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Found 480754 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:61309 (history)  Vaccinated:1993-01-15
Age:45.0  Onset:1993-01-15, Days after vaccination: 0
Gender:Female  Submitted:1993-06-28, Days after onset: 163
Location:Oregon  Entered:1993-11-03, Days after submission: 128
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': EBU930976
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
Administered by: Private     Purchased by: Private
Symptoms: Insomnia, Lymphadenopathy, Malaise, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt recvd vax & exp local tenderness & swelling @ the site; The same day as vax exp tingling arm, malaise lymphaddenopathy & insomnia which resolved p/3 days;

VAERS ID:57415 (history)  Vaccinated:1993-10-30
Age:45.3  Onset:1993-10-30, Days after vaccination: 0
Gender:Female  Submitted:1993-11-01, Days after onset: 2
Location:Washington  Entered:1993-11-15, 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: NONE
Current Illness: NONE
Preexisting Conditions: nuts, tomato, choclate, coffee-multiple foods (not eggs);
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F410340  
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Paraesthesia, Tachycardia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 15 mins following vax pt exp SOB, rapid heart rate, hives on chest & back, mouth tingling;

VAERS ID:57447 (history)  Vaccinated:1993-01-22
Age:45.0  Onset:1993-01-22, Days after vaccination: 0
Gender:Female  Submitted:1993-11-12, Days after onset: 294
Location:South Carolina  Entered:1993-11-16, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES93110046
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia, Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, 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 (narrow)
Write-up: pt recvd vax & following pt devel local irritation & soreness & swelling @ the inject site; pt underwent shoulder surgery & exp limited ability to move rt arm & fingers;

VAERS ID:57648 (history)  Vaccinated:1993-10-20
Age:45.2  Onset:1993-10-21, Days after vaccination: 1
Gender:Male  Submitted:1993-10-21, Days after onset: 0
Location:Ohio  Entered:1993-11-23, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': OH93093
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F410080IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: w/in 4 hrs of vax pt devel a red, raised, fine, itching rash on arm & legs;

VAERS ID:57665 (history)  Vaccinated:1993-10-12
Age:45.2  Onset:1993-10-21, Days after vaccination: 9
Gender:Male  Submitted:1993-10-25, Days after onset: 4
Location:Maryland  Entered:1993-11-24, Days after submission: 30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Maxzide, Capoten, Tenormin;
Current Illness: NONE
Preexisting Conditions: hypertension
Diagnostic Lab Data: lt ear infect/bronchitis/URI;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00963P0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Bronchitis, Chills, Hyperhidrosis, Myalgia, Otitis media, Pharyngitis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad)
Write-up: 21OCT93 chills & fever 102, mild nausea, loss of appetite 3-4 days; sweating, achiness;

VAERS ID:57710 (history)  Vaccinated:1993-10-29
Age:45.1  Onset:1993-10-29, Days after vaccination: 0
Gender:Female  Submitted:1993-11-12, Days after onset: 14
Location:Missouri  Entered:1993-11-26, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: PCN & sulfa;
Diagnostic Lab Data: NONE
CDC 'Split Type': MO93110
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F411230IMLA
Administered by: Public     Purchased by: Public
Symptoms: Nuchal rigidity
SMQs:
Write-up: flu shot given 29OCT93 lt deltoid; stiff neck on lt side onset approx 2PM same day; duration approx 6 days; no other sx;

VAERS ID:57787 (history)  Vaccinated:1993-09-20
Age:45.3  Onset:1993-09-20, Days after vaccination: 0
Gender:Female  Submitted:1993-09-23, Days after onset: 3
Location:Wisconsin  Entered:1993-11-29, Days after submission: 67
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: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1043W0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Breast pain, Insomnia, Neck pain, Pain
SMQs:, Lipodystrophy (broad), Arthritis (broad)
Write-up: 1 hr following immun pt had sharp, piercing pain between shoulder blades; unable to sleep that noc; exp sharp pain; lt breast pain & pain in neck;

VAERS ID:58057 (history)  Vaccinated:1993-10-06
Age:45.0  Onset:1993-10-08, Days after vaccination: 2
Gender:Female  Submitted:1993-12-06, Days after onset: 59
Location:New York  Entered:1993-12-09, 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: NONE
Current Illness: acute sinus infection;
Preexisting Conditions: acute sinus infection, erythromycin allergy; medical hx: asthma;
Diagnostic Lab Data: 22OCT93: SGOT 42, ESR 34;
CDC 'Split Type': WAES93110751
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1687V IM 
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Aspartate aminotransferase increased, Asthenia, Conjunctivitis, Dyspnoea, Lymphadenopathy, Rash, Red blood cell sedimentation rate increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recvd vax 6OCT93 & 2 days later pt exp nausea; fever; aching joints; swollen lymph nodes of the lt neck; red, burning eyes; h/a & resp distress; pt presented to ER;

VAERS ID:58111 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:1993-12-08
Location:Texas  Entered:1993-12-10, Days after submission: 2
Life Threatening? Yes
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES93110826
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Dyspepsia, Hepatitis, Infection, Jaundice, Weight increased
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (broad), Lack of efficacy/effect (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Gastrointestinal nonspecific dysfunction (narrow)
Write-up: pt recvd vax in 1990 & 1992 recvd another 3 doses w/no response; OCT93 devel indigestion; short time later devel severe jaundice & gained 40 pounds, presumed to be fluid in abdo; MD who examined state died of fulminant overwhelming hep B i;

VAERS ID:58159 (history)  Vaccinated:1993-10-07
Age:45.7  Onset:1993-10-14, Days after vaccination: 7
Gender:Female  Submitted:1993-12-01, Days after onset: 48
Location:Illinois  Entered:1993-12-13, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NKA, on Solu Medrol in Sept vs poison ivy
Diagnostic Lab Data:
CDC 'Split Type': IL93123
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES346911  LA
Administered by: Military     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax 7OCT93 & 1 wk p/vax devel redness, aching, swelling from 2" below inject site to elbow; area warm to touch;

VAERS ID:58214 (history)  Vaccinated:1993-10-21
Age:45.2  Onset:1993-10-21, Days after vaccination: 0
Gender:Female  Submitted:1993-11-04, Days after onset: 14
Location:California  Entered:1993-12-13, Days after submission: 39
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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH4938158  LA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: c/o light headness c/o feeling warm lasted 15 mins;

VAERS ID:58280 (history)  Vaccinated:1993-11-09
Age:45.8  Onset:1993-11-15, Days after vaccination: 6
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1993-12-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Tinoremin, Lopid, Estrase, Zantac
Current Illness: NONE
Preexisting Conditions: diabetic dx in 1992 controlled by diet;
Diagnostic Lab Data: NONE
CDC 'Split Type': CA93109
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE)LEDERLE LABORATORIES3599091IMLA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3569041IMRA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site mass, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: A few hrs post inject noticed 2 marble sized lumps in rt arm; got up 15NOV, took shower & noticed red area, size of hand, sl raised warm to touch @ inject site;

VAERS ID:58282 (history)  Vaccinated:1993-10-21
Age:45.3  Onset:1993-10-27, Days after vaccination: 6
Gender:Female  Submitted:1993-10-27, Days after onset: 0
Location:California  Entered:1993-12-17, Days after submission: 51
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Psychotropic meds
Current Illness:
Preexisting Conditions: hx anxiety reactions;
Diagnostic Lab Data:
CDC 'Split Type': CA93111
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH4938148 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Anxiety, Dizziness, Dyspnoea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: w/in approx 5 mins p/shots c/o dizziness & problems catching breath. No apparent resp distress-R20; collapsed & became unconscious; VS remained WNL; 911 called; pt very unsteady on feet; anxiety react;

VAERS ID:58297 (history)  Vaccinated:1993-09-13
Age:45.7  Onset:1993-10-14, Days after vaccination: 31
Gender:Female  Submitted:1993-11-05, Days after onset: 22
Location:Georga  Entered:1993-12-17, Days after submission: 42
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: RVC-no restrictions; anorexia as a teen; scoliosis of thoracic spine; fx lt thigh crashed skiing, 8th grade-traction 3mos & body cast 3 mons;
Diagnostic Lab Data: 27AUG93 Rubella virus IGG AB (EIA) 0.06-non-immune; mumps virus IGG AB (EIA) $g3.90 immune; Rubeola virus IGG AB (EIA) immune $g4.30;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1055A40IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0713W SCRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Arthritis, Arthropathy
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: pain & stiffness in joints of fingers, wrists, knees & feet over a period of about 2 wks; dx by MD as reactive arthritis due to vax;

VAERS ID:58562 (history)  Vaccinated:1993-10-26
Age:45.2  Onset:1993-11-01, Days after vaccination: 6
Gender:Female  Submitted:1993-12-03, Days after onset: 32
Location:Pennsylvania  Entered:1993-12-29, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Norvasc, PRemarin;
Current Illness: NONE
Preexisting Conditions: hypertension & kidney stones (sponge kidney);
Diagnostic Lab Data: NONE
CDC 'Split Type': PA93176
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F41032  RA
Administered by: Public     Purchased by: Unknown
Symptoms: Chills, Influenza, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: pt recvd shot 26OCT93 1 wk later came down flu; fever 101.7, chills, ache;

VAERS ID:58844 (history)  Vaccinated:1993-11-11
Age:45.2  Onset:1993-11-18, Days after vaccination: 7
Gender:Female  Submitted:1993-11-23, Days after onset: 5
Location:Washington  Entered:1994-01-06, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp react w/swine flu;
Other Medications: Ibuprofen, AMitriptyline; Multivit & beta carotene, vit E;
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': WA93986
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00763P0IMA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Myalgia, Pyrexia, Rash maculo-papular
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: red, splotchy rash on arms, legs, stomach last nite; today marked myalgias, arthralgias t98.9;

VAERS ID:58848 (history)  Vaccinated:1993-12-03
Age:45.1  Onset:1993-12-03, Days after vaccination: 0
Gender:Female  Submitted:1993-12-06, Days after onset: 3
Location:Washington  Entered:1994-01-06, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WA93991
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1239W2IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Back pain, Hypokinesia, Injection site hypersensitivity, Injection site oedema, Neck pain, Pain
SMQs:, Retroperitoneal fibrosis (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 (narrow), Arthritis (broad)
Write-up: pt states couldn''t move rt arm p/vax; pain in back of neck , arm & shoulder; can''t do anything to make self comfortable; some redness & swelling @ site; no temp; pt consulted MD;

VAERS ID:59149 (history)  Vaccinated:1993-05-05
Age:45.3  Onset:1993-05-06, Days after vaccination: 1
Gender:Female  Submitted:1993-05-07, Days after onset: 1
Location:Maryland  Entered:1994-01-18, Days after submission: 256
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': MD93038
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1523V1 LA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus, Skin striae
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: lt arm itchy & swollen/red around site-streaking down arm (like an S) about 4"; throat is itchy; took only Nuprin; reaction began on Thursday 6MAY inject given 5MAY;

VAERS ID:59150 (history)  Vaccinated:1993-10-13
Age:45.7  Onset:1993-10-15, Days after vaccination: 2
Gender:Male  Submitted:1993-10-25, Days after onset: 10
Location:Maryland  Entered:1994-01-18, Days after submission: 85
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Capoten, Lozol
Current Illness: hypertension
Preexisting Conditions: hypertenison
Diagnostic Lab Data: NONE
CDC 'Split Type': MD93044
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00193P IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Neck pain, Neuropathy, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: 15OCT93 pain @ site; lt brachial plexus neuropathy; 17OCT93 pain in lt arm, neck, tips of fingers;

VAERS ID:59387 (history)  Vaccinated:1994-01-07
Age:45.3  Onset:1994-01-07, Days after vaccination: 0
Gender:Female  Submitted:1994-01-10, Days after onset: 3
Location:Tennessee  Entered:1994-01-31, Days after submission: 21
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': TN94014
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3E41123 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Headache, Injection site hypersensitivity, Injection site mass, Myalgia, Pruritus, Pyrexia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: arm @ inject site red the size of a small orange itchy-leghargic feeling h/a, feels achy, chills & fevers;

VAERS ID:59739 (history)  Vaccinated:1993-10-21
Age:45.8  Onset:0000-00-00
Gender:Male  Submitted:1993-12-16
Location:Alaska  Entered:1994-02-08, Days after submission: 54
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp joint aches & swelling, weakness & fatigue @ 45 y/o w/Hep B #1 dose;
Other Medications: ASA, Vit C
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: WBC; sed rate WNL:
CDC 'Split Type': AK94001
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1014V1IMRA
Administered by: Other     Purchased by: Public
Symptoms: Condition aggravated, Osteoarthritis
SMQs:
Write-up: systemic ache-pain muscular (arms/legs); systemic ache-pain areas of articulation; weakness & fatigue @ x''s severe; sleeplessness due to pain; onset 1st inject-cont swelling-joints; pain in joints & insomnia;

VAERS ID:60005 (history)  Vaccinated:1994-02-05
Age:45.1  Onset:1994-02-05, Days after vaccination: 0
Gender:Male  Submitted:1994-02-16, Days after onset: 11
Location:North Carolina  Entered:1994-02-23, 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: marked leukopenia; BP 90/60;
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    
Administered by: Military     Purchased by: Other
Symptoms: Diarrhoea, Hypotension, Leukopenia, Nausea, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt devel hypotension, diarrhea, fever, nausea/vomiting;

VAERS ID:60044 (history)  Vaccinated:1994-01-12
Age:45.5  Onset:1994-01-19, Days after vaccination: 7
Gender:Female  Submitted:1994-02-04, Days after onset: 16
Location:Nevada  Entered:1994-02-24, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: estrace
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': NV94001
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1390W SCLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Hypokinesia, Oedema peripheral, Pain, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: about 1 wk p/shot arm kept hurting, went to wrists & hands into the fingers, its hard to bend fingers & they feel swollen, now in both arms, wrists & fingers; also ankles been aching for about wk; c/o itching;

VAERS ID:60262 (history)  Vaccinated:1993-04-12
Age:45.5  Onset:1993-04-12, Days after vaccination: 0
Gender:Male  Submitted:1994-02-22, Days after onset: 316
Location:Tennessee  Entered:1994-03-04, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp flu synd, coughing & temp @ age 45/46yrs w/Hep B doses 1 & 2;
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': TN94033
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1061V2  
Administered by: Public     Purchased by: Public
Symptoms: Cough, Influenza, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: pt recvd vax & began having flu like sx, coughing & t103; went to MD;

VAERS ID:60416 (history)  Vaccinated:1993-10-05
Age:45.0  Onset:1993-10-11, Days after vaccination: 6
Gender:Female  Submitted:1993-10-21, Days after onset: 10
Location:Oregon  Entered:1994-03-11, Days after submission: 141
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': 893309002J
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH4938226 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Headache, Infection, Neuropathy, Paraesthesia, Tongue disorder
SMQs:, Peripheral neuropathy (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: pt recvd flu vax 5OCT93 & 6 days later devel a lt sided h/a; MD dx idiopathic viral neuropathy;

VAERS ID:60617 (history)  Vaccinated:1993-11-19
Age:45.5  Onset:1993-11-19, Days after vaccination: 0
Gender:Female  Submitted:1993-11-23, Days after onset: 4
Location:Iowa  Entered:1994-03-14, Days after submission: 111
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: The pt has hayfever, & is allergic to molds & mildew;
Diagnostic Lab Data:
CDC 'Split Type': 893336001C
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH49381830IMLA
Administered by: Other     Purchased by: Private
Symptoms: Abdominal pain, Dizziness, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: Pt recvd flu vax & 19NOV93 later that day pt exp muscle aches, h/a & abdo pain; 3 days later was dizzy;

VAERS ID:60618 (history)  Vaccinated:1993-11-11
Age:45.0  Onset:1993-11-15, Days after vaccination: 4
Gender:Male  Submitted:1993-11-18, Days after onset: 3
Location:Idaho  Entered:1994-03-14, Days after submission: 116
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 893328008C
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis exfoliative, Injection site hypersensitivity, Tremor
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (narrow)
Write-up: Pt recvd vax & 4 days later ex shaking & tremors which lasted 5 mins; noted a dime-sized area of redness @ inject site w/subsequent sloughing of the sking;

VAERS ID:62591 (history)  Vaccinated:1993-01-13
Age:45.8  Onset:1993-01-22, Days after vaccination: 9
Gender:Male  Submitted:0000-00-00
Location:Maryland  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: allergy, fermented product; allergy, PCN;
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES93011488
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1252V0IM 
Administered by: Public     Purchased by: Other
Symptoms: Headache, Influenza, Myalgia, Pharyngitis, Pyrexia, Rhinitis, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad)
Write-up: pt recvd vax 13JAN93 & 22JAN93 exp flu-like sx consisting of lethargy, h/a, body aches, fever & cold sx; sx were worse @ noc; pt was treated w/Motrin;

