisconsin  Entered:2005-09-15, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETHUNK  UN
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: Smallpox Vaccine reaction with secondary cellulitis.

VAERS ID:244167 (history)  Vaccinated:2005-09-06
Age:21.0  Onset:2005-09-06, Days after vaccination: 0
Gender:Male  Submitted:2005-09-08, Days after onset: 2
Location:Wisconsin  Entered:2005-09-15, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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TTOX: TETANUS TOXOID (NO BRAND NAME)AVENTIS PASTEURU1048BA1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Hypoaesthesia, Nausea, Pain, Pallor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Donor stated approx. 5hrs after shot was given he began to experience it. Arm pain going down left side of body with it. Thumb pain, mild dizziness, nausea, paleness, and numbness tingling in shoulder. Donor states symptoms lasted approx 12 hours and resolved on their own with no treatment required.

VAERS ID:244365 (history)  Vaccinated:2005-08-01
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2005-09-20
Location:Unknown  Entered:2005-09-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data: positive serum HCG
CDC Split Type:
Vaccination
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DT: DT ADSORBED (NO BRAND NAME)BSIEW10308   
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.X6775   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: No adverse events at this time. Patient had vaccine on last normal menstrual cycle with positive pregnancy test this date.

VAERS ID:244368 (history)  Vaccinated:2005-09-06
Age:21.0  Onset:2005-09-15, Days after vaccination: 9
Gender:Male  Submitted:2005-09-20, Days after onset: 5
Location:Wisconsin  Entered:2005-09-20
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
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
Administered by: Military     Purchased by: Military
Symptoms: Dermatitis contact, Erythema multiforme, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Presented on 9/15/05 with c/o rash to the L arm s/p smallpox vaccination. Dx. erythema multiforme vs contact dermatitis. Given order for Periactin 4mg tid and Hydrocortisone Cream 1% tid.

VAERS ID:244572 (history)  Vaccinated:1999-04-01
Age:21.0  Onset:1999-04-01, Days after vaccination: 0
Gender:Male  Submitted:2005-09-26, Days after onset: 2369
Location:Unknown  Entered:2005-09-26
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: VA Hospital.
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 2 RA
Administered by: Military     Purchased by: Military
Symptoms: Arthropathy, Cardiac disorder, Hypersensitivity
SMQs:, Angioedema (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Heart Problems, Weakened Joints, allergies.

VAERS ID:244576 (history)  Vaccinated:2004-07-03
Age:21.0  Onset:2004-09-15, Days after vaccination: 74
Gender:Female  Submitted:2005-09-26, Days after onset: 376
Location:Unknown  Entered:2005-09-26
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: BUNION ON LEFT FOOT DUE FOR SURGERY, MILD CERVICAL DYSPLASIA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 2SCRA
Administered by: Military     Purchased by: Other
Symptoms: Hyperkeratosis, Injection site hypersensitivity, Kidney infection, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: I RECEIVED MY FIRST ANTHRAX VACCINE DOSE ON 14 MAY 2004, SAME DAY AS MY SMALLPOX VACCINATION. THE SECOND DOSE OF THE ANTHRAX VACCINE WAS GIVEN ON 18 JUN 2004 AT THE EMEDS ALONG WITH HEPATITIS B VACCINATION. THE THIRD DOSE WAS GIVEN ON 3 JULY 2004 ALSO. APPROXIMATELY THE MIDDLE OF SEPTEMBER WHEN I RETURNED HOME, I BEGAN EXPERIENCING HIVES AND ITCHINESS AT THE SITE OF THE 1ST AND 3RD DOSE (RIGHT ARM). IT WOULD LAST FOR APPROXIMATELY 1-2 DAYS AND THEN DISAPPEAR, BUT CONTINUED TO RETURN OFF AND ON. I INFORMED MY DOCTOR OF THIS AND HE SIMPLY SAID THAT AS LONG AS IT DOESN''T SPREAD, I WOULD BE OK, BUT THAT IT MAY ONLY GET WORSE AFTER THE NEXT DOSE. NO TREATMENT. AROUND THE MONTHS OF MARCH AND APRIL, I BEGAN EXPERIENCING HIVES AND ITCHINESS ON MY LEFT ARM, THE SITE OF THE 2ND INJECTION. NOT ONLY THERE BUT ALSO PARTS OF MY FACE: UNDER MY EYE ONE DAY, ON MY EYEBROW ANOTHER DAY, SOMETIMES ON THE CHEEKS, SOMETIMES AROUND THE LIPS. THERE HAS BEEN NO CHANGE TO MY FACIAL CARE. SINCE APRIL, IT HAS BEEN ON AND OFF, SPORADIC. IN NOV 2004, BUMPS BEGAN TO FORM CLOSE TO MY ANAL AREA. IT WAS LATER DIAGNOSED AS ACTINIC KERATOSIS, IN AN AREA OF MY BODY WHERE THE SUN HAS NEVER HIT. IN DEC 2004, I WAS TAKEN TO THE HOSPITAL FOR A KIDNEY INFECTION AND TREATED WITH ANTIBIOTICS. I ALSO HAVE A HISTORY OF LOW GRADE CERVICAL DYSPLASIA (LGSIL OR CIN 1), WITH TREATMENT SUCH AS COLPOSCOPY AND A LEEP. THE BEGINNING MONTHS OF 2005 FOLLOWING THE DEPLOYMENT, A COLPOSCOPY WAS CONDUCTED WITH A DIAGNOSIS OF MILD TO MODERATE CERVICAL DYSPLASIA (HGSIL OR CIN 1-2) WITH A TREATMENT OF A LEEP AND AN EVALUATION: ERODED CERVIX. THE HIVES AND ITCHINESS STILL CONTINUE.

