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Case Details (Sorted by Age)

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VAERS ID:131008 (history)  Vaccinated:1999-09-29
Age:41.1  Onset:1999-10-19, Days after vaccination: 20
Gender:Female  Submitted:1999-11-17, Days after onset: 29
Location:Tennessee  Entered:1999-11-22, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: OCp, fosamax
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1175H SCRA
Administered by: Other     Purchased by: Private
Symptoms: Headache, Infection, Lymphadenopathy, Myalgia, Neck pain, Pharyngitis, Pyrexia, Rash maculo-papular
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt reported fever, body aches, swollen glands, rash;exam +adenopathy, diffuse red maculo papular rash face, arms, trunk, legs;referred to PCP for tx & eval by MD;pt devel h/a, felt achy, sore throat;viral illness;

VAERS ID:131427 (history)  Vaccinated:1999-11-08
Age:41.1  Onset:1999-11-09, Days after vaccination: 1
Gender:Female  Submitted:1999-11-16, Days after onset: 7
Location:Maine  Entered:1999-11-26, 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: Wellbutrin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NOEn
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7258BA  LA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Injection site hypersensitivity, Injection site oedema, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: red & swelling in site of lt deltoid;joints ache small fever 99.9;hives all over chest & arm relieved w/DPH;

VAERS ID:131454 (history)  Vaccinated:1999-10-15
Age:41.0  Onset:1999-10-15, Days after vaccination: 0
Gender:Female  Submitted:1999-11-03, Days after onset: 19
Location:Arkansas  Entered:1999-11-29, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: AR9945
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site pain, Myasthenic syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: p/vax pt rt upper deltoid are rt arm site of inj felt numb immed p/vax;rt arm felt very sore & by 12noon rt arm felt achy down to elbow;felt numb sensation from inj site to rt elbow;numbness spreading to rt side of neck down rt forearm;

VAERS ID:132213 (history)  Vaccinated:1999-09-30
Age:41.4  Onset:0000-00-00
Gender:Female  Submitted:1999-11-15
Location:Colorado  Entered:1999-12-07, Days after submission: 22
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 21 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Elavil, Percoset, Tegratol, Estrogen, Valium;
Current Illness: NONE
Preexisting Conditions: allergies-PCn, sulfa;Medical conditions-Bioplar disorder, chronic back pain;
Diagnostic Lab Data: 10/10/99 ALT= 3807;Lactate Dehydrogenase=23,930;HCT=31.5;CK=1244;Platelets=50;AST=7367;GGT=20;BUN=106;Creatine=6;
CDC Split Type: U199900952
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0130AA IMA
Administered by: Private     Purchased by: Private
Symptoms: Hepatic failure, Lung disorder, Renal failure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), 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), Chronic kidney disease (narrow), Tumour lysis syndrome (broad)
Write-up: p/vax pt devel mul organ failure-liver, kidney & pulmonary;unk etiology;pt hosp for 21 days;pt recovered from this exp;

VAERS ID:132536 (history)  Vaccinated:1999-04-15
Age:41.0  Onset:1999-04-15, Days after vaccination: 0
Gender:Male  Submitted:1999-12-06, Days after onset: 235
Location:Florida  Entered:1999-12-15, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Apparent pharingitis in March 99 - Treated, resolved
Diagnostic Lab Data: Direct immunofluorscences of skin and indirect immunofluorscence from blood support clinical dx of pemphigus
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0332SCUN
Administered by: Military     Purchased by: Military
Symptoms: Dermatitis exfoliative, Laryngospasm, Mouth ulceration, Pharyngitis, Stomatitis
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Agranulocytosis (broad), Systemic lupus erythematosus (broad), Dystonia (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: 15 April 99: dose #1-several hours later patient had sore mouth, sore throat, sloughing of "skin in mouth". 29 April 99: dose #2-several hours later had sensation of "throat closing" and sores developing in mouth Per follow-up: Continuous symptoms in the mouth. SM has to drink sterioids on a daily basis and rinse mouth 6 x a day for 10-15 minutes. Need always to be close to a Dermatology since I break out a lot. SM took 3 shots only. All 3 times had to go to emergency room.

VAERS ID:132558 (history)  Vaccinated:1999-10-13
Age:41.3  Onset:1999-10-13, Days after vaccination: 0
Gender:Female  Submitted:1999-10-29, Days after onset: 16
Location:Nebraska  Entered:1999-12-15, Days after submission: 47
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0150AA  A
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Arm red, swollen, and sore for a week; stayed red for a long time. O.K. now.

VAERS ID:132696 (history)  Vaccinated:1999-10-28
Age:41.9  Onset:1999-10-28, Days after vaccination: 0
Gender:Female  Submitted:1999-12-14, Days after onset: 47
Location:Illinois  Entered:1999-12-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0126FA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Broke out in hives.

VAERS ID:132057 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:1999-10-20
Location:Massachusetts  Entered:1999-12-28, Days after submission: 69
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
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0107AA   
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES462810   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dyspnoea, Palpitations, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: Low grade temp. at 8:00a.m., 10-18-99. at 13:00 temp. 101.8.Palpitations,shortness of breath & vomiting.

VAERS ID:132251 (history)  Vaccinated:1999-11-13
Age:41.2  Onset:1999-11-15, Days after vaccination: 2
Gender:Male  Submitted:1999-11-23, Days after onset: 8
Location:North Carolina  Entered:1999-12-28, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: DENIED
Preexisting Conditions: DENIED
Diagnostic Lab Data:
CDC Split Type: NC99095
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0131J0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: Left-sided Bell''s Palsy, left-sided facial drooping, unable to raise left eyebrow, close left eye, unable to raise left side of mouth. Tx''d with Prednisone and Valtrex.

VAERS ID:132319 (history)  Vaccinated:1999-11-20
Age:41.0  Onset:1999-11-20, Days after vaccination: 0
Gender:Female  Submitted:1999-11-22, Days after onset: 2
Location:Virginia  Entered:1999-12-28, 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: Glucophage, Synthoid
Current Illness: NONE
Preexisting Conditions: Diabetes, Hypothyroidism, Pcn allergy
Diagnostic Lab Data: 11/23/99 Seen in ER-dx''d with Strept Throat
CDC Split Type: VA99067
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02289P0IMRA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4630210IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Chest pain, Headache, Injection site hypersensitivity, Injection site oedema, Injection site pain, Laryngospasm, Nausea, Oedema peripheral, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 1-2 hrs after vax, arm swelling, had heaviness in chest, nausea, "throat felt swollen". Then, began w/headache, abd. pain. Fever began 11/20/99 also, and is 102F today. Today, left uppr arm laterally is warm, swollen and tender.

VAERS ID:131754 (history)  Vaccinated:1999-10-15
Age:41.4  Onset:1999-10-15, Days after vaccination: 0
Gender:Female  Submitted:1999-11-01, Days after onset: 17
Location:North Carolina  Entered:1999-12-29, Days after submission: 58
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: Hx of PPD +
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3B2A60IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chest pain, Cough, Dyspnoea, Laryngospasm, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Approx 2 hrs after injection, had fever 102.3. Approx 5 hrs later, throat felt swollen, SOB, chest soreness with cough.

VAERS ID:131797 (history)  Vaccinated:1999-10-09
Age:41.6  Onset:1999-10-09, Days after vaccination: 0
Gender:Female  Submitted:1999-11-12, Days after onset: 34
Location:Colorado  Entered:1999-12-29, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Was on antibiotic for a cyst
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS00399P IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: On 10/9/99, that afternoon, area itched. Wednesday, it itched & Thursday, it hurt. Area 2-3" around where shot was given; was red, swollen & sore. Sent to MD. MD stated that it was a reaction from Thermerosol.

VAERS ID:131875 (history)  Vaccinated:1999-10-20
Age:41.4  Onset:1999-10-20, Days after vaccination: 0
Gender:Female  Submitted:1999-11-11, Days after onset: 22
Location:New Hampshire  Entered:1999-12-29, Days after submission: 48
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0130AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Within one hour of vaccine pt complained of itchy little red spots. Approx. 3 1/2 hrs after vaccine, pt developed increase of itching, hives on face, neck, torso and arms. Treated with Benadryl.

VAERS ID:133009 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:0000-00-00
Gender:Male  Submitted:1999-12-26
Location:Florida  Entered:2000-01-05, 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: Synthroid, Provental, Feldene, Bentyl, Comtil, Xanax, Soma, Surguilair
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.1731H SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0012AN IMLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Faint rash trunk & thighs. Temp 101, joints ache.

VAERS ID:132483 (history)  Vaccinated:1999-11-30
Age:41.7  Onset:1999-12-01, Days after vaccination: 1
Gender:Female  Submitted:1999-12-06, Days after onset: 5
Location:New York  Entered:2000-01-06, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dicloxacillin, Ortho Novum, Prozac, Darvocet
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0061AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Soreness, lump under skin, increased in size X 3 days, redness at site, no itch, no fever.

VAERS ID:133280 (history)  Vaccinated:1999-11-15
Age:41.0  Onset:1999-11-15, Days after vaccination: 0
Gender:Female  Submitted:2000-01-06, Days after onset: 52
Location:Unknown  Entered:2000-01-14, 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
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998230 IMA
Administered by: Other     Purchased by: Unknown
Symptoms: Hypokinesia, Injection site pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient received influenza vaccination. Next day complained of pain in arm, severely decreased range of motion, tender @ injection site, no erythema.

VAERS ID:133297 (history)  Vaccinated:1999-10-01
Age:41.0  Onset:1999-10-01, Days after vaccination: 0
Gender:Female  Submitted:1999-10-11, Days after onset: 10
Location:Alaska  Entered:2000-01-14, Days after submission: 95
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: AK200012
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2953A40IMRA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Headache, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Rash, hives, severe, headache, pressure in chest.

VAERS ID:133511 (history)  Vaccinated:2000-01-12
Age:41.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:North Carolina  Entered:2000-02-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD/Pasteur/lot #252011/L/forearm/5/1996
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4653191IMRA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUA071AA1SCLA
Administered by: Military     Purchased by: Military
Symptoms: Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Fever, body aches & malaise. Tx: NSAIDS.

VAERS ID:133651 (history)  Vaccinated:1999-01-08
Age:41.0  Onset:0000-00-00
Gender:Male  Submitted:2000-01-13
Location:Delaware  Entered:2000-02-03, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0302SCA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER  IMA
Administered by: Military     Purchased by: Military
Symptoms: Amnesia, Asthenia, Cough, Dyspnoea, Eye pain, Headache, Insomnia, Pruritus, Rash, Somnolence, Thinking abnormal
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Since having the Anthrax series, pt has experienced fatigue, lethargy, little physical and mental endurance, reduced concentration, short term memory loss, difficulty sleeping, cough,headaches, sore eyes, SOB and itchy rashes.

VAERS ID:133671 (history)  Vaccinated:1999-11-05
Age:41.0  Onset:1999-11-06, Days after vaccination: 1
Gender:Male  Submitted:1999-11-09, Days after onset: 3
Location:Washington  Entered:2000-02-03, Days after submission: 86
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vicodin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WA991624
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4988120 IMLA
Administered by: Military     Purchased by: Unknown
Symptoms: Injection site mass, Somnolence, Thinking abnormal, Vasodilatation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: 10 x 12 cm induration, temp l/upper outer arm post injection lasting 4 days. Extreme lethargy, slow mentation.

VAERS ID:133792 (history)  Vaccinated:1999-03-23
Age:41.0  Onset:1999-06-01, Days after vaccination: 70
Gender:Male  Submitted:2000-02-03, Days after onset: 247
Location:Delaware  Entered:2000-02-08, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0434SCLA
Administered by: Military     Purchased by: Military
Symptoms: Facial palsy, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow)
Write-up: Pt recv''d 5th dose of Anthrax on 3/23/99;pt states he was dxed w/ Bell''s Palsy in late May.Tx w/ prednisone. Patient states to still have Bell''s Palsy symptom to date. Patient states that he went to the Anthrax briefing at theater on 2/2/00 given by the allergist who mentioned that he was seeing a patient with Bell''s Palsy which the patient thought was Anthrax related. Patient states that after asking the doctor "How was these adverse reactions tracked? The doctor answered through pilling out a VAERS form patient states that at that point he decided to report related incident by filling a VAERS form at Public Health the following day. Per follow-up: Approx 6 mos after shot #6 (24Sep99) a raised rash formed on L upper ulnar side of arm. Rash was itching. Pt also states same type of rash on R arm, same spot. Rash on R arm resolved, L did not. Pt saw provider on 24 May and was given a hydrocortisone type cream to apply, shortly after, a second rash appeared in close proximity to L axilla area - this rash was on the front part of top of arm. Pt has refilled cream x 1 and rash is still present, however rash does not alway itch. Pt also states possible spread to inner thigh area, but not as severe.

VAERS ID:133984 (history)  Vaccinated:2000-01-24
Age:41.0  Onset:2000-01-24, Days after vaccination: 0
Gender:Female  Submitted:2000-01-25, Days after onset: 1
Location:Minnesota  Entered:2000-02-15, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Propulcid, Zantac, Naproxin
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02189P3IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Amblyopia, Conjunctivitis, Dysgeusia, Ear disorder, Eye disorder, Face oedema, Paraesthesia oral, Pruritus, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow)
Write-up: 12:45-eyes itchy, grainy, vision blurred, eyes red and swollen. 1:15-Mouth tingly with metallic taste. 1:45-burning and itching inside ears. 2:30-red itchy blotches on face.Throuout evening pt was diaphoretic. Tx with Benadryl, Prednisone.

VAERS ID:134000 (history)  Vaccinated:2000-01-17
Age:41.6  Onset:2000-01-17, Days after vaccination: 0
Gender:Male  Submitted:2000-02-07, Days after onset: 21
Location:California  Entered:2000-02-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Denies
Current Illness: Denies
Preexisting Conditions: Hep A 1996
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7302BA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Headache, Hyperhidrosis, Nausea, Peripheral vascular disorder, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Chills, fever, sensation of coldness of hands and feet, sweating, severe headache, nausea, vomiting. Denies redness or swelling of inject site. Sx resolved spontaneously w/in 24 hours.

VAERS ID:134018 (history)  Vaccinated:2000-02-01
Age:41.0  Onset:0000-00-00
Gender:Male  Submitted:2000-02-03
Location:Colorado  Entered:2000-02-15, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURERFAV047   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Decreased appetite, Influenza like illness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Approx 10 hrs post vax, devel flu like illness with fever, aches, and loss of appetite, No evidence of allergic reaction. No alleregies or medical consitions diagnosed prior to the date of vaccine. A vaccine date 18Jan00 - Lot Number FAV037 - Adverse event date 18/19 Jan- rash, flu like symptoms. Not at injectionsite. Vaccine Date 1Feb00 - Lot Number FAV047-Adverse event swelling on arm greater than 10 centimeters - flu like symptoms, severe rash on arms, back & stomach. extremely tired, sleeping greater than 10 hrs.

VAERS ID:134019 (history)  Vaccinated:1999-07-11
Age:41.0  Onset:1999-07-11, Days after vaccination: 0
Gender:Male  Submitted:2000-01-24, Days after onset: 197
Location:Kansas  Entered:2000-02-15, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV044   
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Chills, Immune system disorder, Influenza, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Low immune system, tired all the time, no ambition to do anything, body aches, flu like symptoms, chills; can not get warmed up.

VAERS ID:134154 (history)  Vaccinated:1999-09-14
Age:41.0  Onset:1999-09-15, Days after vaccination: 1
Gender:Female  Submitted:1999-09-17, Days after onset: 2
Location:California  Entered:2000-02-17, Days after submission: 153
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
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998216 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Ear pain, Eye pain, Hypokinesia, Neck pain, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: At time of vax w/bioject system, I felt pain all the way down to my elbow. By early evening, my arm was so sore, that i could not move it. I woke up at 1:00am, w/numbness in entire R/arm & side of face. Pain in eye, ear & neck w/tingling.

VAERS ID:134593 (history)  Vaccinated:2000-02-13
Age:41.0  Onset:2000-02-14, Days after vaccination: 1
Gender:Male  Submitted:2000-02-17, Days after onset: 3
Location:Wisconsin  Entered:2000-03-07, Days after submission: 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:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0311SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt experienced tenderness and itching. Also redness over the entire upper back part of arm - injection site. Symptoms fading. Tenderness noted on 02/14 and redness and itching on 02/16.

VAERS ID:134636 (history)  Vaccinated:2000-02-26
Age:41.0  Onset:2000-02-26, Days after vaccination: 0
Gender:Male  Submitted:2000-02-26, Days after onset: 0
Location:New Mexico  Entered:2000-03-08, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0241 LA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Diarrhoea, Dizziness, Headache, Myalgia, Pyrexia, Vasodilatation, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: First Anthrax on 2/13/2000, noting nausea, subjective fever/chills, myalgias/arthralgias and diarrhea for a couple of days. Today complaining of headache and mild nausea. Treat with Tylenol, as needed. After returning to work, had to go home from work because of headache (frontal pressure), mild light-headedness, nausea and vomiting x 1 this morning, fever and hot flashes, on 2/27/2000.

VAERS ID:134684 (history)  Vaccinated:2000-02-13
Age:41.0  Onset:2000-02-14, Days after vaccination: 1
Gender:Male  Submitted:2000-02-26, Days after onset: 12
Location:Unknown  Entered:2000-03-10, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Physical exam-negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0430SCLA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Headache, Pain, Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: 2/14 pain-L ankle, weakness in same ankle throughout day-resolved. 2/15 feverish-resolved. 2/17 red pimple-like dots lower abdo, both arms-resolved. 2/19 feverish, pressure devel on R side of head-resolved w/ excep of fever.

VAERS ID:150011 (history)  Vaccinated:1999-11-06
Age:41.0  Onset:1999-11-07, Days after vaccination: 1
Gender:Male  Submitted:2000-02-03, Days after onset: 88
Location:Massachusetts  Entered:2000-03-13, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0373SC 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Fatigue, Headache, Injection site hypersensitivity, Injection site oedema, Injection site pain, Lymphoedema, Vasodilation procedure
SMQs:, Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Extreme fatigue, headaches (low grade but persistent), triceps of arm swollen almost as large as biceps. Area of shot is about 4 inches long, red, warm and tender to the touch for about 2 weeks. This was the 4th shot and the worst reaction. Lymph nodes on back of head swollen for several months. Also, joint and finger pain.

VAERS ID:150065 (history)  Vaccinated:1999-11-12
Age:41.0  Onset:1999-11-13, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:New Hampshire  Entered:2000-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to amoxicillin, codeine
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES00011AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Influenza like illness, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: High fever, arm swelling, flu-like symptoms x 2 days. Treated with Benadryl. Symptoms lasted 2-3 days. Did not see doctor or report symptoms at time of adverse event.

VAERS ID:150081 (history)  Vaccinated:1999-08-10
Age:41.0  Onset:1999-08-10, Days after vaccination: 0
Gender:Male  Submitted:2000-03-07, Days after onset: 210
Location:Indiana  Entered:2000-03-15, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC Split Type:
Vaccination
Manufacturer
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM130B91IMLA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Fatigue, Joint stiffness
SMQs:, Arthritis (broad)
Write-up: Within one hour, I experienced overwhelming fatigue and exhaustion. Within a day or two of the shot, I began experiencing soreness and stiffness in my fingers, thumbs, toes, hips, elbows and wrists. Almost seven months post vax, I continue to have problems with exhaustion and joint pain. .

VAERS ID:150179 (history)  Vaccinated:1999-11-05
Age:41.0  Onset:1999-11-07, Days after vaccination: 2
Gender:Male  Submitted:2000-03-03, Days after onset: 117
Location:Texas  Entered:2000-03-17, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0244SC 
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Hair disorder, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever like symptoms. extreme fatigue, hair hardly grows.