VAERS ID:62681 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Wisconsin  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: allergy, sulfa;
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES93020868
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: pt rcvd vax; approx 2-4 wks later pt devel arthritis & arthralgia; was decided that pt would not continue the vax;

VAERS ID:62831 (history)  Vaccinated:1993-02-03
Age:45.4  Onset:1993-02-04, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:New Hampshire  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrogen patch
Current Illness:
Preexisting Conditions: allergy, trazodone;
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES93030241
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1427V0IM 
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: pt recvd vax 3FEB93 & 24 hrs following vax pt devel a t014; No further details were provided;

VAERS ID:62841 (history)  Vaccinated:1993-01-13
Age:45.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Georga  Entered:1994-03-14
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: no relevant data
CDC 'Split Type': WAES93030401
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Hypersensitivity (narrow)
Write-up: pt rcvd vax; pt exp slight reaction & itching; pt devel rash on arms,legs & sides; pt neg for anti-HBs; when pt rcvd 4th dose of vax; subsequently lab evaluation was pos for anti-HBs;

VAERS ID:63488 (history)  Vaccinated:1992-10-01
Age:45.3  Onset:1992-10-01, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES93040269
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.SC1  
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Headache, Nausea, Vasodilatation
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recvd vax; day after vax, pt exp nausea; flushing of her face; a persistent headache & fatigue;

VAERS ID:63500 (history)  Vaccinated:1993-04-12
Age:45.0  Onset:1993-04-13, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC 'Split Type': WAES93040457
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1060V0IM 
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Diarrhoea, Headache
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: pt recvd vax; w/in 24 hrs pt devel abdominal pain; joint pain; diarrhea & headache;

VAERS ID:63553 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:California  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: LDH 210 05apr93 elevated;
CDC 'Split Type': WAES93041400
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 5  
Administered by: Other     Purchased by: Other
Symptoms: Blood lactate dehydrogenase increased, Infection
SMQs:
Write-up: pt rcvd vax; pt failed to seroconvert following 6 doses of vax in 92; series repeated in jan93; pt subsequently seroconverted;on 11mar93 pt gave blood & was told he was pos core antibody;

VAERS ID:63671 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:1993-03-06
Location:Connecticut  Entered:1994-03-14, Days after submission: 373
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: no relevant data;
CDC 'Split Type': WAES93060185
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0935V   
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dizziness, Dysgeusia, Ear pain, Headache, Neck pain, Pharyngitis, Pyrexia
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: pt recvd vax; pt devel metallic taste & dizziness; exp headache; neck pain; sore throat, fatigue, chills & low grade fever; pt tx intravenous fluids in ER;

VAERS ID:63685 (history)  Vaccinated:1992-12-01
Age:45.2  Onset:1992-12-01, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1994-03-14
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: hepatitis;
Diagnostic Lab Data: 24MAY93 Anti-HBs neg;
CDC 'Split Type': WAES93060602
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0842V IM 
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax 1DEC92 & w/in 6 to 8 hrs of inject pt devel hives; 24MAY93, lab eval was neg for anti-HBs;

VAERS ID:64009 (history)  Vaccinated:1993-03-18
Age:45.6  Onset:1993-03-25, Days after vaccination: 7
Gender:Male  Submitted:0000-00-00
Location:Iowa  Entered:1994-03-14
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: no relevant data;
CDC 'Split Type': WAES93061254
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0296W0IM 
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH 0IM 
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER  PO 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Hypertonia, Hypokinesia, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: pt recvd vax; pt exp''d pain & tenderness at inject site, myalgia, arthralgia, & a frozen left shoulder; pt dx w/ adhesive capsulitis;

VAERS ID:64053 (history)  Vaccinated:1993-07-12
Age:45.0  Onset:1993-07-15, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:Maine  Entered:1994-03-14
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: no relevant data;
CDC 'Split Type': WAES93070963
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Neuropathy
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: pt recvd vax; 3 days after vax pt devel neuropathy & arthralgia in both legs;

VAERS ID:64091 (history)  Vaccinated:1993-06-02
Age:45.0  Onset:1993-06-02, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1994-03-14
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: allergies;
Diagnostic Lab Data: no relevant data;
CDC 'Split Type': WAES93080339
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1651V0IM 
Administered by: Other     Purchased by: Other
Symptoms: Chest pain, Dyspnoea, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax; w/ 20 min of vax pt devel hives around neck, shortness of breath & heaviness in her chest ;

VAERS ID:64247 (history)  Vaccinated:1993-09-17
Age:45.0  Onset:1993-09-17, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Illinois  Entered:1994-03-14
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, fish; allergy, flowers;
Diagnostic Lab Data: no relevant data;
CDC 'Split Type': WAES93100016
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Dyspepsia, Headache, Influenza, Laryngospasm, Neck pain, Pyrexia, Rhinitis, Speech disorder
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific dysfunction (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recvd vax & exp pain from shoulder up to neck; pt had f w/ t 101; exp flu-like symtoms of runny nose, h & stomach upset; pt also exp throat swelling & trouble talking;

VAERS ID:64270 (history)  Vaccinated:1993-09-29
Age:45.0  Onset:1993-10-06, Days after vaccination: 7
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp faitgue,, facial pain, hives @ 45 y/o w/Recombivax 1st dose;
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES93100490
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1517V1IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Condition aggravated, Hyperhidrosis, Nausea, Pruritus, Serum sickness, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Pt recvd vax & 6OCT93 presented to MD w/cont sx of scattered, pruritic hives throughout body; pt was treated w/Medrol dosepak & cortisone ointment; c/o fatigue, sweating & nausea; pt vomited; 7OCT93 dx serum sickness;

VAERS ID:60774 (history)  Vaccinated:1993-10-17
Age:45.5  Onset:1993-10-17, Days after vaccination: 0
Gender:Female  Submitted:1993-10-27, Days after onset: 10
Location:Oklahoma  Entered:1994-03-16, Days after submission: 140
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dilantin, Synthroid, Prozac, Dyazide, Ativan
Current Illness: NONE
Preexisting Conditions: pt has multiple medical problems, including sz disorder & hypothyroidism; also has depression;
Diagnostic Lab Data:
CDC 'Split Type': 893313013J
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH4938125 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Dermatitis exfoliative, Injection site reaction, Rash, Skin ulcer
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & w/in 15 mins of the inject devel erythema; 2 hrs later pt devel an 18-20 cm wide vesicle on arm; sloughing resulted in superficial ulceration; also devel 8-10 cm area of eschar @ the site;

VAERS ID:61003 (history)  Vaccinated:1994-01-06
Age:45.3  Onset:1994-01-28, Days after vaccination: 22
Gender:Female  Submitted:1994-03-21, Days after onset: 52
Location:North Carolina  Entered:1994-03-24, 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: Synthroid, Estrace
Current Illness: NONE
Preexisting Conditions: Hypothroidism
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1143W0  
Administered by: Unknown     Purchased by: Private
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Oligo articular arthritis-wrists tenosynovium;

VAERS ID:61100 (history)  Vaccinated:1993-11-17
Age:45.9  Onset:1993-11-30, Days after vaccination: 13
Gender:Female  Submitted:1994-03-24, Days after onset: 114
Location:Florida  Entered:1994-03-29, 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: Calan Sr
Current Illness: NONE
Preexisting Conditions: Phenothiazine
Diagnostic Lab Data: ANA titer, Sed rate, Rubella Titer, Rheum fact, CBC w/plat, SMAC 21;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.1141W IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Lymphadenopathy, Myalgia, Oedema peripheral, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: 30NOV93 swollen glands, joint pain, numbness, tingling & aching from elbows to hands; swelling of hands & feet; given DPH & Advil w/ minor relief; several months numbness has resolved; minor swelling still exists;

VAERS ID:64571 (history)  Vaccinated:1993-10-06
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:1993-10-11
Location:Oregon  Entered:1994-04-04, Days after submission: 175
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 893292005J
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH49381873IMLA
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Vasodilatation
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recvd vax & felt warm & devel severe diarrhea

VAERS ID:61666 (history)  Vaccinated:1994-03-07
Age:45.7  Onset:1994-03-07, Days after vaccination: 0
Gender:Female  Submitted:1994-03-10, Days after onset: 3
Location:Colorado  Entered:1994-04-08, Days after submission: 28
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: allergies
Diagnostic Lab Data:
CDC 'Split Type': CO94014
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES3L510920IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: swelling of upper rt arm w/redness for 36 hrs APAP given;

VAERS ID:61699 (history)  Vaccinated:1993-05-03
Age:45.5  Onset:1993-05-05, Days after vaccination: 2
Gender:Female  Submitted:1993-05-10, Days after onset: 5
Location:Michigan  Entered:1994-04-11, Days after submission: 336
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nolamine; Advil;
Current Illness: NONE
Preexisting Conditions: Equillium problem 7 yrs ago; allergies, milk, cheese, wine apples, vitamins, Novocaine, Sarvon & other pain pills, h/a;
Diagnostic Lab Data:
CDC 'Split Type': MI93069
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0685V0IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Chills, Condition aggravated, Hallucination, Photophobia, Pyrexia, Thinking abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: Pt recvd vax & tired & hallucinating, t102, tired, hot & cold chills, achy, malaise, h/a; loss of appetite, photophoiba, not thinking straight 1 wk from vax;

VAERS ID:61875 (history)  Vaccinated:1994-04-06
Age:45.3  Onset:1994-04-06, Days after vaccination: 0
Gender:Female  Submitted:1994-04-14, Days after onset: 8
Location:Vermont  Entered:1994-04-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC 'Split Type': VT94001
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1290A4   
Administered by: Unknown     Purchased by: Private
Symptoms: Arthralgia, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Wed nite-itching on arms & legs; Thursday night worse; Friday still had redness on Arms & legs; MOnday felt joint pain;

VAERS ID:61877 (history)  Vaccinated:1994-03-22
Age:45.4  Onset:1994-03-22, Days after vaccination: 0
Gender:Female  Submitted:1994-03-22, Days after onset: 0
Location:Wisconsin  Entered:1994-04-18, Days after submission: 26
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': WI94012
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1301W2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: starting getting dizzy about 1230-1PM; then 15-20 mins later became nauseated & started vomiting; Instructed to contact MD;

VAERS ID:62147 (history)  Vaccinated:1993-11-30
Age:45.3  Onset:1993-11-30, Days after vaccination: 0
Gender:Male  Submitted:1993-12-30, Days after onset: 30
Location:Washington  Entered:1994-04-26, Days after submission: 116
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: hayfever
Diagnostic Lab Data: NONE
CDC 'Split Type': WA941030
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1247A40IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Asthenia, Hyperhidrosis, Influenza, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad)
Write-up: pt reports 4 hrs p/immun feeling tired & taking temp which was 100 that time; took ASA that time & called in ill @ work; pt states had noc sweats; had 48 hrs flu;

VAERS ID:62256 (history)  Vaccinated:1994-04-12
Age:45.1  Onset:1994-04-14, Days after vaccination: 2
Gender:Female  Submitted:1994-04-25, Days after onset: 11
Location:Wisconsin  Entered:1994-05-02, 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: had been exposed to fifth disease
Preexisting Conditions: arthritis in spine
Diagnostic Lab Data:
CDC 'Split Type': WI94025
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1689W2 LA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Face oedema, Hypersensitivity, Oedema peripheral, Paraesthesia, Pruritus, Pyrexia, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recvd vax & devel t102, fever w/rash no itching; in evening rash itching; skin tingles,edematous face & hands, t100 orally-aching joints; seen by MD 15APR94 MD stated allergy but didn''t know to what;

VAERS ID:62476 (history)  Vaccinated:1994-04-25
Age:45.3  Onset:1994-04-26, Days after vaccination: 1
Gender:Female  Submitted:1994-04-28, Days after onset: 2
Location:Indiana  Entered:1994-05-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: abrasions laceration rt arm
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)BERNA BIOTECH, LTD1212403  LA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: inject given 26APR94; reported swelling & redness lt shoulder;

VAERS ID:65067 (history)  Vaccinated:1993-10-01
Age:45.0  Onset:1993-10-01, Days after vaccination: 0
Gender:Male  Submitted:1994-03-21, Days after onset: 171
Location:Ohio  Entered:1994-05-06, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp similar rxn w/flu vax 92-93 formula;
Other Medications: none;
Current Illness: none;
Preexisting Conditions: pt has hx of heart disease; pt had similar rxn when recv flugen
Diagnostic Lab Data:
CDC 'Split Type': 894087003A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH  IMA
Administered by: Public     Purchased by: Other
Symptoms: Angioneurotic oedema, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax & devel hives, angioedema & a fever;

VAERS ID:63060 (history)  Vaccinated:1994-05-16
Age:45.3  Onset:1994-05-16, Days after vaccination: 0
Gender:Female  Submitted:1994-05-19, Days after onset: 3
Location:Ohio  Entered:1994-05-23, 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: HCTZ, Premarin, Naprosyn, Darvocet;
Current Illness: NONE
Preexisting Conditions: Morphine, Codeine, Asthma, Hypertension
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES366935 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Injection site oedema, Nausea, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: On day of receiving vax approx 10PM devel sever h/a, nausea, pain, erythema, edema @ site, pain in axilla;

VAERS ID:63087 (history)  Vaccinated:1994-05-10
Age:45.5  Onset:1994-05-12, Days after vaccination: 2
Gender:Male  Submitted:1994-05-16, Days after onset: 4
Location:Michigan  Entered:1994-05-24, 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: Immunoglobulin lot# IG101A
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: transaminases elevated slightly;
CDC 'Split Type': MI94060
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MICHIGAN DEPT PUB HLTHTD6131A IMRA
Administered by: Public     Purchased by: Public
Symptoms: Hepatic function abnormal, Pruritus, Rash maculo-papular
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 2 days p/vax pt devel a severe pruritic, macular rash from waist down especially groin, buttocks, & ankles;

VAERS ID:65111 (history)  Vaccinated:1992-10-20
Age:45.0  Onset:1992-10-24, Days after vaccination: 4
Gender:Male  Submitted:1994-03-30, Days after onset: 522
Location:Ohio  Entered:1994-05-25, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp angioedema, generalized hives, fever w/last year''s flu vax
Other Medications:
Current Illness:
Preexisting Conditions: heart disease
Diagnostic Lab Data: n/s
CDC 'Split Type': 28957
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Angioneurotic oedema, Pyrexia, Serum sickness, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: angioedema, generalized hives & fever are reported in pt who recvd flu vax; 4 days p/pt recvd vax pt exp angioedema, generalized hives & fever; pt treated in ER;

VAERS ID:65213 (history)  Vaccinated:1993-10-25
Age:45.0  Onset:1993-10-26, Days after vaccination: 1
Gender:Female  Submitted:1993-11-01, Days after onset: 6
Location:Unknown  Entered:1994-05-25, Days after submission: 204
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/s
Current Illness:
Preexisting Conditions: allergy to PCN
Diagnostic Lab Data:
CDC 'Split Type': 27284
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00573P IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Injection site hypersensitivity, Injection site inflammation, Injection site pain, Vasodilatation
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: tiredness & erythema/inflammation @ inject site are reported in a pt who recvd 1 dose of flu vax; pt exp redness in inject site w/warmth & tenderness;

VAERS ID:65263 (history)  Vaccinated:1993-11-05
Age:45.0  Onset:1993-12-13, Days after vaccination: 38
Gender:Female  Submitted:1994-01-13, Days after onset: 31
Location:Unknown  Entered:1994-05-25, Days after submission: 131
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: allergies to dust & molds; gald bladder removed
Diagnostic Lab Data: hepatitis screening-neg for Hep A, B, C
CDC 'Split Type': 28292
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS01293P IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Asthenia, Hepatic function abnormal, Hyperbilirubinaemia
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad)
Write-up: pt recvd vax 5NOV93 & 13DEC93 pt underwent routine physical which revealed liver enzymes were elevated; AST, ALT, Bilirubin & GGT were all elevated; pt also noticed inc fatigue; hepatitis screening was neg for Hep A,B & C;

VAERS ID:63129 (history)  Vaccinated:1994-05-11
Age:45.0  Onset:1994-05-14, Days after vaccination: 3
Gender:Female  Submitted:1994-05-17, Days after onset: 3
Location:California  Entered:1994-05-27, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp hives @ 45 w/Hep B doses 1 & 2;
Other Medications: Feldene; Entex
Current Illness: NONE
Preexisting Conditions: pollen;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1248W2IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: hives; itching; starting elbows, shoulder-hands, thighs, feet, face, chest; SOB (DPH taken first); MD gave steroids;

VAERS ID:63183 (history)  Vaccinated:1993-06-16
Age:45.9  Onset:1994-01-01, Days after vaccination: 199
Gender:Male  Submitted:1994-05-25, Days after onset: 143
Location:Illinois  Entered:1994-05-31, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: allergy-none; smokes 1/2 pack per day;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1095A40IM 
Administered by: Public     Purchased by: Public
Symptoms: Alopecia, Hair disorder
SMQs:
Write-up: noticed inc hair/loss/breakage probably since before JUN93; last hair perm in JUN93: tints hair;

VAERS ID:65438 (history)  Vaccinated:1993-05-07
Age:45.8  Onset:1993-05-10, Days after vaccination: 3
Gender:Female  Submitted:1993-05-14, Days after onset: 4
Location:North Carolina  Entered:1994-06-02, Days after submission: 384
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: healthy
Preexisting Conditions: healthy
Diagnostic Lab Data: NONE
CDC 'Split Type': 930113703
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES344912 IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: MD has seen an unusually high incidence of reacts following immu w/Td; 1 of 3 w/in 1 wk who exp extreme swelling (size of small grapefruit) of inject site, fever to 103, & nausea;

VAERS ID:63361 (history)  Vaccinated:1994-04-22
Age:45.9  Onset:1994-04-25, Days after vaccination: 3
Gender:Male  Submitted:1994-04-25, Days after onset: 0
Location:Michigan  Entered:1994-06-10, Days after submission: 46
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': MI94062
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1269A41 RA
Administered by: Public     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 25JAN94 below inject site approx 1 1/2 -2 inches area is red, warm, swollen approx 4 inches x 3 inches;

VAERS ID:64855 (history)  Vaccinated:1994-07-07
Age:45.4  Onset:1994-07-08, Days after vaccination: 1
Gender:Female  Submitted:1994-07-08, Days after onset: 0
Location:Florida  Entered:1994-07-20, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp numbness & migraines w/ 1st dose of Hep B @ 45 y/o
Other Medications: none;
Current Illness: none;
Preexisting Conditions: none;
Diagnostic Lab Data:
CDC 'Split Type': FL94048
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1335A41IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Chest pain, Dyspnoea, Paraesthesia, Tremor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (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 (broad), Cardiomyopathy (broad)
Write-up: pt recvd vax & c/o tremors in Lt arm & tingling in Lt hand; also c/o SOB, & tiredness(weakness) & chest tightness;

VAERS ID:64913 (history)  Vaccinated:1994-03-02
Age:45.2  Onset:1994-03-15, Days after vaccination: 13
Gender:Female  Submitted:1994-03-28, Days after onset: 13
Location:Oregon  Entered:1994-07-25, Days after submission: 118
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: sed rate, cbc arthritic panel all were neg; rubella antibody 1gG=50 on 25mar94;
CDC 'Split Type':
Vaccination
Manufacturer
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Site
MUR: MUMPS + RUBELLA (FOREIGN)MERCK & CO. INC.0333W0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Arthropathy, Osteoarthritis
SMQs:, Arthritis (broad)
Write-up: pt recvd vax & devel severe stiffness, aching, soreness, pain, swelling of all jts esp wrist, knees, ankles, hips, hands & pelvic area;

VAERS ID:64924 (history)  Vaccinated:1994-01-11
Age:45.1  Onset:1994-07-21, Days after vaccination: 191
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1994-07-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergy, environmental anesthesia
Diagnostic Lab Data: local rxn;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER360959 IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & devel local rxn - area redness & lump;

VAERS ID:64968 (history)  Vaccinated:1994-07-07
Age:45.3  Onset:1994-07-20, Days after vaccination: 13
Gender:Female  Submitted:1994-07-21, Days after onset: 1
Location:New Mexico  Entered:1994-07-26, 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: Glynase, Insulin, Synthroid
Current Illness: NA
Preexisting Conditions: type II DM, hypothyroid, allergies: MSO4, Codeine, Erythromycin
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1492W0SC 
Administered by: Other     Purchased by: Public
Symptoms: Pharyngitis, Pruritus, Pyrexia, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: 13 days p/vax had flushing & itchy face; 14th day-gen pinpoint pruritic rah, t99.7, sore (mildly inflamed) throat

VAERS ID:65378 (history)  Vaccinated:1994-05-03
Age:45.2  Onset:1994-05-04, Days after vaccination: 1
Gender:Female  Submitted:1994-05-06, Days after onset: 2
Location:Wisconsin  Entered:1994-07-29, Days after submission: 84
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: lacy rash 24 degree prior to vax;
Preexisting Conditions: none;
Diagnostic Lab Data: none;
CDC 'Split Type': WI94046
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1246W2 LA
Administered by: Public     Purchased by: Unknown
Symptoms: Asthenia, Condition aggravated, Headache, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: pt recvd vax & devel terrible headache, nausea, vomiting, achy muscles, tired; arm felt heavy but often like that;

VAERS ID:65936 (history)  Vaccinated:1994-07-18
Age:45.0  Onset:1994-08-12, Days after vaccination: 25
Gender:Male  Submitted:1994-08-15, Days after onset: 3
Location:Nevada  Entered:1994-08-18, Days after submission: 3
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: hepatitis B (unsure @ time if B)
Diagnostic Lab Data: BUN 55, creat 2.5, sed rate 35, anti HBs pos SRU 60 anti HBc pos; HBsAG neg;
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1406A40IM 
Administered by: Public     Purchased by: Private
Symptoms: Blood creatinine increased, Blood urea increased, Condition aggravated, Infection, Malaise, Red blood cell sedimentation rate increased, Renal failure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad)
Write-up: immune response related to renal failure w/no other known risk factors; did not feel well for month s/p vaccine; nephrologist felt vax may have caused this due to immune markers present prior to vax that were not known to pt;

VAERS ID:66286 (history)  Vaccinated:1994-08-23
Age:45.3  Onset:1994-08-24, Days after vaccination: 1
Gender:Female  Submitted:1994-08-25, Days after onset: 1
Location:California  Entered:1994-09-02, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: SInus rx; hormones, premarin & progesterone;
Current Illness: NONE
Preexisting Conditions: allergies to pollen; slow react delayed react to bug bites & facial skin allergies;
Diagnostic Lab Data: NONE
CDC 'Split Type': CA94103
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1301W2 A
Administered by: Other     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Myalgia, Pruritus, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: soreness of arm day of inject; swelling, hot to touch, itchy, soreness area around inject site the following day; some rash around this area @ 1 inch lasting for 4 hrs;

VAERS ID:66690 (history)  Vaccinated:1993-10-08
Age:45.9  Onset:1993-10-08, Days after vaccination: 0
Gender:Female  Submitted:1993-10-14, Days after onset: 6
Location:Pennsylvania  Entered:1994-09-09, Days after submission: 330
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: healthy
Preexisting Conditions: resp allergies
Diagnostic Lab Data: NONE
CDC 'Split Type': 930218103
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE)LEDERLE LABORATORIES359910 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Headache, Infection, Influenza, Malaise
SMQs:
Write-up: 1 of 4 pts vaxed from the same lot exp an adverse event; pt exp flu-like sx (chills, h/a, malaise) w/in 24 hrs following vax; treated w/APAP & bed rest; pt recovered;

VAERS ID:66830 (history)  Vaccinated:1993-05-12
Age:45.3  Onset:1993-08-01, Days after vaccination: 81
Gender:Female  Submitted:1994-09-14, Days after onset: 409
Location:Georga  Entered:1994-09-20, Days after submission: 6
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp nausea, aching, malaise, h/a @ 44 yrs w/Hep B dose 1;
Other Medications: NONE
Current Illness:
Preexisting Conditions: allergy, sulfa
Diagnostic Lab Data: 19NOV93 Serum cholesterol 224; Serum alk phos 500; SGOT 74; SGPT 97; GGT 451; 12OCT93 serum alk phos 459; SGOT 12OCT93 50; SGPT 74; FEB94 liver biopsy (cirrhosis); 22OCT93 Ultrasound gall/liver/biliary sys nl;AUG93 liver enzymes-elevated;
CDC 'Split Type': WAES94040774
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 3IM 
Administered by: Military     Purchased by: Military
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Condition aggravated, Diarrhoea, Globulins increased, Hepatic cirrhosis, Hepatitis, Hypercholesterolaemia
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Lipodystrophy (broad), Noninfectious diarrhoea (narrow)
Write-up: pt recvd vax 12MAY93 & lab eval in AUG93 revealed elevated liver enzymes; lab eval on 12OCT93 revealed serum alkaline phosphatase 459, SGOT 50, SGPT 74; au ultrasound on 22OCT93 revealed that the gallbladder liver & biliary system nl;

VAERS ID:66890 (history)  Vaccinated:1994-07-27
Age:45.7  Onset:1994-07-31, Days after vaccination: 4
Gender:Male  Submitted:1994-08-01, Days after onset: 1
Location:Ohio  Entered:1994-09-23, Days after submission: 53
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hismanal, Zantac
Current Illness: NONE
Preexisting Conditions: environmental allergies, dust, mite, grasses, trees;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1323A40IMLA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD130611A3PO 
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Oedema genital, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: itch around the neck, mouth, body & between the 2 legs; develops rash all over the body; eyes itch, swell, so does the part between the 2 legs;

VAERS ID:67132 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:1994-10-02
Location:Virginia  Entered:1994-10-06, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none;
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Condition aggravated, Skin hypertrophy
SMQs:
Write-up: pt recvd vax & had keloid enlarged; Rt arm became irritated never healed; when healed keloid existed;

VAERS ID:67315 (history)  Vaccinated:1994-09-20
Age:45.8  Onset:1994-09-22, Days after vaccination: 2
Gender:Female  Submitted:1994-10-11, Days after onset: 19
Location:Rhode Island  Entered:1994-10-14, 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:
Current Illness: none;
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES3809570IM 
Administered by: Private     Purchased by: Unknown
Symptoms: Pain, Vasodilatation
SMQs:
Write-up: pt recvd vax & had redness & pain;

VAERS ID:67604 (history)  Vaccinated:1994-08-24
Age:45.6  Onset:1994-08-25, Days after vaccination: 1
Gender:Female  Submitted:1994-10-07, Days after onset: 43
Location:Colorado  Entered:1994-10-24, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Propranodol
Current Illness:
Preexisting Conditions: tetracycline
Diagnostic Lab Data: microscopic exam of smear;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1247A40IMA
Administered by: Private     Purchased by: Public
Symptoms: Vaginal infection
SMQs:
Write-up: vaginal yeast infect; 1 wk; Micronazale (OTC) x 1 wk;

VAERS ID:68226 (history)  Vaccinated:1993-12-07
Age:45.1  Onset:1993-12-09, Days after vaccination: 2
Gender:Female  Submitted:1994-04-06, Days after onset: 117
Location:Florida  Entered:1994-10-26, Days after submission: 203
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: bicillin;
Current Illness: sore throat;
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': CO5226
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES3C51048 IMLA
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: pt recvd vax; cellulitis at site;

VAERS ID:68230 (history)  Vaccinated:1994-02-04
Age:45.9  Onset:1994-02-04, Days after vaccination: 0
Gender:Female  Submitted:1994-04-06, Days after onset: 60
Location:Illinois  Entered:1994-10-26, Days after submission: 203
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: advil;
Current Illness: sinus infect;
Preexisting Conditions: none;
Diagnostic Lab Data:
CDC 'Split Type': CO5275
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES    
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site oedema, Injection site pain, Rash, Skin striae, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax; swelling, warm, tender at site; streaking & rash down arm; swelling persists 1 wk later;

VAERS ID:68237 (history)  Vaccinated:1994-03-05
Age:45.7  Onset:1994-03-05, Days after vaccination: 0
Gender:Female  Submitted:1994-04-18, Days after onset: 43
Location:Wisconsin  Entered:1994-10-26, Days after submission: 191
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': CO5321
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES3L51092   
Administered by: Private     Purchased by: Private
Symptoms: Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recvd vax; small knot at site, tender to touch;

VAERS ID:68240 (history)  Vaccinated:1994-03-05
Age:45.3  Onset:1994-03-05, Days after vaccination: 0
Gender:Female  Submitted:1994-04-18, Days after onset: 43
Location:Wisconsin  Entered:1994-10-26, Days after submission: 191
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': CO5324
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES3L51092   
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax; "little" red & swollen at site;

VAERS ID:68638 (history)  Vaccinated:1993-10-08
Age:45.4  Onset:1993-10-08, Days after vaccination: 0
Gender:Female  Submitted:1994-08-23, Days after onset: 319
Location:Michigan  Entered:1994-10-26, Days after submission: 64
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No
Other Medications: Premarin, Thyroid Med
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC 'Split Type': CO5041
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F41124 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anaphylactoid reaction, Chest pain, Laryngospasm
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: anaphylatic react, not described; to ER 20 mins p/inject on 8OCT93 w/tightness of chest, sensation of throat closing; tx w/DPH, Solu Medrol, Proventil inhaler; referred to allergist;

VAERS ID:68656 (history)  Vaccinated:1993-10-25
Age:45.8  Onset:1993-10-25, Days after vaccination: 0
Gender:Female  Submitted:1994-08-23, Days after onset: 302
Location:Utah  Entered:1994-10-26, Days after submission: 64
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none;
Current Illness:
Preexisting Conditions: allergy to pcn, sulfa, codeine;
Diagnostic Lab Data:
CDC 'Split Type': CO5070
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F41028   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: pt recvd vax; fever of 103 w/ aching;

VAERS ID:68686 (history)  Vaccinated:1993-09-17
Age:45.7  Onset:1993-09-17, Days after vaccination: 0
Gender:Female  Submitted:1994-08-23, Days after onset: 340
Location:Nebraska  Entered:1994-10-26, Days after submission: 64
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No
Other Medications: Nordate Birth Control
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': CO5119
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F411710IMRA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Chest pain, Condition aggravated, Conjunctivitis, Eye disorder, Galactorrhoea, Hypertonia, Pain
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: whites of eyes turned red, then pupils turned white as reported by pt; eye color light blue/gray; also had thick white mucous which cleared w/warm water; pain in ankle, sharp pain in rib cage on inspiration & pain in arm; muscle spasms;

VAERS ID:67779 (history)  Vaccinated:1994-10-20
Age:45.5  Onset:1994-10-20, Days after vaccination: 0
Gender:Female  Submitted:1994-10-21, Days after onset: 1
Location:Wisconsin  Entered:1994-10-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: was off work; superior vena cava obstruc
Preexisting Conditions: diabetic; vein obstruction; chronic epstein barr; allergic to demeral codeine;
Diagnostic Lab Data: seen by er;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Private
Symptoms: Injection site oedema, Pruritus, Rash, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax & w/in 15 min started itching; face turned red; rash on face; hives & swelling around inject site; to er; tx w/ atarax;

VAERS ID:67861 (history)  Vaccinated:1994-09-16
Age:45.4  Onset:0000-00-00
Gender:Female  Submitted:1994-10-25
Location:Minnesota  Entered:1994-10-31, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: puncture wound lt foot
Preexisting Conditions: allergict to Ergot/w/o pseudotumor cerebr; borderline HTn; kidney stone & cystocele
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4F61059 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt came into office 5 days post inject reporting several days of inc pain, swelling, redness @ site; objective findings were a 15 cm area of firm SC; tx w/ meds;

VAERS ID:67872 (history)  Vaccinated:1994-10-15
Age:45.5  Onset:1994-10-16, Days after vaccination: 1
Gender:Female  Submitted:1994-10-17, Days after onset: 1
Location:North Dakota  Entered:1994-10-31, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Ogen-hormone
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F510230 LA
Administered by: Other     Purchased by: Private
Symptoms: Amblyopia, Eye pain, Face oedema, Injection site hypersensitivity, Injection site mass, Myalgia, Paraesthesia oral, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Optic nerve disorders (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: 16OCT woke up eyes puffy & sore, vision can''t focus; 17OCT eye dark & puffy, tingling sensation around hard mouth, arm sore, inject site 2" round sore, red; seen by MD-rx for itching Doxipin & DPH;

VAERS ID:70190 (history)  Vaccinated:1993-11-16
Age:45.0  Onset:1993-11-16, Days after vaccination: 0
Gender:Unknown  Submitted:1994-02-03, Days after onset: 79
Location:California  Entered:1994-10-31, Days after submission: 270
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type': 930045521
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Public
Symptoms: Abdominal pain, Dizziness, Headache, Hypotension, Vasodilatation, Visual disturbance
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: pt recvd vax;10 mins p/ vax exp dizziness,pt''s BP "bottomed out";subsided;addtly exp hot flashes,loss of focus & ha 10 mins p/vax;ha are recurring & pt has also exp rt upper quadrant pain since day of vax;sxs tx in er w/ epi & dph;released

VAERS ID:70358 (history)  Vaccinated:1993-12-20
Age:45.0  Onset:1993-12-20, Days after vaccination: 0
Gender:Female  Submitted:1994-03-24, Days after onset: 94
Location:Michigan  Entered:1994-10-31, Days after submission: 221
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp facial flushing w/Engerix-B #1 dose
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergic to cortisone;
Diagnostic Lab Data:
CDC 'Split Type': 940004531
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Face oedema, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recvd vax & exp facial flushing; addtly face & eye were swollen & had lt elbow pain; 24 hrs later exp facial redness; tx DPH

VAERS ID:70411 (history)  Vaccinated:1994-01-10
Age:45.0  Onset:1994-01-17, Days after vaccination: 7
Gender:Male  Submitted:1994-04-28, Days after onset: 100
Location:Florida  Entered:1994-10-31, Days after submission: 186
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: cold sxs;
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 940036631
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad)
Write-up: pt recvd vax;1 wk later,exp tinnitus & lightheadedness; outcome:unresolved

VAERS ID:70413 (history)  Vaccinated:1994-03-29
Age:45.0  Onset:1994-03-31, Days after vaccination: 2
Gender:Female  Submitted:1994-05-27, Days after onset: 56
Location:Pennsylvania  Entered:1994-10-31, Days after submission: 157
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control;multivitamin
Current Illness:
Preexisting Conditions: no nka
Diagnostic Lab Data:
CDC 'Split Type': 940036651
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1291A20IMA
Administered by: Private     Purchased by: Other
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax;2 days later, exp a pruritic rash over entire body sparing face,hands,& feet;tx over the counter dph; sxs still persisting as of 24apr94;

VAERS ID:70427 (history)  Vaccinated:1993-04-20
Age:45.1  Onset:1993-04-20, Days after vaccination: 0
Gender:Female  Submitted:1994-04-05, Days after onset: 350
Location:Unknown  Entered:1994-10-31, Days after submission: 209
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: thyroid med;
Current Illness:
Preexisting Conditions: thyroid problems
Diagnostic Lab Data: CPK 14oct93 =158 units/L?;CHOL=204 MG/DL? 4dec93;
CDC 'Split Type': 940008101
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1069A42  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Blood creatine phosphokinase increased, Chills, Infection, Injection site pain, Myalgia, Oedema peripheral, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: pt recvd vax;exp pain at inject site p/ 3 dose of vax;approx 7 mo later exp hand swelling,soreness & polyarthralgia;also exp viral synd type sxs;chills, fever, & aching; tx w/ prednisone;sxs resolved 2-4 days;all arthritis nl;

VAERS ID:70431 (history)  Vaccinated:1994-02-02
Age:45.0  Onset:1994-02-02, Days after vaccination: 0
Gender:Male  Submitted:1994-03-18, Days after onset: 44
Location:California  Entered:1994-10-31, Days after submission: 227
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: synthroid, zestril;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 940009621
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1099A42IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Dizziness, Dysgeusia
SMQs:, Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: pt recvd vax for prophylaxis;w/in secs of adm of vax,exp dizziness,a metallic taste in mouth,and chills;pt tx w/ O2;events subsided approcx 3 hrs p/ onset;

VAERS ID:70508 (history)  Vaccinated:1994-03-04
Age:45.0  Onset:1994-03-11, Days after vaccination: 7
Gender:Female  Submitted:1994-03-30, Days after onset: 19
Location:Ohio  Entered:1994-10-31, Days after submission: 215
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: EBV 1:80 pre vax; EBV 1:1280 post vax;
CDC 'Split Type': 940026411
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Infection, Influenza, Laboratory test abnormal, Lymphadenopathy
SMQs:, Guillain-Barre syndrome (broad)
Write-up: pt recvd vax & 1 wk p/vax pt exp flu-like sx (fatigue & swollen lymph nodes) & an elevated Epstein-Barr antigen;

VAERS ID:70840 (history)  Vaccinated:1994-05-16
Age:45.0  Onset:1994-05-17, Days after vaccination: 1
Gender:Male  Submitted:1994-06-29, Days after onset: 43
Location:California  Entered:1994-10-31, Days after submission: 124
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': 940047351
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1325A20IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)
Write-up: pt recvd vax & 24 hrs later exp SOB & fatigue; pt sx lasted 2 wks;

VAERS ID:67963 (history)  Vaccinated:1994-10-17
Age:45.9  Onset:1994-10-17, Days after vaccination: 0
Gender:Female  Submitted:1994-10-17, Days after onset: 0
Location:Texas  Entered:1994-11-04, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Minitran, Monopril,Coumadin,Lasix,Pepcid,Hydralazine,Theo-dur,Micro-K
Current Illness: unk
Preexisting Conditions: severe cardiomyopathy(has been considered for cardiac transplant); pt has HTN,s/p cholecystectomy;asthma; hx of peptic ulcer disease & anemia;
Diagnostic Lab Data: CT scan: head--nl; Doppler studies of carotids--mild stenosis on left, severe stenosis on right, theophylline level 10.7;
CDC 'Split Type': 894292001K
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49481102IMRA
Administered by: Private     Purchased by: Private
Symptoms: Angiopathy, Asthenia, Convulsion, Eye disorder, Hypertonia, Hyperventilation, Hypotension, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt recvd flu vax & while nurse was removing the needle from pt''s arm pt became weak, dizzy & sweaty; when MD saw pt was stiff, but relaxed immed afterward; MD noted sl deviation of the eyes to the rt; pulse thready 80-96bpm & BP 106/76;

VAERS ID:68066 (history)  Vaccinated:1994-10-26
Age:45.6  Onset:1994-10-27, Days after vaccination: 1
Gender:Female  Submitted:1994-11-03, Days after onset: 7
Location:Massachusetts  Entered:1994-11-07, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F501050IMLA
Administered by: Other     Purchased by: Public
Symptoms: Face oedema, Oedema peripheral, Paraesthesia, Paraesthesia oral, Pruritus, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 24 hrs p/vax had diffuse itching; 48 hrs had hives 72 hrs later diffuse hives; 80 hrs later swollen, numb legs-went to ER & was given Epi & DPH & Pred; 36 hrs later lips became swollen & numb again & pt recvd Epi, Cortisone & Pred;

VAERS ID:68081 (history)  Vaccinated:1994-10-30
Age:45.5  Onset:1994-10-30, Days after vaccination: 0
Gender:Female  Submitted:1994-11-02, Days after onset: 3
Location:Oklahoma  Entered:1994-11-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F510210IMA
Administered by: Public     Purchased by: Public
Symptoms: Asthma, Conjunctivitis, Cough, Headache, Rhinitis, Sinusitis
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: apporx 4 hrs p/vax exp sudden onset of runny nose, eye irritation, nasal/sinus congestion draining into nasopharynx causing coughing/wheezing, h/a, injected ocnjunctive; sx resolved w/in 24 hrs; pt did take DPH 2 hrs p/onset sx;

VAERS ID:68112 (history)  Vaccinated:1994-10-27
Age:45.4  Onset:1994-10-27, Days after vaccination: 0
Gender:Female  Submitted:1994-10-28, Days after onset: 1
Location:Florida  Entered:1994-11-07, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp similar rxn @ 41 yrs w/flu;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F51072 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Cough, Lacrimal disorder, Malaise, Pharyngitis, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Lacrimal disorders (narrow)
Write-up: cough began 630PM 27JUN94 by 9PM had watery eyes & runny nose-c/o feeling bad w/cold sx today 28OCT94; states had similar react p/flu vax approx 4 yrs ago; non since & has taken it even year; t99;

VAERS ID:68362 (history)  Vaccinated:1994-10-13
Age:45.1  Onset:1994-10-14, Days after vaccination: 1
Gender:Female  Submitted:1994-10-28, Days after onset: 14
Location:Missouri  Entered:1994-11-10, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: septra d/s x 10 days;
Current Illness: was being tx for UTI;
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': MO94091
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F511330IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax; pt exp chills; fever & purple colored rash (pruitic) 20 hrs after vax;had also been taking septra x 10 days;

VAERS ID:68475 (history)  Vaccinated:1994-10-28
Age:45.3  Onset:1994-10-28, Days after vaccination: 0
Gender:Female  Submitted:1994-11-03, Days after onset: 6
Location:Colorado  Entered:1994-11-14, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Lo Estrin 1/20
Current Illness: NONE
Preexisting Conditions: PCN, Bactrim; allergic rhinitis
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F510550IMA
Administered by: Other     Purchased by: Unknown
Symptoms: Asthenia, Chest pain, Conjunctivitis, Cough, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: 28OCT94 730-8AM flu vax; 11AM non productive cough, sl tight in chest; 12N bilateral conjunctivitis, no discharge; 1P myalgias, h/a; 630P t100.8, myalgias; 29OCT94 dec conjunctivitis, inc fatigue otherwise OK

VAERS ID:68600 (history)  Vaccinated:1994-10-27
Age:45.0  Onset:1994-11-09, Days after vaccination: 13
Gender:Female  Submitted:1994-11-09, Days after onset: 0
Location:Illinois  Entered:1994-11-19, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES49510890SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Breast pain, Chest pain, Pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Lipodystrophy (broad)
Write-up: 2 days post vax c/o pain rt chest radiates rt breast to shoulder is sharp-still occuring 10 days post vax; 14NOV994 still sporadic-has consulted MD who is evaluating pain;

VAERS ID:68605 (history)  Vaccinated:1994-11-07
Age:45.4  Onset:1994-11-07, Days after vaccination: 0
Gender:Male  Submitted:1994-11-11, Days after onset: 4
Location:Alabama  Entered:1994-11-19, 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: NA
Current Illness: puncture wound lt hand
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES380914 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Lymphadenopathy, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: swelling of deltoid region of rt arm, swelling of soft tissue in rt neck/shoulder, enlargement fo clavicular lymph node;

VAERS ID:69016 (history)  Vaccinated:1994-11-17
Age:45.1  Onset:1994-11-17, Days after vaccination: 0
Gender:Female  Submitted:1994-11-17, Days after onset: 0
Location:Arizona  Entered:1994-11-28, 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: flu sx, mild, 1 week ago
Preexisting Conditions: none;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4948148 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Oedema, Pruritus, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: hard swelling occurred @ site immed; pt returned to work, called husband 15-20 mins later c/o redness, swelling, itching; husband advised DPH, ice arm;p/ 1 hr,sxs cont,felt hot,neck/chest red;to clinic,tx w/ dph;

VAERS ID:69036 (history)  Vaccinated:1994-11-14
Age:45.1  Onset:1994-11-15, Days after vaccination: 1
Gender:Male  Submitted:1994-11-21, Days after onset: 6
Location:New York  Entered:1994-11-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: seen by dermatologist today who did blood test
CDC 'Split Type':
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F511291IMLA
Administered by: Other     Purchased by: Private
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: red raised rash all over body less than 24 hrs p/flu shot not itchy remains on Antihistamine;

VAERS ID:71727 (history)  Vaccinated:1994-06-30
Age:45.2  Onset:1994-07-09, Days after vaccination: 9
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1994-12-07
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: No relevant data;
CDC 'Split Type': WAES94070448
Vaccination
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RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.1270W   
Administered by: Other     Purchased by: Other
Symptoms: Lymphadenopathy
SMQs:
Write-up: pt recvd vax 30JUN94 & 9JUL94 pt devel swollen glands under ears & base of the skull; No further details were provided;

VAERS ID:69540 (history)  Vaccinated:1994-10-19
Age:45.6  Onset:1994-10-19, Days after vaccination: 0
Gender:Male  Submitted:1994-11-15, Days after onset: 27
Location:California  Entered:1994-12-12, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: chronic hepatitis-BC
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00474P0 A
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES3769670 A
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia, Myalgia, Myasthenic syndrome, Oedema peripheral
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: sl soreness p/shot-by evening arm was sore & felt heavy; following morning unable to arm-arm neither red or hot, sl swollen; sx improved w/in 24 hrs; missed one day of work;

VAERS ID:69599 (history)  Vaccinated:1994-11-16
Age:45.1  Onset:1994-11-16, Days after vaccination: 0
Gender:Male  Submitted:1994-11-28, Days after onset: 12
Location:Massachusetts  Entered:1994-12-14, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F10590SCLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Diarrhoea, Dyspepsia, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: head felt like it would explode, upset stomach, diarrhea, achiness all over, very tired;

VAERS ID:69654 (history)  Vaccinated:1994-12-06
Age:45.6  Onset:1994-12-09, Days after vaccination: 3
Gender:Male  Submitted:1994-12-09, Days after onset: 0
Location:Florida  Entered:1994-12-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none;
Preexisting Conditions: diabetic, hypertension, HIV pos;
Diagnostic Lab Data: none;
CDC 'Split Type':
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PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES3789730IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site abscess, Injection site mass, Injection site oedema, Tremor, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recvd vax; swelling, hot, induration of lt deltoid area; ? inject abscess;also c/o some tremors after inject;

VAERS ID:69704 (history)  Vaccinated:1994-10-18
Age:45.1  Onset:1994-10-20, Days after vaccination: 2
Gender:Female  Submitted:1994-12-12, Days after onset: 53
Location:California  Entered:1994-12-19, 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: Dipenlenx
Current Illness:
Preexisting Conditions: ulcerative colitis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   RA
Administered by: Other     Purchased by: Unknown
Symptoms: Abdominal pain, Cellulitis, Diarrhoea, Hypersensitivity, Oedema peripheral, Rash, Somnolence, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recvd vax & exp allergic react rt arm-FU; pt states slept a lot; some warmth; pt noticed some redness around rt elbow w/swelling & ince warmth; exp some abdo pain & chills; bowel movements watery x 6; poss cellulitis vx urticarial;

VAERS ID:70018 (history)  Vaccinated:1994-06-07
Age:45.5  Onset:1994-06-07, Days after vaccination: 0
Gender:Female  Submitted:1994-12-28, Days after onset: 204
Location:Minnesota  Entered:1995-01-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: in pt, secs p/ vax,ha & vertigo x 2 days w/ hep B vax dose 2
Other Medications: none
Current Illness: none
Preexisting Conditions: no known conditions;
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1095A41IMLA
Administered by: Public     Purchased by: Public
Symptoms: Headache
SMQs:
Write-up: pt recvd vax;devel severe h/a 12 hrs post inject x 2 days despite advil post inject;

VAERS ID:71197 (history)  Vaccinated:1995-01-13
Age:45.3  Onset:1995-01-14, Days after vaccination: 1
Gender:Female  Submitted:1995-01-26, Days after onset: 12
Location:Alaska  Entered:1995-01-31, 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: rubella, Rubeola titer drawn 16MAR93/non-immune;
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0181A0SCLA
Administered by: Unknown     Purchased by: Private
Symptoms: Arthralgia, Headache, Injection site pain, Malaise, Myalgia, Pyrexia, Rash, Sinusitis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 14JAN95 sudden onset h/a, malaise; 23JAN95 sinus congestion, muscle pain, t99.3; 24JAN95 body aches, t99.4; 25JAN95 joint pain, h/a; 26JAN95 rash pain @ inject site;

VAERS ID:71354 (history)  Vaccinated:1994-10-29
Age:45.6  Onset:1994-11-03, Days after vaccination: 5
Gender:Female  Submitted:1995-02-03, Days after onset: 92
Location:Massachusetts  Entered:1995-02-07, 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:
CDC 'Split Type': MA9502
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F510160 LA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Myalgia, Myasthenic syndrome, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: upper arm aching & weak; cannot lift as much as usual in certain positions; It still hurts three months p/shot;

VAERS ID:71362 (history)  Vaccinated:1994-11-03
Age:45.2  Onset:1994-11-04, Days after vaccination: 1
Gender:Female  Submitted:1995-01-27, Days after onset: 84
Location:Ohio  Entered:1995-02-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Inderal, BCP
Current Illness: NONE
Preexisting Conditions: NKA/Inderal Cardiac
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49480380IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Diarrhoea, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: onset of severe abdo cramping/diarrhea (approx 2-4 stool) w/nausea but no vomiting which started 10-12 hrs p/flu vax & stopped 12-15 hrs later;

VAERS ID:72299 (history)  Vaccinated:1994-10-11
Age:45.2  Onset:1994-10-13, Days after vaccination: 2
Gender:Female  Submitted:1994-11-09, Days after onset: 27
Location:Ohio  Entered:1995-02-07, Days after submission: 90
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: hx of allergy to bactrim;
Diagnostic Lab Data:
CDC 'Split Type': 894342001L
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4948053 IMLA
Administered by: Private     Purchased by: Private
Symptoms: 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: pt recvd vax; devel edema, erythema & pruritus at inject site;

VAERS ID:72301 (history)  Vaccinated:1994-10-27
Age:45.4  Onset:1994-10-28, Days after vaccination: 1
Gender:Female  Submitted:1994-11-09, Days after onset: 12
Location:Ohio  Entered:1995-02-07, Days after submission: 90
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 894342003L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4948053 IMLA
Administered by: Private     Purchased by: Private
Symptoms: 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: pt recvd vax; devel edema, erythema & pruritus at inject site;

VAERS ID:72502 (history)  Vaccinated:1994-10-25
Age:45.1  Onset:1994-10-26, Days after vaccination: 1
Gender:Female  Submitted:1994-11-07, Days after onset: 12
Location:Connecticut  Entered:1995-02-07, Days after submission: 92
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: estrace, provera
Current Illness: none
Preexisting Conditions: pt has hx of salicylate intolerance
Diagnostic Lab Data:
CDC 'Split Type': 894319005K
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49481142IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: pt recvd vax;pt devel erythematous,hot area at inject site, resolved in 2 days;

VAERS ID:71450 (history)  Vaccinated:1994-10-17
Age:45.7  Onset:1994-10-17, Days after vaccination: 0
Gender:Female  Submitted:1994-12-29, Days after onset: 73
Location:Michigan  Entered:1995-02-13, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp react 12 yrs ago w/flu vax #1 dose
Other Medications: Premarin
Current Illness: NONE
Preexisting Conditions: mitral valve prolapse
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49481110 LA
Administered by: Public     Purchased by: Private
Symptoms: Gait disturbance, Headache, Insomnia, Palpitations, Vertigo
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (narrow)
Write-up: devel h/a & palpations afternoon of 17OCT94, both became inc worse during evening, woke twice during noc severe h/a, inc palpations & vertigo, 4AM had unsteady gait from vertigo; forced fluids in AM around noon 18OCT94 sx began subsiding;

VAERS ID:72837 (history)  Vaccinated:1994-04-29
Age:45.6  Onset:1994-04-30, Days after vaccination: 1
Gender:Male  Submitted:1994-05-06, Days after onset: 6
Location:Florida  Entered:1995-03-01, Days after submission: 299
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: wound; healthy
Preexisting Conditions: healthy; pt last does of tetanus toxoid was approx 7yrs ago
Diagnostic Lab Data: NONE
CDC 'Split Type': 940095801
Vaccination
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TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3249041IMA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & w/in 24 hrs devel inj site rxn (erythema & induration approx 2cm in diameter); tx''d w/APAP/warm compresses; As of this report, rxn unchanged; seen by RN; no new tx iniitated; last tetanus was approx 7 yrs ago

VAERS ID:72842 (history)  Vaccinated:1994-07-25
Age:45.5  Onset:1994-07-25, Days after vaccination: 0
Gender:Female  Submitted:1994-07-26, Days after onset: 1
Location:Texas  Entered:1995-03-01, Days after submission: 218
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Medrol
Current Illness: minor finger laceration
Preexisting Conditions: last TTox was 10 yrs ago; MD reports pt may be allergic to Thimerosal; @ one time pt attempted to wear contact lenses; had a severe react to them because lens solution contained Thimerosal;
Diagnostic Lab Data: NONE
CDC 'Split Type': 940159601
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3649351IMA
Administered by: Private     Purchased by: Private
Symptoms: Dysphonia, Laryngeal oedema, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & devel myalgias, tingling all over & body laryngeal edema; tx''d w/Adrenalin (1/4 ml SQ) & DPH; pt improved significantly w/in 30 mins; next day pt reported to MD was still a little hoarse

VAERS ID:72846 (history)  Vaccinated:1994-06-08
Age:45.1  Onset:1994-06-09, Days after vaccination: 1
Gender:Female  Submitted:1994-08-23, Days after onset: 75
Location:New Hampshire  Entered:1995-03-01, Days after submission: 190
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: unk
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': 940179504
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES366933 IM 
Administered by: Private     Purchased by: Private
Symptoms: Facial palsy, Injection site hypersensitivity
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow)
Write-up: 1 of 4 pts vaxed during the last yr (different lots) who exp large hives @ inj site; hives described as red mound-not abscessed, quarter to 1/2 dollar size; pt also dx w/Bell''s Palsy; No further details available

VAERS ID:71990 (history)  Vaccinated:1994-10-27
Age:45.5  Onset:1994-11-12, Days after vaccination: 16
Gender:Male  Submitted:1994-12-09, Days after onset: 27
Location:Colorado  Entered:1995-03-09, Days after submission: 90
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Blood smapled, xray
CDC 'Split Type': CO95006
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F51146 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Infection, Pharyngitis, Rheumatoid arthritis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Arthritis (narrow)
Write-up: 27OCT recvd vax in rt deltoid; 12NOV began exp join pain rt shoulder, hand elbow; 25NOV consulted w/MD dx rheumatoid arthritis; 28NOV retunr to MD c/o sore throat-typ B step throat-tx w/PCN x 10 days;

VAERS ID:72006 (history)  Vaccinated:1994-10-13
Age:45.6  Onset:1994-10-15, Days after vaccination: 2
Gender:Female  Submitted:1995-01-27, Days after onset: 104
Location:Ohio  Entered:1995-03-09, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Xanax, Procardia, Vitamins
Current Illness: NONE
Preexisting Conditions: NKA-coronary artery spasm, cyst on brain
Diagnostic Lab Data: NONE
CDC 'Split Type':
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Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4948100 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: nl discomfort w/initial inj- became inc painful over several days; severe pain radiating down into arm & hand w/inc activity of arm; went to MD in JAN95; placed on ATB & is to begain PT

VAERS ID:72945 (history)  Vaccinated:1994-06-07
Age:45.8  Onset:1994-06-10, Days after vaccination: 3
Gender:Male  Submitted:1994-06-17, Days after onset: 7
Location:Virginia  Entered:1995-03-13, Days after submission: 269
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: has hypertension
Diagnostic Lab Data: testing for potency, PH: result satisfactory;
CDC 'Split Type': 894196011A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49480080IMLA
Administered by: Private     Purchased by: Other
Symptoms: Pain, Skin nodule, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recvd vax;devel local rxn characterized by redness, induration & pain & warmth; tx w/ Ancef 2 g followed by dicloxacillin for 7 days;

VAERS ID:72864 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Male  Submitted:1994-02-14
Location:Massachusetts  Entered:1995-03-14, Days after submission: 393
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 894075003A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)PFIZER/WYETH    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Hypertonia, Infection
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: pt devel tetanus 8 hrs p/last TTox booster (MFR unk); pt was treated w/tetanus immune globulin & recovered;

VAERS ID:72878 (history)  Vaccinated:1994-06-21
Age:45.8  Onset:1994-06-23, Days after vaccination: 2
Gender:Male  Submitted:1994-06-24, Days after onset: 1
Location:West Virginia  Entered:1995-03-14, Days after submission: 263
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: injury, laceration of lip
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 894201013A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)PFIZER/WYETH49380571IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Injection site oedema, Injection site pain, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recvd vax; devel soreness & swelling at inject site followed by n,v,chills & fever; was tx w/ dph cream & application ice;

VAERS ID:73128 (history)  Vaccinated:1994-09-15
Age:45.9  Onset:1994-10-03, Days after vaccination: 18
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1995-03-17
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: urticaria
Diagnostic Lab Data: 23NOV92 Anti-HBs 0.7SRU; 23AUG93 Anti-HBs 0.9SRU
CDC 'Split Type': WAES93081256
Vaccination
Manufacturer
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Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 9IM 
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recvd 3rd dose of vax & failed to seroconvert; 15SEP94 & on 3OCT94 devel urticaria which persisted for 1wk; pt reported a prev history of urticaria assoc w/stress, felt that recent episode was also stress related;

VAERS ID:73152 (history)  Vaccinated:1993-11-01
Age:45.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Ohio  Entered:1995-03-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: DEC93 Anti-HBc pos; HBsAg neg; Anti-HBs neg;
CDC 'Split Type': WAES94011292
Vaccination
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Military     Purchased by: Military
Symptoms: Infection, Laboratory test interference
SMQs:
Write-up: pt recv vax & reporter noted it was felt that the anti-HBc was a false pos which was probably due to cross-sensitivity; No further info provided;

VAERS ID:73499 (history)  Vaccinated:1993-07-29
Age:45.8  Onset:1993-08-01, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:1995-03-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: depo-medrol
Current Illness:
Preexisting Conditions: mitral valve prolapse; hayfever; allergy,poiison ivy;
Diagnostic Lab Data:
CDC 'Split Type': WAES94030679
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1522V1IM 
Administered by: Other     Purchased by: Private
Symptoms: Ecchymosis, Injection site atrophy, Injection site hypersensitivity, Injection site necrosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax;in aug1993 pt had an indented, reddened & bruised area at inject site that was dx as subcutaneous necrosis of the underlying tissue; no pain or dec motion in arm;to MD

VAERS ID:73705 (history)  Vaccinated:1994-02-01
Age:45.0  Onset:1994-02-01, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Oregon  Entered:1995-03-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: lupus
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES94031608
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: pt recv vax;devel monoarticular arthritis;

VAERS ID:74375 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1995-03-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES94090581
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Alopecia
SMQs:
Write-up: pt recv vax; devel alopecia;neg hx of alopecia in the family;

VAERS ID:74394 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1995-03-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rash @ 45 y/o w/REcombivax dose 1
Other Medications:
Current Illness:
Preexisting Conditions: rheumatoid, arthritis
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES94090983
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Arthritis, Hypersensitivity
SMQs:, Angioedema (broad), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: pt recv vax & devel arthritis & delayed hypersensitivity; No further details were provided;

VAERS ID:74436 (history)  Vaccinated:1994-10-01
Age:45.3  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1995-03-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rash @ 45y/o w/recombivax dose 2
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES94110053
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Rash maculo-papular, Similar reaction on previous exposure to drug
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv vax & 10 days later exp a generalized macular papular rash on palms & soles; rash resolved over 3 to 5 days, & pt recovered;

VAERS ID:74569 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1995-03-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES94111037
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alopecia, Rheumatoid arthritis
SMQs:, Arthritis (narrow)
Write-up: pt recv vax in 1992 & exp an autoimmune rxn in 1994 which consisted of rheumatoid arthritis & hair loss; sx were worsening @ the time of the report; no further details were provided;

VAERS ID:73183 (history)  Vaccinated:1995-01-18
Age:45.5  Onset:1995-01-18, Days after vaccination: 0
Gender:Female  Submitted:1995-01-20, Days after onset: 2
Location:Washington  Entered:1995-04-13, Days after submission: 82
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: denies
Preexisting Conditions: denies
Diagnostic Lab Data:
CDC 'Split Type': WA951087
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F51153  LA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES3809570 RA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site 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: pt recvd vax; inj site is hard, red & sore;? fever,swelling 5-6" all around site;severe sxs were relieved w/ apap;Ibuprofen taken for anoth problem;

VAERS ID:73398 (history)  Vaccinated:1994-11-01
Age:45.3  Onset:1994-11-16, Days after vaccination: 15
Gender:Female  Submitted:1995-02-21, Days after onset: 97
Location:California  Entered:1995-04-24, Days after submission: 61
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TIclio, ASA, Keflex Glyburide, Elavil, NPH insulin, Baclofen & vitamins
Current Illness: NONE
Preexisting Conditions: diabetes, neuropathy, neuritis; allergies Damasone, Zostrix, Neosporin ointment
Diagnostic Lab Data: nl EKG, chem & coag panels, nl cath urine w/C&S, nl CXR; emesis guiac pos; stool guiac neg;
CDC 'Split Type': CA95048
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F510258IMLA
Administered by: Other     Purchased by: Public
Symptoms: Angiopathy, Asthenia, Dizziness, Gastrointestinal haemorrhage, Haematemesis, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Gastrointestinal haemorrhage (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Vestibular disorders (broad)
Write-up: pt visiting parent & became ill w/severe retching & vomiting, but no nausea; also had weakness & dizziness so severe that could not open eyes; had broken blood vessels in sclera & around eyes; devel blood in emesis; seen @ ER;

VAERS ID:73618 (history)  Vaccinated:1995-04-23
Age:45.3  Onset:1995-04-24, Days after vaccination: 1
Gender:Female  Submitted:1995-04-25, Days after onset: 1
Location:New York  Entered:1995-05-01, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: ?puncture wound lt foot
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES374904 IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: reddened sl raised area approx 5"x5" @ inj site lt deltoid;

VAERS ID:74716 (history)  Vaccinated:1994-10-18
Age:45.5  Onset:1994-10-19, Days after vaccination: 1
Gender:Female  Submitted:1995-01-03, Days after onset: 76
Location:North Carolina  Entered:1995-05-01, Days after submission: 117
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 895073001S
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4948043 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv flu vax & the following day devel redness, swelling, & warmth @ the inj site; pt was treated w/DPH q 4 hr as needed & ice compresses 4 times daily to inj site;

VAERS ID:77730 (history)  Vaccinated:1994-01-14
Age:45.5  Onset:1994-01-14, Days after vaccination: 0
Gender:Female  Submitted:1995-05-08, Days after onset: 478
Location:California  Entered:1995-06-01, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp erythema assoc w/tetanus vax in the past
Other Medications: Hormone replacement therapy, Vasotec, Procardia
Current Illness: NONE
Preexisting Conditions: HTN, benign mediastinal tumor in 1981
Diagnostic Lab Data:
CDC 'Split Type': CO5551
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES3J51047 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: area of induration 13" x 10" @ inj site

VAERS ID:77767 (history)  Vaccinated:1994-05-31
Age:45.1  Onset:1994-06-01, Days after vaccination: 1
Gender:Female  Submitted:1995-05-09, Days after onset: 342
Location:Louisiana  Entered:1995-06-01, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: laceration rt hand
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': CO5420
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES3E51087 IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site inflammation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: redness & inflammation @ site;no tx

VAERS ID:74772 (history)  Vaccinated:1995-05-12
Age:45.7  Onset:1995-05-20, Days after vaccination: 8
Gender:Female  Submitted:1995-05-22, Days after onset: 2
Location:Georga  Entered:1995-06-12, 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:
Diagnostic Lab Data:
CDC 'Split Type': GA95077
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4F610580IMLA
Administered by: Public     Purchased by: Public
Symptoms: Skin nodule, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: large red area w/hard place greater than a fifty cent piece-area appeared 1 wk p/shot were given;

VAERS ID:75289 (history)  Vaccinated:1995-06-16
Age:45.6  Onset:1995-06-17, Days after vaccination: 1
Gender:Female  Submitted:1995-06-19, Days after onset: 2
Location:Ohio  Entered:1995-06-22, 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: inderal, anti depressant, butalbatol;
Current Illness: abrasion lt knee & early cell
Preexisting Conditions: nkda
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES396905  RA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax;noted redness,induration,tenderness,blisters;fussiness & redness;solumedrol given; less redness at site w/ epi;

VAERS ID:75398 (history)  Vaccinated:1995-03-02
Age:45.5  Onset:1995-04-01, Days after vaccination: 30
Gender:Male  Submitted:1995-06-14, Days after onset: 73
Location:Ohio  Entered:1995-06-26, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EMG
CDC 'Split Type': OH95077
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1378A11IMLA
Administered by: Public     Purchased by: Public
Symptoms: Immune system disorder, Infection, Myasthenic syndrome, Neuropathy, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad)
Write-up: pt recv vax lt arm paresthesia & weakness of rt hand; auto immun response to an unk virus; median nerve rt forearm damaged;

VAERS ID:75675 (history)  Vaccinated:1995-02-08
Age:45.0  Onset:1995-02-14, Days after vaccination: 6
Gender:Female  Submitted:1995-06-02, Days after onset: 107
Location:New York  Entered:1995-06-29, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Diarrhoea, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt had nausea & diarrhea & cold sweats on days following the vax;

VAERS ID:80514 (history)  Vaccinated:1994-06-15
Age:45.4  Onset:1994-06-15, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1995-07-14
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: no relevant data
CDC 'Split Type': WAES94070200
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1679W1SC 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax; 5 hrs later exp muscle soreness, redness & sl swelling at inject site; tx w/ ibuprofen & sxs resolved w/in 48 hrs;

VAERS ID:80517 (history)  Vaccinated:1994-06-28
Age:45.7  Onset:1994-06-28, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1995-07-14
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: No relevant data;
CDC 'Split Type': WAES94070329
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1793W0SC 
Administered by: Other     Purchased by: Other
Symptoms: Myalgia, Oedema peripheral, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: pt recvd vax 28JUN94 & 6hrs later pt devel redness, swelling & soreness which lasted for at least 72hrs;

VAERS ID:76474 (history)  Vaccinated:1995-06-02
Age:45.3  Onset:1995-06-02, Days after vaccination: 0
Gender:Female  Submitted:1995-08-02, Days after onset: 61
Location:Colorado  Entered:1995-08-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Premarin, provera
Current Illness: NONE
Preexisting Conditions: PCN
Diagnostic Lab Data: pending
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3689180IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: lt arm pain since DT administered on 2JUN95; dec sensation over 2nd & 3rd digits of lt hand; no fever, local swelling; tx NSAIDS, heat, referral to PT

VAERS ID:76706 (history)  Vaccinated:1995-08-01
Age:45.1  Onset:1995-08-02, Days after vaccination: 1
Gender:Female  Submitted:1995-08-08, Days after onset: 6
Location:Arizona  Entered:1995-08-18, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: APAP to relieve pain
Current Illness: had cold several days a/
Preexisting Conditions: hayfever-gets shot annually, gastritis-no med presently
Diagnostic Lab Data:
CDC 'Split Type': AZ9520
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4E61168 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Malaise, Neck pain, Oedema, Pain, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: 2AUG95 notice soreness to touch x 1-2 days;4AUG95 soreness gone;7AUG95 woke w/sore arm feeling sl feverish & malaise;early PM noticing redness & swelling & some swelling & discomfort going up arm into neck;area of redness-cant raise arm;

VAERS ID:76956 (history)  Vaccinated:1995-06-23
Age:45.2  Onset:1995-06-27, Days after vaccination: 4
Gender:Female  Submitted:1995-06-30, Days after onset: 3
Location:Alaska  Entered:1995-08-29, 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: NONE
Current Illness: NONE
Preexisting Conditions: NKA, no birth defects, miral valve problem
Diagnostic Lab Data: NONE
CDC 'Split Type': AK95029
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4L61153 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site mass, Injection site pain, Pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax 28JUN95 c/o pain 2" below inj site, hard knot inj site, site warm to touch; but no redness or swelling; reports pain is getting worse daily instead of decreasing; 30JUN pt reports improvement, on meds

VAERS ID:76998 (history)  Vaccinated:1995-08-10
Age:45.5  Onset:1995-08-11, Days after vaccination: 1
Gender:Female  Submitted:1995-08-15, Days after onset: 4
Location:North Carolina  Entered:1995-08-31, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: PPD given 10AUG95
Current Illness: NONE
Preexisting Conditions: PCN-drug allergy, only medical condition ulcers
Diagnostic Lab Data: PPD was neg;
CDC 'Split Type': NC95084
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4H61118 IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0988A SCRA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Ecchymosis, Headache, Injection site hypersensitivity, Injection site oedema, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: pt c/o fever 100-101, aching in arms, h/a, lightheaded, dizziness started approx 24hrs p/vax lasted approx 36hrs; also c/o swelling & redness @ inj site (DT)/MMR caused bruising @ site;

VAERS ID:81243 (history)  Vaccinated:1994-09-14
Age:45.0  Onset:1994-09-14, Days after vaccination: 0
Gender:Female  Submitted:1994-09-15, Days after onset: 1
Location:Virginia  Entered:1995-09-06, Days after submission: 356
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none
Other Medications:
Current Illness: none
Preexisting Conditions: no oth allergies
Diagnostic Lab Data: none
CDC 'Split Type': 940193702
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES370945   
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Myalgia, Pain, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax; inadvertently given Pnu-immune intradermally instead of PPD mantoux;exp burning & itching immed p/ adm;large area of redness; tender to touch w/in 24 hrs; antihistamine;

VAERS ID:81246 (history)  Vaccinated:1994-09-14
Age:45.0  Onset:1994-09-14, Days after vaccination: 0
Gender:Female  Submitted:1994-09-15, Days after onset: 1
Location:Virginia  Entered:1995-09-06, Days after submission: 356
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none known
Other Medications: na
Current Illness: none
Preexisting Conditions: no oth allergies; healthy female
Diagnostic Lab Data: none
CDC 'Split Type': 940193701
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES370945   
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site pain, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax;inadvertently recvd pnu-immune instead of PPD mantoux;exp itching & burning immed p/ vax; had red area, tender to touch w/in 24 hrs; tx antihistamine & ice;

VAERS ID:81373 (history)  Vaccinated:1994-10-14
Age:45.9  Onset:1994-10-14, Days after vaccination: 0
Gender:Male  Submitted:1994-11-10, Days after onset: 27
Location:Florida  Entered:1995-09-06, Days after submission: 299
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Bactrim DS/Ansamycin/G-CSF
Current Illness: healthy
Preexisting Conditions: allergies: Sudafed (rash);ACtifed (rash);no birth defects;medical conditions AIDS (CDC stage A3; chronic HBV infect
Diagnostic Lab Data: NONE
CDC 'Split Type': 940234701
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E2614KA IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES3609610SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & approx 2 wks later had routine office visit & reported to MD that for 2 days following vax had fever of 100.5, erythema-6" long & soreness @ pnu-immune inj site;rx APAP;recovered;

VAERS ID:77271 (history)  Vaccinated:1995-07-14
Age:45.6  Onset:1995-07-15, Days after vaccination: 1
Gender:Female  Submitted:1995-07-17, Days after onset: 2
Location:California  Entered:1995-09-11, Days after submission: 56
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': CA95101
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1319A62IMLA
Administered by: Public     Purchased by: Public
Symptoms: Influenza, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: c/o gen aches & pains beginning 15JUL95; c/o flu-like sx; mild sx cont

VAERS ID:77427 (history)  Vaccinated:1995-09-07
Age:45.7  Onset:1995-09-08, Days after vaccination: 1
Gender:Female  Submitted:1995-09-11, Days after onset: 3
Location:New York  Entered:1995-09-15, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergic codeine
Diagnostic Lab Data:
CDC 'Split Type': NYS95052
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5C211154IMLL
Administered by: Public     Purchased by: Public
Symptoms: Chills, Nausea, Oedema, Pain, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: fever, cold chills, nauseated, pain in arm, redness, swelling for 48 hrs;

VAERS ID:81026 (history)  Vaccinated:1995-06-30
Age:45.0  Onset:1995-07-19, Days after vaccination: 19
Gender:Male  Submitted:1995-08-16, Days after onset: 28
Location:Unknown  Entered:1995-09-22, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: anti inflammatory analgesics;
Current Illness:
Preexisting Conditions: spinal surgery for spinal decompression
Diagnostic Lab Data: stress test
CDC 'Split Type': 950074891
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0IM 
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Chest pain, Myelitis, Neuropathy, Paraesthesia, Paralysis, Thinking abnormal, Tremor
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: pt recvd vax;exp fatigue, shakiness, partial paralysis of feet, chest pain; to er for chest pain & had a stress test;

VAERS ID:77644 (history)  Vaccinated:1995-07-06
Age:45.1  Onset:0000-00-00
Gender:Female  Submitted:1995-09-18
Location:New York  Entered:1995-09-25, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CT-neg; MRI contrast neg; all lab lymes neg;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: numbness of entire lt leg x 6 days 5wks p/inj of 2nd vaccine;

VAERS ID:77854 (history)  Vaccinated:1995-09-25
Age:45.8  Onset:1995-09-25, Days after vaccination: 0
Gender:Male  Submitted:1995-09-27, Days after onset: 2
Location:Montana  Entered:1995-10-02, 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: Tenormin
Current Illness: NONE
Preexisting Conditions: PCN
Diagnostic Lab Data:
CDC 'Split Type': MT95014
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5E710250IMLA
Administered by: Public     Purchased by: Public
Symptoms: Back pain, Hyperhidrosis, Injection site hypersensitivity, Injection site oedema, Injection site pain, Pain, Pallor, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: swelling & redness @ site of inj to the size of a football; pain radiating down arm & in back;area warm to touch, pale & diaphoretic; sent to MD 26SEP95 tx Robaxin, Naprosin

VAERS ID:81734 (history)  Vaccinated:1994-06-16
Age:45.9  Onset:1994-06-22, Days after vaccination: 6
Gender:Male  Submitted:1995-08-31, Days after onset: 435
Location:Virginia  Entered:1995-10-13, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp local rxn p/1st dose in series;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': CO5462
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.J06612 A
Administered by: Public     Purchased by: Other
Symptoms: Headache, Injection site reaction, Myalgia, Pyrexia, Similar reaction on previous exposure to drug
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: local rxn immed;then 1 wk later h/a,myalgia,intermittent fever throughout noc & into next day,then resolved;

VAERS ID:81975 (history)  Vaccinated:1994-09-23
Age:45.6  Onset:1994-10-04, Days after vaccination: 11
Gender:Female  Submitted:1995-08-31, Days after onset: 331
Location:Michigan  Entered:1995-10-13, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': CO5587
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.J10554  
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: severe hives p/vax;prev full series 3yrs prior w/booster 2yrs ago;29NOV94 f/u;tx w/susprine & Duodezone & DPH;7OCT94 went to hosp treated w/Pred

VAERS ID:78150 (history)  Vaccinated:1995-09-01
Age:45.0  Onset:1995-09-18, Days after vaccination: 17
Gender:Female  Submitted:1995-10-03, Days after onset: 15
Location:Ohio  Entered:1995-10-16, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': OH95145
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0200B1 RA
Administered by: Public     Purchased by: Public
Symptoms: Face oedema, Hypokinesia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax 1SEP95, 18SEP-19SEP exp difficulty, chewing on rt side of mouth, jaw was swollen

VAERS ID:81769 (history)  Vaccinated:1994-08-12
Age:45.4  Onset:1994-08-12, Days after vaccination: 0
Gender:Female  Submitted:1995-08-31, Days after onset: 384
Location:Florida  Entered:1995-10-17, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to numerous ATB, including kelfin & Cepro
Diagnostic Lab Data:
CDC 'Split Type': CO5500
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST. 1  
Administered by: Private     Purchased by: Unknown
Symptoms: Asthma, Chills, Nausea, Pyrexia, Tongue oedema, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: chills & fever, nausea & vomiting w/in 5mins of 2nd dose; w/in 24hrs devel wheezing, urticaria & swollen tongue;unprovoked bite by known rabid fox;bitten in lt heel

VAERS ID:78232 (history)  Vaccinated:1995-10-10
Age:45.0  Onset:1995-10-12, Days after vaccination: 2
Gender:Female  Submitted:1995-10-13, Days after onset: 1
Location:Alabama  Entered:1995-10-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications: Premarin
Current Illness: NONE
Preexisting Conditions: migraine h/a, iron deficiency, hypercholesterolemia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5E710250 RA
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: induration, pain & swelling @ rt deltoid area around site of inj measuring approx 4 to 5 cms in diameter;Medrol dosepak given

VAERS ID:79238 (history)  Vaccinated:1995-07-26
Age:45.9  Onset:1995-08-12, Days after vaccination: 17
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:1995-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lodine
Current Illness:
Preexisting Conditions: sprain ankle; allergy ceclor; allergy latex; allergy caffeine;
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES95080975
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.SC0  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Pruritus, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax;19 days p/ vax devel 15 lesions mostly on torso & leg;md reported that on 12aug95 devel 15-20 intensely pruritic, nickel quarter sized,erythematous maculopapular lesions w/ a papule centrally located in many of them;

VAERS ID:78409 (history)  Vaccinated:1995-10-12
Age:45.8  Onset:1995-10-12, Days after vaccination: 0
Gender:Female  Submitted:1995-10-16, Days after onset: 4
Location:Massachusetts  Entered:1995-10-27, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': MA9508
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER5F611343 LA
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER1558A  RA
Administered by: Public     Purchased by: Public
Symptoms: Conjunctivitis, Dysphonia, Headache, Hypoaesthesia, Pharyngitis, Pyrexia, Vasodilatation
SMQs:, Severe cutaneous adverse reactions (broad), Agranulocytosis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: w/in 3hrs exp numbness of lips-hoarseness flushing-temp inc-red eyes-red throat-went to ER @ hosp was given Epi & Pred inj & script for Pred decreasing dose pack & DPH;next day eyes clear, throat ok, pounding, h/a, red face, hot flashes

VAERS ID:78546 (history)  Vaccinated:1995-10-23
Age:45.5  Onset:1995-10-23, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:1995-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp achey w/flu vax in 1993
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': WA951179
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958139 IM 
Administered by: Public     Purchased by: Public
Symptoms: Myalgia, Nausea, Pyrexia, Similar reaction on previous exposure to drug
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: pt exp flu vax 630PM started aches, queazy, no vomiting, fever, chills; did not call MD-ill in bed 24OCT;back to work 25OCT-still achey w/low grade fever

VAERS ID:78578 (history)  Vaccinated:1995-09-15
Age:45.0  Onset:1995-09-18, Days after vaccination: 3
Gender:Female  Submitted:1995-09-21, Days after onset: 3
Location:Florida  Entered:1995-11-01, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Human globulin lot 608p01b, Ibuprofen for h/a
Current Illness: NONE
Preexisting Conditions: allergies-NKA
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.K04880IMRA
Administered by: Public     Purchased by: Other
Symptoms: Hypokinesia, Myasthenic syndrome
SMQs:, Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: legs feel weird;started feeling strange on lt leg 18SEP95;leg felt different & has difficulty lifting foot

VAERS ID:78589 (history)  Vaccinated:1995-10-11
Age:45.0  Onset:1995-10-12, Days after vaccination: 1
Gender:Male  Submitted:1995-10-16, Days after onset: 4
Location:Florida  Entered:1995-11-02, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: had c/o prodionol sxs
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC 'Split Type': FL95068
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F611270IMLA
Administered by: Other     Purchased by: Public
Symptoms: Myalgia, Rhinitis
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: c/o nasal congestion & body aches 8-10 hrs sp/ inj;sxs lasted 24-48hrs;denied having fever @ any time

VAERS ID:78854 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:1994-10-26
Gender:Female  Submitted:1995-10-30, Days after onset: 369
Location:Idaho  Entered:1995-11-09, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sudfed
Current Illness:
Preexisting Conditions: MA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dysgeusia, Headache, Multiple sclerosis, Oedema, Paraesthesia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Demyelination (narrow)
Write-up: numbness complete lt side more so in face w/eye, hose effected, swelling lt side-felt like being pushed into ground like something heavy on tope of head-metal taste in mouth

VAERS ID:78861 (history)  Vaccinated:1995-10-03
Age:45.5  Onset:1995-10-04, Days after vaccination: 1
Gender:Female  Submitted:1995-10-10, Days after onset: 6
Location:California  Entered:1995-11-09, Days after submission: 30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': CA95128
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49581510IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: redness, heat, swelling @ inj site

VAERS ID:78966 (history)  Vaccinated:1995-11-17
Age:45.7  Onset:1995-11-20, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1995-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Altace
Current Illness: NONE
Preexisting Conditions: high blood pressure
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: 2" round red bump @ inj site itched alot & was very hot to touch;

VAERS ID:81596 (history)  Vaccinated:1994-09-23
Age:45.0  Onset:1994-09-24, Days after vaccination: 1
Gender:Female  Submitted:1994-10-18, Days after onset: 24
Location:Unknown  Entered:1995-11-14, Days after submission: 392
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrogen
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': 940091061
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax w/in 24hrs p/vax exp hives;tx DPH spray;still has hives

VAERS ID:82047 (history)  Vaccinated:1994-11-03
Age:45.0  Onset:1994-11-03, Days after vaccination: 0
Gender:Female  Submitted:1995-02-23, Days after onset: 112
Location:Kansas  Entered:1995-11-14, Days after submission: 264
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Elavil, Mefloquine
Current Illness: NONE
Preexisting Conditions: nausea to codeine, rash to PCN;
Diagnostic Lab Data:
CDC 'Split Type': 940106251
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMCR3164920IMLA
Administered by: Other     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & 6hrs p/vax exp a rash;

VAERS ID:82107 (history)  Vaccinated:1994-05-13
Age:45.0  Onset:1994-05-17, Days after vaccination: 4
Gender:Female  Submitted:1995-01-20, Days after onset: 248
Location:Kansas  Entered:1995-11-14, Days after submission: 298
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': 950005051
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: pt recvd vax & 2 wks post vax exp general aching & pain in joints,especially finger joints,& gen fatigue;these sx lasted 2 days & resolved completely;pt decided to discontinue the vax series;

VAERS ID:82391 (history)  Vaccinated:1995-04-15
Age:45.0  Onset:1995-04-22, Days after vaccination: 7
Gender:Female  Submitted:1995-05-17, Days after onset: 25
Location:California  Entered:1995-11-14, Days after submission: 181
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: ANA-0 sl positive (elevated);
CDC 'Split Type': 950043701
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: pt recvd vax 15APR95 & approx 1 wk post vax pt exp aches & pains in joints particularly in one hip;sx are somewhat better but persist;

VAERS ID:82400 (history)  Vaccinated:1995-04-25
Age:45.5  Onset:1995-04-26, Days after vaccination: 1
Gender:Female  Submitted:1995-05-23, Days after onset: 27
Location:Unknown  Entered:1995-11-14, Days after submission: 175
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': 950046041
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1472A11  
Administered by: Other     Purchased by: Other
Symptoms: Erythema nodosum, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax & 24hrs p/vax pt exp swelling in foot & was found to have erythema nodosum;sx cont

VAERS ID:82456 (history)  Vaccinated:1995-05-22
Age:45.0  Onset:1995-05-25, Days after vaccination: 3
Gender:Female  Submitted:1995-07-14, Days after onset: 50
Location:New Jersey  Entered:1995-11-14, Days after submission: 123
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': 950047991
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1653B22IMA
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recvd vax & 3 days post vax exp diarrhea,nausea,vomiting,high fever;sx persisted for 48hrs & then abated;

VAERS ID:79001 (history)  Vaccinated:1995-11-06
Age:45.9  Onset:1995-11-06, Days after vaccination: 0
Gender:Female  Submitted:1995-11-13, Days after onset: 7
Location:Texas  Entered:1995-11-16, 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: Ventolin inhaler, Tilade
Current Illness: NONE
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F610142IM 
Administered by: Private     Purchased by: Private
Symptoms: Angioneurotic oedema, Asthma, Laryngospasm, Pruritus, Rhinitis
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Dystonia (broad), Oropharyngeal allergic conditions (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: 7hrs p/vax acute onset of sneezing, wheezing, angioedema & itching of face & throat, hoarseness;responded slowly to ventolin inhaler & DPH

VAERS ID:79108 (history)  Vaccinated:1995-10-25
Age:45.6  Onset:1995-10-28, Days after vaccination: 3
Gender:Male  Submitted:1995-11-01, Days after onset: 4
Location:Tennessee  Entered:1995-11-17, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp red swollen, hot to touch, streaking @ 45yrs w/TD
Other Medications: NONE
Current Illness: accident-suture rt index finger
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': TN95113
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F611190 LA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: lt deltoid area-red swollen, irritated, warm to touch;

VAERS ID:82161 (history)  Vaccinated:1994-11-30
Age:45.9  Onset:1994-11-30, Days after vaccination: 0
Gender:Female  Submitted:1995-09-20, Days after onset: 293
Location:Texas  Entered:1995-11-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zovirax
Current Illness:
Preexisting Conditions: codeine causes blurry vision
Diagnostic Lab Data:
CDC 'Split Type': CO5745
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES 1IMA
Administered by: Other     Purchased by: Other
Symptoms: Chest pain, Chills, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: pt recvd vax; chest tightness, chills & fever lasted 24 hrs; very sore arm for 203 days;

VAERS ID:82172 (history)  Vaccinated:1994-11-04
Age:45.6  Onset:1994-11-11, Days after vaccination: 7
Gender:Male  Submitted:1995-09-20, Days after onset: 312
Location:Connecticut  Entered:1995-11-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': CO5770
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F51085 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)
Write-up: pt recvd pain in shoulder & arm muscle which is annoying;has gotten no better, no worse since time of inj

VAERS ID:82794 (history)  Vaccinated:1994-10-12
Age:45.0  Onset:1994-10-12, Days after vaccination: 0
Gender:Male  Submitted:1995-09-20, Days after onset: 343
Location:Pennsylvania  Entered:1995-11-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pred
Current Illness: NONE
Preexisting Conditions: arthritis being treated w/Pred
Diagnostic Lab Data:
CDC 'Split Type': CO5660
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F51132  LA
Administered by: Other     Purchased by: Other
Symptoms: Eye pain, Injection site pain, Neck pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Arthritis (broad)
Write-up: soreness @ site & deltoid area,then progressed to include neck & into eye;15OCT94 went to ER & was treated w/Motrin & DPH;to MD sometime later who took pt off meds because pt is on Pred for arthritis;was given unk type of med by MD;

VAERS ID:82799 (history)  Vaccinated:1994-11-01
Age:45.3  Onset:1994-11-01, Days after vaccination: 0
Gender:Male  Submitted:1995-09-20, Days after onset: 322
Location:Virginia  Entered:1995-11-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': CO5671
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: burning pain in lt flank;onset 1 hr p/vax;subsided w/in 48hrs;

VAERS ID:82228 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1995-12-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: sclerosis, multiple
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES95081123
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recvd vax in 1986 & exp joint pain, intermittent rash & low grade fever; no further details were provided;

VAERS ID:80108 (history)  Vaccinated:1995-10-30
Age:45.0  Onset:1995-10-30, Days after vaccination: 0
Gender:Female  Submitted:1995-12-14, Days after onset: 45
Location:West Virginia  Entered:1995-12-18, 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: hydrochlorethiazide/triamterbe thyroid;
Current Illness: none
Preexisting Conditions: htn
Diagnostic Lab Data: tissue culture revealed agrobacterium radiobacter;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Abscess, Infection, Injection site oedema, Injection site pain, Myositis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recvd vax;swollen lt upper arm, pain, low grade T;recvd IV unasym & po augmentin;c/o small air pockets (deltoid abscess) incision & drainage;po cynoflexacin;

VAERS ID:80591 (history)  Vaccinated:1995-12-01
Age:45.6  Onset:1995-12-02, Days after vaccination: 1
Gender:Male  Submitted:1995-12-06, Days after onset: 4
Location:Pennsylvania  Entered:1996-01-02, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Acupril, Varapamil; BP meds
Current Illness: NONE
Preexisting Conditions: high blood pressure
Diagnostic Lab Data: NONE
CDC 'Split Type': PA95224
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F61024 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site oedema, Myalgia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: the next AM p/getting 1st flu shot ever pt''s lt arm very sore, red, hot, swollen @ inj site;saw MD 4DEC & was put on Keflex

VAERS ID:80793 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:1995-11-06
Gender:Female  Submitted:1995-12-07, Days after onset: 31
Location:Unknown  Entered:1996-01-11, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH495101   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site oedema, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax; devel severe irritation at site of inject;swelling & hot to touch;rash on neck, face & back;

VAERS ID:80852 (history)  Vaccinated:1995-12-15
Age:45.0  Onset:1995-12-15, Days after vaccination: 0
Gender:Female  Submitted:1996-01-05, Days after onset: 21
Location:Texas  Entered:1996-01-16, 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: allergy bee stings, PCN
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Unknown
Symptoms: Arthralgia, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: rash, joint pain med-pac (pred) DPH by MD;

VAERS ID:80889 (history)  Vaccinated:1995-12-02
Age:45.0  Onset:1995-12-04, Days after vaccination: 2
Gender:Female  Submitted:1995-12-27, Days after onset: 23
Location:New Jersey  Entered:1996-01-16, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness:
Preexisting Conditions: diabetes
Diagnostic Lab Data: NA
CDC 'Split Type': NJ9557
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES398904 IM 
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis exfoliative, Injection site hypersensitivity, Injection site oedema, Injection site pain, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt c/o redness @ site, swelling & pain @ site;pt also c/o skin peeling & itching @ site of inj

VAERS ID:81293 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:1995-12-13
Location:Texas  Entered:1996-01-16, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F61119   
Administered by: Private     Purchased by: Public
Symptoms: Chills, Pharyngitis, Rhinitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow)
Write-up: initially chills, congestions, sneezing duration 6 to 7 hrs

VAERS ID:81294 (history)  Vaccinated:1995-10-05
Age:45.3  Onset:1995-10-06, Days after vaccination: 1
Gender:Male  Submitted:1995-10-10, Days after onset: 4
Location:Texas  Entered:1996-01-16, Days after submission: 98
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: diabetes, arthritis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F61119   
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Pain, Pharyngitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad)
Write-up: c/o of sore throat, trunk pain, extreme fatigue

VAERS ID:81299 (history)  Vaccinated:1995-10-06
Age:45.0  Onset:1995-10-20, Days after vaccination: 14
Gender:Male  Submitted:1995-10-27, Days after onset: 7
Location:Texas  Entered:1996-01-16, Days after submission: 81
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Seldane, Naprosyn PRN, Becovelent inhalent
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F61119   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up:

VAERS ID:80984 (history)  Vaccinated:1995-12-14
Age:45.2  Onset:1995-12-15, Days after vaccination: 1
Gender:Male  Submitted:1995-12-15, Days after onset: 0
Location:Texas  Entered:1996-01-17, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to PCN
Diagnostic Lab Data: supportive measures
CDC 'Split Type': TX95245
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.K01253 LA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: erythema 50mm in diameter to lt forearm;sl induration

VAERS ID:80992 (history)  Vaccinated:1995-11-28
Age:45.6  Onset:1995-11-28, Days after vaccination: 0
Gender:Female  Submitted:1995-11-29, Days after onset: 1
Location:Texas  Entered:1996-01-17, Days after submission: 49
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Calan, Azmacort
Current Illness: NONE
Preexisting Conditions: stadol, asthma;HTN
Diagnostic Lab Data: NA
CDC 'Split Type': TX95239
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0962A IMRA
Administered by: Public     Purchased by: Public
Symptoms: Arrhythmia, Dizziness, Hypertension, Nausea, Paraesthesia, Syncope, Vasodilatation, Visual disturbance
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: w/in 2-3 mins of vax pt felt lightheaded w/visual disturbances, lips numb, very flushed;felt nauseated & like would faint;9AM BP 170/100, P80;910 DPH-255PM BP 124/72; pt observed until 330PM

VAERS ID:80965 (history)  Vaccinated:1995-12-13
Age:45.6  Onset:1995-12-14, Days after vaccination: 1
Gender:Female  Submitted:1996-01-03, Days after onset: 20
Location:New Hampshire  Entered:1996-01-19, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Polycitra;despramine
Current Illness: NA
Preexisting Conditions: Elavil
Diagnostic Lab Data:
CDC 'Split Type': NH95032
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1284B0 RA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H711423 LA
Administered by: Private     Purchased by: Public
Symptoms: Myalgia, Oedema, Pain, Pruritus, Skin nodule, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: arm swelled 12x6 cm induration itching & pain (5cm erythema at center painful & hot);

VAERS ID:81644 (history)  Vaccinated:1995-02-22
Age:45.5  Onset:1995-02-27, Days after vaccination: 5
Gender:Male  Submitted:1996-01-10, Days after onset: 317
Location:Hawaii  Entered:1996-01-31, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NET consult
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
TYP: TYPHOID VI POLYSACCHARIDE (ACETONE INACTIVATED DRIED)PFIZER/WYETH 4SCLA
Administered by: Military     Purchased by: Military
Symptoms: Coordination abnormal, Deafness, Ear pain, Facial palsy, Headache, Herpes zoster, Myasthenic syndrome, Pharyngitis
SMQs:, Agranulocytosis (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow)
Write-up: pt devel sore throat w/lt ear & eye pain 5days post vax;MD dx hunt synd/herpes zoster;has residual lt facial paralysis

VAERS ID:81829 (history)  Vaccinated:1995-08-22
Age:45.0  Onset:1995-09-07, Days after vaccination: 16
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:1996-01-31
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:
Diagnostic Lab Data: no relevant data;
CDC 'Split Type': WAES95091285
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Arthritis, Rash maculo-papular
SMQs:, Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: pt recvd vax 22AUG95 & 7SEP95 pt devel 7-10 generalized lesions of macular papular nature & arthritic pain in major joints;no further details were provided;

VAERS ID:82998 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Ohio  Entered:1996-01-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: sclerosis, multiple
Preexisting Conditions: sclerosis, multiple
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES95100776
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & exp rash;MD questioned whether the pt would be able to receive a 2nd dose;No further details were provided;

VAERS ID:83146 (history)  Vaccinated:1995-08-16
Age:45.0  Onset:1995-09-27, Days after vaccination: 42
Gender:Female  Submitted:0000-00-00
Location:North Carolina  Entered:1996-01-31
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:
Diagnostic Lab Data: varicella antibody equivocal
CDC 'Split Type': WAES95110429
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0414B1  
Administered by: Other     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: pt recvd 2 doses of vax & lab eval 6-7wks post vax revealed 11 neg titers & 6 equivocal titers;

VAERS ID:82330 (history)  Vaccinated:1995-11-16
Age:45.3  Onset:1995-11-18, Days after vaccination: 2
Gender:Female  Submitted:1995-12-13, Days after onset: 25
Location:Wisconsin  Entered:1996-02-12, Days after submission: 61
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: premarin-no allergy
Diagnostic Lab Data: NONE
CDC 'Split Type': WI95071
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5C71115 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: lt like ball & socket of shoulder had a constant ache-scale of 1-10 "8";Saturday noc started & until 1 wk later;gone in November last week returned but not as bad

VAERS ID:84133 (history)  Vaccinated:1995-10-11
Age:45.4  Onset:1995-10-12, Days after vaccination: 1
Gender:Female  Submitted:1995-10-13, Days after onset: 1
Location:Oklahoma  Entered:1996-02-26, Days after submission: 136
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': 895332009L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958199 IMA
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Myasthenic syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 11OCT95 & pt devel an inj site rxn characterized by pain,warmth,swelling & redness;this is one of nine patients from this site who exp above rxn p/vax

VAERS ID:84167 (history)  Vaccinated:1995-10-25
Age:45.0  Onset:1995-10-28, Days after vaccination: 3
Gender:Male  Submitted:1995-10-30, Days after onset: 2
Location:Oregon  Entered:1996-02-26, Days after submission: 119
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 895337007L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958117  LA
Administered by: Private     Purchased by: Private
Symptoms: Facial palsy, Hypotonia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: pt recv vax 25OCT95 & 28OCT95 reported a lopsided smile & droopy lt eyelid;reportedly,MD suspects Bell''s palsy,although has not yet examined the pt

VAERS ID:84435 (history)  Vaccinated:1995-03-23
Age:45.8  Onset:1995-04-09, Days after vaccination: 17
Gender:Female  Submitted:0000-00-00
Location:Virginia  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: diabetes
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES95040921
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: pt recv vax 23MAR95 & 9APR95 pt exp numbness & tingling in the lt arm,particularly in the lt hand;

VAERS ID:84548 (history)  Vaccinated:1995-05-25
Age:45.2  Onset:1995-06-17, Days after vaccination: 23
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1996-02-27
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: lab work confirmed thrombocytopenia & enlarged liver
CDC 'Split Type': WAES95061012
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Hepatomegaly, Personality disorder, Pruritus, Tachycardia, Thrombocytopenia
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: pt recv vax 25MAY95 & 17JUN95 pt exp rapid pulse & a feeling that something was going on inside body that had no control over;feeling progressed to joint pain in legs (hips,knees,ankles);also exp itchiness in palms & feet,thrombocytopenia

VAERS ID:84751 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:1993-01-15
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES95091133
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: pt recv vax;devel Bell''s Palsy;

VAERS ID:84781 (history)  Vaccinated:1994-10-01
Age:45.8  Onset:1994-12-01, Days after vaccination: 61
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 8JUN94 in pt,muscle pain of knee,ankle & back;rt leg aciatica w/1st dose
Other Medications:
Current Illness:
Preexisting Conditions: injury back; allergy pcn;
Diagnostic Lab Data: Anti HBs neg;
CDC 'Split Type': WAES95101035
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0443A0IM 
Administered by: Other     Purchased by: Public
Symptoms: Back pain, Hypertonia, Myalgia, Nuchal rigidity, Oedema peripheral, Similar reaction on previous exposure to drug, Skin nodule, Weight increased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: pt recv vax;stiffness in shoulders & neck;back pain;pain & swelling in lt knee;muscle pain in back,neck & shoulders;exp unexplained weight gain;tx w/ meds;devel lump on lt heel;tx by chiropractor;md does not feel sx related to vax;

VAERS ID:84862 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES95120223
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Rash maculo-papular, Ventricular extrasystoles
SMQs:, Ventricular tachyarrhythmias (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & exp PVC''s for approx 48hr;also devel lyme disease;

VAERS ID:83548 (history)  Vaccinated:1995-07-12
Age:45.0  Onset:1995-07-12, Days after vaccination: 0
Gender:Female  Submitted:1996-03-02, Days after onset: 234
Location:New Hampshire  Entered:1996-03-11, Days after submission: 9
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: had a severe pneumonia in SEP94
Preexisting Conditions: NONE
Diagnostic Lab Data: CAT Scan;bronchoscope
CDC 'Split Type':
Vaccination
Manufacturer
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Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Private     Purchased by: Private
Symptoms: Bronchiectasis, Bronchiolitis, Chest pain, Dyspnoea, Immune system disorder, Laryngeal oedema, Pneumonia, Pulmonary oedema
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: extreme bronchospasm/asthmatic attack;edema of airways,dyspnea,extreme inflammation & edema documented by bronchoscope still cont 6mos later;bronchiectasis caused by antigens in vax close to severe pneumonia/immunogenic rxn

VAERS ID:85139 (history)  Vaccinated:1994-09-17
Age:45.1  Onset:1994-09-18, Days after vaccination: 1
Gender:Female  Submitted:1995-02-17, Days after onset: 152
Location:Tennessee  Entered:1996-03-14, Days after submission: 391
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:
Diagnostic Lab Data:
CDC 'Split Type': 895066008A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)PFIZER/WYETH4938039 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & devel redness,induration,warmth & pain @ inj site

VAERS ID:85206 (history)  Vaccinated:1995-11-22
Age:45.0  Onset:1996-01-24, Days after vaccination: 63
Gender:Male  Submitted:1996-01-29, Days after onset: 5
Location:Minnesota  Entered:1996-03-25, Days after submission: 56
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: engerix 6dec95, 18jan93, 12aug92, 13jul92;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: HAV 24jan96 = 0 nonresponder; HBSA nov93 = 0 nonresponder; HBSA responder post dose 4;
CDC 'Split Type': 960009992
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM417A40IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: pt recv vax;found to be nonresponder;

VAERS ID:83959 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:1996-03-12
Gender:Female  Submitted:1996-03-20, Days after onset: 8
Location:New York  Entered:1996-03-26, 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: lanoxin;
Current Illness: job related injury
Preexisting Conditions: allergic to pcn;
Diagnostic Lab Data: none
CDC 'Split Type': BA96011
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Diarrhoea, Injection site oedema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (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: pt recv vax;local rxn,tenderness,swelling,fever & d;to MD;tx w/ atb;

VAERS ID:85271 (history)  Vaccinated:1995-07-29
Age:45.9  Onset:1995-07-29, Days after vaccination: 0
Gender:Female  Submitted:1995-08-22, Days after onset: 24
Location:Illinois  Entered:1996-04-01, Days after submission: 223
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Provera;
Current Illness: unk
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': 895261015L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH  IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site mass, Injection site oedema, Injection site pain, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax; 1wk later,devel swelling & nodule at inject site, which radiated to finger tips;pain worsened over 3 wk;

VAERS ID:84498 (history)  Vaccinated:1995-11-01
Age:45.0  Onset:1995-11-04, Days after vaccination: 3
Gender:Female  Submitted:1996-03-22, Days after onset: 139
Location:Missouri  Entered:1996-04-02, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: denies
Other Medications: denies
Current Illness: denies
Preexisting Conditions: codeine
Diagnostic Lab Data: NONE
CDC 'Split Type': MO96024
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1331A61 RA
Administered by: Other     Purchased by: Public
Symptoms: Pneumonia, Respiratory disorder
SMQs:, Acute central respiratory depression (broad), Eosinophilic pneumonia (broad)
Write-up: pt reports p/each hep B vax has had a resp illness w/an onset of 3 days p/vax;each time pt saw pvt MD;1NOV95 devel pneumonia;

VAERS ID:84499 (history)  Vaccinated:1996-03-06
Age:45.4  Onset:1996-03-09, Days after vaccination: 3
Gender:Female  Submitted:1996-03-22, Days after onset: 13
Location:Missouri  Entered:1996-04-02, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: denies
Other Medications: denies
Current Illness: denies
Preexisting Conditions: codeine
Diagnostic Lab Data: NONE
CDC 'Split Type': MO96025
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1331A62 RA
Administered by: Other     Purchased by: Public
Symptoms: Infection, Respiratory disorder
SMQs:, Acute central respiratory depression (broad)
Write-up: pt reports p/each hep B vax has had a resp illness w/an onset of 3 days p/vax;each time pt saw pvt MD;6MAR96 pt devel lung infect w/ATB tx of Cefaclor;MD told pt it was not a rxn;pt feels it is a allergic rxn

VAERS ID:84715 (history)  Vaccinated:1996-03-27
Age:45.8  Onset:1996-03-27, Days after vaccination: 0
Gender:Male  Submitted:1996-04-04, Days after onset: 8
Location:Oregon  Entered:1996-04-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt denies
Other Medications: paxil
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA434A40IMRA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: 110PM pt recv vax;210PM nausea,queasy,dizzy;progressed to pt going home ill;nausea cont (dizziness) all that day in 1/2 of following day;no tx other than bed rest

VAERS ID:84716 (history)  Vaccinated:1996-03-25
Age:45.5  Onset:1996-03-25, Days after vaccination: 0
Gender:Female  Submitted:1996-03-25, Days after onset: 0
Location:Oregon  Entered:1996-04-09, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: denies
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA434A40IMRA
Administered by: Other     Purchased by: Public
Symptoms: Malaise, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 0100 pt recv vax;0230PM pt felt nauseated;315PM inc nausea & vomited x 2;330PM cont nausea,went home ill;10:00 nausea resolved;

VAERS ID:85438 (history)  Vaccinated:1996-04-23
Age:45.8  Onset:1996-04-23, Days after vaccination: 0
Gender:Male  Submitted:1996-04-25, Days after onset: 2
Location:North Carolina  Entered:1996-04-30, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: diet controlled diabetes/PCN allergy
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4334020IMRA
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES5H710050IMLA
Administered by: Private     Purchased by: Other
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: pt c/o inc fever beginning on evening of 23APR p/receiving vax during routine PE;pt stated had fever since that day (approx 48hrs) 103 during this visit;recv Solumedrol & Pred

VAERS ID:86047 (history)  Vaccinated:1995-09-01
Age:45.0  Onset:1995-09-01, Days after vaccination: 0
Gender:Female  Submitted:1995-09-18, Days after onset: 17
Location:West Virginia  Entered:1996-05-13, Days after submission: 238
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dilantin,Phenobarb, Synthroid
Current Illness:
Preexisting Conditions: sz disorder & thyroid problem
Diagnostic Lab Data: unk
CDC 'Split Type': 0010150950205
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00785P IMA
Administered by: Public     Purchased by: Other
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax SEP95&devel a hard lump @ the inj site;hx of sz disorder&a thyroid problem;takes Dilantin,Phenobarb,synthroid;

VAERS ID:86050 (history)  Vaccinated:1995-08-28
Age:45.0  Onset:1995-09-05, Days after vaccination: 8
Gender:Female  Submitted:1995-09-18, Days after onset: 13
Location:Michigan  Entered:1996-05-13, Days after submission: 238
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: influenza FEB95/hayfever
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150950208
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS02165P0IMA
Administered by: Other     Purchased by: Public
Symptoms: Cough, Drug ineffective, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: pt recv vax 28AUG95 & 5SEP95 devel nausea, vomiting, & t102-103 x3 days;also exp gen aching & a cough;cough worsened as the wk progressed;pt seen @ clinic & placed on Bactrim;

VAERS ID:86162 (history)  Vaccinated:1995-10-17
Age:45.0  Onset:1995-10-17, Days after vaccination: 0
Gender:Female  Submitted:1995-12-15, Days after onset: 59
Location:New York  Entered:1996-05-13, Days after submission: 149
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness:
Preexisting Conditions: asthma;allergies to certain foods (egg whites);possible rxn to certain meds
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150950298
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS    
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 17OCT95 & exp redness & swelling @ the inj site shortly p/vax;MD was not aware of the event;

VAERS ID:86020 (history)  Vaccinated:1996-02-19
Age:45.8  Onset:1996-03-14, Days after vaccination: 24
Gender:Female  Submitted:1996-05-07, Days after onset: 53
Location:Missouri  Entered:1996-05-14, 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: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: 4 MRI''s
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA468A61IMLA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES5L610121SCLA
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, 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), Cardiomyopathy (broad)
Write-up: numbness in hands & feet, SOB, heart palpitations;conditions have since subsided;pt has numbness in rt hand & foot periodically

VAERS ID:87785 (history)  Vaccinated:1995-05-17
Age:45.8  Onset:1995-05-18, Days after vaccination: 1
Gender:Female  Submitted:1995-05-23, Days after onset: 5
Location:Missouri  Entered:1996-06-18, Days after submission: 392
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: healthy
Diagnostic Lab Data: NONE
CDC 'Split Type': 895150005L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES 0IMA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus, Pyrexia, Rash
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), Hypersensitivity (narrow)
Write-up: pt recv vax 17MAY95 & w/in 24hr pt devel an inj site rxn of erythema & swelling approx 3inches in diameter & fever;fever resolved w/in 24hr;22MAY pt began devel a pruritic rash on neck;seen by MD;tx included ATB;rash resolved in 1mo;

VAERS ID:87789 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:1995-06-12
Location:Pennsylvania  Entered:1996-06-18, Days after submission: 372
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: healthy
Preexisting Conditions: healthy;recv last tetanus vax 10yr ago
Diagnostic Lab Data: unk
CDC 'Split Type': 895165001L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES374904 IM 
Administered by: Private     Purchased by: Private
Symptoms: Hypokinesia, Injection site hypersensitivity, Injection site pain, Myalgia, Neuropathy
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & initially following vax pt exp redness & local pain @ site;@ time of report 12JUN95 pt entire arm hurts when moves it;describes sx as discomfort;according to reporting pt MD suspects nerve damage;

VAERS ID:87824 (history)  Vaccinated:1996-02-09
Age:45.3  Onset:1996-02-10, Days after vaccination: 1
Gender:Female  Submitted:1996-02-13, Days after onset: 3
Location:Pennsylvania  Entered:1996-06-18, Days after submission: 125
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: sinusitis
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC 'Split Type': 896047002L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES430978 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Oedema, Pain, Skin discolouration, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 9FEB96 & devel an inj site rxn, characterized by arm pain & edema over half of arm & a wheal area of discoloration w/a dark red center;As of 12FEB96 the rxn was worsening;tx w/DPH & cool compresses;

VAERS ID:87831 (history)  Vaccinated:1995-12-02
Age:45.0  Onset:1995-12-04, Days after vaccination: 2
Gender:Female  Submitted:1996-02-26, Days after onset: 84
Location:New Jersey  Entered:1996-06-18, Days after submission: 112
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: humulin insulin
Current Illness: NONE
Preexisting Conditions: inuslin dependent diabetic
Diagnostic Lab Data:
CDC 'Split Type': 896064006L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES  IMRA
Administered by: Private     Purchased by: Private
Symptoms: Neuropathy, Pain
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad)
Write-up: pt recv vax & exp pain, radiating 6 inches below rt deltoid which persists as of the date of this report;the pt was dx w/mononeuropathy

VAERS ID:87260 (history)  Vaccinated:1996-04-01
Age:45.0  Onset:1996-04-01, Days after vaccination: 0
Gender:Male  Submitted:1996-06-21, Days after onset: 80
Location:Colorado  Entered:1996-06-24, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: cervical spine MRI dis herniation;C-5, C-6 w/nerve compression C-6;no denervation of paraspinals on electrodiagnostics
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
Administered by: Other     Purchased by: Other
Symptoms: Bone disorder, Muscle atrophy, Myasthenic syndrome, Neuropathy, Pain
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: pt recv vax MAR96 & APR96 & sx of shoulder & neck pain w/weakness LUE;clinical atrophy of supraspinatus, scapular spine, upper lt arm muscle masses;EMG/NCV acute partial denervation C-6 myotome vs upper trunk brachial plexus;

VAERS ID:87270 (history)  Vaccinated:1996-05-02
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:1996-05-08
Location:Florida  Entered:1996-06-24, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: laceration
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4315770 RA
Administered by: Public     Purchased by: Other
Symptoms: Oedema, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: large red, swollen area noted to posterior upper arm w/smaller, darker, red area in center

VAERS ID:87492 (history)  Vaccinated:1996-04-26
Age:45.1  Onset:0000-00-00
Gender:Male  Submitted:1996-06-21
Location:Colorado  Entered:1996-07-01, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: 2nd vaccine-lf shoulder pain
Preexisting Conditions: NONE
Diagnostic Lab Data: cervical spine MRi disc herniation c-5, c-6 w/nerve compression c-6;no denervation of electrodiagnostics;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1 LA
Administered by: Public     Purchased by: Other
Symptoms: Bone disorder, Hypokinesia, Muscle atrophy, Myasthenic syndrome, Myopathy, Neck pain, Neuropathy, Pain
SMQs:, Rhabdomyolysis/myopathy (narrow), Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: pt recv vax MAR96 & APR96 sx of shoulder & neck pain w/weakness LUE;clinical atrophy of supraspinatus, scapular spine, upper lt arm muscle masses;EMG/NEV acute partial denervation c-6 myotome vs upper trunk of brachial plexus

VAERS ID:87588 (history)  Vaccinated:1996-06-19
Age:45.8  Onset:1996-06-20, Days after vaccination: 1
Gender:Female  Submitted:1996-07-01, Days after onset: 11
Location:New York  Entered:1996-07-08, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Asthma
Diagnostic Lab Data: NONE
CDC 'Split Type': NYS96058
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49680011IMLA
Administered by: Public     Purchased by: Public
Symptoms: Eczema, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt reported devel gen rash 1 day p/vax; seen by MD 1JUL96 dx eczematous dermatitis no topic dermatitis;rx lidex syrter

VAERS ID:87624 (history)  Vaccinated:1996-06-14
Age:45.9  Onset:1996-06-14, Days after vaccination: 0
Gender:Female  Submitted:1996-06-27, Days after onset: 13
Location:California  Entered:1996-07-08, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: sulfur drugs
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Chills, Dizziness, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad)
Write-up: high fever, chills, aching joints, nausea, dizzy

VAERS ID:87955 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:1996-07-10
Location:Massachusetts  Entered:1996-07-17, 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: Pemoline, Ampicill, Ibuprofen
Current Illness: NONE
Preexisting Conditions: panic disorder, (trauma related) PMS
Diagnostic Lab Data: no relevant informational tests
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: no adverse effect other than mildly sore p/the inj was given;on contact w/a rusty nail in sole of foot some 1 1/2mo later no lockjaw developed

VAERS ID:88540 (history)  Vaccinated:1996-03-28
Age:45.1  Onset:1996-05-06, Days after vaccination: 39
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma;sz disorder;Osteoporosis;depression;mitral regurgitation, mild;melas sydn;
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES96050624
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0750B0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Peripheral vascular disorder, Phlebitis, Vasculitis
SMQs:, Severe cutaneous adverse reactions (narrow), Thrombophlebitis (broad), Vasculitis (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 28MAR96 & 6MAY96 pt devel 5x10 cm vesicular rash on lt buttock;in addition devel vasculitis or phlebitis in lt thigh vein;

VAERS ID:88626 (history)  Vaccinated:1996-04-09
Age:45.4  Onset:1996-05-16, Days after vaccination: 37
Gender:Male  Submitted:0000-00-00
Location:Illinois  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DIalysis, Erythropoietin
Current Illness:
Preexisting Conditions: glomeruonephritis, membranous;COPD;HTN;
Diagnostic Lab Data: 16MAY96 IGG negative (<10);
CDC 'Split Type': WAES96051971
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 2 doses of vax 12MAR96 & 9APR96 & 16MAY96 an antibody IgG titer was <10 which indicated that the pt was non-immune; pt on dialysis & awaiting a kidney transplant;

VAERS ID:88642 (history)  Vaccinated:1995-11-01
Age:45.0  Onset:1996-04-01, Days after vaccination: 152
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: APR96 varicella antibody-failure to develop antibodies
CDC 'Split Type': WAES96052264
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 2 doses of vax OCT95 & NOV95;APR96 pt failed to develop antibodies;23MAY96 Md was exposed to chicken pox;

VAERS ID:89153 (history)  Vaccinated:1996-01-23
Age:45.0  Onset:1996-01-24, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Illinois  Entered:1996-08-02
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: No relevant data;
CDC 'Split Type': WAES96050359
Vaccination
Manufacturer
Lot
Dose
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site oedema, Pain, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & exp cellulitis @ inj site; No further details were provided;

VAERS ID:88918 (history)  Vaccinated:1996-07-23
Age:45.8  Onset:0000-00-00
Gender:Female  Submitted:1996-07-30
Location:Illinois  Entered:1996-08-12, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin;TB skin test by Connaught lot# 242211 given 23JUL96;
Current Illness: NONE
Preexisting Conditions: allergic to PCN
Diagnostic Lab Data:
CDC 'Split Type': IL960077
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L710954 LA
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Face oedema, Laryngospasm, Oedema peripheral, Pyrexia, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 23JUL96 11AM mild local raised welt over TB skin test;t100, achy joints, puffiness around eyes & both hands;later in day mouth & throat felt thick;24JUL96 saw MD, rx DPH, APAP & fluids;25JUL96 sting like sunburn to touch (hot & sore);

VAERS ID:88982 (history)  Vaccinated:1996-06-12
Age:45.7  Onset:1996-06-15, Days after vaccination: 3
Gender:Female  Submitted:1996-06-20, Days after onset: 5
Location:Washington  Entered:1996-08-14, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': WA961247
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1320B  RA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash maculo-papular, Skin disorder
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt noticed an itchy rash starting on elbows 15JUN96 3PM which gradually spread;pt states taking DPH;describes rash as clustered bumps appear like orange peel texture;

VAERS ID:88990 (history)  Vaccinated:1996-04-22
Age:45.5  Onset:1996-05-03, Days after vaccination: 11
Gender:Female  Submitted:1996-05-15, Days after onset: 12
Location:Washington  Entered:1996-08-14, Days after submission: 91
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Relafin
Current Illness: fibromyalgia
Preexisting Conditions: hayfever
Diagnostic Lab Data: NONE as of 15MAY96
CDC 'Split Type': WA961260
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0621B0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Face oedema, Lymphadenopathy, Malaise, Myalgia, Oedema, Osteoarthritis
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: extreme swelling of chin radiating to neck w/large bump lt neck;gen malaise & achiness;3MAY96 peaked 4-5MAY96;13MAY swelling of joint lt ankle;

VAERS ID:89229 (history)  Vaccinated:1996-08-05
Age:45.4  Onset:1996-08-05, Days after vaccination: 0
Gender:Female  Submitted:1996-08-15, Days after onset: 10
Location:Ohio  Entered:1996-08-20, 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: Synthroid, Zantac, Pred, APAP
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Chest pain,