VAERS ID:245200 (history)  Vaccinated:2005-08-16
Age:21.0  Onset:2005-08-16, Days after vaccination: 0
Gender:Female  Submitted:2005-08-17, Days after onset: 1
Location:Ohio  Entered:2005-10-11, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
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MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1658AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Phone call from father @ 3:30 reporting his daughter just got dizzy, lowered to ground and fainted. He was right there and able to catch her. Following day father reports no further problems and fine today.

VAERS ID:245210 (history)  Vaccinated:2004-01-23
Age:21.0  Onset:2004-03-05, Days after vaccination: 42
Gender:Male  Submitted:2005-10-11, Days after onset: 584
Location:Oklahoma  Entered:2005-10-11
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 26 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Spinal tap Computerized axial tomography of head Magnetic Resonance imaging of brain and brain stem Magnetic resonance imaging of spinal canal
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IDLA
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER 0IDRA
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER 0IDRA
Administered by: Military     Purchased by: Military
Symptoms: Facial palsy, Guillain-Barre syndrome, Hypoaesthesia, Muscular weakness, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad)
Write-up: Symptoms Weakness in the arms, and legs. Numbness all over body, left facial droop, blurry vision. It took all of three weeks to take over entire body. Diagnoses Guillain-Barre Syndrome Treatment Immunoglobin Gamma Globulin

VAERS ID:245233 (history)  Vaccinated:2003-10-10
Age:21.0  Onset:2005-04-01, Days after vaccination: 539
Gender:Female  Submitted:2005-10-10, Days after onset: 191
Location:West Virginia  Entered:2005-10-12, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 34 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 200501962
Vaccination
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Dose
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM    
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEUR 0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia
SMQs:, Peripheral neuropathy (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Initial report received on Oct 03 2005 about a consumer report. A 21 year old female stated that she received Meningitis vaccine and Hepatitis B vaccine #1 on Oct 10 2003, Hepatitis B vaccine #2 on Jan 22 2004 and Hepatitis B vaccine #3 on Dec 0 2004, no lot numbers were provided. She was vaccinated at her college student health center. Then, in April 2005, she had arm and leg weakness and was hospitalized from April 21 2005 in her college town and transferred to another hospital in Atlanta from May 14 2005 to May 19 2005. She was then in a rehab hospital from may 19 2005 to June 14 2005. She said she had a GBS like illness. She is now wheelchair bound and is unable to lift her arms. Her immunization record have been requested and a VAERS report will be submitted.