VAERS ID:150182 (history)  Vaccinated:2000-02-29
Age:41.0  Onset:2000-03-05, Days after vaccination: 5
Gender:Female  Submitted:2000-03-16, Days after onset: 11
Location:Nevada  Entered:2000-03-17, 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: Ortho-Cept, Zoloft, sleep medications (nos)
Current Illness:
Preexisting Conditions: Splenectomy due to a motor vehicle accident in 1992. No known drug allergies. No history of Lyme disease.
Diagnostic Lab Data:
CDC Split Type: 20000070531
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Back pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad)
Write-up: Five days post vax, pt experienced pain and cramping in feet (which resolved) and pain in her back and hip joints. Other joints (nos) were starting to hurt. She has been unable to get out of bed since 03/05/00. She was treated with Advil. The vaccinee denies injury. She worked out with a personal trainer 3 times weekly. She reported these events after seeing a television show about

VAERS ID:150190 (history)  Vaccinated:2000-02-23
Age:41.0  Onset:2000-02-24, Days after vaccination: 1
Gender:Female  Submitted:2000-03-03, Days after onset: 8
Location:New York  Entered:2000-03-17, 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: Etanercept, Prednisone, isoniazid, Celebrex
Current Illness:
Preexisting Conditions: Rheumatoid arthritis.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3213A61IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.347J1SCRA
Administered by: Public     Purchased by: Other
Symptoms: Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Patchy hives developed within 36 hours, spread to entire body within 60 hours. Saw doctor at 48 hours and again at 72 hours post vax. Received, following second visit, Methylprednisolone, 4mg dose pack. Fever peaked at 103.5 at 120 hours post vax. Still recovering.

VAERS ID:150471 (history)  Vaccinated:2000-03-01
Age:41.0  Onset:2000-03-10, Days after vaccination: 9
Gender:Female  Submitted:2000-03-22, Days after onset: 12
Location:New York  Entered:2000-03-27, 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: Celebrex, Plaquenil, Theo-Dur, Allegra, Prevacid, Paxil
Current Illness: NONE
Preexisting Conditions: Rheumatoid arthritis, Asthma.
Diagnostic Lab Data: 3/13 Mono-test - negative, Rubella - non immune, Rubeola - immune.
CDC Split Type:
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0930J0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Cough, Diarrhoea, Laboratory test abnormal, Lymphadenopathy, Pharyngolaryngeal pain, Pyrexia, Spleen disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Posterior auricular and post neck cervical lymph adenopathy, mild sore throat, low grade fever, abdominal cramps, yellow diarrhea, mild cough, tender spleen, no rash. Still recovering as of 3/22/2000.

VAERS ID:150540 (history)  Vaccinated:2000-03-13
Age:41.0  Onset:2000-03-14, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Montana  Entered:2000-03-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Mild COPD
Diagnostic Lab Data:
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0473SCLA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1764J1IMLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 30 cm area on left forearm with erythema, swelling, and pain.

VAERS ID:150723 (history)  Vaccinated:2000-02-25
Age:41.0  Onset:2000-03-24, Days after vaccination: 28
Gender:Male  Submitted:2000-03-24, Days after onset: 0
Location:North Carolina  Entered:2000-04-03, 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: NONE
Diagnostic Lab Data: culture
CDC Split Type:
Vaccination
Manufacturer
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Dose
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0243SC 
Administered by: Military     Purchased by: Military
Symptoms: Cyst
SMQs:
Write-up: Cysts on chest and genitals - reoccurring.

VAERS ID:150778 (history)  Vaccinated:1999-08-31
Age:41.0  Onset:1999-09-01, Days after vaccination: 1
Gender:Male  Submitted:2000-03-28, Days after onset: 209
Location:North Dakota  Entered:2000-04-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: ESR-1, CK-42, WBC-5.3, Lyme A B-pending
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0433SCLA
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain upper, Arthralgia, Joint stiffness, Myalgia, Red blood cell sedimentation rate decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Pt had complaints of hip aching and right bicep pain with elbow flexing. Pt also experienced hip stiffness in the AM. Symptoms began in 12/99. Exam essentially normal. Also has occasional sharp epigastric pain relieved by bowel movement. Pt reported complaints 3/28/00.

VAERS ID:150789 (history)  Vaccinated:2000-03-09
Age:41.0  Onset:2000-03-22, Days after vaccination: 13
Gender:Female  Submitted:2000-03-27, Days after onset: 5
Location:Oregon  Entered:2000-04-06, 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: Prenatal vitamins
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1014J0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Lethargy, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow)
Write-up: Headache, fever, chills, body aches, lethargy and rash for 14 days, post vax.

VAERS ID:150914 (history)  Vaccinated:2000-04-01
Age:41.0  Onset:2000-04-02, Days after vaccination: 1
Gender:Female  Submitted:2000-04-03, Days after onset: 0
Location:Tennessee  Entered:2000-04-12, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0313SCLA
Administered by: Military     Purchased by: Military
Symptoms: Headache, Oedema peripheral, Vasodilation procedure
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left arm swollen post injection with fever. Left arm 12" in diameter. Right arm unaffected - 11" in diameter. Headache on left side of her head, directly above her eye.

VAERS ID:150924 (history)  Vaccinated:2000-03-28
Age:41.0  Onset:2000-03-30, Days after vaccination: 2
Gender:Male  Submitted:2000-03-31, Days after onset: 1
Location:Virginia  Entered:2000-04-12, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0475SCRA
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Headache, Hypoaesthesia, Joint swelling, Pyrexia, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Rash, swollen elbow and forearm, slight fever, headache, numbness in hand, treated with Augmentin, swelling reduced 4/2/00. Positive for cellulitis.

VAERS ID:150952 (history)  Vaccinated:2000-01-22
Age:41.0  Onset:2000-02-15, Days after vaccination: 24
Gender:Male  Submitted:2000-02-17, Days after onset: 2
Location:New Jersey  Entered:2000-04-13, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 4SCRA
Administered by: Military     Purchased by: Military
Symptoms: Hypersensitivity, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow)
Write-up: Within first week, post vax, had minor itching all over my body with no rash. As of 2/15/2000, rash appeared all over body with severe itching, including injection site. Follow up on 05/17/2000: "Patient recovered from adverse event."

VAERS ID:151059 (history)  Vaccinated:2000-02-17
Age:41.0  Onset:0000-00-00
Gender:Male  Submitted:2000-03-28
Location:Oregon  Entered:2000-04-24, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: methotrexate, thyroid
Current Illness:
Preexisting Conditions: Thyroid disorder
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1280J SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES40055AA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1363J SCRA
Administered by: Private     Purchased by: Private
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt complained of right arm numbness, paresthesia to II digit, symptoms are slowly improving.

VAERS ID:151107 (history)  Vaccinated:2000-04-03
Age:41.0  Onset:2000-04-04, Days after vaccination: 1
Gender:Male  Submitted:2000-04-04, Days after onset: 0
Location:Virginia  Entered:2000-04-26, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: phenobarbitol allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 4SC 
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Glossitis, Headache, Neck pain, Pain in jaw, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Osteonecrosis (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Acute swelling of tongue, leading to raw and cracking skin throughout mouth, sloughing of skin. Intense pain and unable to consume solid foods. Secondary symptoms include fatigue associated with headaches (temple area), neck and jaw soreness. The onset of symptoms occurred within 12-15 hours of the shot, but were definitely present upon awakening the next morning. Given that I am in excellent health, was well rested (just off leave), and am not taking any other medication, the Anthrax vaccination is the probable culprit for these reactions.

VAERS ID:151108 (history)  Vaccinated:1999-10-15
Age:41.0  Onset:1999-10-21, Days after vaccination: 6
Gender:Male  Submitted:2000-04-24, Days after onset: 186
Location:Colorado  Entered:2000-04-26, 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: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0414SC 
Administered by: Military     Purchased by: Military
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Developed arthritis in knees, hands, hips and shoulders. On a follow report received 10/10/2000 pt states that "arthritis is back, hands, ankles weak."

VAERS ID:151109 (history)  Vaccinated:2000-03-13
Age:41.0  Onset:2000-03-14, Days after vaccination: 1
Gender:Male  Submitted:2000-04-24, Days after onset: 40
Location:Colorado  Entered:2000-04-26, 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: Arthritis
Preexisting Conditions:
Diagnostic Lab Data: Blood test, MRI
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0245SC 
Administered by: Military     Purchased by: Military
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Arthritis developed one day after receiving shot. He has been under a doctors care since Sept 99 after receiving his 5th Anthrax shot.

VAERS ID:151677 (history)  Vaccinated:2000-04-13
Age:41.0  Onset:2000-04-14, Days after vaccination: 1
Gender:Male  Submitted:2000-04-27, Days after onset: 13
Location:Mississippi  Entered:2000-05-08, 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:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 1SC 
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Muscular weakness, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Post vax, the pt developed leg muscle weakness, soreness all the time; especially after running. Also, fatigue is an issue.

VAERS ID:151793 (history)  Vaccinated:2000-03-25
Age:41.0  Onset:2000-03-26, Days after vaccination: 1
Gender:Male  Submitted:2000-03-28, Days after onset: 2
Location:Pennsylvania  Entered:2000-05-09, Days after submission: 41
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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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0242SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt had pain, erythema and increased warmth to left arm. Biceps measurements of left arm 32.5cm and right arm 31.0cm. Had 2 erythematous patches about 8cm X 11cm noted superior and inferior to left elbow. No pain noted today. Pt treated by MD with Benadryl and ibuprofen. Left elbow measurement 30.5cm, right elbow 27.5cm. Pt feeling better today but not fully recovered yet. Follow up 06/05/2000: "Patient recovered from adverse event."

VAERS ID:151807 (history)  Vaccinated:1999-10-05
Age:41.0  Onset:2000-02-03, Days after vaccination: 121
Gender:Male  Submitted:2000-04-13, Days after onset: 69
Location:South Dakota  Entered:2000-05-10, Days after submission: 27
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: AMA-$g1:80, CBC-wnl, ESR-3, RF-<20.0
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0384SC 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Red blood cell sedimentation rate decreased
SMQs:, Arthritis (broad)
Write-up: Pt experienced upper extremity/shoulder/elbow arthralgia. Progressively worsened since start of Anthrax series (9/23/98). Follow up 06/05/2000: "Patient did not recover from adverse event. Shoulders ache; both elbows and muscles in arms hurt especially with exertion. Left arm more than right."

VAERS ID:151829 (history)  Vaccinated:1999-08-10
Age:41.0  Onset:1999-08-10, Days after vaccination: 0
Gender:Male  Submitted:2000-04-22, Days after onset: 256
Location:Indiana  Entered:2000-05-10, 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: hx of hernia
Diagnostic Lab Data:
CDC Split Type: 20000032911
Vaccination
Manufacturer
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Fatigue, Injection site pain, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: A report from a 41 year old male pt with a follow-up from a lawyer. On 7/7/99, the pt received his first injection with Lymerix at an unspecified dose with no effects. On 8/10/99, he received the second dose of Lymerix and shortly afterward he experienced severe soreness in the arm where the shot was given. Within less than an hour, the pt experienced severe unusual fatigue/exhaustion. He felt so fatigued he had to stop driving his car and rest inside his car. After a short rest he drove home and rested in bed for a few hours. He returned to his office but still felt bad. As the days passed, the arm soreness resolved. A day or two after the shot, he experienced severe soreness in his fingers, knees, hips, ankles, toes, elbows and other joint in his body. the pt continues to experience nagging pain in his finger and knee joints. The pain and stiffness is worse in the morning, however, the condition usually improves a little later in the day. He also feels slightly fatigues most of the time. Occasionally, he suffers from an overwhelming feeling of severe fatigue, the same feeling he had about an hour after the second shot. Aspirin, ibuprofen and Tylenol have been used as treatment. The most recent information received on 2/17/00 reports the symptoms are ongoing.

VAERS ID:151830 (history)  Vaccinated:1999-07-01
Age:41.0  Onset:1999-08-13, Days after vaccination: 43
Gender:Male  Submitted:2000-04-21, Days after onset: 252
Location:Indiana  Entered:2000-05-10, Days after submission: 19
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: UNK
Diagnostic Lab Data:
CDC Split Type: 20000040031
Vaccination
Manufacturer
Lot
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY130291IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Dizziness, Fatigue, Injection site pain, Joint stiffness
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: In 07/99, and on unspecified date, the vaccinee received the first and second doses of the vax. Post second vax, on approximately 08/13/99, the vaccinee experienced severe fatigue and severe soreness at the injection site. Additionally, he experienced severe joint soreness of the fingers, knees, ankles, wrists, and other joints. The vaccinee had worsening of symptoms in the morning, and his symptoms improved as the day went on. Additionally he experienced lightheadedness and a feeling of tightness in the joints. He received systematic treatment with OTC analgesics. The most recent information, received on 03/14/2000, reports the condition of the pt as unknown.

VAERS ID:151933 (history)  Vaccinated:1999-04-05
Age:41.0  Onset:1999-07-05, Days after vaccination: 91
Gender:Male  Submitted:0000-00-00
Location:Washington  Entered:2000-05-15
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: sarcoidosis, esophageal reflux
Diagnostic Lab Data: x-ray, ct
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0340IM 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Haemoptysis, Infection, Rash, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Approximately 2-3 days post vax, pt began to cough up blood, brown and green mucous. The pt''s inner thigh had a red and purple rash, nose was inflamed with lesions, and mucosa. Pt experienced joint pain in elbow, and knees. Pt''s nose is bloody and infected with a pus type discharge.

VAERS ID:152029 (history)  Vaccinated:2000-05-06
Age:41.0  Onset:2000-05-07, Days after vaccination: 1
Gender:Male  Submitted:2000-05-08, Days after onset: 1
Location:Pennsylvania  Entered:2000-05-17, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0475SCLA
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0230J2IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site haemorrhage, Injection site pain, Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling at injection site of dose 6 that was received on 5/6/00. Area is bruised and tender, firm but no nodule.

VAERS ID:152056 (history)  Vaccinated:1993-12-14
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:2000-03-07
Location:Florida  Entered:2000-05-18, Days after submission: 71
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: Lab test-"positive for Hep-B"
CDC Split Type: WAES99021433
Vaccination
Manufacturer
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Hepatitis
SMQs:, Hepatitis, non-infectious (narrow)
Write-up: Information has been received from an approximately 41 year old female who on 6/10/93, 7/14/93 and 12/14/93 was vaccinated with the 1st, 2nd and 3rd doses of Hep-B vaccine recombinant. In approximately 1993, lab evaluation revealed a "positive test for Hep-B". No further information is available.

VAERS ID:152064 (history)  Vaccinated:1998-08-21
Age:41.0  Onset:0000-00-00
Gender:Male  Submitted:2000-03-07
Location:Idaho  Entered:2000-05-18, Days after submission: 71
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lortab, Pepcid,
Current Illness:
Preexisting Conditions: spinal surgery, allergy to Reglan, codeine, hx of hep b exposure
Diagnostic Lab Data:
CDC Split Type: WAES99030384
Vaccination
Manufacturer
Lot
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IM 
Administered by: Private     Purchased by: Other
Symptoms: Chest pain, Dizziness, Hypoaesthesia, Malaise, Tinnitus
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (broad)
Write-up: Information has been received from a licensed practical nurse concerning a 41 year old male. The pt was potential exposed to Hep B during surgery and was vaccinated with Hep B. The pt reported no adverse effects following the first vaccination. In August of 1998 shortly after the second vaccination, the pt telephoned the medical center and reported that he was feeling sick, he experienced dizziness, chest pain, numbness in his left arm and the left side of his face and terrible arm sensation. He was sent to the ER but was not admitted. The pt felt the symptoms were related to hep b vaccine. Follow up information received from a nurse on 4/5/99 noted that the pt telephoned the medical center and reported that his chest pain had persisted and also he experienced ringing in his ears. The pt indicated that the hospital believed there was an association between his symptoms and Hep b vaccine. As cited by the pt,

VAERS ID:152145 (history)  Vaccinated:1999-05-01
Age:41.0  Onset:1999-05-03, Days after vaccination: 2
Gender:Female  Submitted:2000-03-07, Days after onset: 309
Location:Florida  Entered:2000-05-19, Days after submission: 72
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: Sulfa allergy
Diagnostic Lab Data:
CDC Split Type: WAES99051688
Vaccination
Manufacturer
Lot
Dose
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Nasal congestion
SMQs:
Write-up: Information has been received from a 41 year old female social worker who in May 1999, was vaccinated with 1 dose of Hep-B vaccine recombinant and a couple days, post vax, she experienced "stuffed up nose." She sought unspecified medical attention. No further information is available.

VAERS ID:152179 (history)  Vaccinated:1999-07-01
Age:41.0  Onset:1999-07-02, Days after vaccination: 1
Gender:Female  Submitted:2000-03-07, Days after onset: 249
Location:Missouri  Entered:2000-05-19, Days after submission: 72
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: allergy to amoxicillin, cephalosporin, PCN
Diagnostic Lab Data:
CDC Split Type: WAES99080450
Vaccination
Manufacturer
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1584E0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Menstruation irregular, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Fertility disorders (broad)
Write-up: Information has been received from a physician concerning a 41 year old female pt, who on 7/1/99 was vaccinated IM in the left deltoid with a first dose of Hep B. On 7/2/99, the pt developed a fever and started menstruating, which was not appropriate for her cycle. It was reported that the pt thought it was related to stress. On 8/2/99, the pt was vaccinated IM in the left deltoid with a second dose of Hep B vaccine. On 8/3/99, the pt developed a fever and began menstruating again, "when it was not due." Follow up information from a physician reported that the pt subsequently recovered.

VAERS ID:152204 (history)  Vaccinated:1999-11-13
Age:41.0  Onset:1999-11-17, Days after vaccination: 4
Gender:Female  Submitted:2000-05-11, Days after onset: 175
Location:Minnesota  Entered:2000-05-22, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Spinal tap, EMG
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Clumsiness, Guillain-Barre syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: Pt was immunized with a flu vaccine on 11/13/99. Pt was hospitalized and diagnosed with Guillain Barre syndrome 11/21/99. Pt is still on disability. Annual follow up states patient has difficulty moving hands, is very clumsy and easily drops items. Patients legs are achy and weak and there is tingling in feet. Patient cannot run with ease and is fatigued.

VAERS ID:152238 (history)  Vaccinated:2000-04-14
Age:41.0  Onset:2000-04-16, Days after vaccination: 2
Gender:Male  Submitted:2000-05-11, Days after onset: 25
Location:Guam  Entered:2000-05-23, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH    
Administered by: Military     Purchased by: Military
Symptoms: Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: After 2nd Anthrax shot, pt developed hives and facial swelling for 2 days.

VAERS ID:152239 (history)  Vaccinated:2000-02-05
Age:41.0  Onset:2000-02-05, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Guam  Entered:2000-05-23
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: UA
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH    
Administered by: Military     Purchased by: Military
Symptoms: Cough, Headache, Hyperhidrosis, Injection site hypersensitivity, Injection site oedema, Lethargy, Myalgia, Pharyngolaryngeal pain, Pruritus, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: On 2/5/00 post vax, the pt developed a fever, cold sweats, myalgia, headaches, lethargy, swelling, redness and itching at injection site. On 2/14/00, the pt experienced near syncope, headaches, myalgia, temp to 101, sore throat, and cough.

VAERS ID:152345 (history)  Vaccinated:1999-10-14
Age:41.0  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:2000-03-07, Days after onset: 145
Location:Michigan  Entered:2000-05-25, Days after submission: 78
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WAES99111202
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0265J0IM 
Administered by: Public     Purchased by: Private
Symptoms: Dyspnoea, Headache, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Approximately 12 hours post vax, the pt developed a severe headache, became short of breath and felt like she was having a heart attack. Additionally, the pt experienced itchy arms although she had no rash. Follow up information from a physician reported that the pt did not seek medical treatment and that approximately 1 1/2 hours later the symptoms resolved with the severe symptoms lasting about 45 minutes.

VAERS ID:152406 (history)  Vaccinated:2000-04-01
Age:41.0  Onset:2000-04-01, Days after vaccination: 0
Gender:Female  Submitted:2000-04-03, Days after onset: 1
Location:Wyoming  Entered:2000-05-25, Days after submission: 52
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: chest tight (cold symptoms) prior
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER4998062  RA
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Chills, Headache, Neck pain, Pain
SMQs:, Arthritis (broad)
Write-up: Pt had a red streak about 3 inches long running down from her injection site. She also had severe body pain and chills all night. Had to leave work early the day of shot. Still has pain in neck and severe headache. Tylenol did not and still does not help.

