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Found 485503 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:177004 (history)  Vaccinated:2001-10-20
Age:44.0  Onset:2001-10-20, Days after vaccination: 0
Gender:Female  Submitted:2001-10-22, Days after onset: 2
Location:Texas  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: Premarin
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Hypersensitivity, Injection site mass, Injection site swelling, Injection site warmth, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Post vax the patient developed a knot in the left deltoid that night. The next day the patient had a hot, large swollen area and some difficulty breathing. The patient was diagnosed with a moderate allergic reaction. The patient experienced wheezing at the time seen and was treated with Medrol dose pack.

VAERS ID:177160 (history)  Vaccinated:2001-10-30
Age:44.0  Onset:2001-11-01, Days after vaccination: 2
Gender:Female  Submitted:2001-11-01, Days after onset: 0
Location:Alabama  Entered:2001-11-05, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Pt had allergic reaction to Thimersal in contact lens solution about 20 years ago. Seasonal allergies, takes Claritin.
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU0573AA0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Feeling hot
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: 70cmx60cm red area (knot) on upper arm, warm to touch, developed about 48 hours after administration of vaccine. Treatment ice and Ibuprofen. Reported to Occupational Health Nurse.

VAERS ID:177231 (history)  Vaccinated:2001-10-29
Age:44.0  Onset:2001-10-30, Days after vaccination: 1
Gender:Female  Submitted:2001-10-31, Days after onset: 1
Location:Georgia  Entered:2001-11-06, 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: Sulfa
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESEO5221KA IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site induration, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt c/o hard knot at injection site with slight soreness. No c/o redness or fever.

VAERS ID:177278 (history)  Vaccinated:2001-10-02
Age:44.0  Onset:2001-10-02, Days after vaccination: 0
Gender:Female  Submitted:2001-10-30, Days after onset: 28
Location:Florida  Entered:2001-11-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5235A4 IM 
Administered by: Other     Purchased by: Other
Symptoms: Cold sweat, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Donor had rxn after leaving center. Felt clammy, sweaty. and nauseated.

VAERS ID:177519 (history)  Vaccinated:0000-00-00
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2001-03-08
Location:Florida  Entered:2001-11-09, Days after submission: 246
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: UNK
CDC 'Split Type': U200100204
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0435AA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Pharyngolaryngeal pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: It was reported that a 44 year old female patient received a Fluzone SV vaccination. Reportedly sometime after receiving the vaccination the patient developed 3cm of cellulitis, urticaria and a sore throat. Further information is requested. From additional correspondence received on 02/21/2001, it was reported, "reviewed, no additional information at this time - CD 02/14/2001". This case is closed.

VAERS ID:177541 (history)  Vaccinated:2000-12-11
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2001-03-10
Location:Indiana  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': U200100230
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0454AA IM 
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: It was reported on 12/12/2000, the patient developed a fever of 101F, severe body aches and malaise for approximately 5 hours. Also developed redness and swelling at the site. The patient''s muscles ached for about 12 hours. The patient was treated with Tylenol.

VAERS ID:177628 (history)  Vaccinated:2001-09-24
Age:44.0  Onset:2001-09-27, Days after vaccination: 3
Gender:Female  Submitted:2001-11-05, Days after onset: 39
Location:New Jersey  Entered:2001-11-12, 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: Lithium
Current Illness: None
Preexisting Conditions: Sulfa and acetameniphen
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0593AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Post vax the injection site was red, hot and itchy. The patient had hives on her chest and abdomen. The patient was treated with Medrol Dispenspack and Zyrtec.

VAERS ID:177858 (history)  Vaccinated:2001-10-11
Age:44.0  Onset:2001-10-14, Days after vaccination: 3
Gender:Female  Submitted:2001-11-05, Days after onset: 22
Location:Florida  Entered:2001-11-16, 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: Arthritis to bilateral knees
Diagnostic Lab Data:
CDC 'Split Type':
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5144A22IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Pain
SMQs:, Arthritis (broad)
Write-up: 3 days, post vax, pt developed pain in left knee, calf and thigh. She took ibuprofen and other OTC arthritic medicines with slight improvement. Also tried ice and heat. She denies any known injury. She is 50% recovered. Left knee, calf and thigh pain/strain. Referred to PCP for further work-up prn.

VAERS ID:177923 (history)  Vaccinated:2001-11-08
Age:44.0  Onset:2001-11-08, Days after vaccination: 0
Gender:Female  Submitted:2001-11-11, Days after onset: 3
Location:Kentucky  Entered:2001-11-19, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic to dust, cats, trees and pollen.
Diagnostic Lab Data: NONE
CDC 'Split Type':
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Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO67AA1IM 
Administered by: Public     Purchased by: 0
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Large red spot. Warm to touch.

VAERS ID:177955 (history)  Vaccinated:1995-01-01
Age:44.0  Onset:1997-04-01, Days after vaccination: 821
Gender:Male  Submitted:2001-11-16, Days after onset: 1690
Location:Unknown  Entered:2001-11-20, Days after submission: 4
Life Threatening? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: lamivudine; sulfamethoxazole (+) zidovudine
Current Illness: Cirrhosis; human immunodeficiency virus antigen positive; hepatitis C; drug abuse
Preexisting Conditions: Chronic sinusitis; hepatitis B
Diagnostic Lab Data: RR-40/min; BP-91/60 mmHg; HR-114/min; breath sounds over his right lung field were decreased; CXR-showed an infiltrate of the entire right lung; Autopsy-showed lobar pneumonia, pleural effusion, ascites, cardiomegaly with unremarkable valve
CDC 'Split Type': WAES01110449
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Ascites, Cardiomegaly, Chest pain, Chills, Dehydration, Dyspnoea, HIV test positive, Haemoptysis, Heart rate increased, Hepatic cirrhosis, Hepatomegaly, Hyperventilation, Hypotension, Hypoxia, Malaise, Meningitis, Night sweats, Oliguria, Pallor, Pleural effusion, Pneumonia, Sepsis, Splenomegaly, Varices oesophageal, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Agranulocytosis (broad), Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Torsade de pointes, shock-associated conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tumour lysis syndrome (broad)
Write-up: It was reported that a 44 year old white male was vaccinated in 1995 with a dose of pneumococcal vaccine 23 polyvalent and a dose of influenza virus vaccine. At the time of vaccination, the pt''s CD4 count was 250 cells/microL (19%) and he was prescribed concomitantly zidovudine, lamivudine and sulfamethoxazole/trimethoprim. It was noted that over the subsequent 2 years, there was a transient increase of his CD4 count to a maximum of 370 cells/microL and then a slow decline. The pt presented in 4/97 to the ER with a 6 day history of violent shaking chills, night sweat and malaise. The pt reported shortness of breath, occasional blood-tinged sputum and pleuritic chest pain for 3 days. The pt was known to have been HIV (+) for 8 years, with risk factors including IV drug abuse. It was noted that the pt had received medical care at the infectious disease clinic at the same hospital. It was noted that at his last appointment, 3 months prior to his presentation to the ER, the pt had a CD4 cell count of 216 cells/microL (16%) and his viral load was 1270 copies/mL. It was reported that the pt completely recovered from a hepatitis b infection, but hat a history of chronic sinusitis and hepatitis C. The pt had never suffered from the opportunistic infections common in AIDS. It was reported that in the ER, the pt was poorly cooperative, appeared pale and coughed occasionally. He was afebrile, hypoxemic and had oliguria. Septic shock with severe bacterial pneumonia was dx''d. Ceftazidime, erythromycin, sulfamethoxazole/trimethoprim and IV hydration were administered. It was reported that the pt required orotracheal intubation and mechanical ventilation. About 11 hours after presenting to the ER, the pt developed recurrent ventricular tachycardia and expired. It was noted that with the exception of minimal aseptic leptomeningitis, the neuropathological findings were unremarkable. There was no evidence that the pt had a concurrent influenza infection. It was reported that Streptococcus pneumoniae was cultured from various blood

VAERS ID:178172 (history)  Vaccinated:2001-11-14
Age:44.0  Onset:2001-11-14, Days after vaccination: 0
Gender:Female  Submitted:2001-11-15, Days after onset: 1
Location:Massachusetts  Entered:2001-11-26, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Same;UNK. INFLUENZA VACCINE;;.00;In Patient
Other Medications: Flovent
Current Illness: NONE
Preexisting Conditions: ASthma, bursitis, had hole in heart-repaired
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0671CA0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Feeling abnormal, Injection site pain, Injection site swelling, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Sore Arm at injection site(painful) and hand swollen . Swelling at site locally, then felt ill and chills 5 hrs after vaccine admin.

VAERS ID:178326 (history)  Vaccinated:2001-10-24
Age:44.0  Onset:2001-10-26, Days after vaccination: 2
Gender:Male  Submitted:2001-11-16, Days after onset: 21
Location:Missouri  Entered:2001-11-28, 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: NONE
Current Illness:
Preexisting Conditions: Allergic to ibuprofen, sulfa, Cipro and EES.
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0591AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Injection site pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: The patient had pain at the injection site, joint pain and hives. The patient was treated with Atarax, ice to the site and Tylenol.

VAERS ID:178352 (history)  Vaccinated:2001-10-26
Age:44.0  Onset:2001-11-26, Days after vaccination: 31
Gender:Female  Submitted:2001-11-26, Days after onset: 0
Location:Texas  Entered:2001-11-28, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0689AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Feeling hot
SMQs:
Write-up: The patient states her left ear and left side of her face became hot within a few minutes post vax. The patient took Benadryl and was OK in about 15 minutes.

VAERS ID:178381 (history)  Vaccinated:2001-11-19
Age:44.0  Onset:2001-11-19, Days after vaccination: 0
Gender:Female  Submitted:2001-11-21, Days after onset: 2
Location:Wisconsin  Entered:2001-11-28, 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: Allergy to PCN
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0692AA IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0820K0IMLA
Administered by: Private     Purchased by: Private
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 developed redness, swelling and heat per pt. No treatment. She never had it looked at and informed us of it today (11/21/01) and that it was better.

VAERS ID:178475 (history)  Vaccinated:1999-12-10
Age:44.0  Onset:1999-12-17, Days after vaccination: 7
Gender:Male  Submitted:2001-11-27, Days after onset: 711
Location:California  Entered:2001-12-03, 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:
CDC 'Split Type':
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TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR00740IMRA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUA107AA0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Influenza like illness, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: About 1 week, post vax, pt developed recurrent a rash on his back and a flu-like illness for 1 month afterwards.

VAERS ID:178524 (history)  Vaccinated:2001-10-26
Age:44.0  Onset:2001-10-28, Days after vaccination: 2
Gender:Male  Submitted:2001-12-18, Days after onset: 51
Location:Pennsylvania  Entered:2001-12-04, 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: Serevent, Flovent
Current Illness: Recent viral gastroenteritis
Preexisting Conditions: Asthma; Previous opthalmic history with regards to his spectacles. He has a marked optical difference between his two eyes with his right eye being more hyperopic than his left.
Diagnostic Lab Data: MRI brain, Orbit cervical spine, Lyme titer, Myasthenia panel - results not provided.
CDC 'Split Type': U2001011820
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0679DA SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Diplopia, Encephalitis, Headache, Malaise, Neck pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Ocular motility disorders (broad), Arthritis (broad)
Write-up: It was reported by the pt that he, a 44 year old male, received a Fluzone ''01-''02 vaccination on 10/26/01. The pt developed double vision on 10/28/01; the double vision is still persisting. Pt also experienced tingling in hands and feet, and a general feeling of malaise. He complained of pain in his neck and continued pressure behind his eyes and has a splitting headache. The pt has seen a neurologist, internal medical doctor and an Ophthamologist. He was dx''d by the Ophthamologist as having post viral encephalitis triggered by the flu vaccination. The pt did state that no spinal tap was performed as of yet. From follow up correspondence received on 12/14/01 additional pt, vaccine, responsible physician, vaccine administrator and laboratory data was provided. From follow up correspondence received on 12/14/01 additional patient, vaccine, responsible physician, vaccine administrator and laboratory data was provided. From follow up correspondence received on 2/11/02 the following information was provided from teh physicians notes dated 1/14/02. The patient returns reporting overall he feels much better. He feels his ptosis is completely resolved. He feels wach eye is moving much better at this time but he questions whether his eyes are crossing inwards more. The patient has previous opthalmic history with regards to his spectacles. When examining his refraction he has a marked optical diffrence between his two eyes with his right eye being much more hyperopic than his left. He is experiencing minimal if any diplopia at this time. The patient is showing a marked improvement in his overall gaze paresis. At present he has relatively full duction in both eyes. His ptosis has also improved. However, he is demonstrating an increase in his objective strabismus angle with partial sensory suppression of his right eye. The fact that this tribasic angle is overall increased at this point is not necessarily concerning. In particular, he had very limited duction in all fields of gaze before which might potentially hide his true

VAERS ID:178615 (history)  Vaccinated:2001-05-29
Age:44.0  Onset:2001-06-05, Days after vaccination: 7
Gender:Male  Submitted:2001-11-29, Days after onset: 177
Location:Oklahoma  Entered:2001-12-05, 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: `
Preexisting Conditions: Hypoglycemia until age 7, and tobacco use
Diagnostic Lab Data: NONE
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0472SC 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Muscle spasms
SMQs:, Dystonia (broad), Arthritis (broad)
Write-up: Anthrax vaccine developed cramps and joint pains. Joints hurt from time to time, comes and goes to include hip, knees, and elbows.

VAERS ID:178670 (history)  Vaccinated:2001-11-13
Age:44.0  Onset:2001-11-16, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:Arkansas  Entered:2001-12-05
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: PPD-neg
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0606L SCLA
Administered by: Other     Purchased by: Private
Symptoms: Anorexia, Colitis, Thrombosis
SMQs:, Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific inflammation (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (broad)
Write-up: Four days after receiving MMR pt complained of "colitis", unable to eat, no vomiting, no diarrhea but states passed bloody mucus per rectum. Seen in ER

VAERS ID:178684 (history)  Vaccinated:2001-11-30
Age:44.0  Onset:2001-11-30, Days after vaccination: 0
Gender:Female  Submitted:2001-12-03, Days after onset: 3
Location:Utah  Entered:2001-12-05, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Prilosec, Entex LA
Current Illness: NONE
Preexisting Conditions: Pollen allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5263A40IMLA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Dysphagia, Nasal congestion, Pharyngeal oedema
SMQs:, Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: About 45 minutes post vax, pt developed swelling of the throat and difficulty swallowing. She became lightheaded and had nasal stuffiness. This lasted about 1 hour. She waited it out, and it went away.

VAERS ID:178698 (history)  Vaccinated:2001-11-05
Age:44.0  Onset:2001-11-06, Days after vaccination: 1
Gender:Male  Submitted:2001-11-27, Days after onset: 21
Location:Maryland  Entered:2001-12-06, 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: Zoloft
Current Illness: NONE
Preexisting Conditions: Occasional Depression
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0694AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Hyperhidrosis, Myalgia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad)
Write-up: Chills, shaking, sweating, muscle aching.

VAERS ID:178726 (history)  Vaccinated:2001-11-21
Age:44.0  Onset:2001-11-21, Days after vaccination: 0
Gender:Male  Submitted:2001-12-03, Days after onset: 12
Location:New Jersey  Entered:2001-12-07, 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: Epinephrine
Current Illness: NONE
Preexisting Conditions: Denied, Reference Consent Form
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0683CA18IMLA
Administered by: Other     Purchased by: Other
Symptoms: Amblyopia, Chest pain, Dizziness
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Check out"feeling dizzy", blurring vision, blood pressure systolic=80 (Pre Vaccine B/P 142/92). Slight chest pressure. Epinephrine ADM, 911 notified, transported to RWJ, evaluated and discharged.

VAERS ID:178777 (history)  Vaccinated:2001-11-19
Age:44.0  Onset:2001-11-20, Days after vaccination: 1
Gender:Female  Submitted:2001-12-06, Days after onset: 16
Location:D.C.  Entered:2001-12-10, 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: NONE
Current Illness: NONE
Preexisting Conditions: Allergy to aspirin; history of anemia (1996)
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0699AA IMRA
Administered by: Other     Purchased by: Public
Symptoms: Injection site pain, Joint range of motion decreased
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Pt received flu vaccine about 2 weeks ago, in the right deltoid. The deltoid pain began about 24 hours, post vax. In the past 2-3 days, she had increased pain, limited use of her shoulder, arm and hand. No erythema, inflammation, induration, masses or lesions. Positive abduction was limited to 45 degrees. Treatment: conservative; ibuprofen and cold therapy. Return if signs and symptoms increase or persist over 5-7 days.

VAERS ID:178839 (history)  Vaccinated:1999-04-13
Age:44.0  Onset:1999-04-14, Days after vaccination: 1
Gender:Male  Submitted:2001-12-04, Days after onset: 965
Location:New York  Entered:2001-12-11, Days after submission: 7
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: Brain Spect, Spinal Tap, 2 clinical diagnostic neurosychological exam.
CDC 'Split Type':
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120F90IM 
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Brain oedema, Cognitive disorder, Depression, Fatigue, Inflammation, Pain, Paraesthesia, Tic
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (narrow), Arthritis (broad)
Write-up: Pt developed immediate sore joints, extreme cognitive decline and depression. Within 1 week, he developed extreme fatigue. Within 1 month he had tingling of his arm, facial tics and an inflamed elbow with extreme pain. Poor cognitive function, no memory, joints hurt. Constantly "sick" since receiving the lyme vaccine. In April, May and June of 1999. Brain swelling. Cannot work.

VAERS ID:178993 (history)  Vaccinated:2001-11-06
Age:44.0  Onset:2001-11-06, Days after vaccination: 0
Gender:Female  Submitted:2001-11-18, Days after onset: 12
Location:Massachusetts  Entered:2001-12-13, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex Sensitive
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO682AA0 RA
Administered by: Private     Purchased by: Private
Symptoms: Flushing, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad)
Write-up: Approximately 16 minutes after flu injection client complained of itchiness all over body and upper body including face was very flushed. Epinephrine 1:1000 0.35cc injected into flu injection site approximately 18 minutes after original flu shot. 911 called at the same time, 4-5 minutes after 1st epinephrine injection. Complained of numb, tingling feeling about face, neck and hands. Second Epi 1:1000 0.15cc injected into the same area. BP 158/84 P 60 Transported to Emergency Room via ambulance approximately 25 minutes after flu vaccine given.

VAERS ID:179045 (history)  Vaccinated:2001-12-05
Age:44.0  Onset:2001-12-06, Days after vaccination: 1
Gender:Female  Submitted:2001-12-07, Days after onset: 1
Location:Virginia  Entered:2001-12-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUO704AA1IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site inflammation, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Inflammation and tenderness

VAERS ID:179169 (history)  Vaccinated:2001-11-27
Age:44.0  Onset:2001-11-29, Days after vaccination: 2
Gender:Female  Submitted:2001-12-06, Days after onset: 7
Location:Indiana  Entered:2001-12-18, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0671DA IMRA
Administered by: 0     Purchased by: 0
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient received the flu vaccine at her workplace(factory). It was administrated by personnel from DeKalb Memorial Hospital. A 5 1/2 x 4 1/2 cm redness lump developed

VAERS ID:179171 (history)  Vaccinated:2001-12-06
Age:44.0  Onset:2001-12-07, Days after vaccination: 1
Gender:Female  Submitted:2001-12-11, Days after onset: 4
Location:Georgia  Entered:2001-12-18, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: Respiratory problems
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4018054 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0923L0IMRA
Administered by: Public     Purchased by: Public
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 developed a 3" X 3" red, warm and swollen area over the injection site with some swelling around axilla. It started the morning after the injection. Treated with warm and wet compresses.

VAERS ID:179392 (history)  Vaccinated:2001-11-06
Age:44.0  Onset:2001-11-15, Days after vaccination: 9
Gender:Male  Submitted:2001-11-28, Days after onset: 13
Location:Georgia  Entered:2001-12-26, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4008284  LA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injection site erythema, Lymphadenopathy
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: A 44 year old male vaccinated at 14:00 on 11/6/01 (do not know which vaccine vial used, but presumed to be same as 11/5). On 11/15/01 recheck revealed primary response along with 4cm area of redness extending down medial arm from vaccine site. Recheck on 11/16/01 revealed only faint redness of medial arm in area previously described, 5-6 erythematous "rays" noted extending from vaccine site in all quadrants. Pt was afebrile and site was not tender. Because of previous 3 cases of presumed cellulitis among 11/5/01 and 11/6/01 vaccinees, the pt was treated with cephalexin as a precaution. Recheck of site on 11/19/01 revealed afebrile pt with no real change in appearance of site. On 11/20/01, e-mail from pt stated that scab had fallen off, "all is looking fine" and no other problems. Clinical dx: probable lymphangitic response to vaccine, r/o early cellulitis.

VAERS ID:179420 (history)  Vaccinated:2001-08-24
Age:44.0  Onset:2001-08-24, Days after vaccination: 0
Gender:Female  Submitted:2001-12-21, Days after onset: 119
Location:Colorado  Entered:2001-12-27, 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: Prozac; Prilosec; Mirapex; Prometrium
Current Illness:
Preexisting Conditions: Hysterectomy; asthma; oophorectomy; bursitis; periorbital disorder; tremor; morphine allergy; depression
Diagnostic Lab Data: Antibody titers-neg; erythrocyte sed rate-slightly elevated at 24 and on 10/3/01 a repeat sed rate was 4 and rheumatoid factor was 203 IU/mL (10 times the normal level); CBC-nml except mild increase in percentage of neutrophils; UA, metabol
CDC 'Split Type': WAES01101998
Vaccination
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Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0672L3IMLA
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Cough, Diarrhoea, Disturbance in attention, Dizziness, Dysphagia, Dyspnoea, Fatigue, Feeling hot, Headache, Hyperhidrosis, Hypoaesthesia, Injection site pain, Injection site swelling, Myalgia, Pharyngolaryngeal pain, Rheumatoid factor, Rhinorrhoea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Information has been received from a physician concerning a 44 year old white female RN with depression, periorbital darkening, "hereditary" tremor, "bursitis" of the left knee and allergies to morphine, droperidol and butorphanol (Stadol) and a history of asthma "that occurred mostly during childhood", hysterectomy, oophorectomy and vaccination with an unspecified hepatitis vaccine, who on 8/24/01 was vaccinated with a 4th dose of Hep-B vaccine recombinant (yeast) in the left deltoid (lot 639853/0672L). The physician reported that the pt was a new employee to the hospital who indicated that she received an "unknown" hepatitis vaccine when it first came out approx. "10-15 years ago". The pt had antibody titers drawn which were "negative". She was then advised to received the Hep-B vaccine series. On 8/24/01, within 5-10 minutes of receiving the vaccine, she began experiencing multiple organ symptoms. On 8/24/01, the pt experienced general sense of warmth, sweating, pain and swelling at the site of injection, diaphoresis and numbness of the affected arm. She complained of difficulty swallowing but not of difficulty breathing. She felt dizzy and nauseous but did not vomit. She was treated with Benadryl and IV steroids in the ER. She had no respiratory symptoms. Most of her symptoms were subjective and not objective. She received a 1 week course of prednisone. On 8/27/01, the pt felt drowsy and fatigued like she was coming down with the flu and "felt mentally not connected". On 9/4/01, the pt developed diarrhea, vomited once, felt tired, felt like her "thyroid zone" was swollen and her throat felt scratchy. She became out of breath when climbing up stairs. The physician reported that the rheumatoid factor was elevated to 10 times the normal level. The pt was referred to a rheumatologist. On 10/4/01, the pt had a constant global headache and crampy abdominal pain with watery diarrhea. The pt was fatigued and dyspneic with a non-productive cough, watery nasal discharge and sore throat. The injection site was still ten

VAERS ID:179444 (history)  Vaccinated:2001-10-30
Age:44.0  Onset:2001-10-30, Days after vaccination: 0
Gender:Female  Submitted:2001-12-19, Days after onset: 50
Location:Alabama  Entered:2001-12-27, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Codeine, Bactrium, Erytmomicin, Fibromyalgia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO5908A  LA
Administered by: Private     Purchased by: Other
Symptoms: Lymphadenopathy, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Ten minutes after the Flu shot, I had sever pain in my entire left arm. The next morning, I had swollen lymph nodes and a lot of swelling in my neck. Left side pain continued for 5-7 days. Swelling 6 weeks. Still swelling in neck.