VAERS ID:245764 (history)  Vaccinated:2005-09-23
Age:21.0  Onset:2005-10-03, Days after vaccination: 10
Gender:Male  Submitted:2005-10-20, Days after onset: 17
Location:Wisconsin  Entered:2005-10-20
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
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1040SCRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Rash papular, Rash pustular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient presented on 10/3/05 with c/o papules/pustules to neck and upper chest wall. Papules and pustules were noted on the chin, neck, upper chest wall and upper arms. Lesions with pruritic. Had small pox vaccination 10 days prior. Order given for Augmentin 875mg q 12 hours with food. RTC if lesions worsen or persist. No follow up was noted.

VAERS ID:245974 (history)  Vaccinated:2005-10-12
Age:21.0  Onset:2005-10-12, Days after vaccination: 0
Gender:Male  Submitted:2005-10-12, Days after onset: 0
Location:Florida  Entered:2005-10-24, 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: UNK
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500390P0IN 
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Flushing, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Pt felt dizzy, lightheaded. Face was flushed and burning sensation. No other treatment.

VAERS ID:246299 (history)  Vaccinated:0000-00-00
Age:21.0  Onset:2005-09-27
Gender:Female  Submitted:2005-10-20, Days after onset: 23
Location:Unknown  Entered:2005-10-28, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Unknown
Symptoms: Skin ulcer
SMQs:
Write-up: Pt husband received smallpox vaccine 2 weeks prior to presentation. He picked at a scab on her right thigh, and an ulcerated, dark lesion appeared with heaper bullous edges 6 days prior to presentation (10/3/05). No pain, fever, pustular drainage noted.

VAERS ID:246530 (history)  Vaccinated:2005-06-21
Age:21.0  Onset:2005-07-05, Days after vaccination: 14
Gender:Male  Submitted:2005-10-27, Days after onset: 114
Location:Michigan  Entered:2005-11-01, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TB Tine 06/17/2005
Current Illness:
Preexisting Conditions: History of reactions to preservatives in vaccines.
Diagnostic Lab Data:
CDC Split Type:
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DTAP: DTAP (DAPTACEL)AVENTIS PASTEUR4525G261   
HEP: HEP B (FOREIGN)MERCK & CO. INC.1093N0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Rash, Stomach discomfort
SMQs:, Anaphylactic reaction (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Fatigue, upset stomach, rash

VAERS ID:246857 (history)  Vaccinated:2004-10-15
Age:21.0  Onset:2004-10-15, Days after vaccination: 0
Gender:Female  Submitted:2005-10-31, Days after onset: 381
Location:North Carolina  Entered:2005-11-04, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin
Current Illness:
Preexisting Conditions: Allergic to penicillin, sulfa, seasonal allergies.
Diagnostic Lab Data:
CDC Split Type:
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DT: DT ADSORBED (NO BRAND NAME)AVENTIS PASTEUR41025AA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Confusional state, Delirium, Dizziness, Pharyngitis, Pyrexia
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Vestibular disorders (broad)
Write-up: 10/15/2004 Patient received DT vaccine, 10/15/2004 PM confusion/delerious overnight. No documented fever. Developed fever on 10/17/2004. 10/19/ evaluated for dizziness. Noted viral pharyngitis (strep test negative 10/19/).

VAERS ID:247011 (history)  Vaccinated:2005-10-24
Age:21.0  Onset:2005-10-24, Days after vaccination: 0
Gender:Female  Submitted:2005-10-24, Days after onset: 0
Location:Washington  Entered:2005-11-07, 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: NO
Current Illness: NO
Preexisting Conditions: Wheat allergies
Diagnostic Lab Data: N/A
CDC Split Type: WA052126
Vaccination
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HEPAB: HEP A + HEP B (TWINRIX)SMITHKLINE BEECHAMAHABB028AB0 RL
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU1576AA0IMLL
Administered by: Public     Purchased by: Private
Symptoms: Injection site reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Developed flat red hive around R arm injection site within 30 minutes- ? end hives across upper back - no respiratory symptoms, vitals stable, monitored in clinic for 1 hr. hives mostly resolved. BP 120/70 HR 80. Discharged 130/80 HR 72. Follow-up call 90 minutes later no change no increased hives. 10/25/05 follow-up call hives have resolved.