VAERS ID:152431 (history)  Vaccinated:2000-02-10
Age:41.0  Onset:2000-02-17, Days after vaccination: 7
Gender:Female  Submitted:2000-04-01, Days after onset: 44
Location:Massachusetts  Entered:2000-05-26, Days after submission: 54
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: penicillin, tetracycline, erythromycin
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURERTD660IMLA
Administered by: Private     Purchased by: Public
Symptoms: Feeling abnormal, Pain
SMQs:, Dementia (broad)
Write-up: Pt felt unwell for one week after vax. She developed painful muscles in left upper arm; which has not resolved for six weeks.

VAERS ID:152438 (history)  Vaccinated:2000-02-28
Age:41.0  Onset:2000-03-01, Days after vaccination: 2
Gender:Female  Submitted:2000-03-30, Days after onset: 29
Location:Puerto Rico  Entered:2000-05-26, Days after submission: 56
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: CBC
CDC Split Type:
Vaccination
Manufacturer
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HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1037E0IM 
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1037E0IM 
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM651A60IM 
Administered by: Other     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt complained of a rash on the body. Treated with Soap - oillum creams and medication. Pt was out of work for one week.

VAERS ID:152560 (history)  Vaccinated:1999-05-21
Age:41.0  Onset:1999-05-22, Days after vaccination: 1
Gender:Female  Submitted:2002-11-26, Days after onset: 1284
Location:New Jersey  Entered:2000-06-01, Days after submission: 908
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Florioet, methylprednisolone, Zolpidem tartrate, Butorphanol tartate, Femotidine, Zalepion, Thyroxine sodium, Parcocet, Ibuprofen
Current Illness: UNK
Preexisting Conditions: allergic rhinitis, allergy to codine, back pain, chest pain, hysterectomy, migraine, neck pain, osteoarthritis, palpitations, possible irritable bowel syndrome, TMJ syndrome, abdominal pain, adrenomyosis, anemia, ankle surgery, back injury, bruise bursitis, chronic headache, chronic sinusitis, constipation, depression, deviated nasal septom, earache, enlarged thyroid, foot pain, fo
Diagnostic Lab Data: Like 30% of the general population, the pt is of a genetic type called HLA-DR4+. Some experts say a key ingredient in Lymerix triggers autoimmune arthritis in such individuals; antinuclear antibody-negative; C-reactive protein serum-48; ery
CDC Split Type: 2000015516
Vaccination
Manufacturer
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Arthritis, Asthenia, Chest pain, Depression, Discomfort, Fibromyalgia, Headache, Hypothyroidism, Influenza like illness, Laboratory test abnormal, Musculoskeletal stiffness, Paraesthesia, Paralysis, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypothyroidism (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (narrow), Arthritis (narrow)
Write-up: In May, 1999, the pt received her first injection of Lymerix and immediately experienced severe flu symptoms. After receiving her second injection, her elbows began to ache. The pain spread down her arms and throughout her body until by November 1999, she could barely clasp a carton of milk. She was reportedly diagnosed with chronic fatigue, depression and fibromyalgia. Eventually, sometime since November 1999, she was diagnosed with autoimmune arthritis. Follow-up received 8/1/00 states following the 2nd injection, by 11/99 she reportedly was so stiff and was suffering so much pain in her chest and arms that she could barely mover fore hours in the morning nor could she barely clasp a carton of milk. According to the legal summons and complaint, the pt has been treated with anti-inflammatory and other medication as well as a pain management specialist with no relief of her symptoms. In a new report posted on the internet on 02/28/2002, the vaccinee stated, "within 48 hrs of the second one (LYMErix) I was in extreme pain." The reporter stated, "she never got the third dose recommended one year later. She remains sickly today. She suffers from arthritic pain in her hands, knees, elbows, hips and shoulders." On 07/22/1994, the pt was seen by the vaccine provider with a chief complaint of "pain of right foot, around metatarsophalangeal joint area." The pain had been present for approx. one month. The pt returned to the vaccine provider on 11/28/1994 with pain around wrist with pain radiation to fingers. The physician prescribed Medrol Dosepak and florioet. On 12/03/1997, tiny subcutaneous nodules less than .5cm diameter were observed around both arms. Fatigue was also documented in 1997 and 1998. On 05/25/1999, the pt telephoned the vaccine provider to request a refill of Stadol NS; no mention of flu-like symptoms, elbow pain or muscle pain was made. The pt was seen by the vaccine provider on 06/04/1999 with chief complaints of crusty and red eyelid for one day, complained of back pain. The physician''s assessme

VAERS ID:152809 (history)  Vaccinated:2000-04-07
Age:41.0  Onset:2000-04-19, Days after vaccination: 12
Gender:Female  Submitted:2000-04-19, Days after onset: 0
Location:New York  Entered:2000-06-08, Days after submission: 50
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra
Current Illness: NONE
Preexisting Conditions: environmental allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0545 SCLA
Administered by: Private     Purchased by: Other
Symptoms: Lymphadenopathy, Rash papular
SMQs:
Write-up: The pt experienced erythematous, papular lesions on face and between breasts. First noticed rash this morning when she woke. No fever was noted. Bilateral tonsilar nodes enlarged. Pharynx and ears appeared normal. Lungs clear bilaterally.

VAERS ID:153056 (history)  Vaccinated:2000-03-09
Age:41.0  Onset:2000-03-10, Days after vaccination: 1
Gender:Female  Submitted:2000-03-14, Days after onset: 4
Location:Idaho  Entered:2000-06-08, Days after submission: 85
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Neoral, Cartiaxt, Vasotec, azathioprine, furosemide, clonidine HCL, atenolol, triazolam
Current Illness: Increased BP; Rx''d with codiene
Preexisting Conditions: 2 kidney transplants, 1991 and 1994; stroke in 1994-complete recovery
Diagnostic Lab Data: MRI-clear vision of kidney; flow perfect (03/08/00)
CDC Split Type: ID00008
Vaccination
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Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3203A40IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM641A60IMLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0010AA0IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR02340IMRA
Administered by: Public     Purchased by: Private
Symptoms: Alopecia
SMQs:
Write-up: On 3/10/2000, noticed twice as much hair as usual came out after shampooing. Each day since, hair is coming out in clumps.

VAERS ID:153568 (history)  Vaccinated:1999-11-16
Age:41.0  Onset:1999-11-18, Days after vaccination: 2
Gender:Female  Submitted:1999-11-23, Days after onset: 5
Location:Arkansas  Entered:2000-06-09, Days after submission: 198
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: AR0001
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0165AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Chest pain, Chills, Cough, Musculoskeletal stiffness, Night sweats, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)
Write-up: At 10:30 achiness, 1-2 hours later chills, took Tylenol. 15:00 temperature of 102 with achiness, stiffness all over. Started stiffness upper body and worked down, cough, when breathed pain in chest. These symptoms continued 3 days worsened in late afternoon and late evening. Day 4 and 5 night sweats, day 6 continue stiff neck.

VAERS ID:153708 (history)  Vaccinated:2000-01-08
Age:41.0  Onset:2000-01-08, Days after vaccination: 0
Gender:Male  Submitted:2000-05-04, Days after onset: 116
Location:Arizona  Entered:2000-06-09, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0135AA IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.0998H IMLA
Administered by: Military     Purchased by: Military
Symptoms: Cold sweat, Hypotension, Hypoventilation, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (narrow), Hypersensitivity (narrow)
Write-up: Post 2nd vax, the client developed, rash, clammy skin, respiratory, shallow, hypotensive (60/30). He remained verbal; no pain, and responsive. With- in 2-3 min, BP 100/60, pulse 80, Resp. 16-20.

VAERS ID:153731 (history)  Vaccinated:2000-05-25
Age:41.0  Onset:2000-05-27, Days after vaccination: 2
Gender:Female  Submitted:2000-05-30, Days after onset: 3
Location:Montana  Entered:2000-06-09, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Grave''s disease, medication still being adjusted
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
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HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM639A40IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR032020 LA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Fatigue, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: 5/27/2000 pt became very dizzy, tired, achy. Her temp was 102.0F, she took some ASA. Her fever increased to 104.0F. Doctor office recommended Tylenol. Temperature dropped to 102.0F but the aches continued. Sunday she had sore throat. Pt recovered fully by Monday.

VAERS ID:153985 (history)  Vaccinated:1999-04-27
Age:41.0  Onset:1999-05-01, Days after vaccination: 4
Gender:Male  Submitted:2000-05-24, Days after onset: 389
Location:Unknown  Entered:2000-06-13, Days after submission: 20
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 (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 0SC 
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: 0     Purchased by: 0
Symptoms: Disturbance in attention, Fatigue, Gastrointestinal disorder, Hypogonadism male, Memory impairment, Myalgia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Fertility disorders (narrow)
Write-up: Pt experienced a probable systemic reaction to the Anthrax vaccine series, including, chronic fatigue, reduced stamina, muscle pain, impaired concentration, memory, orthostasis, sleep disturbance, GI upset, hypogonadism.

VAERS ID:154010 (history)  Vaccinated:1999-11-10
Age:41.0  Onset:1999-11-10, Days after vaccination: 0
Gender:Female  Submitted:1999-11-30, Days after onset: 20
Location:Maryland  Entered:2000-06-13, Days after submission: 195
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ5752116NOV1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982454IM 
Administered by: Other     Purchased by: Other
Symptoms: Hypoaesthesia, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Same day post vax, the pt developed numbness in the fingers of her left arm and an injection site reaction characterized by shooting pains which extended to her left elbow, burning and itching. The numbness and pain resolved, however, the itching at the injection site persisted. This is one of three pts from this facility who experienced an adverse event following receipt of vax.

VAERS ID:154168 (history)  Vaccinated:1999-06-03
Age:41.0  Onset:1999-06-06, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:Arizona  Entered:2000-06-14
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: UNK
Diagnostic Lab Data: UNK
CDC Split Type: 899167068A
Vaccination
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TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)PFIZER/WYETH4978248 IMLA
Administered by: Private     Purchased by: Other
Symptoms: Lymphadenopathy, Subcutaneous nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 3 days post vax, pt went to emergency room with swollen glands and pronounced axillary nodules; she was sent home without treatment. Pt returned to the clinic and a diagnosis of axillary lymphadenopathy was made. She was treated with Tylenol (acetaminophen) and Advil (ibuprofen).

VAERS ID:154214 (history)  Vaccinated:1999-07-14
Age:41.0  Onset:1999-08-01, Days after vaccination: 18
Gender:Male  Submitted:2000-06-08, Days after onset: 312
Location:New Jersey  Entered:2000-06-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Serzone
Current Illness: Depression
Preexisting Conditions: Depression
Diagnostic Lab Data: ALS, Lupus, Rheumatoid Arthritis-nml, blood tests-nml
CDC Split Type:
Vaccination
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1  
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Arthritis, Fatigue, Pain
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Pt experienced joint pain in knees, neck, lower back, shoulder, elbow. Arthritis type pain, requiring elbow surgery and fatigue. Pt saw 9 MD''s from 6/25/99 to present. Annual follow up states patient still has joint pain and fatigue.

VAERS ID:154226 (history)  Vaccinated:2000-06-03
Age:41.0  Onset:2000-06-03, Days after vaccination: 0
Gender:Male  Submitted:2000-06-16, Days after onset: 13
Location:Colorado  Entered:2000-06-14, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0475SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Large local reaction with redness, swelling, and pain surrounding injection site. Hand swelling one day post injection per pt - resolved now - local reaction, 95x80 mm at T+3.

VAERS ID:154364 (history)  Vaccinated:1999-07-07
Age:41.0  Onset:0000-00-00
Gender:Male  Submitted:1999-09-29
Location:Connecticut  Entered:2000-06-15, Days after submission: 260
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin-D, Ventolin
Current Illness:
Preexisting Conditions: allergy to Cefzil, Tylenol, Wellbutrin, bronchitis, rhinitis, sinusitis, smoker
Diagnostic Lab Data:
CDC Split Type: 19990191431
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY123B90IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: On 7/7/99, the pt received his first IM-left deltoid dose of Lymerix. Subsequently, he experienced discomfort and the sensation of heat at the injection site. These symptoms resolved after three weeks. The most recent information received on 7/27/99, reports the condition of the pt is resolved.

VAERS ID:154408 (history)  Vaccinated:1999-06-07
Age:41.0  Onset:1999-06-07, Days after vaccination: 0
Gender:Male  Submitted:1999-09-29, Days after onset: 114
Location:New Jersey  Entered:2000-06-15, Days after submission: 260
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: Elevated triglycerides, environmental allergies; pt received Lamisil for a fungal infection of the toe and Tricor for triglycerides, but these were discontinued before Lymerix therapy
Diagnostic Lab Data: EMG-carpal tunnel syndrome (left wrist) 7/1/99
CDC Split Type: 19990179091
Vaccination
Manufacturer
Lot
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Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Carpal tunnel syndrome, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: This is a spontaneous report from a nurse referring to her 41 year old husband. The pt received his 1st Lymerix shot on 6/7/99 and on the same day, he experienced a sore left arm which resolved in 2 days. On 6/9/99, he experienced paresthesias (tingling and numbness) in his left arm. He saw a physician and had an electromyogram performed on 7/1/99 which revealed carpal tunnel syndrome of the left wrist. This was treated with a wrist splint. On 6/7/99, the received the 2nd Lymerix shot in his right arm, with no untoward affects. The most recent information received on 7/9/99, reports the paresthesia of the left arm and carpal tunnel syndrome on the left wrist are ongoing.

VAERS ID:154409 (history)  Vaccinated:1999-05-26
Age:41.0  Onset:1999-06-07, Days after vaccination: 12
Gender:Male  Submitted:1999-09-29, Days after onset: 114
Location:Wisconsin  Entered:2000-06-15, Days after submission: 260
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: 19990203832
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Dyspnoea, Feeling cold, Hot flush, Pruritus, Rash
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: This is a spontaneous report from a RN referring to a 41 year old male. On 5/26/99, the pt received is 1st dose of Lymerix. Approximately 10 days later, on 6/7/99, the pt experienced generalized rash, itching, shortness of breath, dizziness and hot/cold flashes. She was seen twice by a physician and treated with Medrol Cospak. The most recent information, received on 8/11/99, reports the condition of the pt is recovered.

VAERS ID:154466 (history)  Vaccinated:1999-08-13
Age:41.0  Onset:1999-08-15, Days after vaccination: 2
Gender:Male  Submitted:1999-09-20, Days after onset: 36
Location:Oklahoma  Entered:2000-06-15, Days after submission: 269
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: 19990248171
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Private     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: Within 48 hours post vax, the pt experienced a severe headache. He was treated with Tylenol and Advil. The headache resolved in 22 hours. In addition to this pt several other pts have complained of headache.

VAERS ID:154865 (history)  Vaccinated:1999-06-10
Age:41.0  Onset:1999-06-20, Days after vaccination: 10
Gender:Female  Submitted:2000-05-30, Days after onset: 345
Location:Arizona  Entered:2000-06-21, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99061725
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Lymphadenopathy, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Ten day post vax, pt experienced posterior auricular adenopathy and a rash. No further information is available.

VAERS ID:154869 (history)  Vaccinated:1998-10-13
Age:41.0  Onset:1998-10-14, Days after vaccination: 1
Gender:Female  Submitted:1998-12-22, Days after onset: 69
Location:North Carolina  Entered:2000-06-21, Days after submission: 546
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: U1998006480
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0977210 IM 
Administered by: Other     Purchased by: Other
Symptoms: Feeling hot, Injection site hypersensitivity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: One day post vax, pt complained of hives, redness and warmth 2 X 1.5 inches at injection site.

VAERS ID:154973 (history)  Vaccinated:1998-10-01
Age:41.0  Onset:1998-10-01, Days after vaccination: 0
Gender:Female  Submitted:1999-12-29, Days after onset: 454
Location:Massachusetts  Entered:2000-06-21, Days after submission: 174
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ5390211NOV1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site swelling, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt developed an injection site reaction characterized by a very large red, raised area measuring 4 inches, which resolved after 10 days.

VAERS ID:155139 (history)  Vaccinated:1998-11-06
Age:41.0  Onset:1998-11-07, Days after vaccination: 1
Gender:Female  Submitted:1998-11-10, Days after onset: 3
Location:Connecticut  Entered:2000-06-21, Days after submission: 588
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: U1998007950
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0984600 IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site swelling, Vasodilation procedure
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 24 hours post vax, the pt experienced a huge 4 inch reaction that was slightly raised, red, and hot. Reportedly the reaction was gone by 11/9/98 and the pt recovered.

VAERS ID:155430 (history)  Vaccinated:2000-06-04
Age:41.0  Onset:2000-06-04, Days after vaccination: 0
Gender:Male  Submitted:2000-06-12, Days after onset: 8
Location:Unknown  Entered:2000-06-27, Days after submission: 15
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: tinitus
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV068B SC 
Administered by: Military     Purchased by: Unknown
Symptoms: Arthropathy, Asthenia, Ciliary muscle spasm, Dizziness, Fatigue, Hypoacusis, Tinnitus, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (narrow), Vestibular disorders (broad), Arthritis (broad)
Write-up: Pt experienced hearing loss and increased ringing, dizziness (when bending), weakness in joints, tiredness, muscle spasms / tremors in legs and arm.

VAERS ID:155526 (history)  Vaccinated:1999-10-15
Age:41.0  Onset:1999-10-16, Days after vaccination: 1
Gender:Female  Submitted:2000-01-04, Days after onset: 80
Location:Rhode Island  Entered:2000-06-27, Days after submission: 174
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: Unknown
Diagnostic Lab Data:
CDC Split Type: HQ3144221OCT1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  SCAR
Administered by: Private     Purchased by: Other
Symptoms: Laboratory test abnormal, Vasculitis
SMQs:, Vasculitis (narrow)
Write-up: A physician reported that she inadvertently received a subcutaneous injection of FLU SHIELD on 15-OCT-1999. Within 24 hours, she developed an injection site reaction characterized by redness. The patient recovered within 48 hours.

VAERS ID:155553 (history)  Vaccinated:1999-05-30
Age:41.0  Onset:1999-06-06, Days after vaccination: 7
Gender:Male  Submitted:1999-06-14, Days after onset: 8
Location:Maryland  Entered:2000-06-28, Days after submission: 380
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: U1999003940
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES  IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injury, Insomnia, Pain
SMQs:, Accidents and injuries (narrow), Hostility/aggression (broad)
Write-up: It was reported that a 41 year old male sustained a trampoline injury and was treated for a broken nose and stitches. The pt was given a TD booster in the right deltoid. Reportedly, the pt was fine until 6-7 days later, at which time he developed an intermittent pain in the right forearm; severe enough to awaken him during sleep at night. The pain is reportedly not subsiding.

VAERS ID:155577 (history)  Vaccinated:1999-09-08
Age:41.0  Onset:1999-09-09, Days after vaccination: 1
Gender:Male  Submitted:1999-09-10, Days after onset: 1
Location:New York  Entered:2000-06-28, Days after submission: 292
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: U1999006570
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES1000560 IM 
Administered by: Other     Purchased by: Other
Symptoms: Headache, Injection site erythema, Injection site pain, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: It was reported that a 41 year old male pt received a TD Adult vaccination on 9/8/99 and approximately 24 hours, post vax, he experienced soreness and redness at the injection site, headache, malaise and nausea.

VAERS ID:155854 (history)  Vaccinated:2000-06-16
Age:41.0  Onset:2000-06-16, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Minnesota  Entered:2000-06-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY128A20IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Pain
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Pt reports he developed dizziness, lightheadedness, and general body aches after getting his vaccines.

VAERS ID:156075 (history)  Vaccinated:2000-05-10
Age:41.0  Onset:2000-06-03, Days after vaccination: 24
Gender:Female  Submitted:2000-06-28, Days after onset: 25
Location:Pennsylvania  Entered:2000-07-06, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY144B92IMRA
Administered by: Private     Purchased by: 0
Symptoms: Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The pt experienced swelling and pain in the right hand and right fore arm.

VAERS ID:156128 (history)  Vaccinated:1999-07-09
Age:41.0  Onset:1999-09-01, Days after vaccination: 54
Gender:Male  Submitted:2000-07-07, Days after onset: 310
Location:Unknown  Entered:2000-07-10, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: He has had some baseline discomfort in his knees that he contributes to his work as a construction worker. He has a history of irritable bowel syndrome, appendectomy, bone graft right ear (1984) and multiple fractures post 2 motor vehicle accidents; 1st one by motorcycle (1978) involving right elbow, ankle and foot; 2nd accident was by truck. He underwent exploratory and evidently
Diagnostic Lab Data: MRI-right knee showed horizontal tear of meniscus, X-rays of knee-nml, X-rays of foot-showed minimal osteoarthritis and he had 20 CC''s of inflammatory fluid aspirated from left knee for analysis and culture, Chest X-ray-nml, X-ray hands-deg
CDC Split Type: 2000202101
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Bone disorder, Cyst, Feeling hot, Hypokinesia, Inflammation, Injury, Joint effusion, Joint stiffness, Pain, Pyrexia, Rheumatoid arthritis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow)
Write-up: The pt received Lymerix on 6/4/99 and 7/9/99. In early September, 1999, he experienced an onset of symptoms described as "all joints could not bend" and heat, swelling and "constant pain, 24 hours a day". On 10/29/2000, pt reported a sudden onset of right medial foot discomfort starting about the end of August, 1999. He was told it was related to an old fracture. Soon thereafter, he developed shoulder, back and leg soreness. He noted inflammation with significant swelling and pain involving hand joints, wrists, left shoulder and elbows. He also noted pain and swelling involving his knees and metatarsal phalangeal joints of both feet. He additionally, complained of decreased energy level and morning stiffness. Impression was that the pt had "probable new onset rheumatoid arthritis" as the pt had polyarticular small and large joint symmetrical synovitis of the upper and lower extremities with a positive rheumatoid factor. Rheumatologist thought this was unlikely. Activities of daily living were noted to be hampered (could not grip hammer). He was continued on Celebrex. 11/3/99, visit with 2nd Rheumatologist: 3 weeks ago, fairly acute onset of fevers up to 101F, associated with swelling and pain of his right knee, which progressed to his left knee, also, had severe joint pain in his shoulders and various small joints of his hands. Pt seen by an Orthopedist. 11/18/99, dx''d with "seropositive rheumatoid arthritis". Pt had dramatic response to aspiration and injection of knee. 11/29/99, pt felt to have rheumatoid arthritis and possibly inflammatory osteoarthritis, so prednisone increased. Morning stiffness and has not been able to return to work. 1/3/00, synovial thickening of wrists and some hand joints, right knee effusion. 2/21/00, dx is seropositive rheumatoid arthritis of 4 months duration, unable to taper prednisone below 15 mg. Methotrexate 7.5mg added. This case is considered serious because the pt has been disabled, since he has been out of work. The most recent information received on 6/26/00 reports the outc

VAERS ID:156276 (history)  Vaccinated:2000-04-28
Age:41.0  Onset:2000-04-28, Days after vaccination: 0
Gender:Female  Submitted:2000-05-05, Days after onset: 7
Location:California  Entered:2000-07-11, Days after submission: 67
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: CA000050
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0055AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Body temperature increased, Injection site hypersensitivity, Injection site oedema, Injection site pain, Malaise
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt experienced injection site reaction characterized by pain, swelling and redness. Pt also experienced weakness, elevated temperature, malaise. Treated with Tylenol

VAERS ID:156377 (history)  Vaccinated:1999-09-27
Age:41.0  Onset:1999-10-27, Days after vaccination: 30
Gender:Male  Submitted:2000-06-29, Days after onset: 246
Location:North Carolina  Entered:2000-07-12, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: X-rays and blood work ordered
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0243SCLA
Administered by: Military     Purchased by: Military
Symptoms: Amnesia, Fatigue, Lymphadenopathy, Mucous membrane disorder
SMQs:, Dementia (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Swollen glands, rash symptoms in mouth; treated for a year with no fix. Constantly tired and memory loss.

VAERS ID:156379 (history)  Vaccinated:2000-03-06
Age:41.0  Onset:2000-06-03, Days after vaccination: 89
Gender:Male  Submitted:2000-07-07, Days after onset: 34
Location:New York  Entered:2000-07-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0381SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: One inch diameter, subcutaneous fibroma (L) mid-deltoid at site of Anthrax vaccination.

VAERS ID:156495 (history)  Vaccinated:2000-05-04
Age:41.0  Onset:2000-05-07, Days after vaccination: 3
Gender:Male  Submitted:2000-07-07, Days after onset: 61
Location:New York  Entered:2000-07-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: PCN allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR023420IM 
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Headache, Hyperhidrosis, Nausea, Pallor, Pharyngolaryngeal pain, Rhinorrhoea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Two days post vax pt experienced sore throat and runny nose. The next day pt experienced perfuse sweating, nausea, dizziness and paleness; taken to the ER. Pt treated in ER with anti nausea drug. The following day pt still experiencing headache.

VAERS ID:156546 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:2000-05-16
Location:Unknown  Entered:2000-07-13, Days after submission: 58
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: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99101090
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Injury
SMQs:, Accidents and injuries (narrow), Hostility/aggression (broad)
Write-up: A nurse who was drawing varicella virus vaccine live into a syringe inadvertently splashed herself in the eye.

VAERS ID:157741 (history)  Vaccinated:2000-01-06
Age:41.0  Onset:2000-01-06, Days after vaccination: 0
Gender:Female  Submitted:2000-03-22, Days after onset: 76
Location:Washington  Entered:2000-07-21, Days after submission: 120
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ1720221MAR2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998230 IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Joint range of motion decreased
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Subsequent to receiving the vaccine, pt developed injection site pain described as tender, and she developed severely decreased range of motion in her arm. She was seen by the employee physician.

VAERS ID:157743 (history)  Vaccinated:1998-08-01
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:2000-07-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loestrin; norethindrone A
Current Illness: UNK
Preexisting Conditions: Left leg injury sustained in a motorcycle accident, with resulting limp. The leg reportedly becomes weaker when pt has cold or flu.
Diagnostic Lab Data: UNK
CDC Split Type: 899105009A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES 2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Condition aggravated, Difficulty in walking, Muscular weakness, Pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Within minutes of receiving vax pt experienced tingling in her left arm which then moved to her left leg. Pt stated that the tingling localized in her left leg at the site of a previous injury and that she experienced pain in this area. Pt was unable to walk for a couple of days due to pain and then needed a cane for a couple of weeks. She stated that her leg is now weaker and that experiences pain in the area of a previous injury and that her pre-existing limp is now more pronounced.

VAERS ID:157758 (history)  Vaccinated:1999-09-23
Age:41.0  Onset:1999-09-24, Days after vaccination: 1
Gender:Male  Submitted:2000-03-21, Days after onset: 179
Location:Colorado  Entered:2000-07-21, Days after submission: 121
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: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ0888329SEP1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES465317 IM 
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Pyrexia, Vasodilation procedure
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: One day post vax the pt developed a low grade fever and an injection site reaction characterized by redness, swelling and warmth. Pt was treated with Benadryl and cold packs.

VAERS ID:157759 (history)  Vaccinated:1999-11-07
Age:41.0  Onset:1999-12-16, Days after vaccination: 39
Gender:Female  Submitted:2000-03-21, Days after onset: 96
Location:Pennsylvania  Entered:2000-07-21, Days after submission: 121
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tuberculin PPD
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ0901303FEB2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES461422 IM 
Administered by: Private     Purchased by: Other
Symptoms: Injection site pain, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt developed an injection site reaction with pain radiating down the arm and weakness of the arm. Follow up states patient recovered. .

VAERS ID:157786 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:1999-12-16
Gender:Female  Submitted:2000-03-30, Days after onset: 105
Location:Pennsylvania  Entered:2000-07-21, Days after submission: 112
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tuberculin PPD Merieux
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ1880028MAR2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES  IM 
Administered by: Public     Purchased by: Other
Symptoms: Injection site reaction
SMQs:
Write-up: Approximately one month post vax pt developed injection site reaction.

VAERS ID:157936 (history)  Vaccinated:2000-06-29
Age:41.0  Onset:2000-06-29, Days after vaccination: 0
Gender:Female  Submitted:2000-06-30, Days after onset: 1
Location:South Carolina  Entered:2000-07-25, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: SC00038
Vaccination
Manufacturer
Lot
Dose
Route
Site
CHOL: CHOLERA (USP)PFIZER/WYETH49980900SC 
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Dizziness, Flushing, Heart rate increased, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Pt complained of rapid pulse, weak, shaky and slightly dizzy, hot and flushed. Pt went to ER and had MD exam when she left the Health Dept. Pts skin diaphoretic. Pt refused BP check. Pt advised to take antihistamine.

VAERS ID:157990 (history)  Vaccinated:2000-06-08
Age:41.0  Onset:2000-06-25, Days after vaccination: 17
Gender:Female  Submitted:2000-07-26, Days after onset: 31
Location:Washington  Entered:2000-07-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: sinus problems; back problems
Diagnostic Lab Data: elevated ANA 1:160; sedrate and CBC wnl
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.1861H SC 
Administered by: Public     Purchased by: Public
Symptoms: Antinuclear antibody positive, Arthralgia, Erythema, Joint stiffness, Joint swelling, Pain
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Pt had negative rubella titer 10 - 14 days post vax. Pt experienced achiness in lower body for 24 - 48 hours followed by pain, swelling and redness of joints in fingers and wrists. Pt treated with Feldene for 10 days and improved within 48 hours. Only slight stiffness remains in right index finger.

VAERS ID:158022 (history)  Vaccinated:2000-03-20
Age:41.0  Onset:0000-00-00
Gender:Male  Submitted:2000-05-04
Location:Connecticut  Entered:2000-07-27, Days after submission: 84
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: Bell''s Palsy, motorcycle accident(multiple fractures)
Diagnostic Lab Data:
CDC Split Type: 20000125161
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Difficulty in walking, Hypoaesthesia, Joint swelling
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Post first vax no untoward effects. Post second dose flu-like illness, which lasted a few days and resolved. Post third dose left sided numbness, swelling of hands, wrist, and shoulder, flu-like illness, and could not walk. Treatment included an over the counter non-steroidal. Information received on 4/13/00 reported the patient is now walking and was 80% better. Gets better each day.

VAERS ID:158033 (history)  Vaccinated:1999-05-10
Age:41.0  Onset:1999-08-15, Days after vaccination: 97
Gender:Male  Submitted:2000-05-05, Days after onset: 264
Location:Connecticut  Entered:2000-07-27, Days after submission: 83
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: Bell''s Palsy on two occassions, Lyme disease. Lyme disease was treated with doxycycline and the Bell''s Palsy with prednisone.
Diagnostic Lab Data: ELISA 1.75
CDC Split Type: 20000128661
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Erectile dysfunction, Headache, Hernia, Pain
SMQs:, Arthritis (broad)
Write-up: Post first vax, no untoward effects. Approximately 4 months post second vax in mid-August, pt experienced a headache, testicular pain, and joint pain. The symptoms were treated with Celebrex, tetracycline, Ceftin and IV Rocephin, the headache has improved since Celebrex, and the joint pain is ongoing but better. Information received on 05/05/00 reports the testicular pain resolved, the headache has improved, and the joint pain is ongoing but better. Follow-up states that the pt feels the testicular pain is realted to his long history of Lyme disease. He did report decreased erectile function with decreased nocturnal erections. The pt also reported headaches. The physician reported a small inguinal hernia.

VAERS ID:158249 (history)  Vaccinated:2000-07-05
Age:41.0  Onset:2000-07-05, Days after vaccination: 0
Gender:Female  Submitted:2000-07-20, Days after onset: 15
Location:Unknown  Entered:2000-08-02, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations: got sick;Measles + Mumps + Rubella (MMR II);1;4;In Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1985H1SC 
Administered by: Other     Purchased by: Private
Symptoms: Dehydration, Headache, Immune system disorder
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad)
Write-up: Post vax, the pt was hospitalized with compromised immune system, dehydration, and massive headache.

VAERS ID:158465 (history)  Vaccinated:1999-10-01
Age:41.0  Onset:1999-10-07, Days after vaccination: 6
Gender:Female  Submitted:2000-08-04, Days after onset: 302
Location:New Jersey  Entered:2000-08-07, 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:
Preexisting Conditions: asthma, seasonal allergies
Diagnostic Lab Data:
CDC Split Type: 2000228441
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IM 
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Within one week post vax, the pt complained of aching in every joint and in her hands. All symptoms resolved except for pain and swelling in the right hand ring finger.

VAERS ID:158589 (history)  Vaccinated:1999-10-11
Age:41.0  Onset:1999-12-14, Days after vaccination: 64
Gender:Male  Submitted:2000-08-04, Days after onset: 233
Location:Unknown  Entered:2000-08-08, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: MRI of cervical spine
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY130B92IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: 4 months post vax, the pt was dx with osteoarthritis.

VAERS ID:158726 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:2000-06-20
Gender:Female  Submitted:2000-07-28, Days after onset: 38
Location:Illinois  Entered:2000-08-11, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: High blood pressure, asthma.
Diagnostic Lab Data: MRI - head, neck spine. EEG, EMG, Blood work, spinal tap, ECHO, EKG, CT scan, scan veins in neck, many other tests.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4988186   
Administered by: Private     Purchased by: Unknown
Symptoms: Balance disorder, Dysarthria, Dysgraphia, Loss of consciousness, Myalgia, Paraesthesia, Tongue disorder
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: 06/20 - passed out at work, woke up in ER with slurred speech, tongue would not stick out, tingling in face, imbalance deep pain in leg muscles. Seemed fine later in day but then on 06/23 - slurred speech, imbalance, tingling in face, jaw hard open, tongue would not stick out. Symptoms come and go but continue as of today. Also, handwriting was affected with onset of this episode. Continue to see doctors and no direct cause can be found.

VAERS ID:158915 (history)  Vaccinated:1999-07-08
Age:41.0  Onset:1999-08-01, Days after vaccination: 24
Gender:Female  Submitted:2000-08-10, Days after onset: 375
Location:Michigan  Entered:2000-08-16, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.  SC 
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Joint stiffness
SMQs:, Arthritis (broad)
Write-up: In August 99, there was the onset of moderate to moderate/severe joint pain and stiffness in wrists, hips, knees, and ankles. At the time of this report, there remains mild-moderate joint pain and stiffness primarily in knees. The pain makes activities involving repetative knee bending difficult. Follow up 10/17/2000: "The administrator of the vaccine did not document the Lot #."

VAERS ID:159039 (history)  Vaccinated:2000-03-14
Age:41.0  Onset:2000-03-17, Days after vaccination: 3
Gender:Male  Submitted:2000-04-07, Days after onset: 20
Location:Nevada  Entered:2000-08-22, Days after submission: 137
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: seasonal allergies
Diagnostic Lab Data:
CDC Split Type: NV009
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.1939H0IM 
Administered by: Public     Purchased by: Private
Symptoms: Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)
Write-up: The pt experienced pain in left deltoid with shoulder flexing or if I lean on my elbow, protraction of left shoulder in are where shot was given.

VAERS ID:159090 (history)  Vaccinated:1999-08-26
Age:41.0  Onset:1999-09-28, Days after vaccination: 33
Gender:Female  Submitted:2000-08-15, Days after onset: 322
Location:Florida  Entered:2000-08-23, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: endometriosis
Diagnostic Lab Data: hormone levels; wetness test for eyes
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY130B91IMLA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Dry eye, Menopause, Visual disturbance
SMQs:, Anticholinergic syndrome (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow)
Write-up: On 9/28/99, the pt experienced visual disturbance and dizziness. In 10/99 and 11/99, the pt was diagnosed with dry eye syndrome. No natural tears function. No treatment known yet. In 11/99 the pt was diagnosed as post menopausal (ovaries shut down). Treated with hormone therapy.

VAERS ID:159141 (history)  Vaccinated:2000-08-07
Age:41.0  Onset:2000-08-09, Days after vaccination: 2
Gender:Female  Submitted:2000-08-17, Days after onset: 8
Location:Ohio  Entered:2000-08-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergies to Novocaine, aspirin, bee stings
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3201920IM 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Diarrhoea, Dizziness, Fatigue, Headache, Injection site pain, Nausea, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Post vax, I experienced discomfort at the injection site, fever of 101F-103.6F, headache, dizziness, nausea, fatigue/weakness, diarrhea x 1 day, abdominal cramps and rash on legs, chest and neck. Saw doctor on 8/14/00 and treated with prednisone for 2 days

VAERS ID:159300 (history)  Vaccinated:2000-08-11
Age:41.0  Onset:2000-08-11, Days after vaccination: 0
Gender:Female  Submitted:2000-08-21, Days after onset: 10
Location:Minnesota  Entered:2000-08-29, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa, Temazapam
Current Illness: NONE
Preexisting Conditions: depression, anxiety
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0268AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypokinesia, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Extreme soreness and limited mobility in left shoulder persisting 10 days at time of this report. Reported to nurse practitioner 6 days post vax, she prescribed Anaprox.

VAERS ID:159338 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:0000-00-00
Gender:Male  Submitted:2000-08-14
Location:South Carolina  Entered:2000-08-31, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: pain and swelling and extreme fatigue
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 2SC 
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER 2  
Administered by: Military     Purchased by: Military
Symptoms: Unevaluable event
SMQs:
Write-up:

VAERS ID:159382 (history)  Vaccinated:1985-10-16
Age:41.0  Onset:1985-10-17, Days after vaccination: 1
Gender:Female  Submitted:2000-05-03, Days after onset: 5312
Location:South Carolina  Entered:2000-09-06, Days after submission: 126
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Premarin, hydroxyzine, Fosamax, Paxil, Nasocort, triamcinolone cream
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: ANA:1=640, anti HB surface:112.1
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Hypersensitivity, Muscular weakness, Myalgia, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: From 11/13/85 to present; muscle pain and weakness, chronic fatigue, severe allergies, pruritus (1/93), joint pain. Per doc 199622, patient has joint pain, muscle weakness, chronic fatigue, severe allergies, pruritis, skin sensitivity.

VAERS ID:159687 (history)  Vaccinated:2000-05-02
Age:41.0  Onset:2000-05-02, Days after vaccination: 0
Gender:Female  Submitted:2000-05-09, Days after onset: 7
Location:Virginia  Entered:2000-09-08, Days after submission: 122
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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U200000326
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.R0552 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: It was reported that a 41 year old female pt received an Imovax IM and a Rig Imogam vaccination on May 2, 2000. Reportedly that same day the pt developed a headache, muscle aches and mild fever. The pt was self medicated with Vicodin. Pt was evaluated in hospital and held for 24 hours for observation and discharged. A neurologist evaluated the pt for a headache.

VAERS ID:159839 (history)  Vaccinated:2000-09-08
Age:41.0  Onset:2000-09-08, Days after vaccination: 0
Gender:Male  Submitted:2000-09-11, Days after onset: 3
Location:Florida  Entered:2000-09-15, 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: hypertension
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES7365AA0SCLA
Administered by: Military     Purchased by: Military
Symptoms: Decreased appetite, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Post vax, the pt developed a low grade fever, chills, myalgias, decreased appetite, and mild frontal headache.

VAERS ID:159932 (history)  Vaccinated:2000-02-24
Age:41.0  Onset:2000-02-24, Days after vaccination: 0
Gender:Male  Submitted:2000-03-10, Days after onset: 15
Location:California  Entered:2000-09-20, Days after submission: 193
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: On 3/14/00, Blood work, UA, Upper GI Series-results not available for review.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0475IMRA
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 4 hours, post vax, had abdominal pains and a steady pain in the lower left abdomen.

VAERS ID:160191 (history)  Vaccinated:2000-09-20
Age:41.0  Onset:2000-09-20, Days after vaccination: 0
Gender:Female  Submitted:2000-09-22, Days after onset: 2
Location:Georgia  Entered:2000-09-28, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mitrapex
Current Illness:
Preexisting Conditions: Sleep apnea
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3358A60IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM667B6 IMLA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)PASTEUR MERIEUX INST.R1329 SCLA
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESEJN176A SCRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR0384 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Client remained in clinic 40 minutes, post vax. Went to Rx to purchase Benadryl and states she started having difficulty breathing. She went to the ER, then to her private MD. 3 days, post vax, client states she''s having "asthma-like symptoms: (recovering).

VAERS ID:160351 (history)  Vaccinated:1999-05-26
Age:41.0  Onset:1999-05-28, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:2000-10-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucophage, Zenical, Alanoia
Current Illness:
Preexisting Conditions: diabetes
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Pain
SMQs:, Arthritis (broad)
Write-up: Two days post vax, the pt had pain in hip, knee, and leg; standing caused severe pain-seen in February 2000 and still had pain with exertion. 1

VAERS ID:162251 (history)  Vaccinated:1999-10-12
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:1999-10-29
Location:Illinois  Entered:2000-10-13, Days after submission: 350
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: U1999007760
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0126FA IM 
Administered by: Other     Purchased by: Other
Symptoms: Feeling jittery, Heart rate increased, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypersensitivity (narrow)
Write-up: It was reported that a 41 year old female received Fluzone SV ''99-''00 on 10/12/99. She experienced an elevated heart rate, jitters, nervousness and hives on the throat and neck area. She was seen in the ER. No further information is available at this time.

VAERS ID:162303 (history)  Vaccinated:1999-11-05
Age:41.0  Onset:1999-11-05, Days after vaccination: 0
Gender:Female  Submitted:1999-12-15, Days after onset: 40
Location:Pennsylvania  Entered:2000-10-13, Days after submission: 302
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: U1999009030
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0152AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: It was reported that a 41 year old female received a Fluzone WV ''99-''00 vaccination on 11/5/99. Reportedly, that same day, the pt developed hives on trunk and arms; also experienced itching of her face and scalp. The pt was treated with oral Benadryl and was given oral Benadryl to take home. Correspondence received on 12/1/99, provided additional pt demographic data.

VAERS ID:160686 (history)  Vaccinated:2000-09-07
Age:41.0  Onset:2000-09-11, Days after vaccination: 4
Gender:Female  Submitted:2000-09-28, Days after onset: 17
Location:Michigan  Entered:2000-10-18, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergy to celery, antibiotics, hx of heart valve defect
Diagnostic Lab Data:
CDC Split Type: MI2000074
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0403K0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Joint swelling
SMQs:, Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: On 9/22/00, the pt woke up with severe headaches and backache duration of 1 day. On 9/24/00, the pt woke up with pain and swelling in the right wrist. Later that day pain and swelling in right knee. On 9/26/00 same symptoms but right ankle. on 9/27/00 same symptoms but left ankle. On 9/28/00 the client states she still has symptoms in above mentioned joints, but has not sought treatment.

VAERS ID:160823 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:0000-00-00
Gender:Male  Submitted:2000-10-23
Location:Unknown  Entered:2000-10-24, 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:
Diagnostic Lab Data:
CDC Split Type: 20000306851
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Difficulty in walking, Rheumatoid arthritis
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (narrow)
Write-up: Post vax, the pt developed rheumatoid arthritis which he believed was caused by Lymerix. He could not walk or get himself out of bed. He stated he was relegated to being inside places like malls and not moving around much. The vaccinee stated that it feels like if you try to bend it the skin is going to rip. It kind of feels like your bones are broken in the joint.

VAERS ID:161042 (history)  Vaccinated:2000-10-16
Age:41.0  Onset:2000-10-16, Days after vaccination: 0
Gender:Female  Submitted:2000-10-20, Days after onset: 4
Location:Tennessee  Entered:2000-10-27, 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: Tylenol with codeine
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UA, blood work
CDC Split Type:
Vaccination
Manufacturer
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Dose
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3222A20IM 
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Lacrimation increased, Nausea, Ocular hyperaemia, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Vestibular disorders (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow)
Write-up: 6 hours post vax, the pt woke up with nausea, dizziness, and some hives over torso and inner arms. Eyes also red and watery.

VAERS ID:161343 (history)  Vaccinated:2000-10-25
Age:41.0  Onset:2000-10-26, Days after vaccination: 1
Gender:Female  Submitted:2000-10-30, Days after onset: 4
Location:Connecticut  Entered:2000-11-03, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E64710HA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilation procedure
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Post vax, the pt developed a 2 1/2 x 2 1/2 inch area of redness, raised with edema, and hot to the touch.

VAERS ID:161334 (history)  Vaccinated:2000-10-24
Age:41.9  Onset:2000-10-25, Days after vaccination: 1
Gender:Female  Submitted:2000-10-30, Days after onset: 5
Location:Vermont  Entered:2000-11-06, Days after submission: 7
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: Celexa, Klonopin but not recently used.
Current Illness: NONE
Preexisting Conditions: Multiple episodes of calcium containing kidney stones, bilaterally, requiring 2 surgeries and lithotripsy. Had tubal ligation in 3/00. Had some extra bones removed from her feet, arthroscopic surgery from 1 knee secondary to "loss of cartilage" and she had strabismus surgery as an infant; Depression; she was adopted, so has no family history; migraines for which she had an LP
Diagnostic Lab Data: Labs-nml; ESR-14; Slightly low sodium; CPK-nml; UA-neg; CBC-nml
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Private     Purchased by: Other
Symptoms: Diarrhoea, Hyponatraemia, Injection site hypersensitivity, Injection site oedema, Pain, Serum sickness, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt was to receive PPD intradermally and by mistake was given Pneumovax. Same day post vax, the pt started having some diarrhea followed by brief vomiting and then simply felt unwell on a diffuse nature, culminating in rather severe discomfort and pain across the trapezii on both sides of the shoulders. The following day she was seen by a physician. The injection site was red and swollen and she was clearly unwell. She was transferred to ER where she received some IV fluids and Solu-Medrol IV. Pt was dx with adverse reaction to intradermal injection of pneumonia vaccine, resembling serum sickness.

VAERS ID:161541 (history)  Vaccinated:2000-10-26
Age:41.0  Onset:2000-10-27, Days after vaccination: 1
Gender:Female  Submitted:2000-11-01, Days after onset: 5
Location:Massachusetts  Entered:2000-11-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flovent, Serevent, albuterol
Current Illness: NONE
Preexisting Conditions: Asthma
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0346AA IMLA
Administered by: Private     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives across back requiring several doses of Benadryl.

VAERS ID:161629 (history)  Vaccinated:2000-10-13
Age:41.0  Onset:2000-10-14, Days after vaccination: 1
Gender:Female  Submitted:2000-10-17, Days after onset: 3
Location:California  Entered:2000-11-08, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 10/12/00-Injection Cortisone/RA/4 previously
Current Illness: NONE
Preexisting Conditions: Fibromyalgia, Allergy Voltaren and PCN
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURV0398AA2IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4659110IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Arthralgia, Headache, 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), Arthritis (broad)
Write-up: Joint aches, persistent headache, onset Saturday. Sunday morning symptoms improved. Midday Sunday had aches, fever to 100F, chills, joint and lower extremity. Local reaction Sunday night with swollen, red upper arm. Advil relieved aches. Monday morning had increased redness, swelling and pain locally. Joints improved.

VAERS ID:161633 (history)  Vaccinated:2000-10-19
Age:41.0  Onset:2000-10-19, Days after vaccination: 0
Gender:Male  Submitted:2000-10-31, Days after onset: 12
Location:California  Entered:2000-11-08, 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: NONE
Current Illness: Nose infection
Preexisting Conditions: NONE
Diagnostic Lab Data: Blood cultures were done by PCP per client.
CDC Split Type:
Vaccination
Manufacturer
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0045J SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, 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: Swelling right arm and hand with fever which ranged from 99F to 101F. Also, had a circular red area (quarter sized) around injection site. On 10/20/00, client said he was being treated for "nose infection" by PCP prior and at the time of pneumonia injection received on 10/19/00.

VAERS ID:163308 (history)  Vaccinated:1999-11-08
Age:41.0  Onset:1999-11-08, Days after vaccination: 0
Gender:Female  Submitted:1999-12-16, Days after onset: 38
Location:California  Entered:2000-11-14, Days after submission: 334
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singulair; Maxair; Flovent; Albuterol
Current Illness:
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC Split Type: 19990327241
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3023A20IM 
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Dyspnoea, Heart rate irregular, Malaise
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad)
Write-up: 10 minutes post vax the pt experienced dizziness, shortness of breath, irregular pulse and malaise. The malaise lasted two days. The pt was treated with Benadryl. Engerix B was discontinued. The most recent information received reports the condition of the pt is resolved.

VAERS ID:163386 (history)  Vaccinated:1999-10-27
Age:41.0  Onset:1999-10-27, Days after vaccination: 0
Gender:Female  Submitted:2000-06-20, Days after onset: 237
Location:Tennessee  Entered:2000-11-14, Days after submission: 147
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: 20000185201
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2259A40IMLA
Administered by: Other     Purchased by: Other
Symptoms: Pain, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: On 10/27/99, the pt experienced a bright red rash under both arms which itched and hurt. The rash lasted approximately 3-5 days and resolved.

VAERS ID:163431 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:2000-08-18
Location:New York  Entered:2000-11-14, Days after submission: 88
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: 20000248611
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Cyst
SMQs:
Write-up: Subsequent to receiving vax, the pt developed cysts on the left side of her body.: one 1/4 inch cyst on the temple; one cyst on the ankle and one cyst on the wrist. The temple and wrist cysts resolved in 2-3 days. The ankle cyst has not resolved. No treatment was given. Subsequently, she received her second and third doses of hepatitis B vaccine. No additional cysts developed following the second and third doses. As of 07/27/2000, the outcome of the event is ongoing.

VAERS ID:162223 (history)  Vaccinated:2000-11-10
Age:41.0  Onset:2000-11-10, Days after vaccination: 0
Gender:Female  Submitted:2000-11-13, Days after onset: 3
Location:Virginia  Entered:2000-11-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Asthma; Bipolar
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E70210KA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pain, Pyrexia, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Pt had red, raised rash over entire body with temperature of 100.5F and felt achy all over. Started on Friday night, 11/10/00, post vax, that same afternoon.

VAERS ID:162522 (history)  Vaccinated:2000-10-30
Age:41.0  Onset:2000-10-31, Days after vaccination: 1
Gender:Female  Submitted:2000-11-03, Days after onset: 3
Location:New York  Entered:2000-11-22, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0415AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Injection site erythema
SMQs:, Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: One day post vax, the pt developed a reddened arm and diarrhea.

VAERS ID:162859 (history)  Vaccinated:2000-11-10
Age:41.0  Onset:2000-11-11, Days after vaccination: 1
Gender:Female  Submitted:2000-11-13, Days after onset: 2
Location:Unknown  Entered:2000-11-30, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Allergy to sulfa.
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0403AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt''s arm extremely red, swollen and hot to touch; measured 10 cm X 20 cm around the site of injection.

VAERS ID:163091 (history)  Vaccinated:2000-08-31
Age:41.0  Onset:2000-08-31, Days after vaccination: 0
Gender:Female  Submitted:2000-11-01, Days after onset: 62
Location:Texas  Entered:2000-12-05, Days after submission: 34
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: Was treated for Intestinal ? 8/21/2000
Diagnostic Lab Data:
CDC Split Type: TX00130
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7345AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Developed urticaria rash generalized over arms, hands, lower extremities and trunk. She received vax at 9:00 am and reaction occurred at 9:00 pm same day

VAERS ID:163104 (history)  Vaccinated:2000-11-27
Age:41.0  Onset:2000-11-27, Days after vaccination: 0
Gender:Female  Submitted:2000-12-01, Days after onset: 4
Location:Montana  Entered:2000-12-05, 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: Premarin, Flovent
Current Illness: NONE
Preexisting Conditions: Allergy to PCN and Typhoid vaccine; (+) PPD in 1963; history of 3 anaphylaxis events.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0403AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Cough, Hypoaesthesia oral, Lacrimation increased, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow)
Write-up: Post vax, at 16:00, eyes watering and light cough noted by pt. Took Benadryl and symptoms were relieved some. On 11/29/00 at 08:00, had facial swelling, lips and tongue were tingling, no SOB. Took 50mg of Benadryl at home with good results. Started on Prednisone 20mg 2D X 4D and Claritin 10mg QD X 2-3 months, Pepcid 20mg QD X 8D.

VAERS ID:163512 (history)  Vaccinated:2000-11-13
Age:41.0  Onset:2000-11-14, Days after vaccination: 1
Gender:Female  Submitted:2000-12-01, Days after onset: 17
Location:Wisconsin  Entered:2000-12-11, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tenormin, Premarin, Singulair, previous steroid use.
Current Illness:
Preexisting Conditions: Mitral valve prolapse, mild asthma, recent cataracts
Diagnostic Lab Data: MRI-neg;CSF culture-neg; CSF IgG-1.47, CSF electrophoreses-oligoclonal bands present
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR  IM 
Administered by: Private     Purchased by: Private
Symptoms: CSF test abnormal, Difficulty in walking, Guillain-Barre syndrome, Muscular weakness, Pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow)
Write-up: Received Flu vaccine on 11/13/00. On 11/14/00, developed numbness and tingling in bilateral feet, increased symptoms up both legs, feeling of heaviness and numbness and pain with difficulty ambulating. Denies any upper extremity symptoms. No SOB. IVIG 27gh IV X 5 days. Dx: GBS. Discharged on 11/28/2000; 60 day follow up states the pt still has residual leg weakness.

VAERS ID:163838 (history)  Vaccinated:2000-10-25
Age:41.0  Onset:2000-10-27, Days after vaccination: 2
Gender:Female  Submitted:2000-10-31, Days after onset: 4
Location:Washington  Entered:2000-12-18, Days after submission: 48
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: hypertension, allergy to HCTZ, TB as a child
Diagnostic Lab Data:
CDC Split Type: WA001700
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0400AA1IMLA
Administered by: Private     Purchased by: Other
Symptoms: Contusion, Erythema, Nausea, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: The pt experienced edema, bruising, redness, swelling, and nausea. Symptoms began 10/27/00. No vomiting was experienced.

VAERS ID:163848 (history)  Vaccinated:2000-11-28
Age:41.0  Onset:2000-11-29, Days after vaccination: 1
Gender:Female  Submitted:2000-11-30, Days after onset: 1
Location:Wisconsin  Entered:2000-12-18, 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: Folic acid, sulfadiazine
Current Illness: NONE
Preexisting Conditions: Splenectomy
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0422EA IMRA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Hypertension, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Hypersensitivity (broad)
Write-up: 11/29/2000, started at 12:30, itching, redness (everywhere), increased BP and temperature. Went to her own MD. She reported she was treated with 40mg of prednisone and Benadryl and also a breathing treatment.

VAERS ID:164126 (history)  Vaccinated:2000-02-03
Age:41.0  Onset:2000-03-18, Days after vaccination: 44
Gender:Female  Submitted:2000-10-15, Days after onset: 210
Location:New Jersey  Entered:2000-12-27, Days after submission: 73
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Cytomel, Allegra, Loestrin
Current Illness: NONE
Preexisting Conditions: Hypothyroidism, Premature menopause
Diagnostic Lab Data: MRI; Cervical MRI; 2nd Spinal Tap-all negative.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY130B90IMLA
Administered by: Private     Purchased by: Other
Symptoms: Diarrhoea, Headache, Hypoaesthesia, Hypothyroidism, Lymphoedema, Neck pain
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypothyroidism (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Persistent chronic headache, which started 2 weeks, post vax, lasted 7 months, and still persists!! Numbness in head and on face, pain in neck and swollen on left side. Treated with several medications. Symptoms persist. Had chronic diarrhea and became hyperthyroid.

VAERS ID:164200 (history)  Vaccinated:2000-11-29
Age:41.0  Onset:2000-11-29, Days after vaccination: 0
Gender:Female  Submitted:2000-12-21, Days after onset: 22
Location:Alaska  Entered:2000-12-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40081800IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Reaction at injection site only; next day, swelling, hard, white with red border, very painful. White and pain diminished in 1 week; redness 2" diameter, 3 weeks later (down from 3" hard diameter). Almost gone.

VAERS ID:164242 (history)  Vaccinated:2000-12-04
Age:41.0  Onset:2000-12-04, Days after vaccination: 0
Gender:Female  Submitted:2000-12-19, Days after onset: 15
Location:Colorado  Entered:2000-12-28, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008181   
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Heart rate increased, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: The patient felt feverish right after her shot, but it passed. Then about 8 hours later she became very feverish, difficulty breathing, fast heart beat, and hives. The patient felt okay by the next morning.

VAERS ID:164337 (history)  Vaccinated:2000-12-11
Age:41.0  Onset:2000-12-14, Days after vaccination: 3
Gender:Female  Submitted:2000-12-15, Days after onset: 1
Location:Ohio  Entered:2001-01-02, 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: Effexor, Ultram, MVI, B Complex, Calcium, ibuprofen, Creatine monohydrate, gingko biloba
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0343AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Injection site pain, Myalgia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Pt states had a fever of 102F on 12/14/00 with vomiting and diarrhea, muscle ache and shooting pain in right arm (per phone conversation). Did not report for follow-up.

VAERS ID:164400 (history)  Vaccinated:2000-12-19
Age:41.0  Onset:2000-12-19, Days after vaccination: 0
Gender:Female  Submitted:2000-12-20, Days after onset: 1
Location:Florida  Entered:2001-01-03, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: environmental allergies
Diagnostic Lab Data: Recommended skin tested.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008215 IM 
Administered by: Military     Purchased by: Unknown
Symptoms: Ear disorder, Oedema, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Pt experienced swollen ears and hives.

VAERS ID:164833 (history)  Vaccinated:1999-03-26
Age:41.0  Onset:1999-03-27, Days after vaccination: 1
Gender:Female  Submitted:2001-01-12, Days after onset: 657
Location:Pennsylvania  Entered:2001-01-18, Days after submission: 6
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120A91IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Blindness, Fatigue, Insomnia, Musculoskeletal stiffness, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Arthritis (broad)
Write-up: Constant pain in entire body, severe joint pain in ankle, wrist, knee and shoulder; needle-like pains in right arm, deterioration of vision, shooting pains in arms and legs, traveling pains in upper back, sleeplessness, fatigue, stiff neck and myalgia. 60 day follow-up states the pt us unable to function without medication.

VAERS ID:165200 (history)  Vaccinated:2001-01-17
Age:41.0  Onset:2001-01-17, Days after vaccination: 0
Gender:Female  Submitted:2001-01-18, Days after onset: 1
Location:Florida  Entered:2001-01-24, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD, Connaught, intradermal, right arm, lot # 00143AB, 1 previous dose.
Current Illness: NONE
Preexisting Conditions: Allergic to Sulfa, Penicillin, Mangoes. Hypertension, Borderline Diabetes, Arthritis, and Mitral valve prolapse.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0678K0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Dyspnoea, Erythema, Hypersensitivity
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: This patient telephoned the office in mid afternoon complaining of face and chest redness and shortness of breath. She stated the sickness began approximately an hour after receiving her vaccine. She was instructed to report to the closest ER. She was treated and released from the hospital for an allergic reaction.

VAERS ID:165340 (history)  Vaccinated:2001-01-20
Age:41.0  Onset:2001-01-21, Days after vaccination: 1
Gender:Male  Submitted:2001-01-22, Days after onset: 1
Location:Indiana  Entered:2001-01-30, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Laceration
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0365AA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 6cm X 6cm erythema, tenderness and swelling at injection site.

VAERS ID:165512 (history)  Vaccinated:2000-12-27
Age:41.0  Onset:2000-12-30, Days after vaccination: 3
Gender:Female  Submitted:2001-01-04, Days after onset: 5
Location:Illinois  Entered:2001-02-01, 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: NONE
Preexisting Conditions: Allergic to Penicillin, Bactrim, Fluoroguinolunes
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008221 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Chills, Diarrhoea, Dizziness, Gastrointestinal pain, Influenza like illness
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: This patient complained of flu like symptoms, ie : chills, mild diarrhea, GI discomfort, back and spinal pain, severe dizziness (spinning room) for almost 12 hours, no fever. The symptoms started 3 days after her injection and lasted about 4 days. No treatment was given.

VAERS ID:165831 (history)  Vaccinated:2000-08-11
Age:41.0  Onset:2000-08-13, Days after vaccination: 2
Gender:Male  Submitted:2000-10-10, Days after onset: 58
Location:Unknown  Entered:2001-02-13, Days after submission: 126
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: Lyme-(-); RPR-nml; MRI of brain with 6AD-(-)
CDC Split Type:
Vaccination
Manufacturer
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Dose
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 1SC 
Administered by: Military     Purchased by: Military
Symptoms: Neuropathy peripheral, Paralysis, Vaccine positive rechallenge
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Post vax, Anthrax #4 (within 2-3 days) left peripheral 7th nerve palsy. Post vax, Anthrax #2 (within 2-3 days) left peripheral 7th nerve palsy.

VAERS ID:166078 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:0000-00-00
Gender:Male  Submitted:2001-02-19
Location:New Jersey  Entered:2001-02-22, 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: Crohns Disease, GERD, carpal tunnel release, chronic low back pain, hypertension
Diagnostic Lab Data: ANA - neg, RSR - neg
CDC Split Type: 20010042911
Vaccination
Manufacturer
Lot
Dose
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Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Subsequently the pt experienced whole body arthralgias. A doctor visit was required. The reporter stated that there was no swelling or warmth at the joints. It was unknown if joint fluid was obtained. As of 2/15/01, the outcome of the event is unknown.

VAERS ID:166194 (history)  Vaccinated:2001-01-23
Age:41.0  Onset:2001-02-02, Days after vaccination: 10
Gender:Male  Submitted:2001-02-09, Days after onset: 7
Location:Ohio  Entered:2001-02-27, 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: NONE
Diagnostic Lab Data:
CDC Split Type: OH0002
Vaccination
Manufacturer
Lot
Dose
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Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.R125233IMRA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Fatigue, Nausea, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: The pt experienced itching skin on 2/2/01 and that evening started to break out in hives. States took 2 doses of Benadryl with some relief. States by 2/3/02 morning the whole body was covered with hives and went to the ER. Was given 2 steroid shots and sent home with 3 day supply of steroid medicine. Called on 2/6/01 and the pt states welts are still there, joints are sore, tired with some nausea. Advised to call family MD or go to ER. MD''s office prescribed steroid medication. On 2/9/01 pt is better.

VAERS ID:166257 (history)  Vaccinated:2001-01-05
Age:41.0  Onset:2001-01-05, Days after vaccination: 0
Gender:Male  Submitted:2001-01-08, Days after onset: 3
Location:North Dakota  Entered:2001-03-01, Days after submission: 52
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 (hay fever and pollen)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV048B0SC 
Administered by: Military     Purchased by: Military
Symptoms: Back pain, Malaise, Pyrexia, Sensation of heaviness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad)
Write-up: Pt reports malaise, subjective fevers, backache and left arm heaviness, after 1st dose. This occurred 1/2 day, post vax. No serious reaction. Exam normal.

VAERS ID:166500 (history)  Vaccinated:2000-08-28
Age:41.0  Onset:2000-08-28, Days after vaccination: 0
Gender:Female  Submitted:2000-12-27, Days after onset: 121
Location:Ohio  Entered:2001-03-05, Days after submission: 68
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tuberculin PPD (Mantoux)
Current Illness: UNK
Preexisting Conditions: Concurrent conditions: food allergy
Diagnostic Lab Data: UNK
CDC Split Type: HQ0944213SEP2000
Vaccination
Manufacturer
Lot
Dose
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Site
DTAP: DTAP (ACEL-IMUNE)LEDERLE LABORATORIES473441 IM 
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Discomfort, Fatigue, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Arthritis (broad)
Write-up: A nurse reported a pt with a history of sensitivity to egg whites inadvertently received an injection of Acel-Imune on 8/28/00. She also received vaccine of PPD. Later that day she developed achy joints, profuse sweating and a feeling of being tired. The reporter indicated that the reaction was similar to the one the pt has when she eats egg whites. The pt was treated and recovered; however still had some leg discomfort now and again but felt better.

VAERS ID:167562 (history)  Vaccinated:2000-09-06
Age:41.0  Onset:2000-09-07, Days after vaccination: 1
Gender:Female  Submitted:2001-03-07, Days after onset: 181
Location:New Jersey  Entered:2001-03-15, 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: NONE
Current Illness:
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type: WAES00090519
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1669J1IM 
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Information has been received from a health professional concerning a 41 year old Caucasian female patient who on 09/06/00 was vaccinated with a 2nd dose of Hepatitis B vaccine recombinant. Subsequently, the patient experienced a red, hot, swollen deltoid (injection site). The patient experienced injection site itching. There was no generalized symptoms. The patient took Ibuprofen and recovered by 09/09/00. Medical attention was sought. Additional information has been requested.

VAERS ID:167219 (history)  Vaccinated:2000-11-07
Age:41.0  Onset:2000-11-08, Days after vaccination: 1
Gender:Female  Submitted:2001-02-22, Days after onset: 106
Location:Georgia  Entered:2001-03-16, Days after submission: 22
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: Allergies to pollen
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E70180KA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: My left arm (where the shot was given) broke out in a rash from my elbow to my shoulder. I took Benadryl by mouth and rubbed cortisone on the rash to prevent itching. It went away in 2 1/2 days.

VAERS ID:167238 (history)  Vaccinated:2001-03-07
Age:41.0  Onset:2001-03-08, Days after vaccination: 1
Gender:Male  Submitted:2001-03-09, Days after onset: 1
Location:New Hampshire  Entered:2001-03-19, 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
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAMA981A24IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T05323 RA
Administered by: Private     Purchased by: 0
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Reports of significant swelling, erythema L Upper arm, site of injection.

VAERS ID:168258 (history)  Vaccinated:2000-11-20
Age:41.0  Onset:2000-11-21, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:2001-04-04
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI of T-spine; MRI brain; Wasting from T2 to T4
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0335AB IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cachexia, Faecal incontinence, Injection site pain, Myelitis transverse, Paraplegia, Urinary incontinence
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Noninfectious diarrhoea (broad)
Write-up: Transverse Myelitis; Over a few days, pt developed complete plegia of legs and sensory level at T2 with bladder and bowel incontinence. This has persisted. Pt also has persistent pain at site of injection. Rash. Able to do self care. Stimulation only was walker in house. Wheelchair when goes out. Tired easily. Transverse myelitis.

VAERS ID:168669 (history)  Vaccinated:2001-03-14
Age:41.0  Onset:2001-03-21, Days after vaccination: 7
Gender:Female  Submitted:2001-03-23, Days after onset: 2
Location:Oklahoma  Entered:2001-04-13, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: One Source Multivitamin; FESO4 daily; PPD/Aventis/C0256AA/ID/0 previously
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: OK0112
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0298AA3IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 7 days, post vax, pt had rash with itching (urticaria) on left upper arm below injection site that did progress to injection site. The following morning, urticaria developed bilaterally from distal lower leg to plantar surface of feet. Decrease in rash on left upper arm today.

VAERS ID:168874 (history)  Vaccinated:1999-09-18
Age:41.0  Onset:1999-09-18, Days after vaccination: 0
Gender:Male  Submitted:2000-12-02, Days after onset: 441
Location:Missouri  Entered:2001-04-18, Days after submission: 136
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: C/A monitor NSR, EKG-negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1439H1IM 
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Dry throat, Dyspnoea, Headache, Myalgia, Throat tightness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Pt reported complaint of dry throat, dizziness, headache and muscle pain after receiving 2nd Hep-A vaccine. Pt complained "feels like my throat is closing". Pt given O2 2L NC, placed on C/A monitor-NSR, Benadryl given IM at injection site. Solu-Cortef IV X 1 and EKG. Transferred to ER.

VAERS ID:168934 (history)  Vaccinated:2001-04-13
Age:41.0  Onset:2001-04-13, Days after vaccination: 0
Gender:Female  Submitted:2001-04-17, Days after onset: 4
Location:New Jersey  Entered:2001-04-20, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrocodone, Ambien (Zolpidem Hemitartrate)
Current Illness:
Preexisting Conditions: Crushed vertebrae (cervical spine), Seasonal allergies.
Diagnostic Lab Data:
CDC Split Type: 20010095631
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Headache, Hemiparesis, Hypersensitivity, Hypoaesthesia, Injury, Pyrexia
SMQs:, Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Report 2001009563-1 described numb fingers (right hand) in a 41 year old female who received Lyme disease vaccine recombinant OspA (Lymerix) for the prevention of Lyme Disease. This report was received from the vaccinee and has not been verified by a physician or other health care professional. The vaccinee has seasonal allergies. Her medical history included crushed vertebrae (cervical spine). She took Hydrocodone and Zolpidem Hemitartrate (Ambien) prn. On 04/13/01, the vaccinee received her first left deltoid dose of Lymerix, twenty minutes post-vaccination, she experienced fever, chills, numb fingers (right hand), and weakness. As of 04/13/01, the outcome of the events was resolved. The adverse event of "numb fingers" does not meet ICM serious criteria, but is being submitted as an expedited report by special FDA request per the June 28, 2000 letter. Follow up states the patient also experienced a headache and light headedness.

VAERS ID:169160 (history)  Vaccinated:2001-03-09
Age:41.0  Onset:2001-03-28, Days after vaccination: 19
Gender:Female  Submitted:2001-04-23, Days after onset: 25
Location:Maryland  Entered:2001-04-27, 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: Nasocort
Current Illness: NONE
Preexisting Conditions: Exercise induced asthma, chronic rhinitis.
Diagnostic Lab Data: Mumps Titer 320 on 4/02/2001.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0015L0  
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Infection, Laboratory test abnormal, Lymphadenopathy, Muscle spasms, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad)
Write-up: This patient received MMR at their primary physicians office on 03/09/01 (after neg mump titer). By 03/28/01, she noted right node by both, right jaw / neck very swollen, she had a low grade temp, intense facial pain with spasms, especially after eating. The symptoms gradually went away in 10 days. Fatigue lasted 10 days. Diagnosed with Mumps disease

VAERS ID:169423 (history)  Vaccinated:1999-01-09
Age:41.0  Onset:1999-01-09, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:California  Entered:2001-05-04
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
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0361SC 
Administered by: Military     Purchased by: Military
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Arthritis in hands (1/99); may be linked to Anthrax vaccine.

VAERS ID:169425 (history)  Vaccinated:2001-01-08
Age:41.0  Onset:2001-01-08, Days after vaccination: 0
Gender:Female  Submitted:2001-04-26, Days after onset: 107
Location:Pennsylvania  Entered:2001-05-04, 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: Prozac, Micro D
Current Illness: NONE
Preexisting Conditions: Allergy to Ceclor
Diagnostic Lab Data: Blood test for varicella titer
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1143K0SC 
Administered by: Other     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Generalized hives within several hours, post vax. Treated with topical steroid ointment.

VAERS ID:169467 (history)  Vaccinated:2001-04-24
Age:41.0  Onset:2001-04-25, Days after vaccination: 1
Gender:Female  Submitted:2001-04-26, Days after onset: 1
Location:Wisconsin  Entered:2001-05-04, 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: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0368AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Developed local reaction. Skin had a red, hot and swollen area 3.5cm X 5cm at site of injection.

VAERS ID:169592 (history)  Vaccinated:2001-04-13
Age:41.0  Onset:2001-04-24, Days after vaccination: 11
Gender:Female  Submitted:2001-04-27, Days after onset: 3
Location:Iowa  Entered:2001-05-08, 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:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0377AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Muscle spasms, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad)
Write-up: Pt received TD booster as routine shot on 4/13/01. On 5/24/01, she noticed an electrical "zinging or zapping" sensation going down her arms. This comes and goes. Starting 5/26/01, she noticed more itching and cramping in her (B) arms and hands. I spoke with doctor on 5/25/01 and he recommended conservative therapy and monitoring of symptoms. Pt to call me if symptoms do not resolve in 2 weeks.

VAERS ID:169866 (history)  Vaccinated:2001-04-19
Age:41.0  Onset:2001-04-19, Days after vaccination: 0
Gender:Female  Submitted:2001-04-26, Days after onset: 7
Location:Colorado  Entered:2001-05-15, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Lyme disease. Allergies to, Latium & Sulfa.
Diagnostic Lab Data:
CDC Split Type: CO01006
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3382A42IMLA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: This client received Hepatitis B # 3and then went on a hike where she started breaking out in hives at the injection site, and it started spreading all over her body. The client sat in a hot tub that evening and more hives occurred. Breathing was not compromised and she did not seek medical attention. She did start taking over the counter Benadryl.

VAERS ID:170194 (history)  Vaccinated:2000-08-29
Age:41.0  Onset:2000-09-07, Days after vaccination: 9
Gender:Male  Submitted:2000-10-18, Days after onset: 41
Location:Louisiana  Entered:2001-05-23, Days after submission: 217
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ1071115SEP2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES470536 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Neuropathy peripheral, Pain, Pyrexia
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: A nurse reported that a 41 year old male received an injection of TD Toxoids Adsorbed, Purogenated on 8/29/00. The next day, the pt developed a fever and achiness. On 9/7/00, he developed right arm pain extending from shoulder to elbow. He was dx''d with right arm peripheral neuropathy. The pt was treated with ibuprofen, Medrol (methylprednisolone), and Soma (carisoprodol).

VAERS ID:170248 (history)  Vaccinated:2000-06-30
Age:41.0  Onset:2000-07-06, Days after vaccination: 6
Gender:Female  Submitted:2000-08-03, Days after onset: 28
Location:Pennsylvania  Entered:2001-05-24, Days after submission: 294
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: Amoxicillin w/ Clavulanate Potassium.
Current Illness: Cat bite
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ8372111JUL2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES471637 IM 
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Injection site reaction, Injury
SMQs:, Accidents and injuries (narrow), Hostility/aggression (broad)
Write-up: A nurse reported that a 41 year old female received an injection of TD Toxoids Adsorbed, Purogenated on 6/30/00 as part of wound management following a cat bite. The pt also received therapy with amoxicillin/clavulanate. On 7/6/00, the pt was seen by the physician, who dx''d cellulitis at he TD injection site. The pt was hospitalized. Follow-up information received on 8/2/00, indicated that the pt recovered. On follow-up, the reporter indicated that 2 additional pts developed cellulitis following receipt of TD Toxoids Adsorbed, Purogenated; however, the report did not identify these pts. Neither of them was hospitalized.

VAERS ID:170955 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:1995-01-20
Gender:Female  Submitted:2001-05-30, Days after onset: 2321
Location:Florida  Entered:2001-06-01, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: synthoroid
Current Illness:
Preexisting Conditions: concurrent conditions; hypothyroidism
Diagnostic Lab Data:
CDC Split Type: WAES01033343
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Arthritis, Bronchitis, Infection, Lymphadenopathy, Pyrexia, Rash, Sinusitis, Tinnitus
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Hearing impairment (narrow), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: Secondary transmission; bronchitis; fever; lymphadenopathy; tinnitus; sinusitis; rash; ostroarthritis - Information has been received from a 41 year old female physician, born 21 Jan 1953 with no known drug allergies and hypothyroidism whose sister was vaccinated with measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live second generation in early december 1994. The sister experienced a low grad fever. Lymphadenopathy and arthritis two to three weeks after the vaccination waes# 01033214. The physician visited her sister during the third week post vaccination and felt that the vaccine virus may have been transmitted to her at that time. Concomitant therapy included levothyroxine sodium (synthroid). On 20 jan 1995 the physician experienced a low grade fever, macular rash, lymphadenopathy, sinusitis, bronchitis and diffuse arthritis, which was the worst in her right knee. The sisusitis and bronchitis were treated with azithromycin (Zithromax). The physician noted that most symptoms resolved within a month or two however, the arthritis pain continued and the following summer she developed tinnitus. both the tinnitus and the arthritis continued to the present. The physician had seen a rheumatologist and has since been diagnosed with osteoarthritis of the right knee, left elbow and lumbar sacral spine. no further details were provided. additional information has been requested. A 15-day follow up report received 4/19/2002 adds: Additional info from the physician indicated that she was reporting transmission of rubella from her vaccinated sister to her. Her sister developed lymphadenopathy, polyarthritis and low grade fever after vaccination with measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) (WAES #01033214). The physician developed a fever to 103, lymphadenopathy, arthritis and bronchitis 3 weeks after contact with her vaccinated sister. She noted that she had severe rubella 01/23/1995 with a very high IgM for rube

VAERS ID:170961 (history)  Vaccinated:1997-09-17
Age:41.0  Onset:2000-03-12, Days after vaccination: 907
Gender:Male  Submitted:2001-05-15, Days after onset: 428
Location:Indiana  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES00031849
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0546E0IM 
Administered by: Private     Purchased by: Private
Symptoms: Infection
SMQs:
Write-up: Uaricella - Information has been received from a physician concerning a 41 month old Caucasian male patient who on 17 Sep 1007 was vaccinated IM in the left arm with a first dose of varicelle virus vaccine live lot 623125/0546E. There were no concurrent conditions or known drug allergies. On 12 Mar 2000 the patient broke out with chickenpox. On 13 Mar 2000 the patient''s mother reported that the patient had less than 50 pox. It was noted that 7-10 days later, the patient recovered. No further information is expected.

VAERS ID:170975 (history)  Vaccinated:1999-01-01
Age:41.0  Onset:1999-01-01, Days after vaccination: 0
Gender:Female  Submitted:2001-05-15, Days after onset: 864
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prilosec
Current Illness:
Preexisting Conditions: medical history: cephalosporin allergy: vaccination
Diagnostic Lab Data: test: diagnostic laboratory, date: 07/07/99, normal range: - , comment: negative varicella antibody titer
CDC Split Type: WAES00032094
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Coma, Hypersensitivity
SMQs:, Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow)
Write-up: Lack Of Response - Information has been received from a 41 year old female with a history of cephalosporin allergy and two previous vaccinations, as scheduled, with the varicella virus vaccine live which resulted in a negative titer. This patient was vaccinated with one dose of varicella virus vaccine live this past summer. Unknown site concomitant therapies included omeprozole prilosec. Indoril and Penalar. subsequently the patient experienced a negative varicella antibody titer. The patient sought unspecified medical attention. Additional information has been requested.

VAERS ID:171402 (history)  Vaccinated:2000-09-18
Age:41.0  Onset:2000-09-26, Days after vaccination: 8
Gender:Female  Submitted:2000-11-02, Days after onset: 37
Location:New York  Entered:2001-06-14, Days after submission: 223
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: possible viral illness
Preexisting Conditions: hypothyroidism, hyperlipidemia
Diagnostic Lab Data: Work up - nml, TSH - low, echocardiogram - neg, CBC, metabolic profile, Hep and liver profile, all nml
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3233B61IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Blood thyroid stimulating hormone decreased, Dizziness, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypothyroidism (broad), Hyperthyroidism (broad), Vestibular disorders (broad)
Write-up: The pt went to the ER for symptoms of light headedness, nausea, vomiting and upper body aches and on 10/13/00 states that she is still experiencing these symptoms. Went to MD and TSH was slightly low and medicine was adjusted.

VAERS ID:172283 (history)  Vaccinated:2001-05-30
Age:41.0  Onset:2001-06-01, Days after vaccination: 2
Gender:Female  Submitted:2001-06-20, Days after onset: 19
Location:Minnesota  Entered:2001-06-21, Days after submission: 1
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: polio vaccine was also given on 5/30/01
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: chest x-ray, CBC, blood sugar, thyroid - all normal
CDC Split Type:
Vaccination
Manufacturer
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Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER0193K0IMRA
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURERUA410AA SCLA
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURERU0377AA IMLA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURERR0826 IMRA
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURERUA440AA SCRA
Administered by: Private     Purchased by: Private
Symptoms: Hypertension, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow)
Write-up: On 6/1/01 the pt experienced severely swollen lymph nodes and a temp of 104 for 5 days. On 6/13/01 blood pressure was 190/100 and remains very high. Blood pressure was normal on the day of vaccines.

VAERS ID:172369 (history)  Vaccinated:2001-06-08
Age:41.0  Onset:2001-06-08, Days after vaccination: 0
Gender:Female  Submitted:2001-06-12, Days after onset: 4
Location:North Carolina  Entered:2001-06-25, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prilosec, Norvasc, Lo/Ovral, Desyrel, Orlistat
Current Illness: sore throat
Preexisting Conditions: hypertension
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4735560IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Oedema peripheral, Pharyngolaryngeal pain, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Within 24 hours of receiving vaccine, patient had the onset of a fever of 101-102, sore throat, arm swelling and local erythema.

VAERS ID:172525 (history)  Vaccinated:2001-03-15
Age:41.0  Onset:2001-03-15, Days after vaccination: 0
Gender:Male  Submitted:2001-05-10, Days after onset: 55
Location:Ohio  Entered:2001-06-27, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu-like symptoms;UNK. INFLUENZA VACCINE;0;32.00;In Patient
Other Medications: Levaquin
Current Illness: pneumonia
Preexisting Conditions: penicillin allergy
Diagnostic Lab Data: NONE
CDC Split Type: OH0034
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0839K0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Fatigue, Influenza like illness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Approximately 7 hours after receiving vaccine, patient developed flu-like symptoms of body aching, fatigue and low grade fever for 2 days.

VAERS ID:173030 (history)  Vaccinated:2001-06-22
Age:41.0  Onset:2001-06-24, Days after vaccination: 2
Gender:Female  Submitted:2001-06-29, Days after onset: 5
Location:Michigan  Entered:2001-07-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Scleraderma 1994
Diagnostic Lab Data: Antibody titers drawn on all 4 vaccines on 6/29/01
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (HIBTITER)LEDERLE PRAXSIS4766780IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T05950IM 
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4718650IM 
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0367AA0IM 
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Pruritus, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Vaccines given on 6/23/01. Pt states left buttock turned red with itching at site and generalized body itching 2 days post vax. Pt states that cleared up in 2 days, at which time right buttock turned red around injection site which remains pink and raised rash today on 6/29/01. Afebrile.

VAERS ID:173097 (history)  Vaccinated:2001-07-02
Age:41.0  Onset:2001-07-02, Days after vaccination: 0
Gender:Female  Submitted:2001-07-03, Days after onset: 1
Location:California  Entered:2001-07-10, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURERAU0380AB IMLA
Administered by: Public     Purchased by: Private
Symptoms: Fatigue, Lethargy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad)
Write-up: A few hours after 12 diaphoresis X 15 took motrin. This a.m. awoke with fatique, lethergy, muscle aches - moderate scale

VAERS ID:173204 (history)  Vaccinated:2001-06-29
Age:41.0  Onset:2001-06-30, Days after vaccination: 1
Gender:Female  Submitted:2001-07-02, Days after onset: 2
Location:Unknown  Entered:2001-07-11, 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: Rt sore throat
Preexisting Conditions: Septra
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUA373AD2SCLA
Administered by: Military     Purchased by: Military
Symptoms: Feeling hot, Infection, Joint stiffness, Pain, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Post injection raised spot on L upper arm measuring aprox. 10cm. Hot to touch, painful. no range of motion difficulties, 3 days post. small raised area approx 5 cm. swelling going away

VAERS ID:173206 (history)  Vaccinated:2001-06-15
Age:41.0  Onset:2001-06-15, Days after vaccination: 0
Gender:Male  Submitted:2001-07-02, Days after onset: 17
Location:West Virginia  Entered:2001-07-11, 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: 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)SMITHKLINE BEECHAM5236A41IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dermatitis bullous, Erythema, Infection, Malaise, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 7 days after injection, bulls eye rash and whelps appeared on trunk and spread to legs. Ct went to ER but left without being examined. CT c/o itching and redness with malaise. Ct took zantac , Zyrtec and benedryl X 4 Days. then it resolved completely.

VAERS ID:173501 (history)  Vaccinated:2001-07-10
Age:41.0  Onset:2001-07-11, Days after vaccination: 1
Gender:Female  Submitted:2001-07-18, Days after onset: 7
Location:New York  Entered:2001-07-23, 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: Tapazole
Current Illness:
Preexisting Conditions: Sickle cell trait
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESUO382AA2IMLA
Administered by: Other     Purchased by: Other
Symptoms: Bone pain, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Hypersensitivity (broad)
Write-up: On 7/11/01, pt developed generalized bone pain and left deltoid swelling and pain. She c/o redness in area. On 7/12/01, she developed a feeling of heat in right upper deltoid and also c/o itching. On 7/13/01, symptoms inc in severity. On 7/14/01, she developed temp of 102. On 7/16/01, she returned to work. She was treated with Augmentin 500mg x 10 days.

VAERS ID:173649 (history)  Vaccinated:2001-06-18
Age:41.0  Onset:2001-06-18, Days after vaccination: 0
Gender:Female  Submitted:2001-07-16, Days after onset: 28
Location:Oregon  Entered:2001-07-26, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Arm pain;UNK.TD ADSORBED, ADULTS;;30.00;In Patient
Other Medications: 6/18/01 trazadone, Robaxin, Zyrtec, codeine, Leuquin
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Shoulder MRI: Left bursitis
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0380AB7IMLA
Administered by: Private     Purchased by: Private
Symptoms: Bursitis, Pain
SMQs:
Write-up: Pt developed pain in shoulder, the afternoon, post vax. Because of pain in left shoulder and even the right shoulder that intensified, pt made multiple ER visits and was evaluated by orthopedist. Gradual improvement over 1 month. Still hurting but no weakness.

VAERS ID:173885 (history)  Vaccinated:2001-07-24
Age:41.0  Onset:2001-07-25, Days after vaccination: 1
Gender:Male  Submitted:2001-07-30, Days after onset: 5
Location:Kentucky  Entered:2001-08-02, 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: NONE
Current Illness: NONE
Preexisting Conditions: Suspected PCN allergy
Diagnostic Lab Data: NONE
CDC Split Type: KY2001052
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5186A41IMRA
Administered by: Public     Purchased by: 0
Symptoms: Pruritus, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt returned to clinic on 7/27/01 with red, raised whelps over face, trunk and arms with itching. No respiratory complaints. Used OTC Benadryl and told to go directly to doctor. The doctor Rx''d steroid treatment and continue on Benadryl. Took 1 shot on 6/15/01 and had a rash. Pt related it to something else and did not report it on the next visit.

VAERS ID:174260 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:0000-00-00
Gender:Unknown  Submitted:2001-07-30
Location:Unknown  Entered:2001-08-07, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Diagnostic laboratory-negative for antibodies
CDC Split Type: WAES01032879
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1531J   
Administered by: 0     Purchased by: 0
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt recvd pneumococcal vaccine 23 polyvalent (lot # 1531J or 0677K) and subsequently tested negative for antibodies. The reporter was wondering if there had been "any reports of subpotency with these lots." The records of testing prior to release of lots 0677K and 1531J have been checked by Biological Quality Assurance and found to be satisfactory. Lot #s 0677K and 1531J comply with the standards of the Center for Biologics Evaluation and Research and were released. Unspecified medical attention was sought. Addtl info has been requested.

VAERS ID:174143 (history)  Vaccinated:2000-11-09
Age:41.0  Onset:2000-11-20, Days after vaccination: 11
Gender:Female  Submitted:2001-08-03, Days after onset: 255
Location:West Virginia  Entered:2001-08-10, Days after submission: 7
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Coated aspirin; Lotrel; Paxil; vitamin E
Current Illness:
Preexisting Conditions: Coronary anomaly
Diagnostic Lab Data: Lumbar Puncture
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E71290LA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Cough, Difficulty in walking, Dysarthria, Facial palsy, Hypoaesthesia, Lung disorder, Pyrexia, Upper respiratory tract infection, Vision blurred, Visual acuity reduced, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (broad)
Write-up: On 11/20/00, pt had upper respiratory infection associated with cough, sore throat, wheezing, low-grade temperature and chills with profuse sweating. She kept getting worse and was hospitalized on 12/29/00. On 1/25/00, she had numbness in hands and feet, trouble walking, drooping on the left side of face with slurred speech, asymmetric smile, numb tongue, blurred vision and trouble with eyelids. She was hospitalized and put on IVIG for 5 days. She is still recovering and taking physical therapy. The follow up states that: I have permanent facila damage (the left side of my face does not move); have visual problems; hand, feet and legs still go numb; also still have lung problems. This shot has left me physically and mentally impaired.

VAERS ID:174186 (history)  Vaccinated:2001-06-21
Age:41.0  Onset:2001-07-13, Days after vaccination: 22
Gender:Female  Submitted:2001-07-23, Days after onset: 10
Location:Tennessee  Entered:2001-08-10, 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: Healthy.
Preexisting Conditions: NONE
Diagnostic Lab Data: Blood work - Wnl, Mono strip - Neg, Thyroid - Wnl.
CDC Split Type: TN01031
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0330AA5IMRA
Administered by: Public     Purchased by: Public
Symptoms: Abasia, Arthralgia
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: This client reports swelling and severe aching in the joints of feet knees, hands, wrists, and elbows. Beginning on 07/13/2001 and severe enough on 07/18/01, could hardly walk. She saw a doctor, and had several test. The doctor thought it was a reaction due to the TD vaccine. The client is completely healed on 07/22/01 at church.

VAERS ID:174340 (history)  Vaccinated:2001-05-05
Age:41.0  Onset:2001-05-05, Days after vaccination: 0
Gender:Male  Submitted:2001-07-08, Days after onset: 64
Location:Illinois  Entered:2001-08-14, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1123K1IMLA
Administered by: 0     Purchased by: 0
Symptoms: Dizziness, Hyperhidrosis, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad)
Write-up: Pt began to feel light-headed approx. 1 hour, post vax, with tachycardia and diaphoresis. EMS was called and tool pt to ER. Treated with Vicodin and Tagamet. No Benadryl given.

VAERS ID:174470 (history)  Vaccinated:2001-08-10
Age:41.0  Onset:2001-08-10, Days after vaccination: 0
Gender:Female  Submitted:2001-08-13, Days after onset: 3
Location:Nevada  Entered:2001-08-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin; PPD/LFA/0 previous doses which was given on 8/10/01.
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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HEPA: HEP A (VAQTA)MERCK & CO. INC.0523L0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Dizziness, Dysphonia, Dyspnoea, Headache, Pallor
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Friday evening pt complained of dizziness followed by hoarseness, headache and weakness. Noticed pale skin coloration. She also complained of SOB, beginning on Sunday evening. Client went to see PMD. No Rx''s given.

VAERS ID:174753 (history)  Vaccinated:2001-05-12
Age:41.0  Onset:2001-05-14, Days after vaccination: 2
Gender:Male  Submitted:2001-05-15, Days after onset: 1
Location:Florida  Entered:2001-08-28, Days after submission: 105
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIESU0371AB IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Increased erythema, pain and swelling. Treated with Clindamycin.

VAERS ID:174770 (history)  Vaccinated:2001-08-14
Age:41.0  Onset:2001-08-14, Days after vaccination: 0
Gender:Female  Submitted:2001-08-15, Days after onset: 1
Location:Louisiana  Entered:2001-08-28, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Codeine causes vomiting; Penicillin causes swelling.
Diagnostic Lab Data:
CDC Split Type: LA010802
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0160L1SCLA
Administered by: Public     Purchased by: 0
Symptoms: Asthenia, Blood pressure increased, Nausea, Tachycardia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow)
Write-up: Pt reports about 30 minutes, post vax, she began to feel weak and nauseated. She was training in a nursing home and her BP was 190/100, Pulse was 126. She was driven to the ER and given 2 injections of Benadryl.

VAERS ID:174982 (history)  Vaccinated:2001-05-17
Age:41.0  Onset:2001-05-20, Days after vaccination: 3
Gender:Female  Submitted:2001-06-22, Days after onset: 33
Location:New Hampshire  Entered:2001-09-05, Days after submission: 75
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucophage
Current Illness: NONE
Preexisting Conditions: NIDDM, eczema
Diagnostic Lab Data: WBC 4.7, HGB 11.4, HCT 32.5, ESR 49, blood urea 17, blood creatinine 0.8, blood potassium 4.0, blood sodium 140, blood bicarbonate 27, alanine aminotransferase 42, aspartane aminotransferase 20, blood alkaline phosphatase 82, blood bilirubi
CDC Split Type: HQ1620104JUN2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4743980IMLA
Administered by: Other     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Anaemia, Blood alkaline phosphatase increased, Blood creatinine increased, Flushing, Hypochromic anaemia, Joint swelling, Pruritus, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Retroperitoneal fibrosis (broad), Biliary system related investigations, signs and symptoms (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Arthritis (broad), Tumour lysis syndrome (broad)
Write-up: On 5/20/01, pt developed swollen joints, facial flushing and itching of the hands and feet. She was seen in the ER. Additional information recvd from MD on 6/19/01 indicated that the pt was treated with prednisone tapered over 2 wks and diphenhydramine. She recovered.

VAERS ID:175003 (history)  Vaccinated:2000-10-24
Age:41.0  Onset:2000-10-24, Days after vaccination: 0
Gender:Female  Submitted:2000-12-27, Days after onset: 64
Location:Vermont  Entered:2001-09-05, Days after submission: 251
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram
Current Illness: Depression
Preexisting Conditions: Depression NEC
Diagnostic Lab Data: NONE
CDC Split Type: HQ2870227OCT2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES  SC 
Administered by: Private     Purchased by: Other
Symptoms: Diarrhoea, Discomfort, Injection site swelling, Serum sickness
SMQs:, Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: A physician reported that a 41 year old female received an inadvertent Intradermal injection of Pnu-Imune 23 in her forearm on 10/24/00. PPD was to have been administered. Within 24 hours, the pt experienced diarrhea. Additionally, she experienced total body discomfort, serum sickness symptoms and swelling at the injection site, described as a "quarter-size" local reaction.

VAERS ID:176163 (history)  Vaccinated:1999-04-02
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:2001-10-04
Location:Connecticut  Entered:2001-10-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Anaemia, Arthritis
SMQs:, Haematopoietic erythropenia (broad), Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Possibly after my first vaccine of 04/1999 but definitely after my second vaccine I developed arthritic symptoms in my fingers, feet, elbows, hips, neck shoulders, spine, wrist and knees. I also became anemic.

VAERS ID:176301 (history)  Vaccinated:2001-10-03
Age:41.0  Onset:2001-10-03, Days after vaccination: 0
Gender:Female  Submitted:2001-10-09, Days after onset: 6
Location:California  Entered:2001-10-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Asthmatic
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE02791HA0SCLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt''s left deltoid became extremely swollen to the size of an adult fist. It was erythematous and very tender. It responded to ice.

VAERS ID:176521 (history)  Vaccinated:2000-07-20
Age:41.0  Onset:2001-07-20, Days after vaccination: 365
Gender:Female  Submitted:2001-10-10, Days after onset: 82
Location:New York  Entered:2001-10-22, Days after submission: 12
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: hyperglycemia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY128A20IM 
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Dizziness, Headache, Hypotension, Immune system disorder, Nausea, Photosensitivity reaction, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Pt developed a vise-like headache, nausea, photosensitivity, hypotension, shaking rigors and dizziness. Symptoms persisted for 4 hours. Pt was given Benadryl X 2 doses in office. Dx''d with depressed immune system.

VAERS ID:176559 (history)  Vaccinated:2001-10-13
Age:41.0  Onset:2001-10-14, Days after vaccination: 1
Gender:Female  Submitted:2001-10-15, Days after onset: 1
Location:New York  Entered:2001-10-22, 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: Martoux PPD
Current Illness: NONE
Preexisting Conditions: Uterine fibroids and fibrocystic breasts
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4705920IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: The patient experienced severe arm pain, hives and a fever one day after immunization, worsening the next day. The patient was treated with Medrol dose pack, Benadryl, Tylenol and cool compresses.

VAERS ID:176823 (history)  Vaccinated:2001-05-30
Age:41.0  Onset:2001-05-30, Days after vaccination: 0
Gender:Male  Submitted:2001-10-18, Days after onset: 141
Location:Utah  Entered:2001-10-29, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: UT012918
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3375A40IMLA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM671A40IMLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Muscular weakness, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Pt had headaches, body aches and muscle aches, post vax. He was seen by health professional. He states that he still has muscle aches and weakness. He has been referred to an MD for further testing and follow-up.

VAERS ID:177070 (history)  Vaccinated:2001-10-22
Age:41.0  Onset:2001-10-22, Days after vaccination: 0
Gender:Female  Submitted:2001-10-22, Days after onset: 0
Location:Nevada  Entered:2001-11-01, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspar; Flovent; Trazadone; Depakote; Premarin; Synthroid; Glucophage; Paxil; Geoden; Artane; Maxalt; Alupent
Current Illness: NONE
Preexisting Conditions: Allergy to penicillin, albuterol, Vicodin, Keflex, Vibramycin, Iodine; History of panic disorder; Seizure disorder; DM Type II and psychosis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1456K IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Injection site swelling, Injection site warmth, Stridor, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: The pt developed wheezes and crackles in lungs. There was a large warm and edematous area on her left deltoid about 3". She complained of a headache. She was treated with Benadryl 50mg, IM, and Alupent 0.3cc in NS 3cc RT treatment was given.

VAERS ID:177202 (history)  Vaccinated:1999-06-01
Age:41.0  Onset:1999-06-01, Days after vaccination: 0
Gender:Male  Submitted:2001-10-29, Days after onset: 881
Location:Delaware  Entered:2001-11-06, Days after submission: 8
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ritalin
Current Illness: Undiagnosed Lyme disease
Preexisting Conditions: None
Diagnostic Lab Data: Serum reactive for B B even though multiple tick bites; mainly symptoms
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120F0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Immune system disorder, Injection site pain, Nervous system disorder, Neuropathy
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Soreness at injection site. Lyme symptoms rapidly worsening with neuropathies, central nervous system deficits and autoimmune disease. Recovery is ongoing.

VAERS ID:177218 (history)  Vaccinated:2001-10-17
Age:41.0  Onset:2001-10-17, Days after vaccination: 0
Gender:Female  Submitted:2001-10-29, Days after onset: 12
Location:New Jersey  Entered:2001-11-06, 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: Prevacid, Vitamin E, Miralak, Coace and Claritin.
Current Illness: NONE
Preexisting Conditions: Pemphegoid,Tumor removed from spine recently.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE02741HA   
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0944K   
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Extreme pain in the right arm. She couldn''t move her arm for 3 days.

VAERS ID:177471 (history)  Vaccinated:2000-10-23
Age:41.0  Onset:2000-10-23, Days after vaccination: 0
Gender:Female  Submitted:2001-02-14, Days after onset: 114
Location:Pennsylvania  Entered:2001-11-09, Days after submission: 268
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: Hypercholestemia, Renal Calculi, Seizure disorder,Migraine Ha
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU04158A   
Administered by: Private     Purchased by: Unknown
Symptoms: Dizziness, Hyperhidrosis, Injection site reaction, Nausea, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Edema Nausea Dizziness Sweating Injection Site Reaction It was reported that a 41-year-old woman received a Fluzone SV ''00-''01 vaccination on 23-Oct-2000. Reportedly, fifteen minutes after the vaccination the patient experienced redness and swelling at the injection site, dizziness, nausea and cool and clammy skin. The patient laid down for twenty minutes and the symptoms subsided. Further information is being requested. From additional correspondence received on 7-Feb-2001, it was reported that the patient recovered from this experience. Additional patient, vaccine administrator and responsible physician information was also provided. No further information is expected for this case. Case is closed.

VAERS ID:177527 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:2001-03-12
Location:South Carolina  Entered:2001-11-09, Days after submission: 242
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: B/P medication
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: U200100216
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0435AA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site rash, Injection site warmth
SMQs:, Hypersensitivity (narrow)
Write-up: It was reported that a female patient (2 of 3) received a Fluzone SV vaccination. Reportedly the patient developed a reaction of warmth, erythematous area around the injection site for 24 + hours, measuring greater than 5cm and up to 10cm. Further information is required. From additional correspondence received on 03/06/2001, it was reported that the patient recovered from this experience. Additional vaccine, patient, vaccine administrator and responsible physician information were provided.

VAERS ID:177551 (history)  Vaccinated:2000-12-16
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:2001-03-10
Location:Michigan  Entered:2001-11-09, Days after submission: 244
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: U200100295
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0454AA IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction, Pityriasis rosea
SMQs:
Write-up: A few days after the vaccination, the patient reportedly developed a local reaction at the injection site and then developed Pityriais-Rosea. No further information is anticipated. This case is closed.

VAERS ID:177552 (history)  Vaccinated:2001-01-09
Age:41.0  Onset:2001-01-10, Days after vaccination: 1
Gender:Female  Submitted:2002-05-03, Days after onset: 477
Location:Pennsylvania  Entered:2001-11-09, Days after submission: 174
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: Unspecified drug allergies.
Diagnostic Lab Data: NONE
CDC Split Type: U200100297
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO460AA IM 
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Neck pain, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad)
Write-up: From an initial report received on 01/12/01, it was reported that a 41 year old female was given Fluzone SV ''00 -''01 vaccine on 01/09/01. patient reportedly "developed edema and joint pain- elbow, wrists and ankles and fingers, also neck pain the evening after vaccination still persist". From additional correspondence received on 02/16/01, additional patient, vaccine, responsible physician and vaccine administrator information was provided.

VAERS ID:177663 (history)  Vaccinated:2001-09-18
Age:41.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-10-12, Days after onset: 24
Location:Tennessee  Entered:2001-11-12, Days after submission: 31
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: Allergic to Amoxocillin.
Diagnostic Lab Data: UNK
CDC Split Type: TN01053
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0998K SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: 09/18/2001 Itching, went to MD. He gave medication for itching. 09/19/2001 having trouble breathing. MD gave her inhaler. 09/21/2001 still itching a little, no rash, continue to have trouble breathing. 09/24/2001 did not return call.

VAERS ID:177756 (history)  Vaccinated:2001-11-02
Age:41.0  Onset:2001-11-02, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Kentucky  Entered:2001-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex allergy, depression, back problems, food allergies,
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0676AA0IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen, red, and hot at injection site. No treatment. Injection at 10:00 and had a reaction at 16:00 on the day of injection.

VAERS ID:177851 (history)  Vaccinated:2001-04-09
Age:41.0  Onset:2001-04-10, Days after vaccination: 1
Gender:Female  Submitted:2001-10-16, Days after onset: 189
Location:Michigan  Entered:2001-11-16, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Doppler, x-rays, bone scan, MRI''s, blood tests, EMG
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site pain, Injection site swelling, Muscle spasms, Pain
SMQs:, Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt rec''d tetanus shot. Had severe-pain lasted over 2 wks. Pain-left under arm (felt like shoulder out of joint) immediately after. July-woke up, felt like a shot had been given in sleep. Pain-swelling in arm. Unbearable at times, radiating to shoulder. Muscle spasms. Feels like arm is broken. 10/5/01 (nerve block) no results.

VAERS ID:178052 (history)  Vaccinated:2001-08-07
Age:41.0  Onset:2001-08-08, Days after vaccination: 1
Gender:Female  Submitted:2001-08-08, Days after onset: 0
Location:Minnesota  Entered:2001-11-21, Days after submission: 105
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamins and calcium.
Current Illness: NONE
Preexisting Conditions: Allergic to penicillin, ceftin and septra.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSE5186L60IMLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: The patient experienced extreme redness and heat that started in the face, moved to her ears, down her neck, to her chest and then to her arms and hands. The patient took one Benadryl while the hives were starting down her neck. The patient took a second capsule while the hives were starting down her arms. Within 1 1/2 hours later the redness and heat started to subside.

VAERS ID:178085 (history)  Vaccinated:2001-11-05
Age:41.0  Onset:2001-11-06, Days after vaccination: 1
Gender:Female  Submitted:2001-11-14, Days after onset: 8
Location:Mississippi  Entered:2001-11-21, 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: colchicine; Zantac; Effexor XR; Zyrtec; prednisone
Current Illness:
Preexisting Conditions: Allergy to penicillin and sulfa; possible Behcet''s Syndrome vs Lupus
Diagnostic Lab Data: Mild anemia (chronic); Steroid induced diabetes of recent onset; elevated WBC which was felt to be secondary to steroids.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0598AA1IM 
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1449K0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Anaemia, Diabetes mellitus, Injection site erythema, Injection site pain, Injection site swelling, Myalgia, Pyrexia, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic erythropenia (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Pt developed pain, redness and swelling at the injection site and fever and myalgias.

VAERS ID:178169 (history)  Vaccinated:2001-10-19
Age:41.0  Onset:2001-10-20, Days after vaccination: 1
Gender:Female  Submitted:2001-11-01, Days after onset: 12
Location:Alaska  Entered:2001-11-26, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergy to metronidazole
Diagnostic Lab Data:
CDC Split Type: AK200168
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0573AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Eye swelling, Heart rate increased, Injection site pain, Nausea, Ophthalmoplegia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular motility disorders (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt had soreness in injection site on 10/20/01, which resolved. On 10/20/01 she had an episode of nausea, severe diarrhea, right eye felt like it was paralyzed and reports it was swollen, and her heart rate was rapid and light. Approximately 1 hour after the episode of diarrhea, she reported feeling better and the swelling in her eye went away. She did not have any further episodes.

VAERS ID:178238 (history)  Vaccinated:2001-11-14
Age:41.0  Onset:2001-11-14, Days after vaccination: 0
Gender:Female  Submitted:2001-11-14, Days after onset: 0
Location:Idaho  Entered:2001-11-27, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: EKG/sinus tachycardia
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40180400SCLA
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Feeling cold, Hypoaesthesia, Malaise, Sinus tachycardia, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: SOB an felt funny after flu shot. C/O feeling cold, stridor wheezing R 24/mm, sinus tachycardia, numbness & tingling in fingers. Pulse 100-120, BP 140/90 to 165/90. Pt treated with epinephrine, benadryl, o2.

VAERS ID:178255 (history)  Vaccinated:2001-11-14
Age:41.0  Onset:2001-11-14, Days after vaccination: 0
Gender:Female  Submitted:2001-11-16, Days after onset: 2
Location:Wisconsin  Entered:2001-11-27, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin 0.625 mg
Current Illness:
Preexisting Conditions: Sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0677K IMRA
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity
SMQs:, Angioedema (broad), Hypersensitivity (narrow)
Write-up: Approximately 4 hours within injection, Pt developed redness and lump at site approximately 2-3 cm in diameter.

VAERS ID:178467 (history)  Vaccinated:2001-10-23
Age:41.0  Onset:2001-11-08, Days after vaccination: 16
Gender:Female  Submitted:2002-01-03, Days after onset: 56
Location:Illinois  Entered:2001-12-03, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zesrorectic "Zeneca"
Current Illness: NONE
Preexisting Conditions: High blood pressure
Diagnostic Lab Data: Laboratory tests included EMG, MRI and spinal taps (results not reported). Nuclear magnetic resonance imaging results reported aas "lesion in T-spinal cord." Lumbar puncture results reported increased protein. Electromyogram results were "c
CDC Split Type: HQ8967629NOV2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU692AA0IM 
Administered by: Private     Purchased by: Other
Symptoms: Hypoaesthesia, Neuropathy peripheral, Pain, Proteinuria
SMQs:, Acute renal failure (broad), Peripheral neuropathy (narrow), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Chronic kidney disease (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad)
Write-up: A 41 year old female consumer reported that she received Influenza virus vaccine, Trivalent, Types A and B (2001-2002 formula) (manufacturer unknown) on 23-OCT-2001. Concomitant medication included Zestoctic (manufacturer unknown). On 08-NOV-2001, she developed numbness in her toes and finger, the middle of her back and the tip of her tongue. She also experienced "excruciating" pain. On 23-NOV-2001, she was hospitalized. Laboratory tests included EMG, MRI and spinal taps (results not reported). The reporter noted that Guillian Barre was ruled out. On 27-NOV-2001, she was discharged without a diagnosis. She is scheduled to see a Neurologist. No additional information was available as of the date of this report. Follow up info received 12/31/01. Lab test results were reported. Nuclear magnetic resonance imaging results reported aas "lesion in T-spinal cord." Lumbar puncture results reported increased protein. Electromyogram results were "consistent with peripheral neuropathy."

VAERS ID:178539 (history)  Vaccinated:2001-10-09
Age:41.0  Onset:2001-10-10, Days after vaccination: 1
Gender:Female  Submitted:2001-11-25, Days after onset: 46
Location:South Carolina  Entered:2001-12-04, 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: OCP, Claritin D, Chlortrimeton, MVI
Current Illness: NONE
Preexisting Conditions: Healthy except hay fever.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURU0600AA IM 
Administered by: Private     Purchased by: Other
Symptoms: Injection site reaction
SMQs:
Write-up: Local reaction.

VAERS ID:178543 (history)  Vaccinated:2001-11-26
Age:41.0  Onset:2001-11-26, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Kentucky  Entered:2001-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: medication for irritation Bowel Syndrome
Current Illness: On medication Cipro for infection in arm.
Preexisting Conditions: Irritable bowel Syndrome.
Diagnostic Lab Data:
CDC Split Type: KY2001090
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4018043 IMLA
Administered by: Public     Purchased by: 0
Symptoms: Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Received immunization 10 mm at 10:15 AM. Burning at site immediately and arm continued to burn and "achey" after got home, temperature 101.3F. Aching all arm. Low greater fever. Fells like he''s been "beat-up."

VAERS ID:178626 (history)  Vaccinated:2001-11-19
Age:41.0  Onset:2001-11-19, Days after vaccination: 0
Gender:Female  Submitted:2001-11-29, Days after onset: 10
Location:Connecticut  Entered:2001-12-05, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR00608AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: The patient reported progressive numbness from the fingertips on her left hand, to the fingertips on her right hand, to the toes on both feet. The patient experienced a feeling of heaviness in both forearms. These symptoms began 15 minutes after the injection.

VAERS ID:178778 (history)  Vaccinated:2001-11-14
Age:41.0  Onset:2001-11-16, Days after vaccination: 2
Gender:Female  Submitted:2001-11-28, Days after onset: 12
Location:Pennsylvania  Entered:2001-12-10, 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: OTC Estroven MSAN
Current Illness:
Preexisting Conditions: Allergic to PCN
Diagnostic Lab Data: MRI done on 12/3/01; cervical spine MRI 12/4/01.
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO688AA8 LA
Administered by: Other     Purchased by: Other
Symptoms: Anxiety, Asthenia, Coordination abnormal, Encephalitis, Guillain-Barre syndrome, Muscular weakness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow)
Write-up: Pt is having progressive numbness and weakness of left side of body including her tongue. Pt has been sent to neurologist. There is concern the pt may have Guillain Barre. Pt is in the process of treatment. FU on 12/3 from MD states pt is somewhat anxious and has some give away weakness in her legs as well as astasia abasia when walking. Will start her on steriods and ask her to come back in after getting test results. Diagnosed with acute disseminated encephalomyelitis

VAERS ID:178969 (history)  Vaccinated:2001-12-04
Age:41.0  Onset:2001-12-05, Days after vaccination: 1
Gender:Female  Submitted:2001-12-07, Days after onset: 2
Location:Virginia  Entered:2001-12-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Humalog 75/25; Estrace
Current Illness: NONE
Preexisting Conditions: Sulfur Allergic; Diabetic
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4018052 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Oedema, Paraesthesia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Felt tingling of upper lip then lip began to swell. Saw personal physician who ordered Benadryl 50 mg.

VAERS ID:178994 (history)  Vaccinated:2001-12-04
Age:41.0  Onset:2001-12-04, Days after vaccination: 0
Gender:Female  Submitted:2001-12-04, Days after onset: 0
Location:Unknown  Entered:2001-12-13, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: Non-specific allergies
Diagnostic Lab Data:
CDC Split Type: ME0144
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40180240 LA
Administered by: Other     Purchased by: Public
Symptoms: Pain
SMQs:
Write-up: Immediately after receiving vaccine the pt complained about a burning sensation down the entire length of her left arm. Checked with pt 2-3 hrs later and burning had ceased.

VAERS ID:179034 (history)  Vaccinated:2001-11-08
Age:41.0  Onset:2001-11-08, Days after vaccination: 0
Gender:Female  Submitted:2001-12-07, Days after onset: 29
Location:Unknown  Entered:2001-12-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma and antibiotic allergies.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1456K IM 
Administered by: 0     Purchased by: 0
Symptoms: Asthenia, Dyspnoea, Erythema, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Pt received Pneumovax left deltoid, IM on 11/08/2001. 4.5 to 5 hours later after injection pt experienced swelling, erythema and numbness in left arm with pain. Approximately 12 hours after injection, pt experienced an asthma attack. Pt used her "inhaler" and symptoms improved.

VAERS ID:179037 (history)  Vaccinated:2001-11-06
Age:41.0  Onset:2001-11-08, Days after vaccination: 2
Gender:Female  Submitted:2001-12-10, Days after onset: 32
Location:Michigan  Entered:2001-12-14, 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: NONE
Diagnostic Lab Data: Left shoulder X-ray negative.
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR0685AA  LA
Administered by: Other     Purchased by: Unknown
Symptoms: Joint range of motion decreased, Pain
SMQs:, Arthritis (broad)
Write-up: Initial pain post-injection followed by vigorous, throbbing pain from lateral aspect of upper humerus to anterior mid-humerus and continuing to posterior aspect of forearm and hand. Visited family physician 1 week post-injection. Am now receiving physical therapy. Arm pain and limited movement left arm.

VAERS ID:179214 (history)  Vaccinated:2001-10-30
Age:41.0  Onset:2001-11-20, Days after vaccination: 21
Gender:Female  Submitted:2002-01-02, Days after onset: 43
Location:Oklahoma  Entered:2001-12-19, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: X-rays and blood work were done (no results were provided).
CDC Split Type: U2001012610
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0668AA IMRA
Administered by: Other     Purchased by: Other
Symptoms: Hypoaesthesia, Neuropathy peripheral, Pain
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad)
Write-up: It was reported that a 41 year old female pt received a dose of Fluzone SV ''01-''02 on 10/30/01. On 11/20/01, the pt experienced numbness in her hand. On 11/27/01, she went to a hospital ER with shooting pains in her hand (reporter did not know which hand or if it was the same arm the dose of Fluzone was administered in). The pt was dx''d with brachial neuritis. This was considered to be an "Other Important Medical Event". From follow up correspondence received on 1/2/02, it was confirmed that the numbness in the patient''s hand occurred in the same arm that the Fluzone product was administered. The vaccine administrator and responsible physician information was also provided. 8/11/03: No additional info is anticipated. AE coding was changed. "Brachial plexus neuropathy" is listed in the labeling for the influenza vaccine. Case is closed.

VAERS ID:179622 (history)  Vaccinated:2001-12-14
Age:41.0  Onset:2001-12-14, Days after vaccination: 0
Gender:Female  Submitted:2001-12-17, Days after onset: 3
Location:Unknown  Entered:2002-01-02, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergies and Asthma
Preexisting Conditions: Allergies and Asthma
Diagnostic Lab Data: NONE
CDC Split Type:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1449K0SCLA
Administered by: Military     Purchased by: Unknown
Symptoms: Injection site erythema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt received Pneumovax 14-DEC-2001 at 1100. By 2000 hours 14-DEC-2001, large red welt and pain in arm. Seen 17-DEC-2001, erythema 14 mm in diameter.

VAERS ID:179731 (history)  Vaccinated:2001-12-06
Age:41.0  Onset:2001-12-07, Days after vaccination: 1
Gender:Male  Submitted:2001-12-10, Days after onset: 3
Location:New York  Entered:2002-01-07, 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: NONE
Preexisting Conditions: Patient had molar extraction on the same day as the vaccination.
Diagnostic Lab Data: NONE
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40180240 LA
Administered by: Other     Purchased by: 0
Symptoms: Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: On 12/07/2001, patient c/o dime-sized abrasion-like local reaction. He states it baecame red and "itchy".

VAERS ID:180231 (history)  Vaccinated:2000-09-01
Age:41.0  Onset:2000-09-15, Days after vaccination: 14
Gender:Male  Submitted:2000-10-16, Days after onset: 31
Location:Florida  Entered:2002-01-22, Days after submission: 463
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: nephro-vite, erythromycin elixir, Prilosec, toprol xl, cardizem, insulin
Current Illness:
Preexisting Conditions: Allergic to compazine, pork, and vancoled; dialysis patient;; end stage renal disease; gastroesophageal renal disease; hypertention; positive hepatitis B antibodies; type I diabetes.
Diagnostic Lab Data: hepatitis B antibodies-positive pre-Engerix-B
CDC Split Type: 20000302531
Vaccination
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 3  
Administered by: Other     Purchased by: Other
Symptoms: Diabetes mellitus, Diarrhoea, Gastrooesophageal reflux disease, Hepatitis, Hypertension, Renal failure, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (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), Pseudomembranous colitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Chronic kidney disease (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad)
Write-up: Report 2000030253-1 describes gastroparesis in a 41 year old male who received the hepatitis-B vaccine for prophylaxis of hepatitis-b. The vaccinee is allergic to pork, Vancoled (?) and Compazine. His medical history includes end stage renal disease, type 1 diabetes, hypertension, and gastroesophageal reflux disease. He had positive hepatitis B antibodies before his first dose of the hepatitis-b vaccine. He has been a dialysis patient since 1994. His concomitant medications include erythromycin elixir, metaprolol, dilatiazem chydrochloride, omeprazole, ascorbic acid/folic acid and insulin 70/30 On 01-Sep-00, the vaccinee received his forth dose of the hepatitis-b vaccine. Approximately two weeks later on 15-Sep-00, he experienced vomiting and diarrhea. His primary nephrologist and an associate felt that the vaccinee''s symptoms were related to gastroparesis. The vaccinee was subsequently seen by a gastroenterologist who specialized in hepatology who suggested a casual relationship between the vaccinee''s symptoms and the hepatitis-B vaccine. Stool culture were ordered but a stool speicman was never collected. The vaccinee was started on metronidazole (Flagyl) 250 mg bid or qid for approximately 7-10 days. The vaccinee''s vomiting and diarrhea resolved sometimes during the course of Flagyl. As of 02-SEP-00, the outcome of the event is resolved

VAERS ID:180368 (history)  Vaccinated:2001-02-19
Age:41.0  Onset:2001-02-19, Days after vaccination: 0
Gender:Male  Submitted:2001-03-06, Days after onset: 15
Location:Illinois  Entered:2002-01-24, Days after submission: 324
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: gamma globulin
Diagnostic Lab Data:
CDC Split Type: 20010058221
Vaccination
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Report 20010058221 described itching and rash in a 41 year old male who received hep B vaccine recombinant (Engerix-B) for the prophylaxis of hep B. The vaccinee lived with a hep B carrier. Reportedly, the vaccinee had no known drug allergies or medical history. Concomitant medication: Gamma globulin. On 01/19/2001, the vaccinee received his first "adult" left deltoid dose of Engerix-B and a dose of gamma globulin without adverse event. On 02/19/2001, the vaccinee received his second "adult" left deltoid dose of Engerix-B. Post vaccination, in the evening of 02/19/2001, the vaccinee experienced itching and a full body rash. The adverse events resolved without treatment. As of 02/27/2001, the outcome of the events is resolved.

VAERS ID:180395 (history)  Vaccinated:2001-05-03
Age:41.0  Onset:2001-05-04, Days after vaccination: 1
Gender:Female  Submitted:2001-05-11, Days after onset: 7
Location:Michigan  Entered:2002-01-24, Days after submission: 258
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: 20010116501
Vaccination
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3066A4 SC 
Administered by: Other     Purchased by: Other
Symptoms: Feeling hot, Injection site hypersensitivity, Pruritus, Urine glucose false positive
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Report 2010116501 described injection site warmth in a 41 year old female who received hep B vaccine(Engerix-B). Allergies, medical history, and concomitant medications were not specified. On 05/03/2001, the vaccinee received a 1cc subcutaneous dose of Engerix-B. It was not specified whether or not she had received previous doses of Engerix-B. On 05/04/2001, she began having redness, warmth, and itching at the injection site on her left arm. As of 05/07/2001, the redness is a red circular area around the injection site.

VAERS ID:180398 (history)  Vaccinated:2001-04-25
Age:41.0  Onset:2001-04-28, Days after vaccination: 3
Gender:Male  Submitted:2001-06-08, Days after onset: 41
Location:New York  Entered:2002-01-24, Days after submission: 230
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: allergic to penicillin
Diagnostic Lab Data: CBC, ESR, CRP, urethral culture, urine culture, ulcer culture
CDC Split Type: 2001011999
Vaccination
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5187A20  
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS664A60  
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Chills, Dysuria, Flushing, Malaise, Nausea, Nerve injury, Pain, Paraesthesia, Pruritus, Pyrexia, Rash, Testicular disorder,