VAERS ID:179473 (history)  Vaccinated:2001-12-19
Age:44.0  Onset:2001-12-21, Days after vaccination: 2
Gender:Female  Submitted:2001-12-21, Days after onset: 0
Location:Wisconsin  Entered:2001-12-27, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergy to Dolobid
Diagnostic Lab Data: NONE
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1051L0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The pt''s left shoulder (deltoid) had redness, swelling, tenderness and induration in an area 4cm X 5cm in diameter.

VAERS ID:179547 (history)  Vaccinated:2001-12-14
Age:44.0  Onset:2001-12-15, Days after vaccination: 1
Gender:Male  Submitted:2001-12-20, Days after onset: 5
Location:California  Entered:2001-12-28, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nizoral shampoo and Protonix tabs.
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS218A60IMLA
Administered by: Other     Purchased by: Public
Symptoms: Diarrhoea, Haematochezia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)
Write-up: Pt received Twinrix A/B IM vaccine 12/14/2001 and state next day later in evening had liquid stool with possible blood in it.

VAERS ID:179630 (history)  Vaccinated:2001-12-14
Age:44.0  Onset:2001-12-16, Days after vaccination: 2
Gender:Female  Submitted:2001-12-14, Days after onset: 2
Location:California  Entered:2002-01-02, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Describes sensitivity to medications.
Diagnostic Lab Data:
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0896L0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Dehydration, Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Patient experienced onset of vomiting, diarrhea, nausea approximately 24-48 hours post administration of MMR injection. Treated in ER for dehydration and released.

VAERS ID:179811 (history)  Vaccinated:2001-12-11
Age:44.0  Onset:2001-12-12, Days after vaccination: 1
Gender:Female  Submitted:2001-12-19, Days after onset: 7
Location:Texas  Entered:2002-01-09, 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: ipratropium inhaler; Hydrochlorathiazide; simethicone
Current Illness: NONE
Preexisting Conditions: PPD allergy; asthma
Diagnostic Lab Data: CH50 results pending
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.071860IMRA
Administered by: Other     Purchased by: Public
Symptoms: Injection site erythema, Injection site inflammation, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: The pt developed itchiness, rubor and an erythematous lesion at the site of the injection. Treated with 250mg Solu-Medrol injection (IM).

VAERS ID:179941 (history)  Vaccinated:2001-12-17
Age:44.0  Onset:2001-12-17, Days after vaccination: 0
Gender:Female  Submitted:2002-01-08, Days after onset: 22
Location:Michigan  Entered:2002-01-14, 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: NONE
Current Illness: NONE
Preexisting Conditions: Allergies to codeine, iodine, Cipro, weeds, grass and trees.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40180440IM 
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site inflammation, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Area of injection site became red, inflammed, hard/firm, warm to touch and slightly sore. The area of induration and erythema measured approx. 3" across. Seen in a walk-in clinic by ER physician. Treatment: Benadryl.

VAERS ID:179988 (history)  Vaccinated:2001-11-13
Age:44.0  Onset:2001-11-14, Days after vaccination: 1
Gender:Female  Submitted:2002-01-08, Days after onset: 55
Location:New York  Entered:2002-01-15, 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: Coloca; Soma; estradiol; Darvocet-N 100; Promotrun
Current Illness:
Preexisting Conditions: Vaginal bleeding; chronic back pain; anemia secondary to menorrhagia; depression
Diagnostic Lab Data: WBC-11.6
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0711AA2IMRA
Administered by: Private     Purchased by: 0
Symptoms: Oedema peripheral, Pyrexia, White blood cell count increased
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling of leg, feet, ankle, wrists, hands and fever on 11/14/01. Had Fluzone on 11/13/01. Seen in ER on 11/15/01.

VAERS ID:180011 (history)  Vaccinated:2001-08-08
Age:44.0  Onset:2001-08-21, Days after vaccination: 13
Gender:Male  Submitted:2002-01-10, Days after onset: 142
Location:Texas  Entered:2002-01-15, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: 8/3/01-Rubella antibody level non-reactive
CDC 'Split Type':
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RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.0264L SCRA
Administered by: Private     Purchased by: 0
Symptoms: Laboratory test abnormal, Pruritus, Pyrexia, Rash papular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad)
Write-up: Post vax, the employee reported to employee health on 8/21/01 with a fine, papular rash all over his body. No vesicles or hives; no respiratory involvement but complained of fever, itching and discomfort with the rash.

VAERS ID:180030 (history)  Vaccinated:2001-08-06
Age:44.0  Onset:2001-08-06, Days after vaccination: 0
Gender:Male  Submitted:2001-12-29, Days after onset: 145
Location:Texas  Entered:2002-01-16, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prilosec
Current Illness: NONE
Preexisting Conditions: Asthma; PCN allergy; GERD; Allergic rhinitis
Diagnostic Lab Data: Blood work; office exams; MRI
CDC 'Split Type':
Vaccination
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5235A41  
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS698D61  
Administered by: Private     Purchased by: Private
Symptoms: Blindness, Eye oedema, Eye pain, Headache, Memory impairment, Optic neuritis, Photophobia, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Ocular infections (broad), Hypersensitivity (narrow)
Write-up: From 8/6/01 to 8/7/01, had a dull headache; took Tylenol Sinus & Allergy pills. On 8/8/01, had a feeling of pressure above right eye and a headache. On 8/9/01, had a loss of vision in eye; dx of optic neuritis; over the next 3 weeks, loss of colors, blurring, could not look at bright light and could not see some light (ex. car headlights); pain in eye, swelling. No treatment. From 10/01 to 11/01, began to return; reduction of pain, light flashes. In 12/01, sight is better but not the same (est. 85-90% normal). Also, in August, September and October 2001, had some memory difficulty. Annual follow up states patient has permanent deterioration of right optic nerve, right eye; continued visual problems in right the right eye.

VAERS ID:180098 (history)  Vaccinated:2000-05-03
Age:44.0  Onset:0000-00-00
Gender:Male  Submitted:2002-01-15
Location:Nebraska  Entered:2002-01-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma, epilepsy, pneumonia
Diagnostic Lab Data: UNK
CDC 'Split Type': 20020003781
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS136B91IM 
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Report 20020003781 describes arthritis in a 44 year old male who received Lyme disease vaccine recombinant OspA (LYMErix). The medical history included asthma. The vaccinee had no known drug allergies. The vaccinee''s occupation reportedly put him "at risk for tick bites." Concurrent medical conditions and medications were not known by the reporter. The vaccinee received his first injection of LYMErix (lot Ly104A2) on 04/12/1999. He had no adverse experience following receipt of this injection. He received his second injection of LYMErix (lot LY136B9) on 05/03/2000. An unknown time post-immunization, he experienced "extreme'' joint pain (NOS). The vaccinee reported that he was seen by an "arthritis specialist," who mad a diagnosisi of arthritis (NOS). The vaccinee stated that he remains in a lot of pain and is having difficulty just trying to move about. The vaccinee refused the third injection of LYMErix. The adverse event ''arthritis'' does not meet ICM serious criteria, but is being submitted as an expedited report by special FDA request per the June 28, 2000 letter. The follow up received on 2/4/02, states the vaccinee stated that this specialist recommended that he not receive the third injection of LYMErix and did not specify the treatment or outcome of the event.

VAERS ID:180401 (history)  Vaccinated:0000-00-00
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2001-05-29
Location:Ohio  Entered:2002-01-24, Days after submission: 240
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: concomitant medications were not specified
Current Illness:
Preexisting Conditions: Allergies, medical history were not specified
Diagnostic Lab Data: ANTI-HBS A negative
CDC 'Split Type': 20010130151
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 2  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Report 2001013015-1 describes lack of therapeutic effect in a pt who rec''d hepatitis B vaccine recombinant (Engerix-B). In 1992, the pt rec''d her first, second and third doses of Engerix-B respectively. Recent serological testing revealed that the pt was anti-Hbs A negative. The pt was subsequently administered a dose of hepatitis B vaccine recombinant (Recombivax HB). As of 5/24/01 the outcome of the event was unknown.

VAERS ID:180411 (history)  Vaccinated:2001-04-11
Age:44.0  Onset:2001-04-11, Days after vaccination: 0
Gender:Male  Submitted:2001-06-15, Days after onset: 65
Location:Kentucky  Entered:2002-01-24, Days after submission: 223
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': 20010144801
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3384B60IM 
Administered by: Public     Purchased by: Private
Symptoms: Asthenia
SMQs:, Guillain-Barre syndrome (broad)
Write-up: On 4/11/01, the pt received his 1st IM dose of Engerix-B. Post vax, on 4/11/01, the pt experienced weakness and fatigue. The reporter stated that these adverse events were moderate in severity and possibly related to Engerix-B. No drugs were used to treat the adverse events. They resolved on 4/12/01. Engerix-B was stopped. As of 6/12/01, the adverse events had resolved.

VAERS ID:180459 (history)  Vaccinated:1999-05-01
Age:44.0  Onset:0000-00-00
Gender:Male  Submitted:2002-01-21
Location:New Jersey  Entered:2002-01-24, 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: Xenical (Orlestat); Sporanox (itraconazole); Zestril (lisinopril); acetylsalicylic acid; Atenolol
Current Illness:
Preexisting Conditions: Hypercholesterolemia; Hypertension; Low back pain; Non-sustained Ventricular Tachycardia; Onychomycosis; Premature Ventricular Contractions; Right Bundle Branch Block (1996)
Diagnostic Lab Data: Ice pack test; Nerve conduction studies; EMG-a mildly abn single fiber EMG in the orbicularis oculi muscle which would be consistent with myasthenia gravis or other disorders; Acetylcholine (Ach) receptor binding antibody (Ab) and Ach recep
CDC 'Split Type': 20020008011
Vaccination
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Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Eyelid ptosis, Eyelid retraction, Hepatic steatosis, Myasthenic syndrome, Neuropathy, Skin burning sensation
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)
Write-up: This report describes myasthenia gravis in a 44 year old male who received Lymerix. Following the onset of myasthenia gravis, the pt developed plaques on his knees and elbows that were "suggestive of psoriasis". The pt was referred to a dermatologist. This was not reported as an adverse event due to vaccine administration, but was found during the course of review of the pt''s medical records. Therefore, it is not listed as an adverse event. The pt received his 1st and 2nd injections of Lymerix in 4/99 and 5/99. An unspecified time, post vax, he awoke with left eye ptosis. He placed a patch over his right eye in an unsuccessful attempt to strengthen his left eyelid. The ptosis persisted when he received his 3rd Lymerix on 4/20/00. He was referred to aneuro-ophthalmologist. The pt was seen on 8/23/00 and the physician wrote that the pt "states that 1 year ago, he woke up and noted left eye ptosis. He notes that with fatigue the lid droop is accentuated. He did try to place a patch over the right eye in order to strengthen his left eyelid but this was to no avail. He has had no generalized fatigue. However, he has had occasional burning sensation down both legs with exercise. He has had no complaints of SOB, dysphagia or double vision. He noticed that the left eyelid twitches at times. He received a Lyme vaccination in 4/99 and 5/99, just before the onset of his ptosis." On physical exam, "he did demonstrate mild curtaining and a positive lid twitch sign. There was dermatochalsis noted bilaterally. An ice pack test was carried out and also showed improvement of the ptosis". The physician''s impression was "At this time we need to exclude myasthenia gravis". The pt was seen by the neuro-ophthalmologist on 4/17/01 and he wrote "The vaccinee returns today for follow-up of his myasthenia gravis. He was lost to follow-up for several months. He has undergone a single fiber EMG which does suggest a presence of a neuromuscular defect. He had had no other new neurologic signs or symptoms including no dysarthria, dysphagia, we

VAERS ID:180493 (history)  Vaccinated:1999-04-13
Age:44.0  Onset:0000-00-00
Gender:Male  Submitted:2002-01-17
Location:New Jersey  Entered:2002-01-24, 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:
CDC 'Split Type':
Vaccination
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Insomnia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: After 2nd shot of Lymerix, started experiencing muscle and joint pain and sleeplessness.

VAERS ID:180544 (history)  Vaccinated:2001-10-08
Age:44.0  Onset:2001-10-08, Days after vaccination: 0
Gender:Female  Submitted:2002-01-14, Days after onset: 98
Location:Iowa  Entered:2002-01-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA-Mitral Valve prolapse
Diagnostic Lab Data: Physical therapy for three times a month.
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0710AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Injection site oedema, Injection site pain, Muscular weakness, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: The pt received injection on her left deltroid on 10/08/2001. Injection was immediately painful and deltoid area swelled up. Now she has decreased range of motion on her arm and she can''t swing toward back or twist to hook her buckle seat belt. Arm is weak and she can''t reach arm above her head. It''s very painful at night and it aches all the time. Also, laying down causes more pain.

VAERS ID:180635 (history)  Vaccinated:2001-11-16
Age:44.0  Onset:2001-11-17, Days after vaccination: 1
Gender:Female  Submitted:2001-11-19, Days after onset: 2
Location:Pennsylvania  Entered:2002-01-29, Days after submission: 71
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Swelling, tachycardia;Tetanus Toxoid (Mfr not specified);;30.00;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Asthma
Diagnostic Lab Data: NONE
CDC 'Split Type': PA0206
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0706AA3IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site reaction, Injection site warmth, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt rec''d flu vaccine 11/16/01. On 11/17/01 R arm at injection site developed hives, welt, itchy, redness, site warm to touch. On 11/19/01 R deltoid site size of small lemon, warm to touch and still itchy. Pt put ice on the area on 11/17 and warm compress 11/18/01. On 11/26/01 inflammation subsiding.

VAERS ID:180651 (history)  Vaccinated:2001-12-13
Age:44.0  Onset:2001-12-13, Days after vaccination: 0
Gender:Female  Submitted:2001-12-15, Days after onset: 2
Location:Maine  Entered:2002-01-29, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: NONE
Preexisting Conditions: Latex, hypothyrocdism
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0712AA0IM 
Administered by: Public     Purchased by: 0
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: 12-14 hours post flu vaccination, pt noted tenderness at injection site.

VAERS ID:180815 (history)  Vaccinated:2000-03-09
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2000-03-28
Location:Pennsylvania  Entered:2002-02-04, Days after submission: 678
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': U200000139
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0061AA IM 
Administered by: Private     Purchased by: 0
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: It was reported that a female pt received a TD Adult vaccination on 3/9/00. Reportedly, within 12 hours, the pt developed a rash over her entire body. From correspondence received on 3/27/00, additional pt and responsible physician information was provided.

VAERS ID:180877 (history)  Vaccinated:2000-08-28
Age:44.0  Onset:2000-08-28, Days after vaccination: 0
Gender:Female  Submitted:2000-10-11, Days after onset: 44
Location:Illinois  Entered:2002-02-04, Days after submission: 481
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Codeine, Morphine
Diagnostic Lab Data: NONE
CDC 'Split Type': U200000721
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0138BA0IM 
Administered by: Private     Purchased by: Private
Symptoms: Headache, Palpitations, Throat tightness, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: It was reported that a 44 year old female pt received a TD Adult vaccination on 08/28/2000. Reportedly within 30 mins after the injection the pt developed shakiness, heart racing, tightness in throat and headache. Treatment-observation only. Reportedly the pt recovered from this experience.

VAERS ID:181002 (history)  Vaccinated:2001-01-26
Age:44.0  Onset:2001-01-26, Days after vaccination: 0
Gender:Male  Submitted:2001-04-05, Days after onset: 68
Location:Florida  Entered:2002-02-06, Days after submission: 307
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': U200100457
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0343AA0IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: It was reported that a male pt received a TD Adult vaccination, intradermal on 01/27/2001 at 11am. Reportedly on 01/26/2001 at 11:30pm the pt developed 1/4cm raised center with 1cm margin-erythemic down from 3cn erythemic margin. The pt reportedly recovered from this experience.

VAERS ID:181085 (history)  Vaccinated:2002-01-22
Age:44.0  Onset:2002-01-23, Days after vaccination: 1
Gender:Female  Submitted:2002-01-31, Days after onset: 8
Location:Washington  Entered:2002-02-07, 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: xamax, paxil, dmipramine, nasanel
Current Illness:
Preexisting Conditions: Anxiety disorder
Diagnostic Lab Data:
CDC 'Split Type':
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PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4722090IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pruritus, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: On 01/23/2002 itching then progressed to hives. On 01/27/2002, swelling, redness and approx. 4-5 inches in diameter. Swelling and redness resolved by 01/28/2002 am. Itching resolved on 01/31/2002.

VAERS ID:181281 (history)  Vaccinated:2002-01-20
Age:44.0  Onset:2002-01-21, Days after vaccination: 1
Gender:Female  Submitted:2002-01-29, Days after onset: 8
Location:Minnesota  Entered:2002-02-12, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergic to milk
Diagnostic Lab Data:
CDC 'Split Type':
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MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUB028AC0SCLA
TTOX: TETANUS TOXOID (NO BRAND NAME)SANOFI PASTEURU0518AA1IMRA
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Eye swelling, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: States not feeling well 1-2 days after IZ. On 1/21/02 PM, left arm sore, red and warm. Stayed off work Monday through Wednesday complaining of eyes red and swollen, light-headed also. The size of the area was 2" X 3 1/2" which was raised, reddened, slightly hardened on 1/25/02. No complaints of fever. Back to work on 1/25/02.

VAERS ID:181627 (history)  Vaccinated:2002-02-14
Age:44.0  Onset:2002-02-14, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Louisiana  Entered:2002-02-22
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: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0725AA1IMRA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0956L1IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.1569L1IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIEST105221IMRA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUB077AA0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Face oedema, Skin ulcer, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Mild urticaria about 20 mins after immunizations 4-5 lesions on back, left arms with some mild edema of lower lip. Before patient left the clinic lesions on back disappeared and lip swelling was reduced. Benadryl 50 mg IM right deltoid , lot #019223

VAERS ID:181786 (history)  Vaccinated:0000-00-00
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2002-09-28
Location:Unknown  Entered:2002-02-27, Days after submission: 212
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: anxiety (1989), hypertension (1989), increased erythrocyte sedimentation rate, elevated aspartate aminotransferase concentration, elevated alanine aminotransferase concentration, blood transfusion, elevated lactic dehydrogenaso concentrations, elevated alkaline phosphatase concentrations, hypocalcemia, hypokalemia, hypomagnesamia, hypo?, ?, hypocholesterolemia, decreased iron conce
Diagnostic Lab Data: On 6/29/00, the pt presented to her gastroenterologist for findings of abnormal liver function tests. The gastroenterolgoist referred to lab data from 5/26/00, which showed high AST and ALT values coupled with a "perfectly normal alkanine p
CDC 'Split Type': A0359835A
Vaccination
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS104A20  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Dizziness, Headache, Immune system disorder, Oedema peripheral, Pain, Rheumatoid arthritis, Systemic lupus erythematosus
SMQs:, Cardiac failure (broad), Angioedema (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Arthritis (narrow)
Write-up: This report describes autoimmune hep in a 44 year-old female vaccinee who received lyme disease vaccine recombinant OspA. This report was received as part of litigation proceedings and has not been verified by a physician or other healthcare professional. Medical history, concurrent conditions, and concurrent medications were not provided. The vaccinee reportedly received LYMErix; the number of injections administered was not reported. In a statement of injuries, her attorney alleged that the vaccinee "has been diagnosed with Rheumatoid arthritis in her neck, hands, chest, back, elbows, knees and feet, and suffers pain from this condition every day, along with fatigue and rashes. In addition she has been diagnosed with a mild autoimmune liver hepatitis, and possible lupus. Time to onset following immunization, treatment, and outcomes of the alleged events were not reported. Autoimmune hepatitis and possible lupus are considered medically serious. The follow up states medical history included anxiety (1989), hypertension (1989), increased erythrocyte sedimentation rate, elevated aspartate aminotransferase concentration, elevated alanine aminotransferase concentration, elevated lactic dehydrogenaso concentrations, elevated alkaline phosphatase concentrations, hypocalcemia, hypokalemia, hypomagnesamia, hypo?, ?, hypocholesterolemia, decreased iron concentration, decrerased total iron binding capacity, decreased serum ferritin, decreased transferrin saturation, decreased triglyceride concentration, Lyme disease treated with a 12 week course of doxycycline, and secondary hyperparathyroidism. The most recent info received 5/6/02, did not provide the outcome of the reported events. The follow up states further medical history of toxemia (1977), hayfever, heartburn (1982), gastritis (1982), chronic duodenitis (1985), functional pylorospasm (1982), functional nardiospasm (1982), reflux esophagitis (1985), aeropohagim (1985), erosive duodenitis (1985), esophageal spasm (1990), irritable bowel syndrome (1990), rheumatoid ar

VAERS ID:181852 (history)  Vaccinated:2002-01-14
Age:44.0  Onset:2002-01-16, Days after vaccination: 2
Gender:Male  Submitted:2002-01-12, Days after onset: 4
Location:Connecticut  Entered:2002-03-01, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES0996L0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Prevnar given 1/14/02. Within 24 hrs-redness, tenderness to arm at site radiating to axilla.

VAERS ID:181913 (history)  Vaccinated:2002-02-08
Age:44.0  Onset:2002-02-08, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Oregon  Entered:2002-03-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Naproxen, orthotricyclen
Current Illness:
Preexisting Conditions: Patient reports hx of fibromyalgia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0368AA0 RA
Administered by: Private     Purchased by: Private
Symptoms: Lethargy, Muscle rigidity, Visual disturbance
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad)
Write-up: Muscle tightening, visual disturbances, jaw tightness, lethargy, "feeling drugged".