VAERS ID:247171 (history)  Vaccinated:2005-10-28
Age:21.0  Onset:2005-11-02, Days after vaccination: 5
Gender:Male  Submitted:2005-11-09, Days after onset: 7
Location:California  Entered:2005-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
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HEP: HEP B (FOREIGN)MERCK & CO. INC.0833R2IMRA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Per father client c/o pain to arm which started on 11/02/2005 then on 11/3/2005 started feeling numbness and burning sensation when he bends elbow. Client was seen by Dr on 11/05/2005 and was told irritant in vaccine probably got into nerve. PMD plans to refer to neurologist it unresolved.

VAERS ID:247594 (history)  Vaccinated:2005-10-13
Age:21.0  Onset:2005-10-16, Days after vaccination: 3
Gender:Male  Submitted:2005-10-24, Days after onset: 8
Location:Unknown  Entered:2005-11-16, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aveeno, Triamcinolone cream, Benadryl, Mycostatin, Decadron elixir, Vancomycin, Polysporin ointment, Domeboro topically, hydroxyzine, Whirlpool baths.
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blister, Erythema multiforme, Mouth ulceration, Pruritus, Rash, Rash macular, Skin ulcer, Stevens-Johnson syndrome, Stomatitis
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Small pox vaccine received 10/05/2005, Flu vaccine 10/13/2005, Generalized rash and itching developed 10/16/2005. Also with sores in mouth at ER on 10/17/2005. Rash described as diffuse vesicular rash with some lesions 6-7 mm in circumference on the back. rash on scalp, neck, trunk, arms, legs with scattered macules, papules, water blisters. Involvement in the mouth with an erythematous stomatitis with a soft whitish exudate. Dx of erythema multiforme major possibly 2 hours to vaccines (small pox and less likely to flu discharges 10/24/2005.

VAERS ID:247844 (history)  Vaccinated:2005-11-11
Age:21.0  Onset:2005-11-11, Days after vaccination: 0
Gender:Female  Submitted:2005-11-18, Days after onset: 7
Location:Texas  Entered:2005-11-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: none?
Current Illness: None known
Preexisting Conditions: 1997 viral meningitis; 2002 umbilical hernia repair; 2004 stomach virus; 2005 back injury.
Diagnostic Lab Data: MRI of brain
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1744AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anxiety, Asthenia, Encephalopathy, Palpitations, Speech disorder, Stupor, Visual disturbance
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Chronic kidney disease (broad)
Write-up: Altered mental status and generalized weakness. Discharge summary states encephalopathy. msv Medical records state abnormal vision, palpitations, anxiety, speech disorder. msv.

VAERS ID:248176 (history)  Vaccinated:2005-06-29
Age:21.0  Onset:2005-06-29, Days after vaccination: 0
Gender:Female  Submitted:2005-11-25, Days after onset: 149
Location:Oregon  Entered:2005-11-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 0
Current Illness: NO
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBV004BA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Developed itching and then hives over entire body within hours of administration of Hep B vaccine.

VAERS ID:248391 (history)  Vaccinated:2005-11-07
Age:21.0  Onset:2005-11-08, Days after vaccination: 1
Gender:Female  Submitted:2005-11-11, Days after onset: 3
Location:Minnesota  Entered:2005-11-29, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic to Celesporins.
Diagnostic Lab Data: X-Ray of wrist 11/11/2005 was negative.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR1802FA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pain, Tendonitis
SMQs:
Write-up: Severe wrist left pain starting day after flu shot, progressively worsening each day. F/U with ortho DR. Thought it was Fracture. Diagnosis Dequairvains F/Vaccine.

VAERS ID:248726 (history)  Vaccinated:2005-10-22
Age:21.0  Onset:2005-10-22, Days after vaccination: 0
Gender:Male  Submitted:2005-11-17, Days after onset: 26
Location:Tennessee  Entered:2005-12-05, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: ESRD
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURV1763AA0IM 
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1038P0IM 
Administered by: Other     Purchased by: Public
Symptoms: Medication error
SMQs:
Write-up: Flu and Pneumonia vaccine given in same syringe. Currently in process of re-vaccinating per CDC.

VAERS ID:249355 (history)  Vaccinated:2005-11-21
Age:21.0  Onset:2005-12-01, Days after vaccination: 10
Gender:Female  Submitted:2005-12-08, Days after onset: 7
Location:Pennsylvania  Entered:2005-12-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0992P0 LA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Fatigue, Lymphadenopathy, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Swollen Glands, fever, rash, joint pain and fatigue, lasted 2-3 days. Took Advil.

VAERS ID:249779 (history)  Vaccinated:2005-12-17
Age:21.0  Onset:2005-12-17, Days after vaccination: 0
Gender:Male  Submitted:2005-12-17, Days after onset: 0
Location:South Carolina  Entered:2005-12-27, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS0174R1 RA
Administered by: Military     Purchased by: Military
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: At 7:54 am, patient received Hep A (2) vaccine. He was normal at the time of vaccine (no reactions). Patient sat in the waiting room post-shot after approximately 15 minutes he stated he felt dizzy- he stood- walked for a few minutes and then indicated to us he was dizzy. We administered O2, muffin and juice. Pt. recumbant for 15 minutes until symptoms subsided.

VAERS ID:249832 (history)  Vaccinated:2005-10-26
Age:21.0  Onset:2005-11-25, Days after vaccination: 30
Gender:Female  Submitted:2005-12-01, Days after onset: 6
Location:North Carolina  Entered:2005-12-28, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prenatal vitamins, iron
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: NC05115
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1747AA0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Stillbirth, Unintended pregnancy
SMQs:, Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Pt delivered stillborn infant 11/25/05 32 weeks and 5 days gestation.

VAERS ID:249848 (history)  Vaccinated:2005-12-07
Age:21.0  Onset:2005-12-19, Days after vaccination: 12
Gender:Female  Submitted:2005-12-20, Days after onset: 1
Location:Massachusetts  Entered:2005-12-28, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 23 mg qd;Oral contraceptions
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1872AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.078320SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Rash at injection site for influenza vaccine. Pt prescribed cephalexin 500 mg q.i.d. by another physician.

VAERS ID:249959 (history)  Vaccinated:1989-04-26
Age:21.0  Onset:1989-04-26, Days after vaccination: 0
Gender:Male  Submitted:2005-12-30, Days after onset: 6092
Location:Texas  Entered:2005-12-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: denies
Current Illness: denies
Preexisting Conditions: none hx of egg allergies (n/v/d)
Diagnostic Lab Data: none known
CDC Split Type:
Vaccination
Manufacturer
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEUR    
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEUR    
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEUR8J911480IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dysgeusia, Dyspnoea, Loss of consciousness, Panic reaction, Pharyngitis, Pseudo lymphoma, Rhinitis
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Encounter Background Information: Presents with hx "anaphylatic Rx" to Yellow fever vaccination in 1989. Described rx as sob and passed out 2 hours after multiple vac. Pt doesn''t remember any other symptoms, had paniced, no cp, rash, itch, tight throat, n/v/d, dizziness, etc. Was taken to hospital and observed for few hours and released. Remembers no meds given. Received 4/26/1989: YF, typhoid, oral polio, TD. Did received typhoid/td in 1991, 1994 and 1999 w/o reaction. Allergy to eggs as child (n/v/d). Began eating hardboiled eggs age 20 w/o rx--bad taste in mouth only no reaction. Received IM influenza 12/27/05 w/o reaction, however has a mild cold since 12/23-24/05. PMH: albumenuria, appendicitis, knee surgery 2004, acid reflux. FHX: paternal GF had YF (?vac or dis) and developed hodgkins. Also request to know as being given cortisone shots, can he receive smallpox vaccine? Yes. Advised to stay off steroid injections for 2 weeks for best results and do not take until scab falls off. Pt received oral polio, yf, td, typhoid: Box 13 will not accept unknown names of manufacture of oral polio when submitted.