VAERS ID:182114 (history)  Vaccinated:1998-10-05
Age:44.0  Onset:1998-10-26, Days after vaccination: 21
Gender:Female  Submitted:2002-03-05, Days after onset: 1226
Location:Maryland  Entered:2002-03-08, Days after submission: 3
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: Allergic rhinitis; dermatographia; seizure disorder (off medications since 1990); C6-C7 diskectomy 1989; CTS L more than R 1991
Diagnostic Lab Data: MRI lumbar spine-bilateral S1 foraminal stenosis; Somatosensory Evoked Potentials which demonstrated abnormality in the bilateral peripheral lower sensory pathways and an EMG which revealed an L5-S1 radiculopathy and active denervation of bilateral paraspinal muscles at multiple levels. Repeat EMG in 8/99-worsening and consistent with an acute polyradicular process; LP in 10/99-elevated B. Burgdorferi CSF index;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0175SC 
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER 1IM 
Administered by: Military     Purchased by: Military
Symptoms: Bone disorder, Carpal tunnel syndrome, Congenital foot malformation, Feeling hot, Guillain-Barre syndrome, Infection, Muscle atrophy, Muscular weakness, Neuropathy peripheral, Oedema peripheral, Pain, Paraesthesia, Polyneuropathy
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (narrow), Congenital, familial and genetic disorders (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Demyelination (narrow)
Write-up: The pt developed vague, general foot discomfort/fatigue; pain at metatarsal heads with weight bearing; intermittent lancinating pains in toes; in warm conditions, feet/toes hot and blush; in cooler conditions toes feel "like they are freezing" and ache. Bending over (to vacuum) increases paresthesias/numbness in shins/dorsal feet. Prolonged standing increases fatigue, discomfort and swelling in feet up to ankles. Fasciculations in calves are still precipitated by exertion. Treatment: Foot discomfort and swelling is greatly relieved by foot exercises and leg elevation and swimming. Neurologist assessment: Acute inflammatory polyneuropathy (AIP) or Guillain-Barre temporally associated with influenza and anthrax vaccines; numbness paresthesias and weakness in both feet in L5-S1 distribution bilaterally secondary to residual effects of AIP; autonomic neuropathy secondary to #1 with secondary dependent edema problems; cervical herniated nucleus pulposus (C5-6 HNP) and bilateral carpal tunnel syndrome. Due to the incompatibility of this service member''s medical condition with the demands of operational/remote/overseas environment, it is recommended that she be found unsuitable for such assignment. No prolonged standing, walking, running or jogging. Pt workload should not exceed 10-11 hours per day in order to allow for medical care requirements. She may need time to maintain her swimming program. Continue physical therapy. Allow use of non-confining (soft) footwear as tolerated, continue silicone orthotics with metatarsal bars (Viscoped), avoid further vaccinations unless specifically reviewed by vaccine safety assessment expert. Administer oseltamivir for influenza prophylaxis as indicated. After a LP in 10/99, Lyme neuroborreliosis was considered and she was given a course of Ceftriaxone therapy (2gms IV qd X 30 days). She noted no immediate improvement in her neurologic symptoms. By 8/00, she noted significantly increased weakness and atrophy of the intrinsic muscles of the feet. A repeat MRI in 8/00 showed findings consistent with a diffuse axonal peripheral neuropathy. She now manifests a claw foot-like deformity of the left foot. Update letter: The sensation in the feet/distal lower extremities has improved slightly with improved sensory discrimination. The strength of the foot intrinsic muscle has improved with improved foot function, toe strength and toe coordination. The autonomic neuropathy findings are still evident with shiny skin in the feet/distal lower extremities, vascular hyperreativity and intermittent dysesthesias-but the foot edema no longer seems to be a problem. Pt feels that the improvement in motor strength/function, resolution of the edema problem and control of the dysethesias is a result of a regualar physical therapy program.

VAERS ID:182304 (history)  Vaccinated:2002-03-01
Age:44.0  Onset:2002-03-03, Days after vaccination: 2
Gender:Female  Submitted:2002-03-04, Days after onset: 1
Location:Mississippi  Entered:2002-03-13, 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:
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)SANOFI PASTEUR0517AA1IMRA
Administered by: Military     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site inflammation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The injection site became inflamed, reddened, and induration on 03/03/2002 and the vaccine was administered two days prior.

VAERS ID:182328 (history)  Vaccinated:2000-08-11
Age:44.0  Onset:2000-08-11, Days after vaccination: 0
Gender:Female  Submitted:2002-03-07, Days after onset: 573
Location:Maryland  Entered:2002-03-13, 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: Lipitor, Pulmicort, Premarin, gemfibrozil, serevent
Current Illness:
Preexisting Conditions: concurrent conditions: astma, migraine
Diagnostic Lab Data:
CDC 'Split Type': WAES01011441
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.632392/1378J1IM 
Administered by: Private     Purchased by: 0
Symptoms: Diarrhoea, Dizziness, Fatigue, Headache, Mental impairment, Migraine, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Information has been received from a health professional concerning a 44 year old Caucasian female with no known drug allergies and with asthma and migraines. On 10-JUL-2000, 11-Aug-2000 and 11-JAN-2001, the patient was vaccinated with a first (632392/1378J), second 1632392/1378J) and third (635178/0473K) dose of hepatitis vaccine recombinant (yeast), respectively, in the left deltoid intramuscularly. Concomitant medications include atorvastatin calcium (Lipitor), conjugated estrogens (Premarin), budesonide (Pulmicort), salmetrol xinafoate (Serevent), and gemfibrozil. On 11-Aug-2000, after the second dose was administered, the patient experienced body aches and headaches, but felt better the next day. On 11-Jan-2001 after the third dose, the patient developed a headache, bodyache, dizziness and fatigue in the evening and went to bed. The following day 12-Jan-2001, the patient still felt sick and had nausea with diarrhea that lasted for one day. The third day after vaccination the patient still felt sick. The reporter stated on 17-JAN-2001 that it is now five days later, and symptoms persist. On 20-Jan-2001, the patient stated that she felt "nauseated and dizzy, but the body aches have gone and the headaches are no longer with me". On 26-Jan-2001, the patient described symptoms as: "my head feels as if it is going to explode. I am dizzy, nauseated , and tried to remember my phone number, but had look it up" On 31-JAN-2001, the patient was "feeling much better" and felt that the symptoms were a "combination of Hep shot, the flu and migraine. The patient sought unspecified medical attention. No further information is expected

VAERS ID:182398 (history)  Vaccinated:2001-05-23
Age:44.0  Onset:2001-07-13, Days after vaccination: 51
Gender:Female  Submitted:2002-03-07, Days after onset: 237
Location:Unknown  Entered:2002-03-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES01072136
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Neuropathy, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad)
Write-up: Information has been received from a physician concerning a 44 year old female with intervertebral disc disorder. On 04/18/2001, the pt was vaccinated with hep b vaccine recombinant, polio, diphteria, tetanus and hep a. On 05/323/2001, the pt was vaccinated with the second dose hep b vaccine. On 07/13/2001, the p developed generalize sensory neuropathy described as

VAERS ID:182402 (history)  Vaccinated:2001-07-26
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2002-03-07
Location:Missouri  Entered:2002-03-13, 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: UNK
Current Illness: UNK
Preexisting Conditions: NONE
Diagnostic Lab Data: Serum Hepatitis B (negative)
CDC 'Split Type': WAES01072785
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1820K3IMLA
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Hypokinesia, Injection site erythema, Injection site oedema, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a health professional concerning a 44 year old white female with no past medical history and no known drug allergies who received the complete series of Hepatitis B vaccine recombinant (yeast) "sometime in the past". The medical assistant reported that in approximately July 2001, a titer did not detect seroconversion. On 26 JUL 2001, the patient received an additional dose of Hepatitis B vaccine recombinant (yeast) (Lot # 638713/1820K) IM in the left arm. There were no illnesses at the time of vaccination. On 27 JUL 2001, the patient experienced an injection site reaction of redness, tenderness and swelling. The patient also experienced nausea and fatigue. Unspecified medical attention was sought. The medical assistant reported that the patient put aspirin crushed up, mixed with water on her arm "to take the fever out." The patient also put ice on her arm. The patient''s pain and redness lasted approximately five days. Additional information has been requested.

VAERS ID:182413 (history)  Vaccinated:2001-08-24
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2002-03-07
Location:Unknown  Entered:2002-03-13, Days after submission: 6
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES01090501
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0672L3 LA
Administered by: Private     Purchased by: Other
Symptoms: Cognitive disorder, Confusional state, Dizziness, Dyspnoea, Hypoaesthesia, Musculoskeletal stiffness, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: Information has been received from a registered nurse concerning a 44 year old female hospital employee who in approximately august 2001 experienced a lack of response after being vaccinated with a series of hep b vaccine recombinant. On 08/24/2001, the pt was vaccinated in the left arm with a booster dose of hep b vaccine recombinant. Subsequently, the pt developed shortness of breath, a fever of 99.4 F, confusion, change in cognitive status, lightheadedness and nausea. It was reported that pt also had numbness in her left arm. The pt was taken to the ER and was treated with an IV antihistamine. It was noted that the pt was not hospitalized. She was released from the ER. Subsequently, the pt recovered from shortness of breath, fever of 99.4 F, confusion, change in cognitive status, lightheadedness, nausea and numbness in left arm. It was reported that "now her only complaints are some alteration in cognitive status (some forgetfulness) and tightness and pressure in her neck." It was noted that her physician had her on restricted work, with no lifting allowed. Additionally, pt''s alteration in cognitive status and tightness and pressure in her neck persisted. The pt''s shortness of breath was considered by the reporter to be immediately life threatening. The tightness and pressure in her neck was considered by the reporter to be disabling. Additional info has been requested.

VAERS ID:182943 (history)  Vaccinated:1999-10-07
Age:44.0  Onset:0000-00-00
Gender:Male  Submitted:2005-01-25
Location:Unknown  Entered:2002-03-28, Days after submission: 1034
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin trihydrate, Gaviscon, and omeprazole (Prilosec), Codeine, Paraecetamol, Cephalexin, Rynatan (Chlorpheniramine tannate + Mepyramine tannate + Phenylephrine tannate) Lansoprasole.
Current Illness: UNK
Preexisting Conditions: *The medical history included allergy to chocolate, undescended testicle, hernia, hemorrhoids, scintillating scotomas, atypical URI, sinusitis, bronchitis, shingles (96), chronic fatigue (97), right lumbosacral sprain w/right sciatica (91), and bursitis of the right hip (91). In 1996, the vaccinee experienced visual disturbances, aches and pains in the back of his neck, and dizzy s
Diagnostic Lab Data: HLA-DR4 antigen, 2/9/00, result - absent. Antinuclear antibody, 3/26/01 - 1:40 (ref range, <1:40), pattern: speckled and nucleolar.
CDC 'Split Type': A0361522A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 1 UN
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Hypertonia, Polyarthritis
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (narrow)
Write-up: This report descrives arthritis symptoms in a *44 y.o.* male vaccinee who received Lyme disease vaccine recombinant Ospa. This report was received as part of litigation proceedings *with forwarding of medical records.* *F/UP report on 3/4/03: The medical history included allergy to chocolate, undescended testicle, hernia, hemorrhoids, scintillating scotomas, atypical URI, sinusitis, bronchitis, shingles (96), chronic fatigue (97), right lumbosacral sprain w/right sciatica (91), and bursitis of the right hip (91). In 1996, the vaccinee experienced visual disturbances, aches and pains in the back of his neck, and dizzy spells. The MD''s assessment was "Stress w/psychophysiologic reaction." The vaccinee was hospitalized in 1997 w/paresthesias, headache, and a confusional episode. No Dx was recorded in the MD''s office notes. Testing for HLA-DR4 antigen was negative. Surgical history included tonsillectomy (61), adenoidectomy (61), and correction of undescended testicle surgery and hernia repair (66). Concurrent medications included amoxicillin, alginic acid/ sodium bicarbonate/ magnesium trisilicate (Gaviscon), and omeprazole (Prilosec).* The vaccinee *received his 1st and 2nd injections of LYMErix on 9/10/99 and 10/7/99, respectively. On 2/14/02,* in a statement of injuries, his attorney alleged that the vaccinee "suffers from arthritis symptoms all over his body, including joint pain in his fingers and hands, and severe joint pain in his right shoulder." Time to onset following immunization, treatment, and outcomes of the alleged events were not reported. The adverse events "arthritis symptoms" and "joint pain" do not meet serious criteria, but are being submitted as an adverse event by special FDA per the June 28, 2000 letter. *The following info was obtained from medical records. The vaccinee telephone his MD on 2/2/00 and reported that he had experienced joint stiffening since receiving LYMErix. He requested to be tested for the presence of HLA-DR4 antigen. Testing on 2/9/00 was negative. Please see Lab Data sect

VAERS ID:183106 (history)  Vaccinated:2002-03-25
Age:44.0  Onset:2002-03-25, Days after vaccination: 0
Gender:Female  Submitted:2002-03-28, Days after onset: 3
Location:Washington  Entered:2002-04-03, 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: Upper Resp. Infecton
Preexisting Conditions: Fibramyalgia, IBS (irritable bowel syndrome), asthma
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER4018029   
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER1050L0 RA
Administered by: Other     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Started warm painful right arm noticed, painful to left arm up painful to touch, ached all over but is resolving now.

VAERS ID:183267 (history)  Vaccinated:2002-03-27
Age:44.0  Onset:2002-03-28, Days after vaccination: 1
Gender:Female  Submitted:2002-03-28, Days after onset: 0
Location:Utah  Entered:2002-04-09, 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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV048B2SCLA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Injection site erythema, Injection site hypersensitivity, Injection site inflammation, Injection site reaction, Malaise, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: The pt developed a local reaction (quarter in size) to left upper arm where the vaccine was given. Hot, red and tender to the touch, systemic-complaints of general malaise, aches, nausea and chills, Afebrile.

VAERS ID:183307 (history)  Vaccinated:2001-05-03
Age:44.0  Onset:2001-05-03, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Maine  Entered:2002-04-09
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Premarin, Atenolol
Current Illness:
Preexisting Conditions: High Blood Pressure
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS145A90IMLA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Chills, fever nausea, aches, starting 2 hours after injection.

VAERS ID:184175 (history)  Vaccinated:2002-02-28
Age:44.0  Onset:2002-03-13, Days after vaccination: 13
Gender:Female  Submitted:2002-04-22, Days after onset: 39
Location:New York  Entered:2002-04-22
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: No Known Drug Allergies Food allergy (cherries) = rash
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0601L0IM 
Administered by: Public     Purchased by: Unknown
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: "burning, swelling, tingling and numbness" in both hands and both knees.

VAERS ID:184174 (history)  Vaccinated:2002-04-09
Age:44.0  Onset:2002-04-09, Days after vaccination: 0
Gender:Female  Submitted:2002-04-29, Days after onset: 20
Location:California  Entered:2002-04-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dilantin
Current Illness: None
Preexisting Conditions: Seizure Disorder
Diagnostic Lab Data: Tests were not conducted. Dr. advised to return to offices if symptoms did not decrease. The infection apprears to have been treated successfully; however, any damage to internal organs is unknown.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURUNKNOWN1IMGM
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Tetanus (Td) vaccine was administered by Nurse on Duty in left buttock on 04-09-02. Within hours, pain was experienced in groin area and continued to worsen, with reddening and swelling (from crotch area to hip). Streaking appreared around point of injection; Patient returned to offices on 04-12-02. Doctor treated infection with Cephalexin 500mg caps Generic Keflex.

VAERS ID:184278 (history)  Vaccinated:2002-04-18
Age:44.0  Onset:2002-04-18, Days after vaccination: 0
Gender:Female  Submitted:2002-04-29, Days after onset: 11
Location:Nebraska  Entered:2002-05-07, 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:
Current Illness: NONE
Preexisting Conditions: Allergy to Morphine, codeine and epinephrine
Diagnostic Lab Data: Titer prior to injection showed immune less that ten.
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Other
Symptoms: Chest pain, Headache, Hyperhidrosis, Laboratory test abnormal, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: Headache, fever, sweats, nausea and severe chest pain with vomiting X 48 hours. Contacted employee health 2 to 2 1/2 hours after receiving injection. Still have some nausea and vomiting bile. Had TD/Aventis Pasteur on 11/24/01.

VAERS ID:184336 (history)  Vaccinated:2002-04-26
Age:44.0  Onset:2002-04-28, Days after vaccination: 2
Gender:Female  Submitted:2002-05-01, Days after onset: 3
Location:Kentucky  Entered:2002-05-08, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE known
Diagnostic Lab Data: NONE
CDC 'Split Type': KY2002014
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DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM543A24IMLA
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURUO1793SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0745L1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: No Fever, no pain in ER 04/28/2002. Redness, edema, itching over upper arm (Noncircumferential). Good capillary refill distally. Strong medial and radial pulses. Doctor reports reaction to pertussis of DTaP. Benadryl , continue cool compresses. Child not to receive pertussis anymore.

VAERS ID:184640 (history)  Vaccinated:1997-09-09
Age:44.0  Onset:1997-10-27, Days after vaccination: 48
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:2002-05-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Xanax
Current Illness: Cut (right hand)
Preexisting Conditions: Injury NOS
Diagnostic Lab Data: Rheumatoid factor-increased
CDC 'Split Type': HQ4396108AUG2001
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TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES447412 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Alopecia, Back pain, Cough, Dyspnoea, Epistaxis, Influenza like illness, Lymphadenopathy, Muscle spasms, Neck pain, Rheumatoid factor, Vision blurred
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Arthritis (broad)
Write-up: Information has been received on 08/07/2001 from a consumer. On 09/09/1997, the 44 year old male pt received an injection of TD vaccine following a cut to her right hand. On 10/27/1997, the pt experienced a "stabbing pain in the middle of her back that radiated up the right side of her shoulder blade and neck with muscle spasms." Since that time, the pt has experienced hair loss, blurred vision, enlarged lymph nodes, flu-like symptoms, shortness of breath, cough, and nasal bleeding.

VAERS ID:185315 (history)  Vaccinated:2002-04-08
Age:44.0  Onset:2002-04-08, Days after vaccination: 0
Gender:Female  Submitted:2002-05-16, Days after onset: 38
Location:Unknown  Entered:2002-05-24, 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: Obesity
Diagnostic Lab Data: 4/23/02: measles titer-results pending; ESR-elevated; WBC-nml; CRP-elevated
CDC 'Split Type': WAES0204USA02582
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MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.0531L SCRA
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema, Injection site oedema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Initial and follow-up info has been received from a nurse practitioner concerning a "healthy," obese female pt who was vaccinated with measles virus vaccine SC on 04/08/2002. The pt had no previous past medical history of problems with vaccines, had a negative measles titer and was immunized on 04/08/2002 with measles vaccine. On 04/16/2002, the pt first noted redness on her right arm. On 04/17/2002, the pt called the office complaining of redness at the injection site and called the office again later that day, reporting that the redness was worsening. On 04/18/2002, the pt notified the office that the injection site was not improving and was assessed by the nurse practitioner that same day. The nurse practitioner described the pt''s arm as red, swollen and hot and was diagnosed with a large, suspected cellulitus of the right arm. Dicloxacillin therapy was prescribed for the pt and was instructed to elevate her arm. The pt was scheduled to leave for a trip on 04/20/2002 and she was instructed to cancel her trip due to her arm condition. The pt reported to the nurse practitioner on 04/22/2002 that her erythema was decreasing and she was instructed to continue dicloxacillin therapy. On 04/23/2002, the pt visited the nurse practitioner again and her erythema was worsening. It was redder, and hotter with new areas appearing. The pt had the following lab values performed on 04/23/2002: Measles titer-pending; elevated sedementation rate, normal WBC count; elevated CRP. An HIV test was not performed because the pt had no risk factors. The pt was scheduled to leave for a trip on 04/24/2002; however, she cancelled the trip and the nurse practitioner stated that the airlines refused to refund the pt''s money. The nurse practitioner also stated that the physicians are going to write a letter to get the pt reimbursd for her cancelled trip. The nurse practitioner stated that the pt''s final diagnosis was an atypical measles reaction and the dicloxacilin therapy provided no relief. The nurse practitioner also stated that the pt

VAERS ID:185565 (history)  Vaccinated:2002-05-16
Age:44.0  Onset:2002-05-17, Days after vaccination: 1
Gender:Male  Submitted:2002-05-22, Days after onset: 5
Location:Missouri  Entered:2002-05-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Diet controlled Diabetes
Preexisting Conditions: Diet controlled Diabetes
Diagnostic Lab Data: EMG; exam
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5292A24IMLA
Administered by: Other     Purchased by: Other
Symptoms: Abasia, Asthenia, Guillain-Barre syndrome, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow)
Write-up: On 5/17/02, right leg started feeling weak; on 5/18/02, both legs weak and fell 3 different times and noted weakness of hands; on 5/19/02, legs were getting weaker and grip was getting weaker and fell 4 times. On 5/20/02, weakness increased. Saw company physician and was referred to a Neurologist. Saw the Neurologist on 5/22/02 and was dx''d with Guillain-Barre. Received on 06/11/2003: "Not at this time. The recipient contines to have weakness in all extremities and the treating physician anticipates the recipient will be at maximum medical improvement in May 2005. Due to company police (6 months of leave and 6 months of light duty) the recipient has a possibility of losing his job. He has been with this company for 26 years."

VAERS ID:185628 (history)  Vaccinated:2000-04-26
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2002-05-29
Location:New Jersey  Entered:2002-05-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mylanta, MetroGel, Flonase, Claritin, nasal spray, Cefzil, Advil
Current Illness:
Preexisting Conditions: Acne rosacha; allergic rhinitis; allergy to house grass, trees, dust, iodine, molds, ragweed, dog, dust; gastroesophageal reflux disorder; low backache, sinusitis
Diagnostic Lab Data: Alanine transaminase serum-40U/L; albmin serum-1.3; albumin/globulin atio-1.3; alkaline phosphatase serum-65U/L; aspartate transaminase serum-30U/L; bilirubin direct-0.18mg/dL; bilirubin total-0.87mg/dL; C3 serum-133mg/dL; C4 serum-29.7mg/d
CDC 'Split Type': A0360498A
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 2  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Back pain, Bronchitis, Carpal tunnel syndrome, Dermal cyst, Erythema, Hypokinesia, Muscle spasms, Pain, Sinusitis, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: This report describes cramping and pain of the arms and hands of a 44 year old female who received LYMErix. This report was received as part of litigation proceedings with forwarding of medical records. The medical history included allergies to iodine, trees, grass, ragweed, house dust, dog, molds, and dust mites, for which she received allergy shots. The medical history also included allergy to iodine, seasonal and perennial allergic rhinitis, sinusitis, acne rosacea, gastroesophageal reflux disorder and low back pain treated with chiropractic. Concurrent medications included Mylanta as needed, MetroGel twice daily, Claritin daily, Flonase, nasal spray, Cefzil and Advil. The vaccinee received her third injection of LYMErix on 04/26/2002. In a Statement of Injuries, her attorney alleged that the vaccinee "suffers from pain and cramping in her hands and lower forearms, such that she cannot perform simple tasks such as holding a brush." Time to onset following immunization, treatment, and outcome of the alleged events were not reported. Medical records from the vaccine provider indicated that the vaccinee presented to the physician on 09/14/2000, four months post immunization, seeking a referral to a chiropractor for the treatment of hand and pain. the physician noted, " complains of arthralgia, unable to use thumbs well secondary to pain." On examination, the physician noted "malar rash, tenderness hands equally, increased erythema fingertips." His assessment was "Rule out connective tissue disorder." He prescribed Vioxx, but the vaccinee "refuses meds," she "would like chiropractic referral." Antinuclear antibody titer, anti-double stranded DNA antibody titer, anti-smooth muscle antibody titer, anti-ribonucleoprotein antibody titer and rheumatoid factor were negative. Erythrocyte sedimentation rate, serum complement 3 concentration, and serum complement 4 concentration were within the reference reanges. HLA typing was positive for HLA-B27. The most recent info received on 02/19/2002, did not specify the outcome o

VAERS ID:185662 (history)  Vaccinated:2002-05-21
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2002-05-24
Location:Alabama  Entered:2002-05-30, 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: Electrical shock
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0522AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The pt developed erythema rash post TD vaccination.

VAERS ID:186017 (history)  Vaccinated:2002-05-30
Age:44.0  Onset:2002-05-31, Days after vaccination: 1
Gender:Female  Submitted:2002-06-03, Days after onset: 3
Location:Indiana  Entered:2002-06-04, 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: Prozac, Prevacid, nasacort, Claritin, Lortab
Current Illness:
Preexisting Conditions: Laceration nose, sinus allergies
Diagnostic Lab Data: NONE
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TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURERTD77  LA
Administered by: Other     Purchased by: Other
Symptoms: Discomfort, Injection site erythema, Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The pt developed fever, erythema, discomfort and swelling on left upper arm. Treated with pepcid, steroids, Benadryl and Audptic

VAERS ID:186024 (history)  Vaccinated:2002-04-22
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2002-05-06
Location:California  Entered:2002-06-04, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1479K0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Corneal reflex decreased, Guillain-Barre syndrome, Musculoskeletal stiffness, Paralysis, Polyneuropathy
SMQs:, Peripheral neuropathy (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Demyelination (narrow), Corneal disorders (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad)
Write-up: On 05/06/2002 at 8:30 am phone call received from the daughter of the pt stating that the pt was admitted to the hospital on 05/02/2002 for paralysis from the "neck and below." She also started that the doctor said "the paralysis was due to the MMR vaccine that was given on 04/22/2002." On 05/09/2002 at 3:30pm, spoke with the neurologist and he stated that the pt had Guillain-Barr‚ syndrome with polyneuropathy and diminished reflexes. She complained of severe neck stiffness. The lumbar puncture and MRI results were normal per MD. Dr stated that he informed the family that he would "investigate if the symptoms are related to the MMR vaccine. I never said that it was directly related to the MMR vaccine."

VAERS ID:186995 (history)  Vaccinated:2000-07-25
Age:44.0  Onset:2000-08-26, Days after vaccination: 32
Gender:Female  Submitted:2002-06-11, Days after onset: 654
Location:New York  Entered:2002-06-26, Days after submission: 15
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':
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1  
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Fatigue
SMQs:, Arthritis (broad)
Write-up: Joint pain, fatigue, antibiotics and pain medication were prescribed. I still have the pain and fatigue.

VAERS ID:187034 (history)  Vaccinated:2000-03-18
Age:44.0  Onset:2000-03-28, Days after vaccination: 10
Gender:Male  Submitted:2002-06-24, Days after onset: 817
Location:Mississippi  Entered:2002-06-28, 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: Allergic to shellfish; seasona lenvironmental (grasses, dust)
Diagnostic Lab Data: ANA-positive 1:320 with speckled pattern
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0313SCRA
Administered by: Military     Purchased by: Military
Symptoms: Antinuclear antibody positive, Anxiety, Arthralgia, Autoimmune disorder, Depression, Fatigue, Influenza like illness, Injection site nodule, Insomnia, Mouth ulceration, Myalgia, Pericarditis, Pharyngolaryngeal pain, Systemic lupus erythematosus
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Systemic lupus erythematosus (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Flu-like sx and nodules at injection site post each of 4 anthrax shots. Extreme fatigue, joint pain, muscle pain, pericarditis (that progressed today) post #4 anthrax. Dx with lupus in 2001. In July 2001 pt sought treatment with rheumatologist. His ANA came back as positive with a speckled pattern and he was diagnosed with autoimmune and connective tissue disorder. he was prescribed Flexeril and Celebrex and a decrease in prednisone to 40mg. The Celebrex did not provide relief. Pt also was experiencing a sore throaat and palatal ulcers. He was treated with antibiotics but the symptoms did not resolved. Within few weeks the throat pain reduced but never subsided. The pail will increase on the left side when he has a flare up of symptoms. Shortly after discovering his inability to return to either job he began experiencing sleeplessness, depression and anxiety. Ambien was prescribed for his sleeplessness and he was able to sleep thee full hours per night and awaken feeling rested. Through October and November he was still depressed and the pain had progressed to the point where he could only walk a few days without being exhausted. He began taking Xanax and weaning off Prednisone and stopped taking Ambien. He was officially diagnosed wtih Systemic Lupus Erythematosus in November. He began taking Plaquenil and continued to wean off Prednisone.

VAERS ID:187079 (history)  Vaccinated:2002-05-03
Age:44.0  Onset:2002-05-04, Days after vaccination: 1
Gender:Female  Submitted:2002-05-08, Days after onset: 4
Location:Minnesota  Entered:2002-07-01, Days after submission: 54
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Paxil, Xanax
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1249L1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Lymphadenopathy, Pharyngolaryngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Employee received MMR vaccine. About 22 hrs later noticed swollen neck glands on right, sore throat, fever, headache. Missed two days of work. Is recovering.

VAERS ID:187107 (history)  Vaccinated:1993-09-30
Age:44.0  Onset:1994-09-09, Days after vaccination: 344
Gender:Female  Submitted:2002-06-25, Days after onset: 2846
Location:New Jersey  Entered:2002-07-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: synthroid
Current Illness: NONE
Preexisting Conditions: Herniated disc 1990; poli cyst 1976, hypothyroidism
Diagnostic Lab Data: The reporter has the results of most tests performed since 1998, RF high of 2500 6//01.
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Fatigue, Hypothyroidism, Rheumatoid arthritis, Thyroid disorder
SMQs:, Hypothyroidism (narrow), Hyperthyroidism (broad), Arthritis (narrow)
Write-up: In Sept of 94, began feeling tired. Stubbed toe didn''t heal for 6 months. In Sept of 96, quit smoking, feeling awful. In April 97, thyroid illness-myxedema coma. In following months joint pain. In Feb 98 see rheumatolgoist. RA confirmed 12/98. Still have rheumatoid arthritis.

VAERS ID:187147 (history)  Vaccinated:2002-05-18
Age:44.0  Onset:2002-05-19, Days after vaccination: 1
Gender:Female  Submitted:2002-05-22, Days after onset: 3
Location:Pennsylvania  Entered:2002-07-02, Days after submission: 41
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':
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HEPA: HEP A (VAQTA)MERCK & CO. INC.1569L   
MEN: MENINGOCOCCAL (MENOMUNE)SANOFI PASTEURUB124AA   
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEUR40519AA   
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURT12292   
Administered by: Military     Purchased by: Unknown
Symptoms: Asthenia, Body temperature increased, Eye inflammation, Fatigue, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Corneal disorders (broad), Hypersensitivity (narrow)
Write-up: Hives on trunk and neck next day Sunday. Tiredness, weakness, burning eyes, and feverish on Monday.

VAERS ID:187312 (history)  Vaccinated:2002-07-07
Age:44.0  Onset:2002-07-07, Days after vaccination: 0
Gender:Male  Submitted:2002-07-08, Days after onset: 1
Location:Virginia  Entered:2002-07-09, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: No Known
Diagnostic Lab Data: NONE/will not administer JAE #3.
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JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESEJN209A1SC 
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Developed rash,below site right arm. Rash- antecubital site on left arm-complained of pruitus.

VAERS ID:187377 (history)  Vaccinated:2002-03-21
Age:44.0  Onset:2002-03-21, Days after vaccination: 0
Gender:Female  Submitted:2002-04-15, Days after onset: 24
Location:Colorado  Entered:2002-07-10, Days after submission: 86
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Soma, Nexium, Serzone
Current Illness: NONE
Preexisting Conditions: Fibramyalgia, kidney stones, rosia hyper hipodemia
Diagnostic Lab Data:
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1497L2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Malaise, Pelvic pain
SMQs:
Write-up: When I received the first shot I had body and joint aches but did not connect the two and not on the second shot. There was a point where I wondered if maybe it was the shot but after the third shot, there was no doubt in my mind my hip was affected and I felt very sick that night and next day am still having trouble.

VAERS ID:187574 (history)  Vaccinated:2001-08-21
Age:44.0  Onset:2001-08-26, Days after vaccination: 5
Gender:Female  Submitted:2002-05-30, Days after onset: 277
Location:Unknown  Entered:2002-07-15, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium (unspecified) and multivitamins (unspecified)
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': WAES01090487
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0598L SC 
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from an NP concerning a 44 year old female pt with no known allergies and no significant past medical history who on 8/21/01 was vaccinated with a dose of MMRII (lot 638599/0598L). Concomitant therapy included calcium (unspecified) and multivitamins (unspecified). On 8/26/01, between 04:00 and 06:00, the pt developed a rash characterized by welts and hives from the neck down. It was noted that there were no welts on her face. The pt took Benadryl and reported that the welts went away. During the nights of 9/3/01 and 9/4/01, the rash appeared again. Once again, the pt took Benadryl and the rash remitted. It was noted that the pt was experiencing fewer patches with each reaction and that the rash was decreasing in severity each time it appeared and that the welts were getting smaller. The pt reported that she had changed nothing in her habits. Unspecified medical attention was sought. No further information was available. Additional information has been requested.

VAERS ID:187776 (history)  Vaccinated:2002-07-09
Age:44.0  Onset:2002-07-10, Days after vaccination: 1
Gender:Female  Submitted:2002-07-11, Days after onset: 1
Location:California  Entered:2002-07-19, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEUR40319AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pruritis, erythema, swelling, soreness in arm at injection site 3cm from area raised welt . Benedryl.

VAERS ID:188029 (history)  Vaccinated:2002-01-28
Age:44.0  Onset:2002-01-28, Days after vaccination: 0
Gender:Female  Submitted:2004-05-28, Days after onset: 850
Location:New York  Entered:2002-07-24, Days after submission: 674
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Elavil, Flovent (microgm), Maxair (puff), Aciphex (mg), Maxalt (Rizatriptan Benzoate)
Current Illness: Abdominal pain lower; Arthralgia; Lethargy; Paraesthesia; Vomiting NOS; Visual disturbance NOS; Ringing in ears; Nausea; Gastro-
Preexisting Conditions: Asthma NOS; Fibromyalgia; Ear pain; Temporomandibular joint disorder NOS;Abdominal pain lower; Arthralgia; Lethargy; Paraesthesia; Vomiting NOS; Visual disturbance NOS; Ringing in ears; Nausea; Gastro-oesophageal reflux disease; Fibromyalgia,
Diagnostic Lab Data: CBC, ESR, CPK, Platelet aggregation and serum creatine kinase-all wnl; Blood pressure (03/08/2002): 139/8; Blood pressure (03/15/2002): 118/7; Blood pressure (03/22/2002): 129/6; Neurological examination (03/08/2002): "grossly intact";
CDC 'Split Type': WAES0203USA00984
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.6401381064L0SC 
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Feeling abnormal, Laboratory test abnormal, Lethargy, Tinnitus, Visual disturbance
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Arthritis (broad)
Write-up: Information has been received from a physician concerning a 44 year old female with asthma and fibromyalgia who on 2/14/02 and on 3/5/02 was vaccinated with a 1st and 2nd dose of MMRII. Subsequently, after the 1st dose, the pt reported "feeling differently" and developed arthralgia, vision problems, lethargy and ringing of ears. It was noted that, after the 2nd dose, the pt had a worsening of these symptoms. The physician had done sedimentation rates, CBC, CPK and had ruled out thrombocytopenia, with the pt''s platelets within normal range. The physician told the pt to call if she feels worse and prescribed a non-steroidal anti=inflammatory (rofecoxib). Additional info has been requested. Reported on 06/04/2003: "Information has been received from a physician concerning a 44 year old female with a history of right ear pain (otitis media), temporomandibular joint disorder, abdominal pain, asthma and fibromyalgia who on 01/28/2002 (previously reported as 02/14/2002) and on 03/05/2002 was vaccinated with a first and second dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation), respectively. The patient had been taking glycopyrrolate (Robinul 2mg TID) and rabeprazole sodium (Aciphex 20mg). Subsequently, after the first dose, the patient reported "feeling differently" and developed arthralgia (multiple joint pains), vision problems (blurred double vision), lethargy, ringing or ears, and paresthesias of upper and lower extremities. It was noted that, after the second dose, the patient had a worsening of these symptoms. The physician had done sedimentation rates, CBC, CPK and had ruled out thrombocytopenia, with the patient''s platelets within normal range. On 03/08/2002 the patient was seen in the physician''s office for evaluation of symptoms. The patient felt ill and complained of some nausea. The vital signs were reported to be BP 139/81, P 113, R 16 and had a body temperature of 96.9 deg F. The patient''s body weight was reported to be 107lbs. The l

VAERS ID:188030 (history)  Vaccinated:2002-02-13
Age:44.0  Onset:2002-02-23, Days after vaccination: 10
Gender:Female  Submitted:2002-05-30, Days after onset: 95
Location:Florida  Entered:2002-07-24, Days after submission: 55
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: Temp-2/26/02-98.2F
CDC 'Split Type': WAES0203USA01480
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0902L SC 
Administered by: Public     Purchased by: Private
Symptoms: Fatigue, Lymphadenopathy, Neck pain
SMQs:, Arthritis (broad)
Write-up: Information has been received from an NP concerning a 44 year old Caucasian female with no past medical history and no illness at the time of vaccination, who on 2/13/02, was vaccinated, SC, in the left arm, with a dose of MMRII (lot 639695/0902L). There was no concomitant medication. On 2/23/02, the pt experienced increased fatigue. On 2/25/02, the pt noticed neck swelling with palpable, slightly tender, anterior cervical nodes bilaterally and tender palpable posterior cervical nodes. The pt was afebrile, with a temperature of 98.2F on 2/26/02, when seen in the employee health. Additional info has been requested. Reported on 06/04/2003: "Follow-up information indicated that the patient subsequently recovered. Additional information has been requested. "

VAERS ID:188328 (history)  Vaccinated:2002-07-23
Age:44.0  Onset:2002-07-23, Days after vaccination: 0
Gender:Female  Submitted:2002-07-26, Days after onset: 3
Location:Ohio  Entered:2002-08-02, 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:
CDC 'Split Type':
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0523AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, 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: Left deltoid with softball sized erythematous area warm to the touch. no skin breakdown present. cellulitis, No anaphylaxis.

VAERS ID:188460 (history)  Vaccinated:2001-12-05
Age:44.0  Onset:2001-12-06, Days after vaccination: 1
Gender:Female  Submitted:2002-07-30, Days after onset: 235
Location:Unknown  Entered:2002-08-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unk
Current Illness:
Preexisting Conditions: Unk
Diagnostic Lab Data: Temperature 100 degrees F
CDC 'Split Type': WAES01120688
Vaccination
Manufacturer
Lot
Dose
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0994L IM 
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Feeling hot, Injection site erythema, Injection site oedema, Injection site reaction, Pyrexia, Tenderness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a physician concerning a 44 year old White female who on 12/5/01 at 5:00 pm was vaccinated IM with pneumococcal 23 polyvalent (lot # 640744/0994L). On 12/6/01 at 3:00 pm, the patient developed a fever of 100 degrees F, and an injection site reaction that included erythema to the left deltoid, edema, warmth, and cellulitis. It was also reported that the area was tender to touch. The patient subsequently recovered from the erythema, edema, tenderness, and fever. The outcome of the injection site warmth and cellulitis was unknown. Unspecified medical attention was sought. No further information is expected.

VAERS ID:188540 (history)  Vaccinated:2001-06-19
Age:44.0  Onset:2001-06-25, Days after vaccination: 6
Gender:Female  Submitted:0000-00-00
Location:North Carolina  Entered:2002-08-07
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK;Hep B (unknown mfr);;0;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: back injury 1998
Diagnostic Lab Data: HIDA scan; 2 Transjagular biopsy-the microscopic sections show multiple fragmented pieces of liver parenchyma, most of which show moderate to severe periportal/interface hepatitis consisting of lymphocytes and plasma cells. There are also o
CDC 'Split Type':
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0360L1  
Administered by: Other     Purchased by: Other
Symptoms: Eye disorder, Hepatitis, Hiatus hernia, Injection site fibrosis, Jaundice, Laboratory test abnormal, Oedema, Pruritus, Pyrexia, Rash
SMQs:, Cardiac failure (broad), Cholestasis and jaundice of hepatic origin (narrow), Hepatitis, non-infectious (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow)
Write-up: Fever, rash, itching, jaundice, swelling of stomach and feet. Eyes every yellow. Now have chronic hepatitis autoimmune liver disease. Acute necrosis. Take acute necrosis out, term should be advanced fibrosis. add: ulcett, hiatal hernia.

VAERS ID:188598 (history)  Vaccinated:2002-07-17
Age:44.0  Onset:2002-07-26, Days after vaccination: 9
Gender:Female  Submitted:2002-07-30, Days after onset: 4
Location:Pennsylvania  Entered:2002-08-07, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0023M0SCLA
Administered by: Military     Purchased by: Other
Symptoms: Anorexia, Back pain, Headache, Irritability, Malaise, Myalgia, Neck pain, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: 9 days, post vax, fever to 100.8F, left axilla pain, neck and back pain, malaise, anorexia, irritable, myalgias and headache. On 8/1/02, symptoms resolved.

VAERS ID:188961 (history)  Vaccinated:2002-07-25
Age:44.0  Onset:2002-07-25, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Minnesota  Entered:2002-08-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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TTOX: TETANUS TOXOID (NO BRAND NAME)AVENTIS PASTEURU0521AA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Eye pain, Injection site swelling, Injection site warmth, Oral intake reduced, 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), Glaucoma (broad), Hypersensitivity (broad)
Write-up: On 7/29/02, pt reports arm swelled to twice it''s normal size the day after shot. Had fever and was unable to eat over the weekend. Eyes hurt and had itchy face. Slept OK last night (7/28/02) and back to eating normally. Right arm no longer swollen but still a bit warm to the touch. No fever. Eyes and face feel normal now.

VAERS ID:189305 (history)  Vaccinated:2002-08-06
Age:44.0  Onset:2002-08-06, Days after vaccination: 0
Gender:Male  Submitted:2002-08-20, Days after onset: 14
Location:Maine  Entered:2002-08-26, 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: Ibuprofen, glucosmine, chondroitin
Current Illness: NONE
Preexisting Conditions: Hypertension, arthritis-HTN under stress-
Diagnostic Lab Data: Cardiac work up, echocardiogram, serial enzymes, treadmill stress test, EKG, cardiac monitoring.
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1214L SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient received MMR @0730 on 08/06/2002 at 13:30, patient fainted, fell, and lacerated head and right elbow. Seen in ER, suture of lacerations done. Cardiac work up consisting of treadmill stress test, echocardiogram, serial enzymes, EKG x3, continuous cardiac monitoring done while patient was admitted on cardiac floor overnight for observation. Patient did not have a cardiac event as all testing was WNL. Physicians question of patient had an adverse event from MMR. Reports his daughter had similar episode after receiving MMR vaccine. Discharge Summary states diagnosis is Syncope.

VAERS ID:190046 (history)  Vaccinated:1999-05-19
Age:44.0  Onset:0000-00-00
Gender:Male  Submitted:2002-09-09
Location:New Jersey  Entered:2002-09-11, 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: Lisinopril, Aspirin, Azenolol, Orlistat, Itraconazole
Current Illness: UNK
Preexisting Conditions: Low back pain treated with chiropractic, onychomycosis "for years," hypercholesterolemia, hypertension, right bundle branch block (1996), premature ventricular contractions, and nonsustained ventricular tachycardia
Diagnostic Lab Data: Ach receptor binding antibody-0.1mmol/L; Ach receptor blocking antibody-7%. 9/11/00 nerve conduction studies-repetitive nerve stimulation studies of the right median and spinal accessory nerves were normal. There was no decrement at rest or
CDC 'Split Type': A0357445A
Vaccination
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Lot
Dose
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Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS120B91IM 
Administered by: Other     Purchased by: Other
Symptoms: Myasthenic syndrome, Skin burning sensation
SMQs:, Peripheral neuropathy (broad), Malignancy related conditions (narrow)
Write-up: Report A0357445A (formerly 2002000880-1) describes myasthenia gravis in a 44 year old male who received LYMErix. This report was received as part of litigation proceedings, with forwarding of medical records. Medical history included chronic low back pain treated with chiropractic, onychomycosis "for years," hypercholesterolemia, hypertension, right bundle branch block (1996), premature ventricular contractions, and nonsustained ventricular tachycardia. Concurrent medications included Zestril 20mg daily, acetylsalicylic acid 80mg daily, atenolol 20mg daily, Xcnical, and Sporanox. On 2/11/02, in a Statement of Injuries, the vaccinee''s attorney alleged that the vaccinee "has been diagnosed with ocular myasthenia gravis, an autoimune condition which involving (sic) loss of muscular use in and around his left eye, resulting in a full-time "drooping" of that eye. In addition, the vaccinee suffers a painful burning sensation in the muscle of his thighs, whenever he stands for any length of time." Following the reported onset of myasthenia gravis, the vaccinee developed plagues on his knees and elbows that were "suggestive of psoriasis," and fatty infiltration of the liver. These events were not reported as adverse events due to vaccine administration, but were found during the course of review of the vaccinee''s medical records. Therefore, they are not listed as adverse events. The vaccinee received his first and second injections of LYMErix on 4/23/99 and 5/19/99, respectively. Both injections were from lot LY120B9. An unspecified time post-immunization, he awoke with left eye ptosis. He placed a patch over his right eye in an unsuccessful attempt to strengthen his left eyelid. The ptosis persisted when he received his third injection of lYMErix on 4/20/00. He was referred to a neuro-ophthalmologist. The vaccinee was seen by the neuro-ophthalmologist on 8/23/00. The physician wrote that the vaccinee "states that one year ago he woke up and noted left eye ptosis. He notes that with fatigue the lid drooop is accentuated.

VAERS ID:190223 (history)  Vaccinated:2002-08-15
Age:44.0  Onset:2002-08-16, Days after vaccination: 1
Gender:Female  Submitted:2002-08-19, Days after onset: 3
Location:California  Entered:2002-09-17, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
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TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)SANOFI PASTEUR40516AA0 LA
Administered by: Military     Purchased by: Military
Symptoms: Back pain, Erythema, Fatigue, Headache, Injection site inflammation, Injection site mass, Neck pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Lump in arm, headache, fever 101 for 2 days. Back and neck aches. Fatigue for 5 days. Arm red, swollen and inflamed and sore. Follow up 8/26/02. Patient complained of small, painless lump size of marble. No other symptoms.

VAERS ID:190466 (history)  Vaccinated:2002-08-19
Age:44.0  Onset:2002-09-04, Days after vaccination: 16
Gender:Female  Submitted:2002-09-13, Days after onset: 9
Location:Michigan  Entered:2002-09-23, 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:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0341M1SC 
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash around 21 days. Fluid drained from knee 09/04/2002.

VAERS ID:190550 (history)  Vaccinated:2002-09-09
Age:44.0  Onset:2002-09-09, Days after vaccination: 0
Gender:Female  Submitted:2002-09-16, Days after onset: 7
Location:Alabama  Entered:2002-09-24, 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: Captopril 50mg qd, Clanidine bid
Current Illness: NONE
Preexisting Conditions: Sulfa drugs, HTN
Diagnostic Lab Data: NONE
CDC 'Split Type': AL0222
Vaccination
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Site
TTOX: TETANUS TOXOID (NO BRAND NAME)AVENTIS PASTEURU0524AA  LA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Injection site erythema, Injection site oedema, Injection site pain, Musculoskeletal stiffness, Nausea
SMQs:, Acute pancreatitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Pt reports after receiving shot applied alcohol after getting home noticed after she would apply alcohol arm was getting sore, felt warm and started to swell. Dr presentation to clinic Lt arm at injection site red, edematous. Pt also reports back on neck sore and stiff with HA''s started post being immunized also c/o nausea. Pt instructed if symptoms change or worsen to RTC.

VAERS ID:191422 (history)  Vaccinated:2002-10-15
Age:44.0  Onset:2002-10-15, Days after vaccination: 0
Gender:Female  Submitted:2002-10-15, Days after onset: 0
Location:New Jersey  Entered:2002-10-17, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE304126A1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Apnoea, Back pain, Coma, Convulsion, Eye movement disorder, Feeling hot, Hyperhidrosis, Pallor, Pulse absent, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Gave .5cc of flu vaccine left deltoid at 09:30. Asked patient to remain in medical 5-10 minutes. 09:35 Patient complained of being hot. Advised to remove outer sweater (had on turtleneck under sweater). 09:37 Color pale turned ashen, slumped in chair to right side, eyes rolled to back of head, started to seize, back ache. Jacksonian movements noted of arms and legs. Patient supported. Called across hall to maintenance. Call 911. Gently patted face calling name. Ceased breathing; Carotid pulse absent. Eased to floor. Color: deep red; in progress of starting CPR. Head back; airway patent. Patient woke up coherent. 09:55 About 3-4 minutes unresponsive. BP 124/80. A 48 reg. 911 responded and taken to hospital via ambulance.

VAERS ID:191573 (history)  Vaccinated:2002-10-08
Age:44.0  Onset:2002-10-10, Days after vaccination: 2
Gender:Female  Submitted:2002-10-17, Days after onset: 7
Location:Washington  Entered:2002-10-21, 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: Estrost BCP, Zyrtec, Valtrex
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0816AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site mass, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen red painful "quarter-sized" lump persisting x several days.

VAERS ID:191578 (history)  Vaccinated:2002-09-11
Age:44.0  Onset:2002-09-13, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:Washington  Entered:2002-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Paxil
Current Illness: NONE
Preexisting Conditions: IVP dye/hiatal hernia/renal cell Ca resection
Diagnostic Lab Data: EMG/NCV=demyelinating neuropathy c/w Guillain-Barre syndrome. Spine films nl, bone scan (-) spinal lesions.
CDC 'Split Type':
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Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM724B61IM 
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD  PO 
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Guillain-Barre syndrome, Hypoaesthesia, Muscular weakness, Neuropathy
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow)
Write-up: 09/13/02 back pain (persistent). 9/2/02 numbness L thumb. Approximately 9/26/02 both hands and feet numb; face pain. Approximately 10/10/02 weakness both hands. 10/14/02 weakness? stable/no leg weakness. EMG/NCV=demyelinating neuropathy c/w Guillain-Barre syndrome

VAERS ID:191815 (history)  Vaccinated:2001-11-05
Age:44.0  Onset:2001-11-07, Days after vaccination: 2
Gender:Female  Submitted:2002-03-08, Days after onset: 121
Location:Florida  Entered:2002-10-23, Days after submission: 228
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: Past Medical History-pre cancerous lesions of the left breast.
Diagnostic Lab Data:
CDC 'Split Type': U200101132
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO671EA  LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Lymphadenopathy, Pain
SMQs:
Write-up: It was reported that a 44 year old female patient received a Fluzone SV ''01-''02 vaccination administered in left deltoid. The patient reported 11/07/01, she developed swollen lymph nodes that became painful. A physician evaluated patient and it was felt that the patient had lymphadenopathy with possible lymphadenitis. No treatment prescribed resolved.

VAERS ID:191829 (history)  Vaccinated:2001-11-05
Age:44.0  Onset:2001-11-05, Days after vaccination: 0
Gender:Male  Submitted:2001-12-26, Days after onset: 51
Location:Unknown  Entered:2002-10-23, Days after submission: 300
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': U200101161
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO694AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Hyperhidrosis, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: It was reported that a 44 year old male patient received a Fluzone SV vaccination Lot # UO694AA administered on 11/05/01. Twelve hours later reported the patient developed chills, shaking, aching and sweating. Patient did not return to office for further evaluation.

VAERS ID:191879 (history)  Vaccinated:2001-10-30
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2002-02-07
Location:Virginia  Entered:2002-10-23, Days after submission: 257
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': U200200010
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0677AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Joint range of motion decreased, Pain
SMQs:, Arthritis (broad)
Write-up: From telephone call received at manufacturer on 1/8/02 it was reported that a 44 year old female patient received a Fluzone SV 01-02 vaccination administered on 10/30/01. Somtime after the vaccination (date not specified) the patient developed pain that continues in deltoid area; interferes with range of motion. This event is unresolved.

VAERS ID:192237 (history)  Vaccinated:2002-10-25
Age:44.0  Onset:2002-10-25, Days after vaccination: 0
Gender:Female  Submitted:2002-10-29, Days after onset: 4
Location:Texas  Entered:2002-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft (150 mg/day)
Current Illness: None
Preexisting Conditions: Systemic Lupus Erythematosis
Diagnostic Lab Data: n/a
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE35472HA   
Administered by: Private     Purchased by: Private
Symptoms: Contusion, Fatigue, Headache, Injection site erythema, Injection site oedema, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Day 1: Red, swollen, sore area (circle over 3" in diameter)around the injection point. Day 2: fatigue body achiness, headache, but no fever. Day 4: swelling and redness began to subside somewhat, leaving a large doughnut-shaped green bruise with a reddish interior...and a lot of itching. Day 5 (today): still bruised and itchy.

VAERS ID:192242 (history)  Vaccinated:2002-10-29
Age:44.0  Onset:2002-10-29, Days after vaccination: 0
Gender:Female  Submitted:2002-10-30, Days after onset: 1
Location:Unknown  Entered:2002-10-30
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: general hay fever
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Dyspnoea, Insomnia, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: experienced tachycardia, difficulty sleeping and difficulty breathing. It started within several hours of receiving the vaccination and persisted for more than 24 hours

VAERS ID:192527 (history)  Vaccinated:2002-10-27
Age:44.0  Onset:2002-10-27, Days after vaccination: 0
Gender:Female  Submitted:2002-11-04, Days after onset: 8
Location:Wisconsin  Entered:2002-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO888AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: RECEIVED FLU VACCINE AT 1515 ON 10/27/02, AT APPR 2320 ON 10/27/02 WOKE UP WITH CHILLS FEVER AND BODY ACHES AND PAINS, LASTED THRU 10/29/02

VAERS ID:192570 (history)  Vaccinated:2002-10-24
Age:44.0  Onset:2002-10-24, Days after vaccination: 0
Gender:Female  Submitted:2002-10-27, Days after onset: 3
Location:New York  Entered:2002-11-05, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Allergy to latex
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0910AA0 LA
Administered by: Public     Purchased by: Other
Symptoms: Feeling hot, Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient had dime size area of redness within one hour of injection. 24 hours later was 7cm diameter with warmth; no induration.

VAERS ID:192803 (history)  Vaccinated:2002-10-25
Age:44.0  Onset:2002-10-25, Days after vaccination: 0
Gender:Female  Submitted:2002-11-01, Days after onset: 7
Location:Kentucky  Entered:2002-11-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Altace; Singular; Celebrex; Trileptal; Fibercon; Topomax; Vitamin E; Ecotrin; Multivitamin; Loestrin; Glucophage; Clonidine; Flovent inhaler
Current Illness:
Preexisting Conditions: Diabetes, HBP, IBS, Asthma, Sleep apnea, Neuropathy, Fibromyalgia, Bipolar
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0886AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient reports 10/25/02 18:00 to approximately 23:30, itching all over her body with no rash or fever. 10/26/02 face bright red with rash and itching of face. Face also hot to touch. The rash and itching of face only occurs in the evenings according to the patient. No rash or itching of any other part of her body. Patient has been referred by her doctor to see dermatologist today. 11/1/02.

VAERS ID:192925 (history)  Vaccinated:2002-10-23
Age:44.0  Onset:2002-11-01, Days after vaccination: 9
Gender:Female  Submitted:2002-11-07, Days after onset: 6
Location:Pennsylvania  Entered:2002-11-07
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':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0640IMRA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Diarrhoea, Dry throat, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Patient reported to emergency room at local hospital experienceing diarrhea, dry throat, muscle ache & chest pain. Negative findings. Discharged to home with follow up with PCP 8 Nov 02.

VAERS ID:192930 (history)  Vaccinated:2001-11-06
Age:44.0  Onset:2002-11-06, Days after vaccination: 365
Gender:Male  Submitted:2002-11-08, Days after onset: 2
Location:California  Entered:2002-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I take a multivitamin and mineral supplement daily.
Current Illness: I felt fine,perfectly healthy
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER?0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Chills, Pain, Stomach discomfort, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Flu shot received around 10:15 am (11/6/02). Aches noted by 3:00pm, chills by 4:00pm. Went home early from work. Sour stomach, threw up at midnight. Slept poorly. Tired and achy next day, able to hold down food and worked 4 hours. Never had such a reaction to a flu shot before.

VAERS ID:192999 (history)  Vaccinated:2000-10-22
Age:44.0  Onset:2000-10-22, Days after vaccination: 0
Gender:Female  Submitted:2002-11-08, Days after onset: 747
Location:Florida  Entered:2002-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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RAB: RABIES (IMOVAX)AVENTIS PASTEURT086321IMLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Myalgia, Sluggishness
SMQs:, Rhabdomyolysis/myopathy (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: PT STATED SHE FELT SLUGGISH, HAD SORE MUSCLES, JOINT SORENESS,AND BODY ACHES LASTING FOR 24 HRS. SKIN ALL OVER WAS VERY SORE TO THE TOUCH. TOOK TYLENOL FOR THE DISCOMFORTS.

VAERS ID:193110 (history)  Vaccinated:2002-10-25
Age:44.0  Onset:2002-10-25, Days after vaccination: 0
Gender:Female  Submitted:2002-11-04, Days after onset: 10
Location:Ohio  Entered:2002-11-13, 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:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
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Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0922AA IM 
Administered by: Other     Purchased by: Unknown
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Sore joints in upper arm. Patient also works in meat/deli department. Lifts and slices meats so also wondered if from this. Site looks fine.

VAERS ID:193192 (history)  Vaccinated:2002-11-07
Age:44.0  Onset:2002-11-08, Days after vaccination: 1
Gender:Female  Submitted:2002-11-11, Days after onset: 3
Location:Colorado  Entered:2002-11-13, 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: Lipitor, Prolomax, Prolamarin
Current Illness: NONE
Preexisting Conditions: Tetracychon, sulfa, GERD, hyperlipidemia
Diagnostic Lab Data: B and P; WESR-70
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0875AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Migratory monoarthritis.

VAERS ID:193606 (history)  Vaccinated:2002-11-04
Age:44.0  Onset:2002-11-04, Days after vaccination: 0
Gender:Female  Submitted:2002-11-14, Days after onset: 10
Location:Arkansas  Entered:2002-11-20, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: Recovering from Kidney Infection
Preexisting Conditions: Recent Kidney Infection
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40200080IMLA
Administered by: Other     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up:

VAERS ID:193703 (history)  Vaccinated:2002-10-08
Age:44.0  Onset:2002-10-08, Days after vaccination: 0
Gender:Male  Submitted:2002-10-15, Days after onset: 7
Location:Florida  Entered:2002-11-20, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EKG-tall pisked p-wave
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0874AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Cardiac valve disease, Chest pain, Dyspnoea, Electrocardiogram abnormal, Hot flush, Palpitations, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Within minutes of receiving a flu shot, the pt developed tingling, flushedhands, palpitations, dyspnea and chest and arm pressure. He had been fasting the entire day before and moring of the shot. Brought to the observation room and given oxygen. EKG showed tall pisked p-wave. Pt also had a murmur he denied having in the past or abd EKG-referred to ER. Seen in local ER and referred to cardiologist. EKG at our facility was with tall pisked p-wave-pt had a murmur.

VAERS ID:193743 (history)  Vaccinated:2002-11-04
Age:44.0  Onset:2002-11-05, Days after vaccination: 1
Gender:Female  Submitted:2002-11-14, Days after onset: 9
Location:West Virginia  Entered:2002-11-21, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WV0215
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE34722HA10IMRA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Fatigue, Hot flush, Intestinal ischaemia, Menstruation irregular, Muscular weakness, Paraesthesia oral, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Ischaemic colitis (narrow), Fertility disorders (broad)
Write-up: Weakness 24 hours. Body shakes with standing. Fatigue 10 days after. Chills alternating with hot flashes. Increase BM. Early onset menstraul by 1 week. right roof mouth and right tongue feels burned

VAERS ID:193810 (history)  Vaccinated:2002-11-18
Age:44.0  Onset:2002-11-18, Days after vaccination: 0
Gender:Female  Submitted:2002-11-20, Days after onset: 2
Location:New York  Entered:2002-11-22, 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: Tetracycline, allegra, lipitor, albuterol, detrol, singular, prilosec, benzonatate, adrair
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0358M1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Erythema, Pain
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pneumococcal vaccine given 11/18/02, comes to office 11/20/02 with painful, reddened arm, possible cellulitis, given Augmentin 875mg BID x 10 days.

VAERS ID:193938 (history)  Vaccinated:2002-10-15
Age:44.0  Onset:2002-10-16, Days after vaccination: 1
Gender:Female  Submitted:2002-11-19, Days after onset: 34
Location:Ohio  Entered:2002-11-26, 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: Synthroid, Paxil
Current Illness: NONE
Preexisting Conditions: Asthma, seborrhed/eczema
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE34102HA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypokinesia, Injection site pain, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: One day post immunization: localized pain at injection site, no tx. One week post immunization: decreased ROM in L arm due to increased pain, no redness or swelling, tx with ibuprofen; continued for 5 wks and evaluated 11/19/02. Symptoms and treatment ongoing as of this date.

VAERS ID:194120 (history)  Vaccinated:2002-11-15
Age:44.0  Onset:2002-11-15, Days after vaccination: 0
Gender:Female  Submitted:2002-11-20, Days after onset: 5
Location:North Dakota  Entered:2002-11-27, 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: Penicillin, Codiene, Chronic sinus
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4020034 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0735M0IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 2 hours after vaccine, temp 102 for 4 hours. 24 hours after vaccine hives for 12 hours. Treatment Tylenol and Benadryl.

VAERS ID:194276 (history)  Vaccinated:2002-11-21
Age:44.0  Onset:2002-11-22, Days after vaccination: 1
Gender:Female  Submitted:2002-11-25, Days after onset: 3
Location:Maryland  Entered:2002-12-02, 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
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES31862GA IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0541M0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: Marked cellulitis L arm.

VAERS ID:194431 (history)  Vaccinated:2002-11-14
Age:44.0  Onset:2002-11-15, Days after vaccination: 1
Gender:Female  Submitted:2002-11-20, Days after onset: 5
Location:Minnesota  Entered:2002-12-03, 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: Ativan 0.5 mg last dose 11/19/2002, Synthroid 150 mcg qd
Current Illness: NONE
Preexisting Conditions: Hypothydrodism
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4020022  RA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Dysphonia, Pain
SMQs:, Anticholinergic syndrome (broad), Parkinson-like events (broad), Vestibular disorders (broad)
Write-up: 11/14/2002 Flu shot given. 11/18/2002 Jr stooped at CPHS Toreport that 11/15 at 10:30 while laying in bed felt dizzy for a few seconds and then passed, reported drank glass of colna but that didn''t make the dizzy before. On 11/17 reports she got up at 6:30 and fell back in bed with c/o feeling dizzy, stated she did get up fast 11/18 at 01:00 am states to have gotten up at HS and again felt dizzy, no dizziness in am but reports to have gotten up slowly. No c/o dizziness now or at other times on the weekend. Discussing c/o dizziness from others in the community that had not gotten flu shot, questioned others S+S. c/o hand hurting when riping out some parts also c/o a thickness in voice when talking but no one else noticed this. 11/20/02 TC to JR no home or work. 11/20/2002 TC to manufact reported above, TC message left with manufact to return call. 11/21/2002 TC to JR no c/o dizziness now. Reports by 11/18 felt better after work. Reports hands felt like she had too much salt over weekend had taken ASA qd on Sat- Sun no relief. Did not expand on thickness in speech except felt funny in hand. Again denied any S+S of thick tongue, swollen lips. Encouraged her to call her MD and report everything. She had to me and discuss recommendations for getting that flu shot in the future.

VAERS ID:194607 (history)  Vaccinated:2002-12-02
Age:44.0  Onset:2002-12-03, Days after vaccination: 1
Gender:Male  Submitted:2002-12-05, Days after onset: 2
Location:Texas  Entered:2002-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO ILLNESS
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV 0651SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site hypersensitivity, Injection site oedema, Injection site warmth, Joint stiffness, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Received second shot in series on 2 December 2002. On 3 December 2002 member noticed slight swelling at site with mild temperature at site. 4 December 2002 member noticed increase swelling and redness extending to elbow with associated itching ( members description of itching "Bad"). Member states that when bending arm area is tight. No visible rash.

VAERS ID:194862 (history)  Vaccinated:1999-02-01
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2002-12-05
Location:New York  Entered:2002-12-11, 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: Numerous blood test, spinal tap, bone scan, brain MRI, Ct Scan, EMG''s EEG
CDC 'Split Type':
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS120B9  LA
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Myalgia, Pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Pt was diagnosed with Lyme in Jan 1997 and treated with numerous antibiotics. Aching muscles continued. Received 2 Lyme vaccines in Feb and Mar 1999. Aching muscles, tingling, constant leg pain and weakness got worse since vaccines. Pt suffer these symptoms everyday- constantly. No treatment or doctors has been able to help at all.

VAERS ID:195034 (history)  Vaccinated:2002-12-02
Age:44.0  Onset:2002-12-02, Days after vaccination: 0
Gender:Male  Submitted:2002-12-13, Days after onset: 11
Location:Pennsylvania  Entered:2002-12-13
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: Keflex (antibiotic-hives, nausea following presurgery IV)
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0661SCRA
Administered by: Military     Purchased by: Military
Symptoms: Feeling hot, Injection site mass, Injection site swelling, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Burning sensation and pain radiating up to shoulder-10 minutes. 3 hours later- warmth,pain, swelling at site. 24 hours after vaccination,to present- rash 3" diameter at site (fading) tenderness (fading) skin warmth (gone after 1 week) swelling (gone after 1 week) lump under skin (visible and palpable). Also 2 weeks skeletal/joint pain major joints-shoulders, rt. elbow, hips, knees, cervical and lumbar spine. BACKGROUND: The only reaction from shot #1 was localized pain for 4 days.

VAERS ID:195070 (history)  Vaccinated:2002-12-11
Age:44.0  Onset:2002-12-12, Days after vaccination: 1
Gender:Male  Submitted:1958-12-16, Days after onset: 16067
Location:Texas  Entered:2002-12-17, Days after submission: 16072
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucovance 5 -500 mg Tablet, Lipitor 10 mg, Altace 25
Current Illness: New patient -Diabetic
Preexisting Conditions: Allergic to Amoxicillin, Diabetic, Hypercholestolemia
Diagnostic Lab Data: CBC + CK
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0709M0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Hypokinesia, Injection site pain, Injection site warmth, Malaise, Pain, Peripheral coldness
SMQs:, Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow)
Write-up: Pt woke up midnight with left arm pain could not move arm above shoulder due to pain. Developed malaise pain down the arm. Diarrhea X 1 stool, Left deltoid warm to touch, Coldness in hand, Bilateral ankle joint pain

VAERS ID:195106 (history)  Vaccinated:2002-12-02
Age:44.0  Onset:2002-12-02, Days after vaccination: 0
Gender:Female  Submitted:1958-05-06, Days after onset: 16281
Location:Arizona  Entered:2002-12-17, Days after submission: 16296
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: Augmentin, betadine, tinnutis, took ABx X 9 yrs
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO921CA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Feeling abnormal, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Vestibular disorders (broad)
Write-up: Rapid HR 92, in 4-6 hours after injection. That nite or the next nite, dizziness with turning side to, Head fells fuzzy, Worse after yoga (last nite-not better today.

VAERS ID:195178 (history)  Vaccinated:2002-11-01
Age:44.0  Onset:2002-11-29, Days after vaccination: 28
Gender:Female  Submitted:2002-12-17, Days after onset: 18
Location:Texas  Entered:2002-12-19, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ5676409DEC2002
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4020003 IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Arthritis, Eye oedema, Serum sickness, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: A healthcare professional reported that a 44 year old female received an injection of Flu Shield in November 2002. Subsequently, she developed arthritis, joint pain, arthralgia, and hives. On 11/29/02, she was seen by a physician and a diagnosis of serum sickness was made. Treatment with Celebrex, Vicodin, and Allegra was started. On 12/2/02, she was seen by another physician who confirmed the diagnosis of serum sickness. Celebrex was discontinued and Zantac was added to her therapeutic regimen. No further info was available at the date of this report. This event is considered medically important (OMIC). Additional info was received on 1/13/03, from a physician provided revised symptoms, additional treatment medication, and event outcome. A healthcare professional reported that a 44 year old female received an injection of Flu-shield (2002-2003 Formula) in November 2002. Twenty-four hours post vaccination, she developed right eye swelling (almost swelled shut), which progressed to hives, chills, cough, and joint pain. On 11/29/02, she was seen by a physician and a diagnosis of serum sickness was made. Treatment with Celebrex,, Vicodin, and Allegra was started.On 12/2/02, she was seen by another physician who confirmed the diagnosis of serum sickness. Celebre was discontinued and Zantac was added to her therapeutic regimen. Her symptoms resolved gradually after a course of prednisone. She recovered. This event was considered medically important (OMIC).

VAERS ID:195201 (history)  Vaccinated:2002-11-19
Age:44.0  Onset:2002-11-29, Days after vaccination: 10
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:2002-12-19
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': PJP200200843
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE35822KA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Coma, Hypoaesthesia, Myelitis transverse, Paralysis
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: A report was received from a vaccinee''s family member on 12/10/02 concerning a 44 year old female vaccinee who experienced transverse myelitis 10 days after receiving Fluvirin on approximately 11/19/02. The vaccinee''s past medical history was reported to be unremarkable and no concomitant medication was reported. The vaccinee had never previously received a flu vaccine. On 11/29/02 the vaccinee was hospitalized secondary to loss of the use of both legs, paralysis and numbness below the waist. A neurologist diagnosed the vaccinee with transverse myelitis. It was reported that the vaccinee had good bilateral reflexes and that her muscles were fine, however, the vaccinee could not feel anything in both legs below the waist. It was reported that the vaccinee was being treated by a neurologist and was unresponsive currently to unspecified therapy.

VAERS ID:195235 (history)  Vaccinated:2002-10-29
Age:44.0  Onset:2002-10-30, Days after vaccination: 1
Gender:Female  Submitted:2002-11-08, Days after onset: 9
Location:Maryland  Entered:2002-12-20, Days after submission: 42
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: UNK
Diagnostic Lab Data: NONE
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0710M0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pneumococcal 0.1ml given IM for PPD. Redness 2.5"x1.5". No fever.

VAERS ID:195387 (history)  Vaccinated:2002-12-10
Age:44.0  Onset:2002-12-10, Days after vaccination: 0
Gender:Female  Submitted:2002-12-12, Days after onset: 2
Location:Arizona  Entered:2002-12-26, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0690SCLA
Administered by: Other     Purchased by: Military
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: After receiving immunization patient reported a tingling and burning sensation in her hand. This persisted for 24 hours.

VAERS ID:195404 (history)  Vaccinated:2002-11-05
Age:44.0  Onset:2002-11-05, Days after vaccination: 0
Gender:Female  Submitted:2002-11-14, Days after onset: 9
Location:Idaho  Entered:2002-12-26, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Sore iste, red swollen;Tetanus Toxoid (unknown mfr);;26;In Patient
Other Medications: Zyrtec, Estradinlen, Auphex, Lesapro, Tmgadrin
Current Illness: NONE
Preexisting Conditions: Mold allergy, sulfa allergy, tetanus allergy, depression, asthma, gastric reflux
Diagnostic Lab Data: NONE
CDC 'Split Type': ID02071
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE31892HA3 LA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site warmth, Pruritus, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Red itchy blotch at site approx 4 hrs (warm site). Itching all over approx 10 hrs until Benadryl took effect.

VAERS ID:195655 (history)  Vaccinated:2002-11-08
Age:44.0  Onset:2002-11-08, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Idaho  Entered:2002-12-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PCN
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO935BA  RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Right deltoid immediately swelled once flu vaccine was administered. Ice pack applied.

VAERS ID:195661 (history)  Vaccinated:2002-10-30
Age:44.0  Onset:2002-10-30, Days after vaccination: 0
Gender:Female  Submitted:2002-11-01, Days after onset: 2
Location:Texas  Entered:2002-12-31, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor + Lipitor
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO913AA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Fatigue, Injection site pain, Injection site warmth, Neck pain, Skin discolouration
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: Pain at injection site, 50 cent size, pink + hot. Pain down arm up back of neck, Ice park topically, Declines Benadryl makes her drowsy. 11/01/2002 client out wk, States went home, took Benadryl, Red area did not not increased in size. Tired with soreness in neck & arm.

VAERS ID:195908 (history)  Vaccinated:2002-12-11
Age:44.0  Onset:2002-12-11, Days after vaccination: 0
Gender:Female  Submitted:2002-12-18, Days after onset: 7
Location:California  Entered:2003-01-08, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Passed out during desensitization (allergy shots) needed adrenaline; Anaphylactic shock; Erithromycin, codeine, morphine, ceclor, cipro
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0949AA1 LA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Fifteen minutes later began to pass out. Took Benadryl. Slept 12 hours. Two days later also dizzy while walking.

VAERS ID:195927 (history)  Vaccinated:2002-08-08
Age:44.0  Onset:2002-08-12, Days after vaccination: 4
Gender:Female  Submitted:2002-01-03, Days after onset: 220
Location:Illinois  Entered:2003-01-08, Days after submission: 370
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: EMG, Blood Tests and MRI-all neg
CDC 'Split Type':
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0069M1IM 
Administered by: Other     Purchased by: Unknown
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: On 8/12/02 noticed tingling of nose, fingers and tips of toes. Went to MD on 11/2/02. Still experiencing symptoms.

VAERS ID:196006 (history)  Vaccinated:2002-12-17
Age:44.0  Onset:2002-12-19, Days after vaccination: 2
Gender:Male  Submitted:2003-01-08, Days after onset: 20
Location:Unknown  Entered:2003-01-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seasonal allergy symptoms for the last two years, spring and fall
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSUNKNOWN1SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Developed swelling, redness and itching of the right arm, not extending past the right elbow, one day after receiving the second anthrax dose. Received vaccine before departing Turkey. Presented to local emergency department after returning to CONUS. Received steroid injection and oral prednisone.

VAERS ID:196007 (history)  Vaccinated:2003-01-03
Age:44.0  Onset:2003-01-03, Days after vaccination: 0
Gender:Female  Submitted:2003-01-08, Days after onset: 5
Location:New Jersey  Entered:2003-01-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR40956AA6SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site inflammation, Injection site rash, Injection site warmth, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Hot, erythematous, three inch diameter macular rash on area of vaccination (posterior deltoid of left arm). She also had accompanying burning sensation along the ventral forearm and weakness in the hand. All symptoms and signs resolved completely within four days. She was treated with cold packs. She refused benadryl P.O.

VAERS ID:196259 (history)  Vaccinated:2003-01-03
Age:44.0  Onset:2003-01-03, Days after vaccination: 0
Gender:Female  Submitted:2003-01-06, Days after onset: 3
Location:North Carolina  Entered:2003-01-15, 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: Corzide; Lo-Trol
Current Illness: NONE
Preexisting Conditions: Hypertension
Diagnostic Lab Data: NONE
CDC 'Split Type': NC03001
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TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0520AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Flushing, Headache, Hypokinesia, Injection site erythema, Injection site swelling, Neck pain, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Within 30 minutes, post vax of TD, pt felt flushed. Later that evening, she developed a fever of 101F, swelling and erythema at the injection site. Her "arm was useless, couldn''t pick it up" per pt. Pt reported feeling pain into the neck, shoulders and head. Ibuprofen did not help. Took Goody body ache powder Saturday night and felt better by Sunday AM.

VAERS ID:196366 (history)  Vaccinated:0000-00-00
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2003-01-09
Location:Oklahoma  Entered:2003-01-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: Alcohol use; Multiple Sclerosis; Tobacco use
Diagnostic Lab Data: UNK
CDC 'Split Type': A0364108A
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HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Condition aggravated, Multiple sclerosis
SMQs:, Optic nerve disorders (broad), Demyelination (narrow)
Write-up: On unspecified dates, the subject received the 1st and 2nd injections of Hep-B vaccine (mfr unk). Subsequent to the 2nd injection of Hep-B, the subject experienced an exacerbation of multiple sclerosis. The Hep-B immunization series was discontinued. Additional info was received from the spouse on 11/8/02. He stated that he considered the exacerbation of multiple sclerosis to have resulted in "severe or permanent disability". He considered the event to be possibly related to "Hep-B and Hep-C vaccination". As of 11/8/02, the exacerbation of MS had "improved".

VAERS ID:196422 (history)  Vaccinated:2002-04-05
Age:44.0  Onset:2002-05-25, Days after vaccination: 50
Gender:Male  Submitted:2003-01-09, Days after onset: 229
Location:Ohio  Entered:2003-01-17, 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: Hypertension. The subject''s medical history and concurrent conditions included hypertension (onset 2000). Concurrent medications were not specified. The vaccinee was not obese or a smoker.
Diagnostic Lab Data: Hep B surface antibody on 5/25/02, result negative
CDC 'Split Type': A0372102A
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5178A42 LA
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This report describes a 44 y.o. male who did not respond to the Hep B vaccine recombinant (Engerix-B) immunization series. The subject''s medical history and concurrent conditions included hypertension (onset 2000). Concurrent medications were not specified. The vaccinee was not obese or a smoker. The vaccinee received Engerix-B on 9/15/01 (lot #ENG3382A4), 10/13/01 (lot ENG5178A4) and 4/5/02 (lot ENG5178A4). A Hep B surface antibody titer, measured on 5/25/02, 50 days after the 3rd injection of Engerix-B was "negative."

VAERS ID:196424 (history)  Vaccinated:2002-06-03
Age:44.0  Onset:2002-06-10, Days after vaccination: 7
Gender:Female  Submitted:2003-01-09, Days after onset: 213
Location:Florida  Entered:2003-01-17, 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: Allergy to ampicillin
Diagnostic Lab Data:
CDC 'Split Type': A0374326A
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5213A20  
Administered by: Other     Purchased by: Private
Symptoms: Alopecia, Fatigue, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: This report describes hair loss in a 44 y.o. female who was vaccinated with Hep B vaccine recombinant (Engerix-B) for prophylaxis. The subject''s medical history included allergy to ampicillin. Concurrent medications were not specified. The subject had not experienced any adverse events following previous immunizations. On 6/3/02, the subject received her first injection of Engerix-B. By approximately 6/10/02, she experienced hair loss, skin itching, and fatigue. The events "came on gradually." The subject was seen by a physician. The Engerix-B immunization series was discontinued. As of 10/8/02, the events has "improved".

VAERS ID:196597 (history)  Vaccinated:2002-12-16
Age:44.0  Onset:2002-12-17, Days after vaccination: 1
Gender:Female  Submitted:2002-12-20, Days after onset: 3
Location:South Carolina  Entered:2003-01-22, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Paxil
Current Illness:
Preexisting Conditions: Panic attacks/anxiety per client report. Spasms.
Diagnostic Lab Data: Consent obtained to get note from MD re: 12/17/02 assessment.
CDC 'Split Type': SC0262
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4020027 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Muscle spasms
SMQs:, Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Client reported had redness, swelling L upper arm; spasms in back of head and down neck which began on 12/17/02. Client at HD 12/20 for PPD read and no redness, swelling observed. Hx panic/anxiety attacks and client takes Paxil for. Client reports has had spasms before if doesn''t take Paxil regularly.

VAERS ID:196727 (history)  Vaccinated:2002-12-17
Age:44.0  Onset:2002-12-18, Days after vaccination: 1
Gender:Male  Submitted:2002-12-22, Days after onset: 4
Location:North Carolina  Entered:2003-01-23, Days after submission: 32
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: NOE
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: L arm swelling, itching, severe pain, hot.

VAERS ID:196825 (history)  Vaccinated:2002-12-17
Age:44.0  Onset:2002-12-17, Days after vaccination: 0
Gender:Female  Submitted:2003-01-27, Days after onset: 41
Location:Unknown  Entered:2003-01-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none apparent
Preexisting Conditions: migraine headache; hx broken back (''85)
Diagnostic Lab Data: CBC showed mild anemia and monospot came back positive.
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0650SCLA
Administered by: Military     Purchased by: Military
Symptoms: Anaemia, Cough, Erythema, Eye irritation, Headache, Hyperhidrosis, Myalgia, Nausea, Postnasal drip, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Received first Anthrax @ 13:30 hours on 17 December 2002. At approximately 16:30 hours had relatively sudden onset of HA, fever, myalgias and burning eyes. Came to clinic on 20 December as symptoms had persisted. Over the three day period had also had sweats (? fever), nausea with one episode of vomiting, postnasal drainage and mild cough (without chest pain or shortness of breath). At time of visit, patient was not in distress and was afebrile. HEENT exam were normal except for mild clear nasal drainage and mild erythema of the oropharynx. Neck supple with nontender tonsillar and cervical nodes. Chest was clear. Abdomen was benign. Skin was clear. Husband reported similar symptoms. Treatment was symptomatic (phenergan for nausea and naprosyn for headache).

VAERS ID:197040 (history)  Vaccinated:1999-12-10
Age:44.0  Onset:1999-12-10, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Kansas  Entered:2003-01-31
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:
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0240 LA
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Insomnia, Joint stiffness, Joint swelling, Surgery
SMQs:, Anaphylactic reaction (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Stiffness in joints (knees especially) back, swollen wrist, R knee swelling, Insomnia , migratory swelling, redness, Medical board pending. Sugery L knee 2001, R knee 2002, R wrist 2002

VAERS ID:197328 (history)  Vaccinated:2000-02-22
Age:44.0  Onset:0000-00-00
Gender:Male  Submitted:2003-02-03
Location:Unknown  Entered:2003-02-06, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0444SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest pain, Influenza like illness
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Flu-like symptoms X 2-3 days No headache. Pt has had 6 severe episodes of chest pain from 7/99 - 5/02. Both problems continue to the present.

VAERS ID:197397 (history)  Vaccinated:0000-00-00
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2003-02-03
Location:Unknown  Entered:2003-02-07, 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: UNK
Current Illness:
Preexisting Conditions: Blood transfusion; TB exposure; Uterine dilation and curettage
Diagnostic Lab Data: Lab evaluation before neurologic exam revealed elevated creatine phosphokinase CK at 1675 IU/L with an aldolase of 13. The neurological examination revealed normal cerebral, cerebellar and cranial nerve function. Sensory examination was int
CDC 'Split Type': WAES0301USA02241
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Dysphagia, Fatigue, Headache, Hypotonic urinary bladder, Influenza like illness, Laboratory test abnormal, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Eosinophilic pneumonia (broad)
Write-up: It was reported, in the above stated article, that a 44 year old female nurse with a history of TB exposure, uterine dilation and curettage in 1996 followed by a blood transfusion who in 1989 was vaccinated with hep B vaccine recombinant. Subsequently over a two year period following the birth of her son, experienced diffuse painful myalgias, weakness of the upper extremities, weakness of the lower extremities (proximal $gdistal), dysphagia, lower back spasms and arthralgias, all of a progressive nature. Symptoms began 3 to 4 weeks post-partum and were accompanied by flu-like symptoms, followed by excessive fatigue and polyarthralgias. The pt had intermittent cephalgia thereafter. Lab evaluation before neurologic exam revealed elevated creatine phosphokinase CK at 1675 IU/L with an aldolase of 13. The neurological examination revealed normal cerebral, cerebellar and cranial nerve function. Sensory examination was intact. Motor examination revealed decreased voluntary effort secondary to pain, but with encouragement, nearly normal strength. Repetitive muscle testing revealed fatigability. There was no apparent atrophy or fasciculations. Deep tendon reflexes were 2+. Nerve conduction studies of the left upper and lower extremities were normal, as were repetitive nerve stimulation. Needle examination showed fibrillation potentials and positive waves of the left deltoid with rapidly recruitable, small abundant potentials. Left quadriceps revealed no abnormal spontaneous activity but myopathic appearing untis. Light microscopy revealed dense, focal and multifocal aggragates of large, non-epithelioid histiocytes with fine PAS-positive granules in SC ffat, epimysium, perimysium, and endomysium. The infiltrate appeared as thick epimysial covering, perifascicularly, and more often with centripetal distribution fromt he epimysium and endomysium. Scattered in a few of the aggragates were rare lymphocytes and plasma cells intermixed with histiocytes. Langerhans cell markers CD1a and S100 protein were negative, therefore the m

VAERS ID:197474 (history)  Vaccinated:2002-10-31
Age:44.0  Onset:2002-11-02, Days after vaccination: 2
Gender:Male  Submitted:2003-02-07, Days after onset: 97
Location:South Dakota  Entered:2003-02-10, 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: Proscar, ASA
Current Illness: NONE
Preexisting Conditions: Prostate Prob. neg
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 4 RA
Administered by: Other     Purchased by: Private
Symptoms: Optic neuritis, Vision blurred, Visual disturbance
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Ocular infections (broad)
Write-up: Optic Neuritis Rt. Has seen opthomologist Neurology. Seen at clinic. IV Steroids. The 60 day follow up states optic neuritis in my right eye. My vision has not improved in 6 months. I still have optic neuritis in my right eye "optic nerve." It doesn''t look like the vision will come back. My night vision is very poor. Always blurry and cloudy. I received a letter from VAERS that mentioned possible compensation. I had almost $8, 000 in medical bills because of that flu shot. Do I qualify for that? Please let me know. Thanks

VAERS ID:197624 (history)  Vaccinated:2003-01-18
Age:44.0  Onset:2003-01-19, Days after vaccination: 1
Gender:Male  Submitted:2003-01-31, Days after onset: 12
Location:Pennsylvania  Entered:2003-02-12, 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: Allergy/codine medication
Diagnostic Lab Data: Chest x-ray, CBC normal, CPK 264
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV06715  
Administered by: Military     Purchased by: Military
Symptoms: Blood creatine phosphokinase increased, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: Diffuse myalgia, nausea associated with elevation of total CPK.

VAERS ID:198201 (history)  Vaccinated:2003-02-10
Age:44.0  Onset:2003-02-14, Days after vaccination: 4
Gender:Female  Submitted:2003-02-21, Days after onset: 7
Location:Florida  Entered:2003-02-24, 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: Paxil; Actos; Ameryl; Glucophage; Celebrex; Bextra
Current Illness: NONE
Preexisting Conditions: Diabetic
Diagnostic Lab Data: NONE
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200772IMRA
Administered by: Public     Purchased by: Other
Symptoms: Lymphadenopathy, Vaccination complication
SMQs:
Write-up: Possible inadvertent inoculation of smallpox vaccine to L interal neck area. Pt has area covered and has only minimal lymph node swelling. Pt is well and wroking. Pt has h/o acne. Handwashing emplasized.

VAERS ID:198313 (history)  Vaccinated:2003-02-11
Age:44.0  Onset:2003-02-19, Days after vaccination: 8
Gender:Male  Submitted:2003-02-24, Days after onset: 5
Location:Wyoming  Entered:2003-02-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None stated
Preexisting Conditions: None listed
Diagnostic Lab Data:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710IDLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURUO7050IMRA
Administered by: Military     Purchased by: Military
Symptoms: Cow pox
SMQs:
Write-up: Pt developed generalized vaccinia approximately 8 days after smallpox vaccination.

VAERS ID:198245 (history)  Vaccinated:2002-11-18
Age:44.0  Onset:2002-11-28, Days after vaccination: 10
Gender:Female  Submitted:2003-01-07, Days after onset: 40
Location:Tennessee  Entered:2003-02-25, Days after submission: 49
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': TN03007
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FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE)LEDERLE LABORATORIES4020033 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Hypoaesthesia, Injection site pain, Injection site swelling
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Pt reports a pimple over injection site one week after shot - went away one month later. Pain at injection site one day post shot. Never relieved - now pain with movement of shoulder in all directions, numbness in lt arm, pain awakened pt at night.

VAERS ID:198247 (history)  Vaccinated:2002-12-07
Age:44.0  Onset:2002-12-31, Days after vaccination: 24
Gender:Female  Submitted:2003-02-06, Days after onset: 37
Location:Iowa  Entered:2003-02-25, 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: year around-mold dust
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU0983AA5IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0600L2SC 
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU0524AA3IM 
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Influenza like illness, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Approximately three weeks after immunizations had dizziness, itchiness, flu like symptoms 2/6/03 mild urticaria noted in both upper arms abdomen and both inner thigh area.

VAERS ID:198432 (history)  Vaccinated:2003-02-18
Age:44.0  Onset:2003-02-21, Days after vaccination: 3
Gender:Female  Submitted:2003-02-26, Days after onset: 5
Location:Florida  Entered:2003-02-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Back problems
Diagnostic Lab Data: Results pending bacterial and viral throat cultures, CBC, mono spot; *F/UP report w/lab data on 3/25/03: WBC Count, Flag, 12.9 H x 10-3/uL, ref range 4-10.5; RBC count, result 4.34 x 10-6/uL, range 3.80-5.10; Hemoglobin, result 14.0 g/dL, r
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020771 LA
Administered by: Public     Purchased by: Public
Symptoms: Cough, Dizziness, Dysgeusia, Ear disorder, Erythema, Fatigue, Headache, Migraine, Mouth plaque, Pyrexia, Rhinorrhoea, Upper respiratory tract infection, Visual disturbance
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: During day 7 interview for "read" for smallpox vaccine, c/o "migraine" since day 2 (or 3), visual changes, faint feeling, fever, now also has cough, URI symptoms. Says when vaccine administered immediately got metallic taste in mouth. Exam: T99.4 c/o myalgias, fatigue, ears popping, headache 9/10, opaque 2x3mm grayish plaque on L tonsilar bed, (+) erythema, neck tender, acc nodes grape sized. Assess: viral syndrome, pharyngeal plaque-uncertain etiol. by MD. Day 8 phone to pt and subsequent exam: feels about the same; L/a 7/10 with no sx feeling of fainting or eye problems. States cough is worse, throat not sore but voice is coming and going. No fever, taking ASA/Tylenol. Nose more congested. Exam: T99.0 no change except cough now breaking up, nose is running more. OP injected, but no plaque/membranes or exudate. Assess: viral URI by MD.

VAERS ID:198506 (history)  Vaccinated:2000-05-03
Age:44.0  Onset:0000-00-00
Gender:Male  Submitted:2003-02-14
Location:Nebraska  Entered:2003-02-28, 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: UNK
Preexisting Conditions: Asthma, Epilepsy, Pneumonia
Diagnostic Lab Data: UNK
CDC 'Split Type': A0357251A
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS136B91IM 
Administered by: Private     Purchased by: Public
Symptoms: Arthralgia, Arthritis, Difficulty in walking
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (narrow)
Write-up: Report 2002000378-1 describes arthritis in a 44 year old male who received Lyme disease vaccine recombinant OspA (LYMErix). The medical history included asthma, pneumonia, and epilepsy. The vaccinee had no known drug allergies. The vaccinee''s occupation reportedly put him at risk for tick bites. There was no illness at the time of immunization. Concurrent medications were not known by the reporter. The vaccinee received his first injection of LYMErix (lot LY104A2) on 4/12/99. He had no adverse experience following receipt of this injection. He received his second injection of LYMErix (lot LY136B9) on 5/3/00. An unknown time post-immunization, he experienced extreme joint pain (NOS). The vaccinee reported that he was seen by an arthritis specialist, who made a diagnosis of arthritis (NOS). The vaccinee stated that this specialist recommended that he not receive the third injection of LYMErix. As of 1/8/02, the vaccinee stated that he remains in a lot of pain and is having difficulty just trying to move about. The most recent information, received 2/4/02, did not specify the treatment or outcome of the event. The adverse event arthritis does not meet ICH serious criteria, but is being submitted as an expedited report by special request per the June 28, 2000 letter.

VAERS ID:198582 (history)  Vaccinated:2003-02-12
Age:44.0  Onset:2003-02-14, Days after vaccination: 2
Gender:Female  Submitted:2003-02-28, Days after onset: 14
Location:Nebraska  Entered:2003-02-28
Life Threatening? Yes
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':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest pain, Dizziness, Dyspnoea, Fatigue, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: Smallpox on 2/12/03. On 2/14/03, felt dizzy and lightheaded. BP of 90/45. Normal BP is 120/70. On 2/15/03, had muscle aches, fatigue, headache, and mild dizziness. Then on 2/16/03 PM, had difficulty breathing, tightness in chest, and chest pain. Was hospitalized and had an ECG. Results showed depressed ST waves suggesting possible ischemia. Went home. On and off chest pain. Went back to doctor on 2/26/03. Did more tests and ended in hospital overnight. Results showed a torturous heart artery. No other cardiovascular problems. No symptoms until got smallpox shot. Never got chest pain until smallpox shot.

VAERS ID:198586 (history)  Vaccinated:2003-02-28
Age:44.0  Onset:2003-03-01, Days after vaccination: 1
Gender:Male  Submitted:2003-03-01, Days after onset: 0
Location:California  Entered:2003-03-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200711IDRA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Lymphangitis, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: patient revaccinated on 2/28/03; had original vaccination in childhood; reports within 24 hours of vaccination well-demarcated, raised lesion with erythema without fluctuance or serous fluid, appoximately 7cm distal to deltoid vaccination site of right arm; patient denies pain, fever or exudates and is without lymphadenopathy; suspect normal lymphangitis; patient sent for evaluation; will evaluate patient within 24 hours

VAERS ID:198682 (history)  Vaccinated:2002-11-19
Age:44.0  Onset:2003-11-23, Days after vaccination: 369
Gender:Female  Submitted:2003-02-28, Days after onset: 268
Location:New York  Entered:2003-03-04, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI negative, lumbar puncture (+) oligoclonal band
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE35822KA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Anxiety, Difficulty in walking, Laboratory test abnormal, Muscular weakness, Myelitis, Pain, Sensory disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Over the course of a week, pt developed profound sensory loss and weakness of legs and bladder. Was hospitalized for several weeks and given treatment with steroids and IVIG. Pt has slowly recovered. Can now walk but still with sensory loss pain in legs. Still recovering. The medical record received on 3/3/04 states transverse myelitis and anxiety. Annual follow up on 03/17/04: "The pt has not recovered from adverse events. Still has numbness and tingling from toes up to hips. Feet range from completely "numb" to very painful. Never have normal feeling in feet and legs. Balance is "off" and cannot run. Must always watch feet, especially on stairs or uneven walkways. Still have no idea of "my space" in relation to feet and sometimes legs."

VAERS ID:198854 (history)  Vaccinated:2003-02-14
Age:44.0  Onset:2003-02-14, Days after vaccination: 0
Gender:Female  Submitted:2003-03-04, Days after onset: 18
Location:Tennessee  Entered:2003-03-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CALAN SR 240MG 2 Q AM HCTZ 50MG 2 Q AM PREMARIN 1.25MG QD PAXIL 40MG QD VIOXX 25MG QD PRN NATURAL LAX QD PRN DARVOCET N-100 PRN
Current Illness:
Preexisting Conditions: DEMEROL
Diagnostic Lab Data:
CDC 'Split Type':
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TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0822AA1IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Feeling hot, Injection site induration, Injection site reaction, Oedema, Tenderness, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: LOCALIZED REACTION WITH REDNESS, WARMTH, EDEMA INDURATION WITH TENDERNESS,AND URTICARIA TREATMENT CONSISTED OF COLD COMPRESSION, ADVIL,AND BENEDRYL

VAERS ID:198907 (history)  Vaccinated:2003-02-26
Age:44.0  Onset:2003-03-01, Days after vaccination: 3
Gender:Female  Submitted:2003-03-05, Days after onset: 4
Location:Florida  Entered:2003-03-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Asacal i bid Metrogel MVI
Current Illness: none
Preexisting Conditions: Colitis (calm at this time) Rosecia (not active at this time)
Diagnostic Lab Data: none
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771IDLA
Administered by: Public     Purchased by: Public
Symptoms: Pain, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Sporadic Rash type Left index fingure inner aspect has a Small ~2mm bumb that itches Laft On the arch between the thumb and index fingure dorsal side the is a 1.5 flat red itching spot Left medial aspect of forarm 2mm itching flat red spot. Right ring fingure itching bump Break through menses day 2 and 3 past vaccination with bilateral groin pain.

VAERS ID:198925 (history)  Vaccinated:2003-01-24
Age:44.0  Onset:2003-01-25, Days after vaccination: 1
Gender:Female  Submitted:2003-02-26, Days after onset: 32
Location:Unknown  Entered:2003-03-06, 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:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Erythema, induration and pruritis at injection site 15 x 15cm. Rx Motrin, predisone, benadryl, ice pack

VAERS ID:198954 (history)  Vaccinated:2003-01-30
Age:44.0  Onset:2003-01-31, Days after vaccination: 1
Gender:Female  Submitted:2003-02-03, Days after onset: 3
Location:Virginia  Entered:2003-03-06, 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:
Current Illness: NONE
Preexisting Conditions: Allergic to Amoxicillin, PSVT
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 1 RA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0 LA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Paraesthesia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt rec''d 2nd Anthrax with 1 day local redness and swelling 12" from site. swelling caused parathesia.

VAERS ID:199024 (history)  Vaccinated:2003-02-25
Age:44.0  Onset:2003-02-28, Days after vaccination: 3
Gender:Female  Submitted:2003-03-06, Days after onset: 6
Location:Minnesota  Entered:2003-03-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ACE inhibitor, thiazide, pru omeprazole, low dose prozac
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Cardiac cath on 3/5 - clean coronaries; LVgram EF 45%; Focal small wall motion defect. inferior. TropI = .29, .25 Awaiting ECHO, d/c summary Serum and NP/Rectal swabs to be sent to DH for viral etiology by serology
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020077   
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Chills, Cough, Fatigue, Malaise, Myalgia, Pain, Productive cough, Pyrexia, Tracheobronchitis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: 2/12 sudden onset of high fever, chills, myalgia, malasie, cough and clear sputum (x 1 week). One more week of fatigue left with irritable tracheobronch tree. Desire to wheeze, no dyspnea, trachea hurt some with cough. 2/26 Vaccinated - no symptoms for two days 2/28 bad stabbing shoulder pain not related to exertion. Thought it was the joint, better with Naprosyn. 3/1 Naprosyn, shoulder pain mostly gone but radiation persisted. Chest pain increased to neck while walking 3/3 Had to work, increasing dyspnea and chest pain increased to neck and shoulders 3/4 Went to MD, EKG with T Wave and was admitted to hospital. Follow up 11/04/2003: "Vaccine recipient did recover from adverse event." Follow up on 07/28/04 states: "Pt has recovered from adverse events."

VAERS ID:198984 (history)  Vaccinated:2003-02-20
Age:44.0  Onset:2003-02-25, Days after vaccination: 5
Gender:Female  Submitted:2003-03-06, Days after onset: 9
Location:Colorado  Entered:2003-03-07, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020076   
Administered by: Public     Purchased by: Public
Symptoms: Lethargy, Malaise, Oedema, Pyrexia, Vasodilation procedure
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: 2/26/03 - Left arm swollen and red x 18 hrs. Lymph node soreness x 48 hrs. Saw PCP - But Sx then resolved. Became lethargic 3/1/03/. Has missed 3 days of work - fever, full H/A, Malaise, lethargy. Urged to see HD for neuro eval - Done 3/5/03. Follow up information received on 04/25/2003 states: 4/11/03 - Pt is back at work.

VAERS ID:199191 (history)  Vaccinated:2003-02-04
Age:44.0  Onset:2003-02-04, Days after vaccination: 0
Gender:Female  Submitted:2003-02-05, Days after onset: 1
Location:Michigan  Entered:2003-03-11, Days after submission: 34
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: Fibromyalgia, lung surgery
Diagnostic Lab Data:
CDC 'Split Type': MI2003007
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0530AA  LA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Pain
SMQs:, Arthritis (broad)
Write-up: T/C from pt c/o of muscle and joint pain all over had Td 2-4/03 8:45am. Aching by 4pm same day. No redness on swelling at site. Wonders if a reaction to Td states over 10 yrs since last Td. Was handling a horse when had was jammed against trailer hitch/skin on top of hand broken. Pt cleared wound-no signs of infection today: States she did cal PMD post injury and was referred for Tx. Hx of fibromyalgia and also had lung tumor removed 6/99. Never on chemo or medications, missed work lat night do to feeling ill.

VAERS ID:199426 (history)  Vaccinated:2003-02-25
Age:44.0  Onset:2003-03-10, Days after vaccination: 13
Gender:Male  Submitted:2003-03-11, Days after onset: 1
Location:Alabama  Entered:2003-03-12, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': AL-03-08
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771IDLA
Administered by: Military     Purchased by: Public
Symptoms: Erythema multiforme
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Erythema multiforme, mild to extensive (direct quote from physician who completed paper form. Resolving on 3-11-03

VAERS ID:199602 (history)  Vaccinated:2003-02-18
Age:44.0  Onset:2003-03-04, Days after vaccination: 14
Gender:Female  Submitted:2003-03-13, Days after onset: 9
Location:Minnesota  Entered:2003-03-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 100mg Daily, Allergra 60mg twice daily prn, Lipitor 10mg daily
Current Illness: None
Preexisting Conditions: High Cholesterol
Diagnostic Lab Data:
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Public     Purchased by: Public
Symptoms: Face oedema, Pain
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Right side face pain and swelling began on 03/04/03. Saw MD who is designated as the adverse event physician on 03/06/03. Prescription given for Famvir 500mg to be taken for 7 days. Was hospitalized from 03/07/03 through 03/10/03 for IV antibiotic treatment, oral antiviral treatment and pain control.

VAERS ID:199605 (history)  Vaccinated:2003-02-24
Age:44.0  Onset:2003-02-26, Days after vaccination: 2
Gender:Female  Submitted:2003-03-13, Days after onset: 15
Location:Maryland  Entered:2003-03-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: trilisate (Mg trisalicilate)prn Allegra prn Hydrazine prn
Current Illness: None
Preexisting Conditions: Chronic urticaria Sciatica (post L4-5 trauma; 1984)
Diagnostic Lab Data: None
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200772IDLA
Administered by: Public     Purchased by: Public
Symptoms: Fatigue, Malaise, Migraine, Muscular weakness, Oedema, Pain, Paraesthesia, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Vaccinee has history of chronic urticaria and sciatica post-trauma (1984), both quiescent prior to vaccination. On day 2 post-smallpox vaccination, vaccinee developed paresthesias of dorsal left hand + minor swelling of hand. Left hand paresthesias have remitted and relapsed subsequently, and continue intermittently through day 18. No report of muscle weakness. Flare of sciatica on days 5-8 (resolved). Otherwise, no similar symptoms at other sites. Symptoms imnproved by NSAIDs (trilisate). No history of similar symptoms. Migraine-like HA on day 10 post-vaccination; Pruritis. Also fatigue + malaise. Otherwise no systemic symptoms. No fever. No nuchal rigidity. No LE weakness except with sciatica.

VAERS ID:199638 (history)  Vaccinated:2003-02-20
Age:44.0  Onset:2003-02-28, Days after vaccination: 8
Gender:Male  Submitted:2003-03-14, Days after onset: 14
Location:Minnesota  Entered:2003-03-14
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: Swabs from his forehead and eyelid were negative for vaccinia by polymerase chain reaction (PCR) but positive for varicella-zoster virus. PCR was also negative for HSV. His vaccination site was positive for vaccinia by PCR. Viral cultures o
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020077   
Administered by: Public     Purchased by: Public
Symptoms: Blister, Herpes zoster, Malaise, Nausea, Pyrexia, Rash, Rash macular, Vaccination complication, Vomiting
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: A 44 year old male re-vaccinee was vaccinated on 2/20 and had subsequent symptoms of a low grade fever, malaise, nausea and vomiting. On 2/28, he noticed a small red patch on his upper left forehead with two small "pimples", which he rubbed open. Instead of healing, the lesion expanded during the subsequent days. On 3/4, he noticed 1-2 "bumps" on his left eyebrow and on his upper left eyelid, with some additional lesions over the next few days. He had no ocular symptoms. He visited his physician on 3/7 and was also seen by a dermatologist and an ophthalmologist. The forehead lesion was described as a 1.5 x 2.5 cm deep red plaque. It was significant for two confluent black eschars approximately .6 x 1.0 cm in total diameter. There were no vesicles. His left brow and upper eyelid contained approximately 5 faint pink macules and patches with superimposed vesicles that were less than 1 mm in diameter, appeared superficial and were in the same stage of development. Many were grouped though not in the typically florette pattern of herpetic vesicles. None were eroded or crusted. Very small vesicles were also present on his upper left eyelid but did not involve the lash margin. His ophthalmological exam was negative for keratitis, blepharitis, or conjunctival involvement. His vaccination site revealed a major reaction. The scab on his forehead and the eyelid vesicles were unroofed, and swabs for viral culture, DFA, and PCR were obtained from these sites and from his vaccination site. He was placed on valcyclovir and trifluoridine eye drops with close outpatient follow-up.

VAERS ID:199907 (history)  Vaccinated:2003-03-05
Age:44.0  Onset:2003-03-06, Days after vaccination: 1
Gender:Male  Submitted:2003-03-14, Days after onset: 8
Location:California  Entered:2003-03-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURU0852BB4IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.1085M2IMLA
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURW03343SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: On 3/7/03, in the office, pt had red and swollen right deltoid (4 1/2" X 3 3/4"). No temperature. Treated with Tylenol and Benadryl.

VAERS ID:200126 (history)  Vaccinated:2003-03-13
Age:44.0  Onset:2003-03-13, Days after vaccination: 0
Gender:Female  Submitted:2003-03-13, Days after onset: 0
Location:Nevada  Entered:2003-03-25, Days after submission: 12
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Triphasil; ASA; Glucosamine; Chicondolin
Current Illness: NONE
Preexisting Conditions: Bee stings anaphylaxis
Diagnostic Lab Data:
CDC 'Split Type': NV0305
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HEPAB: HEP A + HEP B (TWINRIX)SMITHKLINE BEECHAM317A4 IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Anaphylactic reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)
Write-up: Within 1/2 hour of receiving Twinrix, patient presented to doctor''s office in anaphylaxis. Given epi 1:1000 times 2, 15 minutes apart. Also Benadryl 50mg PO. Did not respond. To Er where treatment with IV Benadryl and steroids. Discharged and readmitted 2 hours later; started in IV steriods and H, H2 blockers. Observed overnight. Discharge is today 3/14/03.

VAERS ID:200246 (history)  Vaccinated:2003-02-01
Age:44.0  Onset:2003-02-04, Days after vaccination: 3
Gender:Male  Submitted:2003-03-16, Days after onset: 40
Location:West Virginia  Entered:2003-03-26, 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:
Current Illness: Congestion
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC - wnl ; CMB - wnl ; 2 view Chest X-Ray - clear ; CBC ; Chain 14
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0692SCLA
Administered by: Military     Purchased by: Military
Symptoms: Cough, Dyspnoea, Lymphadenopathy, Malaise, Neck pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Arthritis (broad)
Write-up: Generalized malaise, neck pain, shortness of breath (mild), lymph nodes swollen in neck, non productive cough, no fever or chills.

VAERS ID:200451 (history)  Vaccinated:2003-02-28
Age:44.0  Onset:2003-03-26, Days after vaccination: 26
Gender:Male  Submitted:2003-03-27, Days after onset: 1
Location:Minnesota  Entered:2003-03-27
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: Hypertension and hx of seizures
Diagnostic Lab Data: electrolytes WNL
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETHBATCH #900  
Administered by: Public     Purchased by: Public
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Generalized seizure on 3/26/2003. 26 days post vaccination; started Dilantin; had seizure in June 20002; tx to hospital.

VAERS ID:200456 (history)  Vaccinated:2003-03-20
Age:44.0  Onset:2003-03-27, Days after vaccination: 7
Gender:Female  Submitted:2003-03-28, Days after onset: 1
Location:New York  Entered:2003-03-28
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: EKG normal Troponin normal (<0.7) ESR normal (5) Echo normal with no evidence of pericardial effusion
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Injection site pain, Lymphadenopathy, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: 44 yo female with no known history of cardiac disease presented one week after vaccination for her take check. At that time she c/o pain at vaccination site and swollen tender axillary lymph nodes on the same side as the vaccination. She complained that the pain had begun to spread across her chest to the other axilla. Pain was described as a "tenderness", not squeezing, not sharp, less than 5/10 in intensity. No other accompanying symptoms were reported. An EKG, troponin, ESR, and echo were done all of which were within normal limits. She was able to go back to work later that day.

VAERS ID:200511 (history)  Vaccinated:2002-10-19
Age:44.0  Onset:2002-10-19, Days after vaccination: 0
Gender:Male  Submitted:2002-11-03, Days after onset: 15
Location:New Mexico  Entered:2003-03-31, Days after submission: 148
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR0984AA10IM 
Administered by: Military     Purchased by: Military
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Chills and subjective fever which began 10 hours after administration. During; 5 hours.

VAERS ID:200660 (history)  Vaccinated:2003-02-12
Age:44.0  Onset:2003-02-15, Days after vaccination: 3
Gender:Female  Submitted:2003-04-01, Days after onset: 45
Location:Florida  Entered:2003-04-01
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: ASD repair 1976
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0632IMLA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020076   
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 3 to 4 days after first and second anthrax vaccinations I had intense itching on thighs, back, stomach, forearms, and buttocks. I had a red rash on stomach and patches of bumps on buttocks. Symptoms were less severe after third anthrax vaccination.

VAERS ID:200860 (history)  Vaccinated:2003-03-25
Age:44.0  Onset:2003-04-01, Days after vaccination: 7
Gender:Female  Submitted:2003-04-02, Days after onset: 1
Location:Kentucky  Entered:2003-04-03, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: EKG, CXray, Hematology work-up, Urinalysis, echogram,
CDC 'Split Type': KY2003048S
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Chest discomfort, Diarrhoea, Dyspnoea, Flushing, Muscular weakness, Pyrexia, Tachycardia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow)
Write-up: Tachycardia Heart rate 128, shortness of breath, chest-tightness, muscle weakness, trembling, low grade temp 99.9F abdominal cramping, diarrhea x3, facial flushing x3

VAERS ID:200872 (history)  Vaccinated:2003-03-11
Age:44.0  Onset:2003-03-21, Days after vaccination: 10
Gender:Female  Submitted:2003-04-01, Days after onset: 11
Location:Florida  Entered:2003-04-03, 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: NONE
Current Illness: NONE
Preexisting Conditions: 1988 Bell''s palsy w/some residual weakness.
Diagnostic Lab Data: Headache, sinusitis, anemia, bronchitis.
CDC 'Split Type':
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Anaemia, Bronchitis, Fatigue, Headache, Malaise, Sinusitis
SMQs:, Haematopoietic erythropenia (broad)
Write-up: Day 10 post vax for smallpox, began having a headache. Described headache as halo type. She became progressively more ill and was not able to attend work due to extreme fatigue and constant headache.

VAERS ID:200937 (history)  Vaccinated:2003-03-23
Age:44.0  Onset:2003-03-30, Days after vaccination: 7
Gender:Female  Submitted:2003-03-31, Days after onset: 1
Location:South Carolina  Entered:2003-04-04, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin pump, Glucosec, Kt, Lasix, Lipitor
Current Illness: NONE
Preexisting Conditions: Allergies PCN, Sulfa, Sudafed
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771 RA
Administered by: Public     Purchased by: Other
Symptoms: Injection site reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Received smallpox vax 3/20/03. Developed hives around site, back arms buttocks and chest. 3/30/03 Instructed to take Benadryl. If worsen go to ER. 3/31/03 Hives have intensified and spread to legs. Ref to MD.

VAERS ID:200943 (history)  Vaccinated:2003-02-13
Age:44.0  Onset:2003-02-18, Days after vaccination: 5
Gender:Female  Submitted:2003-03-28, Days after onset: 38
Location:Nebraska  Entered:2003-04-04, 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
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Headache, Injection site pustule, Lymphadenopathy, Neck pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: On 2/18/03 PT reported cervical neck and upper thoracic pain, axillary and cervical lymph node enlargement and tenderness, headache, joint aches; feels feverish but did not have thermometer; smallpox pustule 10 mm and beginning to dry. Tx - rest, missed 1 day of work.

VAERS ID:200964 (history)  Vaccinated:2003-03-28
Age:44.0  Onset:2003-03-31, Days after vaccination: 3
Gender:Male  Submitted:2003-04-05, Days after onset: 5
Location:Wisconsin  Entered:2003-04-05
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
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
Administered by: Military     Purchased by: Military
Symptoms: Ear pain, Headache, Tinnitus
SMQs:, Hearing impairment (narrow)
Write-up: Ears started ringing a few days after my second anthrax shot (Mar 28, 03) and have continued to. I''ve also had a dull ache in the ears and the lower back portion of my head.

VAERS ID:201038 (history)  Vaccinated:2003-03-02
Age:44.0  Onset:2003-03-16, Days after vaccination: 14
Gender:Male  Submitted:2003-04-07, Days after onset: 21
Location:Virginia  Entered:2003-04-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: SOB
Preexisting Conditions: unknown
Diagnostic Lab Data: vaccinia, influenza, punch biopsy
CDC 'Split Type':
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200711IDLA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Asthma, Pneumonia, Rash, Vaccination complication
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pneu,monia - steroids possible satellite lesion generalized rash Follow up information: Pt states that he received "asthma" after being vaccinated for smallpox.

VAERS ID:201114 (history)  Vaccinated:2003-03-27
Age:44.0  Onset:2003-04-03, Days after vaccination: 7
Gender:Female  Submitted:2003-04-07, Days after onset: 3
Location:New York  Entered:2003-04-07
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: EKG normal per patient report
CDC 'Split Type':
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Public     Purchased by: Public
Symptoms: Breast pain, Chills, Discomfort, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Lipodystrophy (broad)
Write-up: 44 yo female who was vaccinated against smallpox as a child and has no known cardiac disease, vaccinated first on 3/27/2003. One week later was determined to be a no-take and was re-vaccinated on 4/03/2003. Developed fever on 4/3 and tender axillary lymph nodes the following day. Lymph node tenderness progressed and spread to her left breast. She denies any SOB, nausea or diaphoresis. Tenderness in axilla and breast were worse with palpation and improved somewhat with aspirin. She reported her symptoms to an MD colleague who performed an EKG (since pain was in left breast) on 4/6, which was normal per patient. She called the clinic today to report her continuing axillary lymph node and breast tenderness. She denies redness or warmth over lymph nodes. Temp reached a max of 99.8 on 4/2 but she has been afebrile since. She does c/o some chills. She missed work today because of the discomfort. Has been taking aspirin q6 hours.

VAERS ID:201265 (history)  Vaccinated:2003-02-27
Age:44.0  Onset:2003-04-02, Days after vaccination: 34
Gender:Male  Submitted:2003-04-08, Days after onset: 5
Location:Connecticut  Entered:2003-04-10, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: 4/4 EKG = N8R, 4/4 CXR = NAD. Referred to Cardiologist.
CDC 'Split Type': CT200307
Vaccination
Manufacturer
Lot
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Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020077  LA
Administered by: Private     Purchased by: Public
Symptoms: Asthenia, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)
Write-up: Received smallpox vax 2/27/03. Proceeded w/course w/o incident. Minimal c/o tiredness "No fever" Scab off? 3/16/03 No report of Sx''s. 3/4, upon questioning PT, stated did have some palpitations on 4/2 & 4/3.

VAERS ID:201635 (history)  Vaccinated:2003-02-27
Age:44.0  Onset:2003-03-06, Days after vaccination: 7
Gender:Female  Submitted:2003-04-14, Days after onset: 38
Location:Florida  Entered:2003-04-16, 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: NONE
Current Illness: NONE
Preexisting Conditions: Drug allergies - PCN, Keflex
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770 LA
Administered by: Public     Purchased by: Public
Symptoms: Shoulder pain, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: 1 week after administration, L shoulder joint started hurting, aching. This has continued with decreased mobility in shoulder, difficulty sleeping if joint not positioned correctly.

VAERS ID:201816 (history)  Vaccinated:2003-03-14
Age:44.0  Onset:2003-03-27, Days after vaccination: 13
Gender:Female  Submitted:2003-04-10, Days after onset: 13
Location:Arkansas  Entered:2003-04-18, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': AR0329
Vaccination
Manufacturer
Lot
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Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020077   
Administered by: Other     Purchased by: Other
Symptoms: Tachycardia, Thyroid disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypothyroidism (broad), Hyperthyroidism (broad)
Write-up: Developed tachycardia 03/27/03. Wore halter monitor. No heart abnormalities. Thyroid elevated.

VAERS ID:201830 (history)  Vaccinated:2003-03-17
Age:44.0  Onset:2003-03-18, Days after vaccination: 1
Gender:Male  Submitted:2003-04-18, Days after onset: 30
Location:California  Entered:2003-04-19, 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: TST same day, Clisengein
Current Illness: Tx for "? lymph gland in neck"
Preexisting Conditions: Allergic to -zines, such as Compazine, dust, mild and guinea pigs.
Diagnostic Lab Data: CBC-abnormals include: low lymphocytes 23.4, high monocytes 8.4, high eosinphils 4.10; complete metabolic, hepatic function-no abnormals; the pt refused to have skin biopsies taken.
CDC 'Split Type':
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771 LA
Administered by: Private     Purchased by: Public
Symptoms: Headache, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pin point rash progressed to cover most of body in 7 days. Began to resolve 3/27/03. Almost completely resolved by 3/31/03. Accompanied by H/A, extreme itching, no fever. 3/18/03, 10am approximately 29 hrs after vaccination, pt presented with diffuse rash extending primarily over face, neck, trunk and thighs. Rash was very red, fine (pin point) and itchy and progressed over the next several days to the arms, axillae, legs, ankles and genitalia. He did not have fever, respiratory symptoms, or myalgia at any time. Pt noted a cropping aspect to the rash where it improved in the evenings, then was worse the next day when tiny painful scabs formed over the pin-point rash (no notable vesicular or pustular stage). Rash was accompanied by persistent headache lasting throughout the period of rash. Pt was treated in the ER on 3/18 with 150mg Prednisone and 150mg Benadryl immediately after rash was noticed. A closer review of medical history included the following: past allergies to "-zines," such as Compazine, dust, mild and guinea pigs. His TST always displayed erythema without induration; he can eat seafood (saltwater) but can''t eat fresh fish (freshwater). Freshwater fish causes systemic anaphylaxis with the following symptoms: itching, tongue, lip and pharyngeal swelling. Pt had been taking antibiotic Clindomycin until 3/19 or 3/20 ro cervical lymphadenitis. A TST was administered at same time as the vaccinia vaccination (3/17/03). The rash first appeared and first cleared in the face, neck and chest. The rash last appeared and last cleared from his axillae. He received limited relief from diphenhydramine, hydroxyzine and cimetidine. On 3/25/03 pt was given Doxapin x 1 for extreme itching and related distress. On 3/26/03 pt felt much better and seemed to "turn a corner" and get better over the next few days. His rash was 99% resolved by 3/31/03 per pt. Residual skin discoloration/scarring on trunk (4/18/03).

VAERS ID:201912 (history)  Vaccinated:2003-03-20
Age:44.0  Onset:2003-04-17, Days after vaccination: 28
Gender:Female  Submitted:2003-04-21, Days after onset: 4
Location:D.C.  Entered:2003-04-21
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: As above-cardiac enzymes, ECHO, ECG, STRESS Test
CDC 'Split Type':
Vaccination
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Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 1IDLA
Administered by: Public     Purchased by: Other
Symptoms: Chest pain, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Patient awakened from sleep at 3:00am on Thursday, April 17, 2003 with "heaviness in chest and shortness of breath". Patient, a nurse, walked around house hoping symptoms would abate. After an hour was able to return to bed and slept. Later that morning, while driving to work at 8:00am, symptoms returned and worsened. "I was so short of breath and had intense chest pressure". "I had a sense of impending doom." She presented to the ED. Oxygen and nitroglycerin were given. ECG and cardiac enzymes were obtained. Symptoms did not respond to NTG. On examination by cardiologist, new Grade I systolic murmur auscultated. Pt. admitted to hospital for further workup. All cardiac enzymes normal. 2D ECHO normal. Stress test normal. Pt. discharged morning of 4/18/03. Will follow-up with cardiologist in 1 month.

VAERS ID:202026 (history)  Vaccinated:2003-03-18
Age:44.0  Onset:2003-03-30, Days after vaccination: 12
Gender:Female  Submitted:2003-04-15, Days after onset: 15
Location:North Carolina  Entered:2003-04-22, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: fever 4 days;Smallpox (Dryvax);;1;In Patient
Other Medications: Ibuprofen 800 mg PRN, Albuterol PRN-has not used in last 2 months
Current Illness:
Preexisting Conditions: Allergic to PCN and sulfa drugs. Arthritis, asthma, mitral valve prolapse.
Diagnostic Lab Data: EKG - normal sinus rhythm per MD.
CDC 'Split Type': NC03041
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771 RA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Pt reported on 4/8/03 that she experienced one episode of chest pain occurring between 7-9 days post vaccination. Pt described sudden onset of a painful jolt in her chest "like grabbing an electric fence" followed by several hours of soreness and aching. Pt has also had "nagging" headaches daily from day of post vaccination which are not severe.

VAERS ID:202137 (history)  Vaccinated:2003-04-14
Age:44.0  Onset:2003-04-14, Days after vaccination: 0
Gender:Male  Submitted:2003-04-23, Days after onset: 9
Location:New York  Entered:2003-04-24, 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: Synthroid, vitamins, anipul
Current Illness: NONE
Preexisting Conditions: Eye and nose birth defect, hypothyroidism, hypertension
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5377A40 RA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Given Hep B #1 10:45 AM, To Medical 12:45 PM with increased edema, increased erythema right side of face - ear/jaw down to chin. Tight/firm, no SOB, no localized reaction, no hives or itch. Painful.

VAERS ID:202336 (history)  Vaccinated:2003-03-19
Age:44.0  Onset:2003-04-14, Days after vaccination: 26
Gender:Female  Submitted:2003-04-29, Days after onset: 15
Location:Indiana  Entered:2003-04-29
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: NA
Diagnostic Lab Data: Blood cultures negative Several negative monospots Hepatitis panel negative Abdominal ultrasound negative HIV negative Leukopenia 3.2 --$g2K after hospital admit EBV Ab not back yet
CDC 'Split Type': 200305
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771IDLA
Administered by: Public     Purchased by: Public
Symptoms: Alanine aminotransferase increased, Fatigue, Leukopenia, Lymphadenopathy, Myalgia, Periorbital oedema, Pharyngitis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (narrow), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: Patient presented approximately 4 weeks following smallpox vaccination (3-19)with fatigue, fever of 103.2F, pharyngitis, lymphadenopathy, myalgia, wax and waning periorbital edema, with elevated transaminases and leukopenia. Suspected EBV infection and patient required hospitalization (admit date 4-17). In discussion with physician on 4-25 he does not know feel like it is an EBV infection and still unclear on diagnosis.

VAERS ID:202793 (history)  Vaccinated:2003-04-01
Age:44.0  Onset:2003-04-02, Days after vaccination: 1
Gender:Female  Submitted:2003-05-07, Days after onset: 34
Location:Delaware  Entered:2003-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: Nil
Preexisting Conditions: Hypothyroid?
Diagnostic Lab Data: NIL
CDC 'Split Type':
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200761IDLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Diarrhoea, Haematochezia
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)
Write-up: Smallpox Vaccine given on 04/01/2003. About 12-14 hours later, devedloped diarrhoea and stomach cramps with diarrhoea and bloody stools. No other symptoms.

VAERS ID:203035 (history)  Vaccinated:2003-04-24
Age:44.0  Onset:2003-04-25, Days after vaccination: 1
Gender:Male  Submitted:2003-05-13, Days after onset: 18
Location:South Carolina  Entered:2003-05-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: No known allergies
Diagnostic Lab Data:
CDC 'Split Type': SC0316
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0524AA0IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Headache, Influenza like illness, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: States on 04/25 approximately 3:30 pm started to experience body aches. Over weekend, 04/26-04/27, experienced flu-like symptoms - headache, low-grade fever, malaise, body aches, missed work 04/28 due to symptoms.

VAERS ID:203180 (history)  Vaccinated:2003-05-09
Age:44.0  Onset:2003-05-10, Days after vaccination: 1
Gender:Male  Submitted:2003-05-12, Days after onset: 2
Location:Texas  Entered:2003-05-15, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURUB425AA1SCLA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0836AA1  
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURW13661IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Red rash with whelts - arms bilateral, itching. Began 22 hours after injection - began resolving 72 hours. Tx topical Benadryl cream during day, Benadryl 25 mg po - evening at home.

VAERS ID:203415 (history)  Vaccinated:2003-04-29
Age:44.0  Onset:2003-04-30, Days after vaccination: 1
Gender:Female  Submitted:2003-05-20, Days after onset: 20
Location:South Carolina  Entered:2003-05-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucophage, Altace, Elavil, Allegra, Keflex
Current Illness: NONE
Preexisting Conditions: Non-insulin dependent diabetes
Diagnostic Lab Data:
CDC 'Split Type': SC0320
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0445M0SCLA
TTOX: TETANUS TOXOID (NO BRAND NAME)AVENTIS PASTEURU0821AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Infection
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Vaccine administered 4-29-03. Client saw MD 5-1-03. MD''s office called to report reaction 5-2-03. Left posterior tricep area red with heat - 7x11 cm. Keflex prescribed. Client also had sinus infection.

VAERS ID:203665 (history)  Vaccinated:2003-04-21
Age:44.0  Onset:2003-05-04, Days after vaccination: 13
Gender:Female  Submitted:2003-05-06, Days after onset: 2
Location:Ohio  Entered:2003-05-27, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0774M  RA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0736AA  LA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Oedema, Pain, Pyrexia, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Low grade temp and ache on 5/4/03. Rash started on 5/4/03 over entire body, swollen-painful right knee.

VAERS ID:203736 (history)  Vaccinated:2003-04-11
Age:44.0  Onset:2003-04-11, Days after vaccination: 0
Gender:Female  Submitted:2003-05-12, Days after onset: 31
Location:Kentucky  Entered:2003-05-28, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~Measles + Mumps + Rubella (unknown mfr)~1~17~In Sibling|Fever and flu symptoms~Tetanus Toxoid (unknown mfr)~1~0~In Patient
Other Medications: PCN: extreme GI distress; Macrodantin; Bactrim; Doxycyclin; Keflex: SOB/Anaphylaxis; Cipro: Mild SOB; E-Mycim; Tordol; Hyanscodone; MsO4/Demeral Halivanations: Danger to self; Actos 45mg; Zoloft 100mg; Synthroid 125mg; Glucotrol XL 10mg;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)AVENTIS PASTEUR 0 LA
Administered by: Public     Purchased by: Public
Symptoms: Feeling hot, Injection site erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Received rabies immunoglobin with in 2 hours, front of forearm had red circle with white inside of that it was warm to touch. Also the two places on thighs were shots given were red and warm. All 3 places were itching. 1 shot Benadryl given.

VAERS ID:203968 (history)  Vaccinated:2003-02-27
Age:44.0  Onset:2003-03-06, Days after vaccination: 7
Gender:Female  Submitted:2003-05-29, Days after onset: 83
Location:Alabama  Entered:2003-05-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Protonix 40 mg
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': AL0318
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771IDLA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Liver function test abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: While at physicians office for routine physicial, liver enzymes were elevated. Experienced some shortness of breath. Recheck of enzymes scheduled in 3 months. Patient was a "no take" following smallpox vaccination.

VAERS ID:203995 (history)  Vaccinated:2003-04-29
Age:44.0  Onset:2003-05-27, Days after vaccination: 28
Gender:Female  Submitted:2003-05-29, Days after onset: 2
Location:Maine  Entered:2003-05-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0572M0SCLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site vesicles, Malaise, Pyrexia, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Pruritic pustules with some bullae. Vesicule resposule with erosion sequlin. Erythema borders. Malaise with febrile reaction (99.4 F).

VAERS ID:204024 (history)  Vaccinated:2003-05-19
Age:44.0  Onset:2003-05-20, Days after vaccination: 1
Gender:Female  Submitted:2003-05-27, Days after onset: 7
Location:Montana  Entered:2003-06-02, 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: PCN/morphine
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0820AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Diarrhoea, Injection site erythema, Injection site oedema, Muscle spasms, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow)
Write-up: Had adult Td on 5/19/03 after a dog bite. Approx 24 hours later started having muscle cramping in legs and feet. Vomiting and diarrhea, "fever", then asthma-like symptoms. Resolved with Benadryl every 4 hours. Now red swollen area on left arm at site of injection, "size of a softball". Allergic to PCN/morphine.

VAERS ID:204086 (history)  Vaccinated:2003-04-07
Age:44.0  Onset:2003-04-08, Days after vaccination: 1
Gender:Female  Submitted:2003-05-29, Days after onset: 51
Location:California  Entered:2003-06-03, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1008M1SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0567M1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Received #1 MMR and #1 varicella 2/5/03 and #2 MMR and #2 varicella 4/7/03. On 4/8 noted early AM onset of joint pain (generalized) requiring 400 Motrin TID. Pain resolved in 2 days and nor further problems.

VAERS ID:204283 (history)  Vaccinated:2002-04-05
Age:44.0  Onset:2002-04-08, Days after vaccination: 3
Gender:Female  Submitted:2003-05-30, Days after onset: 417
Location:Indiana  Entered:2003-06-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Penicillin allergy; rubella antibody negative; rubeola antibody positive.
Diagnostic Lab Data: Blood pressure (4/26/02) 124/88. Body temp (4/25/02) "fever". Serum measles IgG (3/18/02) 2.93 positive, indicative of immune status. Serum rubella IgG (3/18/02) not immune. Vital sign (4/26/02) pulse 72.
CDC 'Split Type': WAES0205USA00787
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1374L SC 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Chills, Influenza like illness, Musculoskeletal stiffness, Pain, Pyrexia, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Initial and follow-up info has been received from a registered nurse and a physician concerning a 44-year-old white female, "new hire", with penicillin allergy, who was "rubella negative and rubeola positive". On 04/05/2002, the pt was vaccinated SC with a dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) (Lot #640562/1374L). On 04/23/2002 the pt notified the Employee Health department that she experienced joint pain, stiff neck and developed hives, fever and a rash. She asked about "side-effects" of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) and was told that employee health professionals "have seen this reaction recently" and that it should subside. She was instructed to return to Employee Health dept if the symptoms worsened. The rash was first noted a few days post-vaccination and was described as a facial rash, along the jaw. On approx 04/19/2003 (reported on 04/26/2002 as "later last week"), the hives were noted over her lower back and buttocks. At that time, she also had a swollen right knee with fluid. On approx 04/23/2003, she began to develop stiff neck, chills, aching and feeling tired. On 04/25/2002 the Pt called the Employee Health dept and reported that she felt worse and missed 2 days of work. She was reported to have the same symptoms, described as "flu-like". It was reported that she also had a fever, but did not have a thermometer. The pt was treated with acetaminophen (TYLENOL) and diphenhydramine (BENADRYL). On 04/26/2003 she was seen in the Employee Health dept. She "says (she) feels better today" was documented. Her vital signs were reported as temperature 97.1 degrees F, pulse 72 and blood pressure 124/88. She was in no distress. It was noted that she denied rash or joint pain, and the swelling marks on the left buccal mucosa "as a habit". It was specifically noted that her knee exam was normal, with no joint pain or effusion. There was no rash present on her face

VAERS ID:204538 (history)  Vaccinated:2003-05-28
Age:44.0  Onset:2003-05-30, Days after vaccination: 2
Gender:Female  Submitted:2003-06-04, Days after onset: 5
Location:Pennsylvania  Entered:2003-06-05, 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: Zoloft 50mg, Desyrel 50mg, Multivitamin with Iron
Current Illness: NONE
Preexisting Conditions: Depression, Iron deficiency anemia, NKDA
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0829AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Patient went to ER on 05/21/2003 with complaints of redness and swelling at the site of tetanus shot. Patient''s symptoms started on 05/30/2003. On exam, patient was noted to have erythema, warmth and uticaria. No discharge on the right upper deltoid. She was told to apply ice, use Benadryl prn and was given keflex 500mg four times daily. Hold: no fever.

VAERS ID:204677 (history)  Vaccinated:2003-05-09
Age:44.0  Onset:2003-05-16, Days after vaccination: 7
Gender:Female  Submitted:2003-05-27, Days after onset: 11
Location:Georgia  Entered:2003-06-10, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergy to aluminum, monostat, benedol cream
Diagnostic Lab Data:
CDC 'Split Type': GA03058
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS765A60IM 
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD94CP IM 
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 5/9/03 Hep A and Td given. 5/16/03 Rash on arms and legs. 5/19/03 Rash on trunk.

VAERS ID:204735 (history)  Vaccinated:2003-03-14
Age:44.0  Onset:2003-03-15, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:North Carolina  Entered:2003-06-11
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
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0731SC 
Administered by: Military     Purchased by: Military
Symptoms: Unevaluable event
SMQs:
Write-up: Large reaction on left deltoid extending to elbow; 1 day after receiving vaccine. Rx''d with Benadryl.

VAERS ID:204827 (history)  Vaccinated:2003-06-06
Age:44.0  Onset:2003-06-07, Days after vaccination: 1
Gender:Female  Submitted:2003-06-09, Days after onset: 2
Location:Virginia  Entered:2003-06-12, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0833AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Injection site erythema, Injection site oedema, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 06/06/03: Tetanus/diphtheria vaccine was administered in right deltoid (0.5 ml/IM). 06/07/03: Pt complains of pain and tenderness of 1 day of duration in area of vaccination. 06/09/03: Pt complains of local edema, warm skin, erythema of 40mm x 40mm and pain of 2 days of duration. No fever, no axillary lymph nodes. Dx: type III reaction (Arthus reaction). Hx: Tylenol, cold compresses, follow up in 72 hours.

VAERS ID:204874 (history)  Vaccinated:2003-04-13
Age:44.0  Onset:2003-04-14, Days after vaccination: 1
Gender:Female  Submitted:2003-06-06, Days after onset: 53
Location:Unknown  Entered:2003-06-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pt hx: failed infertility treatment in past. At time of vaccination, she did not suspect she could be pregnant after years of failed attempts.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0426M   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: During preemployment screen, antibody testing was done Rubeola (NR). Vaccinated with MMR. Returned to office on 5/30/03 and advised. She is 7 weeks pregnant. She will advise of pregnancy progression. (Measles vaccine is not available).

VAERS ID:204899 (history)  Vaccinated:2003-03-13
Age:44.0  Onset:2003-03-13, Days after vaccination: 0
Gender:Female  Submitted:2003-06-10, Days after onset: 88
Location:Nevada  Entered:2003-06-13, 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: Birth control
Current Illness: UNK
Preexisting Conditions: Bee sting allergy
Diagnostic Lab Data:
CDC 'Split Type': A0401006A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS 0  
Administered by: Public     Purchased by: Other
Symptoms: Anaphylactic reaction, Dyspnoea
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: This report describes the occurrence of an anaphylactic reaction in a 44 year old female who was vaccinated with hepatitis A inactivated & hepatitis B recombinant vaccine (Twinrix) for prophylaxis. This report was received from the subject and has been verified by a physician. The subject''s relevant medical history included allergy to bee stings (onset in the late 1990''s). The subject experienced no adverse events following previous immunizations. Concurrent medications included unspecified birth control medication. On March 13, 2003, the subject received her first injection of Twinrix. On March 13, 2003, at an unspecified time post- immunization, the subject developed an anaphylactic reaction with "closing of airway, difficulty breathing". The subject was seen in the emergency room five times and was admitted to the hospital twice, for strays of one night and two nights respectively. The most recent information was received from the treating physician on May 02, 2003. The physician considered the anaphylactic reaction to be related to Twinrix administered and to have jeopardized the subject of required intervention. The anaphylactic reaction resolved on approximately March 21, 2003. The Twinrix immunization series was discontinued.

VAERS ID:204950 (history)  Vaccinated:2003-06-02
Age:44.0  Onset:2003-06-02, Days after vaccination: 0
Gender:Female  Submitted:2003-06-05, Days after onset: 3
Location:Michigan  Entered:2003-06-16, 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: Ibuprofen, Tylenol, Tums
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.1015M2SCRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Decreased level of consciousness and red swollen area where injection was given the size about 3" diameter.

VAERS ID:204971 (history)  Vaccinated:2003-04-06
Age:44.0  Onset:2003-04-06, Days after vaccination: 0
Gender:Female  Submitted:2003-06-07, Days after onset: 61
Location:Virginia  Entered:2003-06-16, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER    
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site mass, Injection site oedema, Injection site warmth, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extrava