VAERS ID:250092 (history)  Vaccinated:2005-03-15
Age:21.0  Onset:2005-03-23, Days after vaccination: 8
Gender:Female  Submitted:2006-01-03, Days after onset: 286
Location:Massachusetts  Entered:2006-01-06, 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:
Preexisting Conditions: Miscarriage
Diagnostic Lab Data: Serum varicella zoster 02/02/05 negative;Urine beta-human 03/28/05 positive
CDC Split Type: WAES0503USA04269
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0439P1 UN
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Laboratory test abnormal, Premature labour, Unintended pregnancy
SMQs:, Lack of efficacy/effect (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received through the pregnancy registry from a physician concerning a 21 year old female with no pertinent medical history and no drug reactions/allergies who on 15-Feb-2005 and 15-Mar-2005 was vaccinated with the first and second 0.5ml doses of varicella virus vaccine live (Lot # 648317/0439P). There was no concomitant medication. It was noted that the patient discovered she was pregnant on 23-Mar-2005. No symptoms were noted. No other information was available. Unspecified medical attention was sought. There was no product quality complaint. Follow up information indicated that on 02-Feb-2005, the patient was tested for varicella antibodies and the results were negative. The vaccine was not administered for immigration purposes. The patient''s LMP was 21-Feb-2005. The expected day of delivery was noted to be November 2005. On 28-Mar-2005. a HCG was positive. The patient had one previous pregnancy that was a still birth or miscarriage at 4-6 weeks. There was no local reaction at the injection site, and there was no varicella or herpes zoster symptoms post vaccination. Additional follow up information indicated on 03-Sep-2005, the patient gave birth to a 2.5 pound male at 27 weeks gestation. The infant was normal. Additional information has been requested. (OMIC)

VAERS ID:250353 (history)  Vaccinated:2005-12-19
Age:21.0  Onset:0000-00-00
Gender:Male  Submitted:2006-01-04
Location:Unknown  Entered:2006-01-13, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Other
Symptoms: Nonspecific reaction
SMQs:
Write-up: Innoculation to another person (transferred vaccina virus to close contact).

VAERS ID:250616 (history)  Vaccinated:2004-11-02
Age:21.0  Onset:2004-11-02, Days after vaccination: 0
Gender:Female  Submitted:2006-01-06, Days after onset: 430
Location:Oregon  Entered:2006-01-20, 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: NONE
Current Illness: UNK
Preexisting Conditions: The patient''s medical history and concurrent conditions were not reported.
Diagnostic Lab Data: UNK
CDC Split Type: A0535421A
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Dizziness, Flushing, Hypoaesthesia, Injection site reaction, Malaise
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: This case was reported by a nurse and described the occurrence of lower limb numbness in a 20 year old female patient who received hepatitis B vaccine recombinant (Engerix-B). On 02 November 2004, the patient received the first dose of Engerix-B in the left arm. At an unspecified period of time following the administration of Engerix-B, on 02 November 2004, the patient experienced lower limb numbness, tingling, chills, flushing, dizziness, malaise, and an injection site reaction characterized as soreness. The events resolved on an unspecified date in November 2004. The nurse considered the events to possible be related to vaccination with Engerix-B.

VAERS ID:250658 (history)  Vaccinated:2005-03-29
Age:21.0  Onset:2005-04-04, Days after vaccination: 6
Gender:Male  Submitted:2006-01-06, Days after onset: 277
Location:Indiana  Entered:2006-01-20, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: The patient had no pre existing medical conditions. The patient''s concurrent conditions were not reported.
Diagnostic Lab Data: UNK
CDC Split Type: A0553071A
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVA059BA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: This case was reported by a nurse and described the occurrence of hives in a 21 year old male patient who received hepatitis B vaccine recombinant Engerix B. The patient had no pre existing medical conditions. On 3/29/2005, the patient received the first dose of Engerix B (lot AHBVA059BA) in the right deltoid. Approximately six days following the first dose of Engerix B, on 4/4/2005, the patient experienced hives and itching. The hives and itching improved on 4/6/2005. The immunization series with Engerix B was discontinued. The nurse considered the hives and itching to possibly be related to vaccination with Engerix B and that the hives were of questionable etiology.

VAERS ID:250904 (history)  Vaccinated:2006-01-09
Age:21.0  Onset:2006-01-11, Days after vaccination: 2
Gender:Female  Submitted:2006-01-11, Days after onset: 0
Location:Washington  Entered:2006-01-26, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WA052133
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0932R0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEUR07182AA0IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURX030020IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site inflammation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt had red, inflammation at site of injection of Menactra vaccine, 2 days post vaccine right deltoid.

VAERS ID:250905 (history)  Vaccinated:2005-12-12
Age:21.0  Onset:2005-12-18, Days after vaccination: 6
Gender:Male  Submitted:2005-12-22, Days after onset: 4
Location:Idaho  Entered:2006-01-26, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSMIPFAV1040SCLA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720SCRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ00420IMLA
Administered by: Military     Purchased by: Unknown
Symptoms: Erythema, Injection site erythema, Injection site induration, Rash papular
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: 5-6 cm area of induration with erythema around vaccine site 8 days after vaccine improved. Pt developed about 10-12 erythematous papular lesions on face, RUE, torso and right leg, no vesicles no pustules.

VAERS ID:250919 (history)  Vaccinated:2003-01-01
Age:21.0  Onset:2003-01-21, Days after vaccination: 20
Gender:Male  Submitted:2006-01-26, Days after onset: 1101
Location:Unknown  Entered:2006-01-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denies
Preexisting Conditions: denies
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Dry skin, Pruritus, Rash erythematous, Rash macular, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This patient reported receiving his primary SMPX vaccine sometime in January 2003. He also reported received his first AVA vaccination 12/29/2002 and a second AVA vaccine 2 weeks later. Approximately 3-4 weeks post SMPX vaccine (estimated 1/21/03 onset) he developed multiple fine, itchy red raised macular rash starting at/about his inner elbows that slowly spread to his lower and upper arms. The rash had single dots that had a sporadic pattern and grouping...some single, some clustered. He denies any rash to his torso or face. This rash was dry, scaley w/o flakes, worsened with heat or hot water, Lubiderm lotions burned area (hurt) however hydrocortisone cream (over the counter) helped with the itching and rash. The rash lasted 2-4 weeks depending on if summer vs winter months or activity, or amount of itching. He reported having 3-6 occurrences or more since 2003 with his last episodes in May and again in November 2005. He denied any current or past allergies, new/old food allergies, no detergents, perfume, soap, clothing triggers. He has not sought medical care for this problem as treating it on his own has been successful.

VAERS ID:251056 (history)  Vaccinated:2006-01-27
Age:21.0  Onset:2006-01-28, Days after vaccination: 1
Gender:Male  Submitted:2006-01-30, Days after onset: 2
Location:California  Entered:2006-01-30
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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TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ02761IMRA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Pruritus, Rash, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient developed pruritic, erythemic rashes, 10 on left arm and 2 on right arm. Also received Typhoid shot on the same day, 27 Jan 2006. Denies pain on Typhoid shot site but anthrax site on left arm is a little tender to touch. Patient denies any systemic symptoms.

VAERS ID:251065 (history)  Vaccinated:2005-12-08
Age:21.0  Onset:2005-12-08, Days after vaccination: 0
Gender:Female  Submitted:2006-01-30, Days after onset: 53
Location:Colorado  Entered:2006-01-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control
Current Illness:
Preexisting Conditions: Allergy PCN and Amori
Diagnostic Lab Data: Allergic Reaction
CDC Split Type:
Vaccination
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JEV: JAPANESE ENCEPHALITIS (JE-VAX)AVENTIS PASTEUR214A0SCUN
Administered by: Private     Purchased by: Other
Symptoms: Hypersensitivity, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow)
Write-up: Pt work for CDC came for first dose''s Japanese Encephalitis #1 given about 8:30 am. Developed rash was seen Emergency Department.

VAERS ID:251343 (history)  Vaccinated:2006-02-03
Age:21.0  Onset:2006-02-03, Days after vaccination: 0
Gender:Female  Submitted:2006-02-08, Days after onset: 5
Location:Missouri  Entered:2006-02-08
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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MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU1784AA  RA
Administered by: Other     Purchased by: Public
Symptoms: Injection site pain, Injection site reaction, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt developed fever, achiness & L arm pain with swelling at injection site. I spoke with pt on 2/6/06 and her symptoms had resolved. She had slight soreness of L arm.

VAERS ID:251459 (history)  Vaccinated:2006-02-02
Age:21.0  Onset:2006-02-03, Days after vaccination: 1
Gender:Male  Submitted:2006-02-13, Days after onset: 10
Location:Maryland  Entered:2006-02-14, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro;Nasacort;Cymbalta
Current Illness:
Preexisting Conditions: Anxiety, panic disorder/attack
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1586DA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Joint stiffness, Muscle spasms, Musculoskeletal stiffness, Pyrexia, Thirst, Tremor
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: fever (101), uncontrollable shaking, muscle spasms-especially legs, thirst, stiff neck and joints - 4/12/06 Review of 7-page medical record indicates final diagnosis of ''rigors of unclear etiology''. On PE the patient was afebrile with pulse of 101 and 100% oxygen saturation. Treated with IV Ativan, fluids, and rest.

VAERS ID:251624 (history)  Vaccinated:2003-10-25
Age:21.0  Onset:2003-10-25, Days after vaccination: 0
Gender:Male  Submitted:2006-02-17, Days after onset: 846
Location:Texas  Entered:2006-02-17
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: No allergies, no birth defects just knee pain.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Bronchitis, Dyspnoea, Hypersensitivity, Memory impairment, Pharyngitis, Rhinitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (broad), Dementia (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: I have trouble breathing when I work hard. I get sick all the time, mostly chest colds that won''t go away with out medical attention. I have constant joint pain. I forget alot of things that I needed to do or have. It is very frustrating. I have spring and fall allergies, that I never had before. 3/21/06 Received medical records from PCP which reveal patient seen only one time & diagnosed with bronchitis in January, 2006.

VAERS ID:251706 (history)  Vaccinated:2006-02-10
Age:21.0  Onset:2006-02-11, Days after vaccination: 1
Gender:Female  Submitted:2006-02-13, Days after onset: 2
Location:Missouri  Entered:2006-02-21, 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: Claritin; Mircette
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0306R2IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB093AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Rash, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient woke up 2/11/06 AM with 2 small areas (about 1.5" diameter), outlined with redness, centers had blotchy redness. No raised areas; no itching. Each area occurred about 1" above injection site on each arm. Rashes identical no both arms. No fever. Resolving as of 2/13/06.

VAERS ID:251766 (history)  Vaccinated:2006-02-14
Age:21.0  Onset:2006-02-15, Days after vaccination: 1
Gender:Female  Submitted:2006-02-16, Days after onset: 1
Location:Mississippi  Entered:2006-02-22, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKOWN
Current Illness: HEP C
Preexisting Conditions: HEP C
Diagnostic Lab Data: NONE
CDC Split Type: MS06002
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0002R0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Malaise
SMQs:, Guillain-Barre syndrome (broad)
Write-up: PT CALLED INTO CLINIC ON 2/15/2006 STATING THAT SHE WAS FEELING BAD AND WAS WEAK.

VAERS ID:251917 (history)  Vaccinated:2006-02-03
Age:21.0  Onset:2006-02-03, Days after vaccination: 0
Gender:Female  Submitted:2006-02-10, Days after onset: 7
Location:Wisconsin  Entered:2006-02-24, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flagyl
Current Illness: Bacterial Vaginosis
Preexisting Conditions: Depression
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2341AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Feeling hot, Injection site induration, Tenderness
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Patient presents 2/7/06 with 8 cm x 8 cm erythematous area on left deltoid, with a hardened induration at site of administration, very tender to touch, warm to touch. Tx with Duricef. Patient re-presents 2/9/06 with enlargement of erythematous area on left deltoid. Given Taper for prednisone. 98.6kg

VAERS ID:252043 (history)  Vaccinated:2006-02-20
Age:21.0  Onset:2006-02-20, Days after vaccination: 0
Gender:Female  Submitted:2006-02-23, Days after onset: 3
Location:Unknown  Entered:2006-02-27, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURERAHBVB079BA2 LA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB099BA0 RA
Administered by: Other     Purchased by: Other
Symptoms: