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Found 533901 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:75359 (history)  Vaccinated:1994-10-28
Age:35.9  Onset:1994-11-04, Days after vaccination: 7
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:1995-05-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergy, Keflex; Postpartum
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES94110833
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Arthritis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arthritis (narrow)
Write-up: pt recv vax 28OCT94 & 1 to 2 wk later NOV94 devel fever, arthralgia & polyarticular arthritis of feet, knees, elbows & hands; tx Iodine & unspecified anti-inflammatory med;

VAERS ID:74529 (history)  Vaccinated:1995-05-31
Age:35.9  Onset:1995-05-31, Days after vaccination: 0
Gender:Male  Submitted:1995-06-01, Days after onset: 1
Location:Kansas  Entered:1995-06-05, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Chills, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax & presented to ER @ 0130 w/nausea, h/a, fever 99.9, chills starting 5 hr p/vax;

VAERS ID:74532 (history)  Vaccinated:1995-05-22
Age:35.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:1995-06-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: laceration
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Unknown
Symptoms: Serum sickness
SMQs:, Hypersensitivity (narrow)
Write-up: serum sickness

VAERS ID:74552 (history)  Vaccinated:1995-05-30
Age:35.0  Onset:1995-05-31, Days after vaccination: 1
Gender:Female  Submitted:1995-05-31, Days after onset: 0
Location:Kansas  Entered:1995-06-06, Days after submission: 6
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: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4L611530IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Dizziness, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: client started having chills & fever @ 130AM; c/o muscle aches-t102.4; c/o nausea cont to run fever 31MAR95 PM 1JUN95 fever 99; c/o dizziness & general muscle aches; may see MD if sx persist;

VAERS ID:74636 (history)  Vaccinated:1995-05-22
Age:35.0  Onset:1995-05-23, Days after vaccination: 1
Gender:Female  Submitted:1995-06-01, Days after onset: 9
Location:Virginia  Entered:1995-06-08, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: 25may95 WBC 6900;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES4H61156 IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site oedema, Injection site pain, Lymphadenopathy, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax;swelling, no erythema, sl warmth, marked tenderness, lt axillary tender small adenopathy, approx 7x9cm x1cm swelling of lt deltoid;

VAERS ID:74678 (history)  Vaccinated:1995-06-01
Age:35.0  Onset:1995-06-01, Days after vaccination: 0
Gender:Female  Submitted:1995-06-02, Days after onset: 1
Location:Virginia  Entered:1995-06-09, 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: ?tetanus allergy
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.J03741IMRA
Administered by: Military     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: hives on body <8 hr p/2nd vax;

VAERS ID:80416 (history)  Vaccinated:1994-04-11
Age:35.8  Onset:1994-04-20, Days after vaccination: 9
Gender:Female  Submitted:1994-04-20, Days after onset: 0
Location:Ohio  Entered:1995-06-09, Days after submission: 415
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: na
Other Medications:
Current Illness: healthy
Preexisting Conditions: healthy
Diagnostic Lab Data: none
CDC Split Type: 940083202
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3569031IMA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax; returned to ofc w/ inject site rxn of erythema, tenderness, swelling 3-4 " in diam; apap & ice packs used

VAERS ID:80445 (history)  Vaccinated:1994-06-06
Age:35.5  Onset:1994-06-07, Days after vaccination: 1
Gender:Female  Submitted:1994-07-06, Days after onset: 29
Location:Pennsylvania  Entered:1995-06-09, Days after submission: 338
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none
Other Medications: erythromycin
Current Illness: cut on foot
Preexisting Conditions:
Diagnostic Lab Data: na
CDC Split Type: 940148602
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES356903 IMA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax; devel localized rxn of erythema, swelling & pain w/in 24 hrs p/ vax; tx w/ ice & ibuprofen;

VAERS ID:80472 (history)  Vaccinated:1994-11-01
Age:35.3  Onset:1994-11-15, Days after vaccination: 14
Gender:Female  Submitted:1994-12-02, Days after onset: 17
Location:Florida  Entered:1995-06-09, Days after submission: 188
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt states when was in high school thinks had a similar rxn vax unk
Other Medications: NONE
Current Illness: healthy
Preexisting Conditions: allergic to PCN
Diagnostic Lab Data: NONE
CDC Split Type: 940249702
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES382903 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, 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: 1 of 4 pts exp an inj site rxn following vax;lederject syringe w/ 5/8" needle was used;rxn included itching @ site, hardness, swelling, & redness;size of rxn not measured, but very noticeable

VAERS ID:75438 (history)  Vaccinated:1995-05-19
Age:35.5  Onset:1995-05-19, Days after vaccination: 0
Gender:Female  Submitted:1995-06-22, Days after onset: 34
Location:Ohio  Entered:1995-06-26, 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: not known
Current Illness: none
Preexisting Conditions: recvd med clearance from radiation oncologist;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1723A40IMA
Administered by: Other     Purchased by: Private
Symptoms: Influenza, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax; exp 2 hives;lasted few hr; felt flu like sx next day,lasted 3 days;

VAERS ID:75761 (history)  Vaccinated:1995-05-05
Age:35.2  Onset:1995-05-10, Days after vaccination: 5
Gender:Female  Submitted:1995-05-12, Days after onset: 2
Location:California  Entered:1995-07-10, Days after submission: 59
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: NKA
Diagnostic Lab Data:
CDC Split Type: CA95070
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES4H611560 LA
Administered by: Private     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 4x6" area of erythema of lt arm;

VAERS ID:75799 (history)  Vaccinated:1995-04-07
Age:35.6  Onset:1995-04-24, Days after vaccination: 17
Gender:Female  Submitted:1995-04-28, Days after onset: 4
Location:Washington  Entered:1995-07-10, Days after submission: 73
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: inpt, arm swelling at 32 yrs w/ 1 flu vax;
Other Medications: BC pills low dose
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: 2 "arthritis tests"; WBC, SEDrate all wnl;
CDC Split Type: WA951118
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1528W0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Headache, Neck pain, Osteoarthritis, Pain
SMQs:, Guillain-Barre syndrome (broad), Arthritis (narrow)
Write-up: pt recv vax;devel neck pain & HA at 3pm; knee, ankle swelling at 6pm;elbow pain & swelling 9pm; wrist pain 3am;had gene weakness cont; pain intermittent; tx w/ advil, heat;

VAERS ID:80501 (history)  Vaccinated:1994-05-11
Age:35.6  Onset:1994-05-11, Days after vaccination: 0
Gender:Male  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: none
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES94060092
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1679W0SC 
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Pain, Rash
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; same day devel a swollen, tender & red inject site; tenderness & redness descended down the arm to the elbow by 14may94;

VAERS ID:80563 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Arizona  Entered:1995-07-14
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: WAES94100554
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Injection site reaction, Malaise
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax & exp redness, swelling & pain @ inj site;pt also sick;pt devel a local rxn @ the site of the flu vax as well;17OCT94 pt exp had not subsided & pt was planning on visiting MD;

VAERS ID:75909 (history)  Vaccinated:1995-06-21
Age:35.3  Onset:1995-06-21, Days after vaccination: 0
Gender:Male  Submitted:1995-06-22, Days after onset: 1
Location:North Carolina  Entered:1995-07-17, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: allergy to strawberries and onions, prolapsed heart valve
Diagnostic Lab Data: none
CDC Split Type: NC95061
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0988A0 RA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Chest pain, Headache, Pruritus, Pyrexia, Rash maculo-papular, Vasodilatation, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt recv vax;21jun95 n & v;c/o tightness in chest,feeling hot all over;to er;HA,red splotches on chest,itching;chest clear;prescription for pred;22jun95 T 103 last noc;still feels tired,itching, burning inside body;HA

VAERS ID:76044 (history)  Vaccinated:1995-05-22
Age:35.4  Onset:1995-05-29, Days after vaccination: 7
Gender:Female  Submitted:1995-07-21, Days after onset: 53
Location:Kentucky  Entered:1995-07-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1723A4 SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chest pain, Dysuria, Myalgia, Neck pain, Paraesthesia, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: 1-2 days p/vax itching/watering eyes-nose throat;scratchy-ears itching-sl tightness in chest;face flushed;chills, hot flashes w/sweating;gen feeling bad;ringing in ear;joint pain diff moving; stiff neck;burning urination; muscle tired

VAERS ID:77063 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:1995-07-21
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: allergy Demerol
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95060023
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0401B0 LA
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & exp a chickenpox like rash 18 days p/inj; no further details were provided;

VAERS ID:77118 (history)  Vaccinated:1995-06-08
Age:35.0  Onset:1995-06-11, Days after vaccination: 3
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:1995-07-21
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: No relevant data;
CDC Split Type: WAES95060545
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dermatitis bullous, Rhinitis
SMQs:, Severe cutaneous adverse reactions (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax 8JUN95 & 11JUN95 devel a gen rash throughout body w/blisters that did not itch, head congestion, was very tired; approx 10 blisters; pat exposed to chickenpox coincid w vax, vax not impl.

VAERS ID:76224 (history)  Vaccinated:1995-03-17
Age:35.8  Onset:1995-03-18, Days after vaccination: 1
Gender:Female  Submitted:1995-07-24, Days after onset: 127
Location:Washington  Entered:1995-07-31, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 19 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Gamma Globulin Miles INC lot# 608P01B; recvd 4 doses rabies by Connaught lot# K0001 all doses given 20AMR, 24MAR, 31MAR & 14APR
Current Illness:
Preexisting Conditions: crohn''s disease
Diagnostic Lab Data: xrays, small bowel follow through, CBC w/diff, lytes xrays showed bowel obstruction
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.K00010IMA
Administered by: Public     Purchased by: Private
Symptoms: Affect lability, Arthralgia, Condition aggravated, Diarrhoea, Intestinal obstruction, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: day p/vax pt devel nausea, malaise, achy joints, h/a, emotional irritability, diarrhea, fever these lasted throughout vax series; sl lessening toward the end; also devel crohns flare the day p/3rd inj which worsened into bowel obstruction;

VAERS ID:76241 (history)  Vaccinated:1995-06-09
Age:35.0  Onset:1995-06-12, Days after vaccination: 3
Gender:Male  Submitted:1995-06-20, Days after onset: 8
Location:Missouri  Entered:1995-07-31, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: tree pollen
Diagnostic Lab Data: none
CDC Split Type: MO95051
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.2682A0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: pt recv vax;having nose bleed on 12jun95 on awakening at 6am lasting approx 1 1/2 hr & cont spitting out bloody sinus drainage daily to this time 20jun95;

VAERS ID:76257 (history)  Vaccinated:1995-05-31
Age:35.8  Onset:1995-06-22, Days after vaccination: 22
Gender:Male  Submitted:1995-07-27, Days after onset: 35
Location:Texas  Entered:1995-07-31, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none
Other Medications: eskalith, zoloft;
Current Illness: none
Preexisting Conditions: cyclothymia
Diagnostic Lab Data: total bili=4.4;direct bili=2.8; indirect bili 1.6;alk phos=137;GGT=523;SGOT=139; SGPT=306;chest x-ray nl;EBV for mono neg; lymes disease neg;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA425A60IMRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Bilirubinuria, Headache, Hepatic function abnormal, Hyperbilirubinaemia, Osteoarthritis, Pyrexia, Rash
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: pt recv vax;fever 103.2; rash, achy & swollen joints,especially fingers; HA, inc SGOT, SGPT,GGT & bili;sl jaundice;no liver tenderness,bili urine, severe lethargy;these sz lasted 7 days & then felt very well;

VAERS ID:76375 (history)  Vaccinated:1995-07-21
Age:35.0  Onset:1995-07-23, Days after vaccination: 2
Gender:Male  Submitted:1995-07-24, Days after onset: 1
Location:Unknown  Entered:1995-08-03, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESH017B2  
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES5B610750  
Administered by: Military     Purchased by: Military
Symptoms: Anxiety, Orthostatic hypotension, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 23JUl & exp extensive urticaria, fever, anxiety & marked orthostasis latter initially refractory, despite 4 liters; hospitalized & placed on hydrocortisone, DPH, Zantac & Epi

VAERS ID:76470 (history)  Vaccinated:1995-04-11
Age:35.8  Onset:1995-04-15, Days after vaccination: 4
Gender:Female  Submitted:1995-07-11, Days after onset: 87
Location:Washington  Entered:1995-08-07, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WA951142
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1341W0 LA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Arthropathy, Asthenia, Malaise, Myasthenic syndrome, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt exp achy joints, gen malaise, rash; 24MAY flushed face, hands, arms & rash on back; achy joint, jaw temp locked;

VAERS ID:77154 (history)  Vaccinated:1995-04-21
Age:35.3  Onset:1995-04-21, Days after vaccination: 0
Gender:Female  Submitted:1995-05-01, Days after onset: 10
Location:Washington  Entered:1995-09-01, Days after submission: 123
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: swabbed today for c/s;
CDC Split Type: WA951149
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4F610590IMLA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES4L511130SCRA
Administered by: Public     Purchased by: Public
Symptoms: Infection, Injection site oedema, Injection site pain, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax; swollen at site w/ pain since vax time; fever 3 days ago;draining pus lasting 3 days;given keflex x 10 days;

VAERS ID:81258 (history)  Vaccinated:1994-10-04
Age:35.2  Onset:1994-10-04, Days after vaccination: 0
Gender:Female  Submitted:1994-10-11, Days after onset: 7
Location:Michigan  Entered:1995-09-06, Days after submission: 330
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: healthy
Preexisting Conditions: no allergies
Diagnostic Lab Data: none
CDC Split Type: 940213403
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES3789770SC 
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Injection site hypersensitivity, Injection site mass, Injection site oedema
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax; exp local rxn consisting of redness, induration/swelling & diff breathing; epi given;tx included dph,pred,cold compresses;

VAERS ID:81259 (history)  Vaccinated:1994-10-04
Age:35.7  Onset:1994-10-05, Days after vaccination: 1
Gender:Male  Submitted:1994-10-06, Days after onset: 1
Location:Texas  Entered:1995-09-06, Days after submission: 335
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none
Other Medications: seldane, motrin
Current Illness: healthy
Preexisting Conditions:
Diagnostic Lab Data: none
CDC Split Type: 940214601
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F5113 IMRA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES3809560SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: pt recvd vax; fever of 104; inject site react & axillary lymph node enlargement;rx steroids,atbs,dph,apap

VAERS ID:81375 (history)  Vaccinated:1994-11-09
Age:35.7  Onset:1994-11-11, Days after vaccination: 2
Gender:Female  Submitted:1994-11-14, Days after onset: 3
Location:North Carolina  Entered:1995-09-06, Days after submission: 295
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Insulin
Current Illness: type I diabetes
Preexisting Conditions: diabetes;unk if pt had hx of pneumococcal pneumonia;this pt''s 1st pneumococcal immun
Diagnostic Lab Data: NONE
CDC Split Type: 940242601
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES3769690IM 
Administered by: Private     Purchased by: Private
Symptoms: Oedema peripheral, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 1 of 4 adults vaxed on 9NOV94;pt exp swelling & itching following vax;not seen by MD;recovered;

VAERS ID:77274 (history)  Vaccinated:1995-08-10
Age:35.0  Onset:1995-08-13, Days after vaccination: 3
Gender:Female  Submitted:1995-08-17, Days after onset: 4
Location:California  Entered:1995-09-11, Days after submission: 25
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: NONE
CDC Split Type: CA95104
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4G610805  
Administered by: Public     Purchased by: Public
Symptoms: Ecchymosis, Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 13AUG95 site red, swollen, warm, small bruise @ distal edge; swelling @ greatest bigger than golf ball; cold compress w/o relief; 17AUG95 warm compress w/relief

VAERS ID:77361 (history)  Vaccinated:1995-07-27
Age:35.8  Onset:1995-07-27, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:1995-09-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Furoset
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: TX95147
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4F61059  LA
Administered by: Public     Purchased by: Unknown
Symptoms: Dyspnoea, Hypersensitivity, Pain, Paraesthesia, Pruritus, Rash, Rash maculo-papular
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 1230PM elbow to shoulder pain, red splotches shoulder to fingers w/o itching, tingling & numbness of hands, fingers; pc to MD recommended anti-inflam med; breathing problems; rash-itches; allergic

VAERS ID:77392 (history)  Vaccinated:1995-08-31
Age:35.8  Onset:1995-09-13, Days after vaccination: 13
Gender:Female  Submitted:1995-09-06, Days after onset: 7
Location:Maryland  Entered:1995-09-13, 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:
Diagnostic Lab Data: NONE
CDC Split Type: MD95033
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.K06901 RA
Administered by: Public     Purchased by: Unknown
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: 72 hrs p/vax pt devel a bumpy rash on neck, back, chest & in skin folds in joints both arms; spread to face by day 5; was treated by family MD w/DPH; prescription for Pred; rash is cont to spread on day 7; MD advised pt to d/c rabies series

VAERS ID:77871 (history)  Vaccinated:1994-03-01
Age:35.2  Onset:1994-03-01, Days after vaccination: 0
Gender:Female  Submitted:1995-05-07, Days after onset: 431
Location:Florida  Entered:1995-10-02, Days after submission: 148
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NA
Preexisting Conditions: HNP, arthritis in back, hx of a fall prior to vax
Diagnostic Lab Data: blood test were ordered to r/o arthritis; low positive ANA test further testing revealed did not have the disease-pt still showing low positive ANA; 2 MRI''s which show a bulging disk
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Arthritis, Back pain, Condition aggravated, Depression, Malaise, Pain
SMQs:, Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Depression (excl suicide and self injury) (narrow), Arthritis (narrow)
Write-up: pt recvd vax & devel leg pain & felt bad; also states pain severe in back & leg; also devel joint pain in lt fingers of migratory nature; blood test showed low pos ANA test for lupus; further testing revealed didn''t have disease; depression

VAERS ID:77913 (history)  Vaccinated:1995-08-23
Age:35.3  Onset:1995-08-23, Days after vaccination: 0
Gender:Female  Submitted:1995-09-04, Days after onset: 12
Location:California  Entered:1995-10-05, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: EEG WNL; MRI brain WNL
CDC Split Type: CA95110
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0470B  LA
Administered by: Other     Purchased by: Public
Symptoms: Convulsion, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: syncope; probable post syncopal szs w/in 12hrs of vax;

VAERS ID:78032 (history)  Vaccinated:1994-11-10
Age:35.4  Onset:1994-11-10, Days after vaccination: 0
Gender:Female  Submitted:1994-11-29, Days after onset: 19
Location:Oregon  Entered:1995-10-11, Days after submission: 315
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: unk
CDC Split Type: OR9451
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F51072  RA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.147AW0 LA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4A61008  RA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: immed onset of pain @ inj site 10NOV94 cont (unresolved) for next 6days when pt was seen by PMD who treated for arthralgia in rt arm (shoulder/elbow) w/steroid, DepoModral shot & oral antiinflamm;

VAERS ID:81722 (history)  Vaccinated:1994-06-01
Age:35.3  Onset:1994-06-01, Days after vaccination: 0
Gender:Male  Submitted:1995-08-31, Days after onset: 456
Location:New Hampshire  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: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO5430
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.J11031 A
Administered by: Other     Purchased by: Public
Symptoms: Headache, Pharyngitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow)
Write-up: h/a & sore throat;fine by next morning

VAERS ID:81781 (history)  Vaccinated:1994-09-12
Age:35.1  Onset:1994-09-15, Days after vaccination: 3
Gender:Male  Submitted:1995-08-31, Days after onset: 350
Location:Indiana  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: pt recvd Imogam RIG by Merieux lot# J1149J on 12SEP94
Current Illness: raccoon bite rt index finger
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO5552
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.J12081IMLA
Administered by: Private     Purchased by: Private
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: paresthesia from elbow to hand in rt arm upon awaking today;bitten by raccoon on rt index finger on 8SEP94;1st dose of vax given in rt deltoid;2nd dose given lt deltoid;11OCT94 f/u series completed w/o further events

VAERS ID:78284 (history)  Vaccinated:1995-10-09
Age:35.4  Onset:1995-10-14, Days after vaccination: 5
Gender:Female  Submitted:1995-10-17, Days after onset: 3
Location:Pennsylvania  Entered:1995-10-23, 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: RIG by Miles lot# 608PO1B;pt recvd 3rd dose of Rabies by Connaught lot# K0390 on 16OCT95
Current Illness: dog bite
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI scheduled
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.K03091IMRA
Administered by: Private     Purchased by: Private
Symptoms: Amblyopia, Optic neuritis
SMQs:, Optic nerve disorders (narrow), Demyelination (narrow), Ocular infections (broad)
Write-up: pt presented to clinic on 14OCT95 w/ blurred vision; seen by neuro ophthalogist 16OCT95 dx optic neuritis;MRI scheduled

VAERS ID:79220 (history)  Vaccinated:1995-07-27
Age:35.6  Onset:0000-00-00
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:
Current Illness:
Preexisting Conditions: allergy tb skin test; allergy iodine
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES95080732
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site pain, Injection site reaction, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax; devel a tender, itchy, red area on one inch diam at inject site w/ bumps w/in the area;

VAERS ID:79340 (history)  Vaccinated:1995-07-03
Age:35.3  Onset:1995-07-05, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Tennessee  Entered:1995-10-23
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: exposure, varicella
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES95070887
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Headache, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax 3JUL95 & 5JUL95 pt exp h/a;7JUL95 devel fever & began to break out in lesions;@ time of report pt had 100 lesions;9JUL95 pt exp diffuse vesicular rash;

VAERS ID:79361 (history)  Vaccinated:1995-07-01
Age:35.0  Onset:1995-07-18, Days after vaccination: 17
Gender:Male  Submitted:0000-00-00
Location:Illinois  Entered:1995-10-23
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: leukemia, chronic, myelocytic;transplant, bone marrow
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95071309
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax JUL95 & 3 wks later approx 19JUL95 pt devel blister-like lesions on the lip & a generalized rash;over the next 2 days devel 20 to 25 lesions on the inside of mouth & lesions on the cheek & zygoma

VAERS ID:79454 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95061019
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Hypertonia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax & esp stiff neck & muscle aches 7 days p/vax;no further details were provided;

VAERS ID:78352 (history)  Vaccinated:1995-10-02
Age:35.4  Onset:1995-10-02, Days after vaccination: 0
Gender:Male  Submitted:1995-10-09, Days after onset: 7
Location:Iowa  Entered:1995-10-24, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: RIG given on 26SEP95; Prilosec; Loperamide
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.K0367 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pain, Vasodilatation
SMQs:
Write-up: c/o soreness in rt deltoid 3 days p/3rd inj given; 6in by 6in reddened area, hard, warm to touch, did notice burning when inj given

VAERS ID:78489 (history)  Vaccinated:1995-09-19
Age:35.8  Onset:1995-10-03, Days after vaccination: 14
Gender:Female  Submitted:1995-10-20, Days after onset: 17
Location:Texas  Entered:1995-10-30, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Naprosyn
Current Illness: NONE
Preexisting Conditions: arthritis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0183A0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax 19SEP95 & 3OCT95 saw MD d/t onset of fever & rash over entire body, CBC lab drawn, phenergan supp rx given, saw MD again on 10OOCT95 & was cleared to return to work;rash almost completely gone very very few areas noted

VAERS ID:78686 (history)  Vaccinated:1995-10-27
Age:35.6  Onset:1995-10-28, Days after vaccination: 1
Gender:Female  Submitted:1995-10-31, Days after onset: 3
Location:Wyoming  Entered:1995-11-06, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Cozarr;Orthocycline
Current Illness: NONE
Preexisting Conditions: allergit to codeine,Adalatic
Diagnostic Lab Data: NONE
CDC Split Type: WY9521
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49581120 LA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Hypertonia, Injection site hypersensitivity, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: stiffness from shoulder to hand;soreness & tight in shoulder, elbow, wrist;redness/hot @ site;very tender in axillary lymph area;treated w/ASA

VAERS ID:78738 (history)  Vaccinated:1995-10-24
Age:35.8  Onset:1995-10-24, Days after vaccination: 0
Gender:Female  Submitted:1995-11-02, Days after onset: 9
Location:Washington  Entered:1995-11-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: tested w/routine battery: all neg for allergy
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49580862IMLA
Administered by: Public     Purchased by: Private
Symptoms: Eye pain, Injection site hypersensitivity, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Hypersensitivity (narrow)
Write-up: immed itching @ site progressed to 5cm sized red welt; by 2 1/2 hrs later red splotches on chest & reddened, burning eyes;welt @ site lasted 3-4 days;took one dose of DPH 30-45" p/inj;no resp signs/sxs devel

VAERS ID:81547 (history)  Vaccinated:1994-05-16
Age:35.0  Onset:1994-05-17, Days after vaccination: 1
Gender:Female  Submitted:1994-09-08, Days after onset: 114
Location:Unknown  Entered:1995-11-14, Days after submission: 432
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: possible HEP A in the past;
Diagnostic Lab Data:
CDC Split Type: 940081601
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1060A40IMA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Diarrhoea, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recvd vax; 1 & 1/2 days later exp stomach cramps, d & n;

VAERS ID:81606 (history)  Vaccinated:1994-07-01
Age:35.0  Onset:1994-08-16, Days after vaccination: 46
Gender:Female  Submitted:1994-10-11, Days after onset: 56
Location:Virginia  Entered:1995-11-14, Days after submission: 399
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: 940091791
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Osteoarthritis
SMQs:, Arthritis (narrow)
Write-up: pt recvd vax & 45 days later 16AUG94 exp painful swelling in finger joints of both hands,& arthralgia;sx subsided 15 days later (31AUG94);

VAERS ID:81934 (history)  Vaccinated:1994-11-14
Age:35.0  Onset:1994-11-15, Days after vaccination: 1
Gender:Male  Submitted:1995-07-27, Days after onset: 253
Location:Unknown  Entered:1995-11-14, Days after submission: 110
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: synthroid
Current Illness: NONE
Preexisting Conditions: hypothyroid;NKA
Diagnostic Lab Data:
CDC Split Type: 940118271
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1473A20IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthma, Dyspnoea, Influenza, Injection site pain, Lymphadenopathy, Myalgia, Oedema peripheral
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax & w/in 24hrs p/vax exp puffy,swollen,edematous & painful lt hand which had pitting edema;was eval in ER;found that swelling was secondary to lymphatic swelling;Motrin prescribed for pain;also exp flu-sx,myalgia,arthralgia

VAERS ID:82056 (history)  Vaccinated:1994-11-16
Age:35.0  Onset:1994-11-22, Days after vaccination: 6
Gender:Female  Submitted:1995-01-06, Days after onset: 45
Location:Unknown  Entered:1995-11-14, Days after submission: 312
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness:
Preexisting Conditions: arthralgias, depression
Diagnostic Lab Data: rheumatoid screen neg
CDC Split Type: 940110281
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1152A60  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: pt recvd vax & 6 days later exp arthralgia,ankles & wrist were sore as of 27DEC94 sx substantially gone

VAERS ID:82255 (history)  Vaccinated:1993-02-01
Age:35.0  Onset:1993-02-01, Days after vaccination: 0
Gender:Female  Submitted:1995-04-14, Days after onset: 801
Location:Unknown  Entered:1995-11-14, Days after submission: 214
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Inderal
Current Illness:
Preexisting Conditions: allergic to codeine, allergic to demerol, allergic quinine, migraines
Diagnostic Lab Data:
CDC Split Type: 950017681
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Neck pain
SMQs:, Arthritis (broad)
Write-up: pt recvd vax & few hrs post vax exp severe arthralgia which lasted 5 days;joint pain cont in major joints such as hips & the cervical area;vax series discontinued;

VAERS ID:82276 (history)  Vaccinated:1995-03-13
Age:35.0  Onset:1995-03-16, Days after vaccination: 3
Gender:Male  Submitted:1995-04-19, Days after onset: 33
Location:California  Entered:1995-11-14, Days after submission: 209
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp rash @ 35yrs w/Engerix-B dose 1
Other Medications:
Current Illness:
Preexisting Conditions: poss history of hepatitis B
Diagnostic Lab Data:
CDC Split Type: 950026021
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1333A41IMA
Administered by: Other     Purchased by: Other
Symptoms: Asthma, Oedema peripheral, Osteoarthritis, Similar reaction on previous exposure to drug, Skin discolouration, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: pt recvd vax 13MAR95 & 3 days post vax exp hives,swelling o both arms,swollen knuckles,purple knuckles,& wheezing;sx got worse over the next several days;pt was seen in ER 19MAR95 w/hives,wheezing & swelling;treated erythromycin;

VAERS ID:82287 (history)  Vaccinated:1995-03-31
Age:35.0  Onset:1995-04-03, Days after vaccination: 3
Gender:Female  Submitted:1995-04-11, Days after onset: 8
Location:Unknown  Entered:1995-11-14, Days after submission: 217
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: allergic to codeine, allergic to compazine, idiopathic hives;
Diagnostic Lab Data:
CDC Split Type: 950032841
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1405A40IMA
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Headache, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recvd vax;3 days later exp severe HA;4-5 days p/ vax exp abd cramping & a few hives on upper body;6 days post vax she exp joint pain,fever & was covered w/ hives;seen by MD who prescribed corticosteroids on 6apr95;all sx resolved;

VAERS ID:82289 (history)  Vaccinated:1995-03-13
Age:35.0  Onset:1995-04-04, Days after vaccination: 22
Gender:Female  Submitted:1995-04-13, Days after onset: 9
Location:Unknown  Entered:1995-11-14, Days after submission: 215
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: allergic to codeine, allergic to compazine, crohn''s disease;
Diagnostic Lab Data:
CDC Split Type: 950033571
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Headache, Hypersensitivity, Myalgia, Oedema peripheral, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax;w/in several days post vax exp severe HA,abd cramping & hives;w/in 1 wk exp joint pains,arm & leg pains & d;seen by MD prescribed corticosteroids,w/in the last few days,exp inc episodes of d;

VAERS ID:82294 (history)  Vaccinated:1994-08-01
Age:35.0  Onset:1994-09-01, Days after vaccination: 31
Gender:Female  Submitted:1995-04-20, Days after onset: 231
Location:Minnesota  Entered:1995-11-14, Days after submission: 208
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: 950034811
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1280A42IMRA
Administered by: Other     Purchased by: Other
Symptoms: Erythema nodosum
SMQs:, Hypersensitivity (narrow)
Write-up: pt recvd vax;1 month p/ dose 3,was found to have erythema nodosum on anterior thighs;seen by MD who prescribed corticosteroids;

VAERS ID:82478 (history)  Vaccinated:1995-06-11
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:1995-06-16
Location:Colorado  Entered:1995-11-14, Days after submission: 151
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: 950053951
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Ecchymosis, Injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recvd vax & 20mins post vax pt passed out while driving & was involved in an auto accident (fender bender);MD believes that pt may have had a vasovagal episode;pt eval in ER for bruises;

VAERS ID:82545 (history)  Vaccinated:1995-07-07
Age:35.8  Onset:1995-07-08, Days after vaccination: 1
Gender:Female  Submitted:1995-07-24, Days after onset: 16
Location:Georgia  Entered:1995-11-14, Days after submission: 113
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: 950067561
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Lymphadenopathy, Malaise, Migraine, Myalgia, Neck pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax & w/in 24hrs post vax felt unwell;sx were muscle & joint aches,pain in the cervical area,migraine,& low grade fever;these sx gradually inc over 48hrs to severe intensity;pt was seen by MD:sx persist

VAERS ID:82695 (history)  Vaccinated:1995-06-30
Age:35.0  Onset:1995-07-01, Days after vaccination: 1
Gender:Female  Submitted:1995-08-16, Days after onset: 46
Location:Illinois  Entered:1995-11-14, 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: Ativan
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: 950077561
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Other     Purchased by: Other
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: pt recvd vax & w/in 24hrs post vax pt exp numbness on the rt side of face;eye & mouth were sl crooked;sx resolved;

VAERS ID:79042 (history)  Vaccinated:1995-08-01
Age:35.2  Onset:1995-08-30, Days after vaccination: 29
Gender:Female  Submitted:1995-11-08, Days after onset: 70
Location:Ohio  Entered:1995-11-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Condition aggravated, Myelitis, Pain, Paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: mom states whenever child had vax she had a relapse of transverse myelitis (C6-T6); mom being followed by MD, 8/30 devel pain,weakness, 9/9 T6 paralysis.

VAERS ID:79089 (history)  Vaccinated:1995-11-08
Age:35.8  Onset:1995-11-09, Days after vaccination: 1
Gender:Female  Submitted:1995-11-10, Days after onset: 1
Location:Iowa  Entered:1995-11-15, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: sore throat
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Face oedema, Pyrexia, Rash, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: broke out in rash & hives (entire body), body temp, eyes & ears swell-ears felt like full of hot wax-very warm

VAERS ID:79102 (history)  Vaccinated:1995-10-20
Age:35.0  Onset:1995-10-20, Days after vaccination: 0
Gender:Female  Submitted:1995-10-23, Days after onset: 3
Location:Washington  Entered:1995-11-17, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WA951173
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5J610070 LA
Administered by: Public     Purchased by: Public
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 2x3cm indurated in area of inj;no drainage @ site of inj on 21OCT95;On 23OCT95-flat & not red

VAERS ID:79597 (history)  Vaccinated:1995-10-23
Age:35.5  Onset:1995-11-01, Days after vaccination: 9
Gender:Female  Submitted:1995-11-13, Days after onset: 12
Location:Michigan  Entered:1995-11-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: MI95142
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1472A10IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1379A1SC 
Administered by: Public     Purchased by: Public
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), Tendinopathies and ligament disorders (broad)
Write-up: sx started w/muscle & joint aching 1NOV95 then fever above 103 2NOV95 (10 days p/vax); fever lasted for 24hrs then spotted red rash devel on face & trunk, spreading to extremities;saw MD on 5NOV dx as vax rxn on 6NOV95

VAERS ID:79740 (history)  Vaccinated:1995-11-15
Age:35.6  Onset:1995-11-16, Days after vaccination: 1
Gender:Female  Submitted:1995-11-16, Days after onset: 0
Location:Montana  Entered:1995-11-27, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NA
Current Illness: NA
Preexisting Conditions: hayfever
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.K06901 LA
Administered by: Public     Purchased by: Private
Symptoms: Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: swelling & pain to let axilla;rabies ID given to lt deltoid area lasted one day

VAERS ID:79765 (history)  Vaccinated:1995-10-18
Age:35.9  Onset:1995-10-28, Days after vaccination: 10
Gender:Female  Submitted:1995-11-20, Days after onset: 23
Location:Oregon  Entered:1995-11-30, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Zolax
Current Illness: NONE
Preexisting Conditions: allergies: dust; hx of brain tumor w/surgical removal;transient epilepsy
Diagnostic Lab Data: arthritis lab work-up pos streptococcal antibodies
CDC Split Type: OR9563
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1381A0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Arthritis, Headache, Laboratory test abnormal, Oedema peripheral, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: pt recvd vax 18OCT95 & devel gen rash 28OCT; swelling of hand; seen @ clinic dx polyarticular arthritis rt & lt hand bilat w/lab;

VAERS ID:82220 (history)  Vaccinated:1993-05-20
Age:35.2  Onset:1993-06-01, Days after vaccination: 12
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1995-12-01
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 16FEB95 Epstein Barr antibody 758 IGG; Epstein Barr antibody 332NA-G; Epstein Barr antibody 40EBC EA AB; Epstein Barr antibody 66 IGM;
CDC Split Type: WAES95050793
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.1368V0  
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Drug ineffective, Infection, Laboratory test abnormal, Osteoarthritis, Pharyngitis, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: pt recvd vax 20MAY93 & 1JUN93 pt exp clinical rubella w/rash, fever, sore throat & lt knee pain;seen by MD 11AUG93 & 27SEP93 for cont joint pain, swelling & malaise;16FEB95 lab eval revealed pos EBV serology, EBV IgG capsid antibody was 758

VAERS ID:79911 (history)  Vaccinated:1995-11-07
Age:35.7  Onset:1995-11-08, Days after vaccination: 1
Gender:Female  Submitted:1995-11-09, Days after onset: 1
Location:California  Entered:1995-12-07, 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: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1201A SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5E71025 IMRA
Administered by: Other     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: local inflammation: reddened, warm, sl swollen area approx 3" x 1 1/2" rt arm-deltoid area; has taken Ibuprofin;TD given 7NOV95;

VAERS ID:79932 (history)  Vaccinated:1995-12-07
Age:35.2  Onset:1995-12-07, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:1995-12-11
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Provera, Bentyl, Beconase, Estrace, Ativan (PRN), nasal spray, APAP
Current Illness: injury to lt knee @ work;
Preexisting Conditions: Cefzil, demerol, EES; panic attacks; early meanapaus
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER 2 LA
Administered by: Public     Purchased by: Other
Symptoms: Dyspnoea, Face oedema, Laryngospasm, Oedema peripheral, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & w/in 10mins hands, ears, mouth, nose, eyes began to swell & rash;sxs inc to entire body;trouble breathing, throat closing;given Epi, Cortisone, DPH & transferred to ER-given Phenegran, monitored in ER 2hrs;sxs subsided

VAERS ID:79956 (history)  Vaccinated:1995-10-04
Age:35.8  Onset:1995-10-04, Days after vaccination: 0
Gender:Male  Submitted:1995-10-06, Days after onset: 2
Location:Ohio  Entered:1995-12-11, Days after submission: 66
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: NA
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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Site
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)PFIZER/WYETH49480840SCLA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES5F610770SCRA
Administered by: Public     Purchased by: Private
Symptoms: Oedema peripheral, Pain, Rash, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: swelling, tenderness, erythema below inj site rednee is 7" x 6" football shape;s&s began Wednesday 4OCT95;avised pt to apply moist head to lt arm & to f/u to family MD;10OCT95 seen by MD sxs cleared up

VAERS ID:79993 (history)  Vaccinated:1995-10-27
Age:35.2  Onset:1995-10-31, Days after vaccination: 4
Gender:Female  Submitted:1995-12-07, Days after onset: 37
Location:Pennsylvania  Entered:1995-12-13, Days after submission: 6
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: dust, sports injureis
Diagnostic Lab Data: EEG, MRI, ultrasound;
CDC Split Type:
Vaccination
Manufacturer
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Site
MER: MEASLES + RUBELLA (MR-VAX II)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Convulsion, Headache, Hypertonia, Insomnia, Pain, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: sz (2-3)mins-prolonged h/a, muscle spasms lt side face 23OCT;eye strain, sleeping problems, nervousness, chills, facial pain, tension, sleeping diff, fever, weakness, lack of sleep, sz;lack of energy;spasms;exhaustion;h/a while sleeping

VAERS ID:80028 (history)  Vaccinated:1995-10-17
Age:35.9  Onset:1995-10-21, Days after vaccination: 4
Gender:Female  Submitted:1995-11-19, Days after onset: 29
Location:New Jersey  Entered:1995-12-13, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD on 24OCT
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI-brain-lymes test & ACE level-all neg
CDC Split Type:
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 2 RA
Administered by: Other     Purchased by: Other
Symptoms: Eye disorder, Paraesthesia, Paralysis
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Corneal disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: pt recvd vax on 17OCT95 & devel tongue numbness on 21OCT95;pt recvd PPD on 24OCT95 later that evening eyes were blurry & burning on 29OCT95;had paralysis on the rt side of face;

VAERS ID:80103 (history)  Vaccinated:1995-10-09
Age:35.4  Onset:1995-10-10, Days after vaccination: 1
Gender:Male  Submitted:1995-12-04, Days after onset: 55
Location:Iowa  Entered:1995-12-15, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rxn on 23oct with rabies 3rd dose @ 35 years
Other Medications: Prilosec, Immodium
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.K03903IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Skin discolouration, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: reacted the day p/shot given;inj site became sore, swollen, red & warm to touch;also became leather looking

VAERS ID:81058 (history)  Vaccinated:1995-08-01
Age:35.0  Onset:1995-09-09, Days after vaccination: 39
Gender:Male  Submitted:1995-12-06, Days after onset: 88
Location:D.C.  Entered:1996-01-03, 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:
Preexisting Conditions: hiv pos
Diagnostic Lab Data: SGPT 862 9sep95, SGPT 86 11oct95;SGOT 448 9sep95; SGOT 45 on 11oct95; ALKPH 263 9sep95;ALKPH 118 on 11oct95; Bilirubin .6mg/dl on 9sep95; bil .8 mg/dl on 11oct95
CDC Split Type: 950113911
Vaccination
Manufacturer
Lot
Dose
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Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0IM 
Administered by: Private     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood alkaline phosphatase increased, 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)
Write-up: pt recvd vax; exp elev liver enzymes w/in 1 mon of vax;

VAERS ID:80702 (history)  Vaccinated:1995-09-28
Age:35.8  Onset:1995-10-02, Days after vaccination: 4
Gender:Female  Submitted:1996-01-02, Days after onset: 92
Location:New York  Entered:1996-01-04, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? Yes
Previous Vaccinations: NONE
Other Medications: Prozac, Adavan
Current Illness: panic attacks
Preexisting Conditions: PCN, Toradal
Diagnostic Lab Data: Blood test, CAT Scan, x-rays, EKG, EEG
CDC Split Type: NYS95079
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0822AX0  
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Confusional state, Osteoarthritis, Pyrexia, Rash, Stupor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: 3 days post vax pt devel rash on palms & fingers on both hands; high fever (2mos) rash 6wks)-swollen elbows, knuckles knees, chronic fatigue, fainting w/loss of consciousness for 20mins, disoriented, 6 fainting episodes

VAERS ID:80709 (history)  Vaccinated:1995-10-14
Age:35.1  Onset:1995-10-28, Days after vaccination: 14
Gender:Female  Submitted:1995-12-01, Days after onset: 34
Location:Ohio  Entered:1996-01-04, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI abn
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00575P0 LA
Administered by: Other     Purchased by: Private
Symptoms: Laboratory test abnormal, Paraesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow)
Write-up: ringing in ears (for 1 mon); lt sided body numbness (for 1mo); had MRI to have spinal tap & blood work;

VAERS ID:80711 (history)  Vaccinated:1995-12-28
Age:35.7  Onset:1995-12-28, Days after vaccination: 0
Gender:Male  Submitted:1995-12-29, Days after onset: 1
Location:Florida  Entered:1996-01-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: 1hr p/vax severe violent vomiting-stomach pain-diarrhea-for approx 3 hrs;

VAERS ID:80721 (history)  Vaccinated:1995-12-01
Age:35.1  Onset:1995-12-01, Days after vaccination: 0
Gender:Male  Submitted:1995-12-05, Days after onset: 4
Location:Washington  Entered:1996-01-04, Days after submission: 30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: ATB
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WA951193
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49581201IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Dyspnoea, Injection site hypersensitivity
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt had dime sized area of inflammation immed p/vax; had hx of flu shot 1yr ago w/o problems;pt c/o SOB;vital signs remained stable;pt was briefly examined by MD;

VAERS ID:80804 (history)  Vaccinated:1995-08-09
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:1996-01-02
Location:Tennessee  Entered:1996-01-11, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: postpartum
Preexisting Conditions: postpartum
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES95121227
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Angioneurotic oedema, Drug ineffective, Hypersensitivity, Infection, Laboratory test abnormal, Laryngospasm, Pain, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Lack of efficacy/effect (narrow), Dystonia (broad), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax 9AUG95 & devel rubella synd, angioedema & urticaria & was hospitalized;@ the time of the report the pt''s sxs persisted;addl details are being requested;

VAERS ID:80877 (history)  Vaccinated:1995-11-20
Age:35.3  Onset:1995-11-20, Days after vaccination: 0
Gender:Female  Submitted:1995-11-21, Days after onset: 1
Location:Kansas  Entered:1996-01-16, Days after submission: 56
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: ASA/Vitamin E; multivitamin
Current Illness: NONE
Preexisting Conditions: Ceclor, Tetracycline, Keflex, Codeine, Green beans, potatoes, pork, shell fish, peanuts, babnnas, citrus
Diagnostic Lab Data: NONE
CDC Split Type: KS95064
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0738B1IMRA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Dermatitis bullous, Face oedema, Pruritus, Rash, Vasodilatation
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt reported rash beneath lip et blisters on inside of lip et itchy eyes, chills alternating w/hot periods, w/in 30min of inj;pt self-administered DPH;recvd cortisone inj from MD pt eyes had begun to swell;no diff breathing;

VAERS ID:81001 (history)  Vaccinated:1995-12-14
Age:35.0  Onset:1995-12-19, Days after vaccination: 5
Gender:Male  Submitted:1996-01-12, Days after onset: 24
Location:North Carolina  Entered:1996-01-17, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: beta strep neg
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49580720IMLA
Administered by: Other     Purchased by: Private
Symptoms: Back pain, Cough, Headache, Influenza, Myalgia, Pharyngitis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: 19DEC95 c/o h/a, backache, myalgia, sore throat, cough, T100.8, P120, R24, BP 130/70; no rashes, lungs clear; beta strep screen neg;dx flu like synd s/p vaccination

VAERS ID:80974 (history)  Vaccinated:1995-10-09
Age:35.7  Onset:0000-00-00
Gender:Female  Submitted:1996-01-11
Location:Michigan  Entered:1996-01-22, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95110226
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Abortion
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: pt recvd vax 9OCT95 & was in second wk of gestation @ time of vax;LMP was 17SEP95 & estimated date of delivery was 24JUN96;pt aborted pregnancy @ 7wks gestation;No further details are expected

VAERS ID:81117 (history)  Vaccinated:1995-11-29
Age:35.6  Onset:1995-11-29, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1996-01-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recvd Hep B vax on 25OCT95 by SKB lot# 1199A6
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1199A61IMLA
Administered by: Other     Purchased by: Public
Symptoms: Diarrhoea, Injection site pain, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt stated@ site of inj pain, tender;throbbing descending down arm to fingers, diarrhea & nausea x 24hrs; seen by MD

VAERS ID:83014 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  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: 1995 titer neg;
CDC Split Type: WAES95101112
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 2nd dose of vax & 4 & 8 wk p/vax lab eval revealed that pt did not seroconvert;No further details were provided;

VAERS ID:83021 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:New Jersey  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 0.09;
CDC Split Type: WAES95101141
Vaccination
Manufacturer
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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 recvd vax & lab eval revealed a neg varicella antibody titer;no further details were provided;

VAERS ID:83078 (history)  Vaccinated:1995-10-16
Age:35.3  Onset:1995-10-18, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1996-01-31
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: no relevant data
CDC Split Type: WAES95101215
Vaccination
Manufacturer
Lot
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0431B0IM 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Myalgia, Optic neuritis, Rash maculo-papular, Rash pustular, Uveitis, Visual disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (narrow), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Ocular infections (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax;devel myalgia;18oct95 devel 25 small vesicles in a circumoral area,a facial macular rash & pustular rash on lip;to md;pt exp visual visual difficulties;on 13nov95 papillitis & bilateral uveitis;tx w/ steroids w/ improvement;

VAERS ID:83365 (history)  Vaccinated:1995-11-21
Age:35.0  Onset:1995-11-30, Days after vaccination: 9
Gender:Female  Submitted:0000-00-00
Location:New York  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: Pred
Current Illness:
Preexisting Conditions: ashtma
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95120858
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0387B   
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax 21NOV95 & 30NOV95 & pt devel frank varicella w/chicken-pox type rash of 100 lesions on back & face w/1 or 2 vesicular lesions;also exp myalgia;MD felt it was chicken pox rash & that it was related to varicella vax;

VAERS ID:83892 (history)  Vaccinated:1995-09-20
Age:35.3  Onset:1995-10-01, Days after vaccination: 11
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1996-02-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: in pt,fever,swelling arm at 6yrs w/ TTX ;swelling arm at 30 yrs w/ flu vax;
Other Medications: synthroid, tenormin, ortho tri-cyclen, fioricet
Current Illness: none
Preexisting Conditions: allergy pcn; allergy dust; allergy pollen; allergy cipro; allergy sulfa;allergy codeine;
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES95100108
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.1317A0IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Myalgia, Pain, Pruritus, Pyrexia, Rash maculo-papular, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax; devel burning itchy, flushing over nose & cheeks which lasted for 1 wk along w/ fever of 100.3, maculopapular rash; joint ache & aching muscles;

VAERS ID:84250 (history)  Vaccinated:1995-11-07
Age:35.2  Onset:1995-11-07, Days after vaccination: 0
Gender:Female  Submitted:1995-11-08, Days after onset: 1
Location:Colorado  Entered:1996-02-26, Days after submission: 110
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: 895353003L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958129 IMA
Administered by: Private     Purchased by: Private
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: pt recv vax 7NOV95 & immed p/vax devel tingling down arm to wrist & fingers;

VAERS ID:84367 (history)  Vaccinated:1994-09-26
Age:35.8  Onset:1994-09-26, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Iowa  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: infect, resp, upper
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES95020485
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1236W0  
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Nausea, Pyrexia, Thinking abnormal, Vasodilatation
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: pt recv vax & exp dizziness & low fever,felt hot,c/o unaware of speaking to babysitter & did not remember a conversation had an out of body feeling & felt sick to stomach;

VAERS ID:84432 (history)  Vaccinated:1995-03-15
Age:35.0  Onset:1995-03-31, Days after vaccination: 16
Gender:Female  Submitted:0000-00-00
Location:Kansas  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: 31MAR95 Urinalysis WBC w/some RBC;12APR95 elevated liver enzymes
CDC Split Type: WAES95040821
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1416W0  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Hepatic function abnormal, Infection, Nausea, Pyrexia, Urinary tract infection, Vomiting, Weight decreased
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Lack of efficacy/effect (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax 1995;31MAR95 pt to MD w/n,v & sx of UTI;UA revealed white cells w/some red blood cells;tx Sulfa then switched to sulfamethoxazole;12APR95 pt seen by MD-t102,lost 8#,elevated liver enzymes;dx subclinical hepatitis

VAERS ID:84513 (history)  Vaccinated:1995-03-27
Age:35.6  Onset:1995-03-28, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Arkansas  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp itch w/1st dose of Hep B vax
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES95050916
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1541W0  
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & devel rash all over body, which was getting worse;further info from the same source stated that pt''s MD had r/o hepatitis vax had anything to do w/the rash the pt was having;

VAERS ID:84737 (history)  Vaccinated:1995-08-11
Age:35.9  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Kentucky  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: no relevant data
CDC Split Type: WAES95090479
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Diarrhoea, Headache, Hypokinesia, Myasthenic syndrome, Nausea, Oedema peripheral, Paraesthesia
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax;w/in min,arm felt like stone;next am arm felt like it could not be moved & tingling & swelling set in;severe n,severe abd cramps & d;nasal drainage & throat irritation;HA following wk,also backache & general malaise;to MD;

VAERS ID:83490 (history)  Vaccinated:1996-02-09
Age:35.4  Onset:1996-02-09, Days after vaccination: 0
Gender:Female  Submitted:1996-02-21, Days after onset: 12
Location:California  Entered:1996-03-06, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: multi vits & niacin;pt recvd Hep B vax by Merck lot# 1017B 10JAN96;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1017B1IMRA
Administered by: Private     Purchased by: Other
Symptoms: Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: rash on face,arms & trunk,hot,flushed;started feeling hot,face & ears turned red then redness gradually moved down neck,arms,& trunk;denies diff breathing,or any other sx;dec in sx w/in 1hr;

VAERS ID:85122 (history)  Vaccinated:1995-08-18
Age:35.6  Onset:1995-08-19, Days after vaccination: 1
Gender:Male  Submitted:1995-09-13, Days after onset: 25
Location:Georgia  Entered:1996-03-14, Days after submission: 183
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type: 895279009J
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)PFIZER/WYETH4948196 SC 
Administered by: Public     Purchased by: Public
Symptoms: Cough, Pain, Pyrexia, Rash, Somnolence
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow)
Write-up: pt recv vax;exp erythema & arm pain w/in 24 hrs of injection;devel a dry cough,T 101 & extreme lethargy 48 hrs post inject;he claims the sx lasted for 8 hrs;

VAERS ID:83686 (history)  Vaccinated:1996-01-03
Age:35.0  Onset:1996-01-15, Days after vaccination: 12
Gender:Female  Submitted:1996-02-23, Days after onset: 39
Location:New Jersey  Entered:1996-03-15, Days after submission: 21
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: 22JAN96 varicella zoster Ab IgM <20 (reference range <20); CBC w/diff-result WNL x/mono abs elevated 0.84;24JAN96 varicella ABIgG 0.21 (reference range 0.15-0.28 low positive); 5FEB96 varicella ABIgG 0.25;varicellal zoster AbIgM <20
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0904B   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Injection site hypersensitivity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt devel fever, cellulitis @ inj site, & erythematous lesions 12 days p/1 dose of vax given

VAERS ID:84049 (history)  Vaccinated:1996-03-12
Age:35.5  Onset:1996-03-13, Days after vaccination: 1
Gender:Female  Submitted:1996-03-20, Days after onset: 7
Location:New York  Entered:1996-03-27, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: autoimmune thyroiditis
Preexisting Conditions: NKA-auto immune thyroiditis & s/p tetralogy of fallot repair
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4318060IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: soreness lt deltoid few hrs p/vax; itching, followed by local urticaria $g24hrs <36hrs p/vax; 48hrs p/vax local red, tenderness, swelling, urticaria deltoid area only

VAERS ID:84801 (history)  Vaccinated:1996-01-25
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:1996-02-09
Location:North Carolina  Entered:1996-04-15, Days after submission: 65
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H71005   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hyporeflexia, Myalgia, Myopathy, Oedema, Osteoporosis, Pain
SMQs:, Rhabdomyolysis/myopathy (narrow), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Osteoporosis/osteopenia (narrow), Tendinopathies and ligament disorders (broad)
Write-up: unilateral reflex sympathetic dystrophy; dx hand-arm synd

VAERS ID:84900 (history)  Vaccinated:1996-02-13
Age:35.3  Onset:1996-02-14, Days after vaccination: 1
Gender:Female  Submitted:1996-02-29, Days after onset: 15
Location:Virginia  Entered:1996-04-15, Days after submission: 45
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:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: VA96011
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5C71115  RA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: several episodes of syncope beginning 14FEB96;inj site painful but not red;15FEB96 fainted @ work & evaluated by MD;

VAERS ID:84929 (history)  Vaccinated:1996-03-08
Age:35.2  Onset:1996-03-11, Days after vaccination: 3
Gender:Male  Submitted:1996-03-12, Days after onset: 1
Location:Unknown  Entered:1996-04-15, Days after submission: 33
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: 12-mar-96 WBC 64000;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5E71025   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax;3 days later devel pinpoint red,pruritic lesions on elbow,knees and thighs;

VAERS ID:85328 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1996-04-23
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: WAES95121244
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv vax; devel gen rash which was specifically noted at inject site;reporter felt the rash related to vax;

VAERS ID:85741 (history)  Vaccinated:1995-10-11
Age:35.1  Onset:1995-12-29, Days after vaccination: 79
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1996-04-23
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: Titer neg on 29dec95;
CDC Split Type: WAES96011084
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0416B1SC 
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax; blood test showed that pt failed to seroconvert;titers were based on a qualitative test;

VAERS ID:85745 (history)  Vaccinated:1996-01-03
Age:35.5  Onset:1996-01-15, Days after vaccination: 12
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:1996-04-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES96011165
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site inflammation, Injection site oedema, Injection site pain, Lymphocytosis, Myalgia, Pruritus, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax; exp inflam,tenderness,itching,swelling & pain at inject site;myalgia & fever of 102;

VAERS ID:85754 (history)  Vaccinated:1995-12-08
Age:35.5  Onset:1995-12-10, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1996-04-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Blood tests negative; CXR negative; Echocardiogram neg;
CDC Split Type: WAES96011358
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0399B0IM 
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Chest pain, Dermatitis bullous, Hyperaesthesia, Hypokinesia, Myalgia, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 8DEC95 & 10DEC95 pt devel a rash consistent w/ varicella & approx 20DEC95 exp intermittent chest discomfort; routine lab tests, CXR, & echocardiogram that turned out to be negative were performed;

VAERS ID:85804 (history)  Vaccinated:1996-01-19
Age:35.0  Onset:1996-02-09, Days after vaccination: 21
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1996-04-23
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: WAES96031015
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Headache, Herpes zoster, Malaise, Pharyngitis
SMQs:, Severe cutaneous adverse reactions (narrow), Agranulocytosis (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax; exp rash w/ 3 pox on back; pox resolved w/in 1 wk;6mar96 devel 2 more pox on back w/ HA,sore throat & malaise;MD felt pt had devel shingles;

VAERS ID:85390 (history)  Vaccinated:1995-09-29
Age:35.0  Onset:1995-09-29, Days after vaccination: 0
Gender:Female  Submitted:1996-04-05, Days after onset: 189
Location:Florida  Entered:1996-04-29, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: FL96024
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1541W0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: SOB & hives when 10-15min p/inj;saw PMD-DPH given & advised not to cont Hep B series

VAERS ID:85394 (history)  Vaccinated:1996-04-10
Age:35.1  Onset:1996-04-22, Days after vaccination: 12
Gender:Female  Submitted:1996-04-24, Days after onset: 2
Location:Connecticut  Entered:1996-04-29, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Orilerlin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: ESR & titer pending
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0660A  LA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: arthralgias beginning 12 days p/vax;pt recv prev vax <10yrs @ 18yrs old

VAERS ID:85398 (history)  Vaccinated:1995-09-21
Age:35.2  Onset:1995-09-21, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Iowa  Entered:1996-04-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type: IA96013
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1349A0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Agitation, Dizziness, Thirst, Vasodilatation
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Vestibular disorders (broad)
Write-up: pt recv vax;had adverse rxn complicated by panic attack;pt had inc thirst,flushed,dizziness;given meds;improved

VAERS ID:85580 (history)  Vaccinated:1996-02-22
Age:35.5  Onset:1996-03-10, Days after vaccination: 17
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1996-05-06
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: BA968106
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1420B0 LA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: low grade fever, rash on arms & chest

VAERS ID:85611 (history)  Vaccinated:1996-03-31
Age:35.5  Onset:1996-03-31, Days after vaccination: 0
Gender:Male  Submitted:1996-04-09, Days after onset: 8
Location:California  Entered:1996-05-06, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: darvocet
Current Illness: hay fever ?
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CA960039
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L710953IMLA
Administered by: Other     Purchased by: Public
Symptoms: Face oedema, Hypersensitivity, Injection site oedema, Injection site pain, Lacrimal disorder, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Lacrimal disorders (narrow), Hypersensitivity (narrow)
Write-up: about 6 hr p/vax pt arm became swollen & painful;the swelling extended to the lt side of face & lt eye was watery;pt was also having allergy sx;sx lasted 2 days

VAERS ID:86058 (history)  Vaccinated:1995-10-16
Age:35.5  Onset:1995-10-16, Days after vaccination: 0
Gender:Female  Submitted:1995-10-25, Days after onset: 9
Location:California  Entered:1996-05-13, Days after submission: 201
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: 0010150950220
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS 0IMA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Drug ineffective, Laryngitis, Pharyngitis, Pyrexia, Rhinitis
SMQs:, Agranulocytosis (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow)
Write-up: pt recv vax 16OCT95 & that evening devel a sore throat & fever;w/in 48hr devel laryngitis, chills & congestion;fever & chills have subsided;other sx are subsiding;

VAERS ID:86249 (history)  Vaccinated:1996-05-02
Age:35.8  Onset:1996-05-03, Days after vaccination: 1
Gender:Female  Submitted:1996-05-07, Days after onset: 4
Location:Kansas  Entered:1996-05-21, Days after submission: 14
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: KS96018
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1955A60IMLA
Administered by: Public     Purchased by: Private
Symptoms: Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: temp up to 102-nausea/vomiting;soreness over entire body;pt recovered on 6MAY96

VAERS ID:86296 (history)  Vaccinated:1996-05-08
Age:35.4  Onset:1996-05-09, Days after vaccination: 1
Gender:Female  Submitted:1996-05-17, Days after onset: 8
Location:Utah  Entered:1996-05-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type: UT962313
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1168B  RA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H71003  LA
Administered by: Other     Purchased by: Public
Symptoms: Ecchymosis, Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: severe local rxn w/redness, swelling, pain & bruising 2 days later

VAERS ID:86457 (history)  Vaccinated:1996-05-22
Age:35.5  Onset:1996-05-22, Days after vaccination: 0
Gender:Female  Submitted:1996-05-28, Days after onset: 6
Location:Virginia  Entered:1996-05-29, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: nONE
Preexisting Conditions: PCN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1429B0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Myasthenic syndrome, Rash, Tongue oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Malignancy related conditions (narrow), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: felt sensation of heaviness in extremities & swelling of tongue during the noc following inj;noticed rash on neck the next day lasting 2 days 23MAy & 24MAY;very tired x 3 days;

VAERS ID:86673 (history)  Vaccinated:1995-10-23
Age:35.9  Onset:0000-00-00
Gender:Female  Submitted:1996-02-28
Location:Colorado  Entered:1996-06-03, Days after submission: 95
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mantoux text intradermal 23OCT95 to 23OCT95
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896065010L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49580770IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Chest pain, Confusional state, Infection, Myasthenic syndrome, Neck pain, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)
Write-up: pt recv vax 23OCT95 & devel pain, weakness, confusion & fatigue;pt to ER 10FEB96 w/chest pain;was evaluated & released;pt was found to have positive Epstein Barr titer;pt believes all sx were a result of the inj;

VAERS ID:86687 (history)  Vaccinated:1995-10-23
Age:35.5  Onset:0000-00-00
Gender:Female  Submitted:1996-02-21
Location:Montana  Entered:1996-06-03, Days after submission: 102
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: NONE
CDC Split Type: 896117004L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958112 IM 
Administered by: Private     Purchased by: Private
Symptoms: Hypokinesia, Injection site pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax 23OCT95 & exp inject site pain which still persists;pt stated couldn''t lift arm over head or move it side to side & remains in constant pain;exp swelling @ noc;

VAERS ID:86689 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:1996-02-21
Location:Montana  Entered:1996-06-03, Days after submission: 102
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: 896117006L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958112 IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax 24OCT95 & 3wk later exp inj site pain which lasted 2wk;pt was recovered as of the date of this report

VAERS ID:87002 (history)  Vaccinated:1995-10-18
Age:35.6  Onset:1995-10-18, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Colorado  Entered:1996-06-05
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: no relevant data;
CDC Split Type: WAES95101349
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1734W SC 
Administered by: Public     Purchased by: Private
Symptoms: Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: pt recv vax & 12hr later pt face got flushed, red & itchy;pt recovered 19OCT95;

VAERS ID:87063 (history)  Vaccinated:1995-12-01
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1996-06-05
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: adenopathy
Diagnostic Lab Data: biopsy-occipital node hyperplasia
CDC Split Type: WAES96030695
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Influenza, Lymphadenopathy, Neoplasm
SMQs:, Tumours of unspecified malignancy (narrow)
Write-up: pt recv vax DEC95 & in JAN96 pt exp non-specific flu-like sx & devel an explosion of lymph nodes;MD reported that pt had swelling in the carotid & unilateral parotid swelling;biopsy in occipital node revealed hyperplasia;

VAERS ID:86805 (history)  Vaccinated:1996-05-31
Age:35.1  Onset:0000-00-00
Gender:Female  Submitted:1996-06-03
Location:Kentucky  Entered:1996-06-07, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)PFIZER/WYETH4958237 IMRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: erythema/swelling tenderness @ inj site

VAERS ID:86901 (history)  Vaccinated:1996-05-20
Age:35.0  Onset:1996-05-22, Days after vaccination: 2
Gender:Female  Submitted:1996-05-31, Days after onset: 9
Location:Maine  Entered:1996-06-11, 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: NONE
CDC Split Type: ME96013
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA485A60 RA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L710720 LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Oedema, 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)
Write-up: approx 30hr p/inj, lt arm became swollen to elbow, sore & hot;low grade temp-but reached 102; 10 days later, arm OK, recurring low grade fever

VAERS ID:87078 (history)  Vaccinated:1996-05-03
Age:35.4  Onset:1996-05-03, Days after vaccination: 0
Gender:Male  Submitted:1996-05-20, Days after onset: 17
Location:Arizona  Entered:1996-06-17, Days after submission: 28
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: h/o hypoglycemia
Diagnostic Lab Data: lab work was done @ clinic-lab work currently still not accessible will send if needed 29MAY96
CDC Split Type: AZ9625
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1196B0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Amblyopia, Asthenia, Dizziness, Hypotension, Pallor, Speech disorder, Stupor, Tongue oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: w/in 5" p/inj c/o weakness, blurry vision, dizziness, everything is moving slowly, & swollen tongue;P84, BP 110/70, t98.9 TM finger stick 100;sl pale, slurred speech, walking slowly, dazed;seen @ clinic x2hr dx atypical HBV rxn;

VAERS ID:87774 (history)  Vaccinated:1994-11-14
Age:35.1  Onset:1994-11-16, Days after vaccination: 2
Gender:Female  Submitted:1995-01-23, Days after onset: 68
Location:Missouri  Entered:1996-06-18, Days after submission: 511
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: healthy
Preexisting Conditions: last TD vax approx 10yr ago
Diagnostic Lab Data: NONE
CDC Split Type: 80950013703
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES366932 IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 1 of 3 pt recv vax who exp a local rxn;event occurred 3-5 days following vax, described as local redness-4" in diameter @ inj site w/soreness;MD visit-ice recommended for tx-recovered;

VAERS ID:87791 (history)  Vaccinated:1995-06-12
Age:35.7  Onset:1995-06-13, Days after vaccination: 1
Gender:Female  Submitted:1995-06-19, Days after onset: 6
Location:Indiana  Entered:1996-06-18, Days after submission: 365
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: unk
Other Medications: NONE
Current Illness: healthy
Preexisting Conditions: healthy
Diagnostic Lab Data: NONE
CDC Split Type: 895171005L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES368917   
Administered by: Private     Purchased by: Private
Symptoms: Hypokinesia, Injection site mass, Injection site pain, Nausea, Pyrexia, Skin nodule, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax & exp extreme local discomfort & devel nodules @ inj site & extended to entire arm & adjoining chest;pt was unable to move arm for a period of time;pt also exp fever, nausea & vomiting;no tx given; pt recovered;

VAERS ID:87444 (history)  Vaccinated:1996-06-14
Age:35.4  Onset:1996-06-15, Days after vaccination: 1
Gender:Female  Submitted:1996-06-19, Days after onset: 4
Location:North Carolina  Entered:1996-07-01, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bactrim, Glucophaze, Nordette, Metregel
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: NC96072
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4318040IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: started w/fever Saturday PM;broke out in rash Wednesday 19JUN96 on upper trunk, face, neck, & upper arms;

VAERS ID:87458 (history)  Vaccinated:1996-05-22
Age:35.5  Onset:1996-05-22, Days after vaccination: 0
Gender:Female  Submitted:1996-05-24, Days after onset: 2
Location:Georgia  Entered:1996-07-01, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Leuatol
Current Illness: NONE
Preexisting Conditions: HTN
Diagnostic Lab Data: NONE
CDC Split Type: GA96071
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H710051IMLA
Administered by: Public     Purchased by: Public
Symptoms: Myalgia, Oedema, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: p/vax pt arm felt sore;by noc time swollen & aching;ice applied;second noc heat applied;APAP & DPH taken

VAERS ID:87554 (history)  Vaccinated:1996-05-01
Age:35.4  Onset:1996-06-01, Days after vaccination: 31
Gender:Male  Submitted:1996-07-03, Days after onset: 32
Location:New Jersey  Entered:1996-07-05, Days after submission: 2
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: JUN96 Glucose 64;Lactate 3.2;RBC count 58;WBC count 101;lymphocytes 89%;monospot neg;lyme titer neg; RPR neg;IGG 1-10;
CDC Split Type: WAES96061344
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0398B0SC 
Administered by: Other     Purchased by: Other
Symptoms: Anuria, Confusional state, Laboratory test abnormal, Myasthenic syndrome, Myelitis, Optic neuritis, Paralysis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (narrow), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Ocular infections (broad), Tumour lysis syndrome (broad)
Write-up: pt recv vax & 4wks post vax could not urinate & c/o muscle weakness & tingling in the legs;pt hosp for urinary problems & to r/o GBS;exp optic neuritis;dx viral encephalomyelitis;paraplegia both legs-no sensation to pin or vibration;

VAERS ID:88151 (history)  Vaccinated:1996-02-16
Age:35.2  Onset:1996-03-05, Days after vaccination: 18
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1996-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt devel higv-like wheat @ the inj site w/dose 1 of varicella;
Other Medications: Birth control pills
Current Illness: NONE
Preexisting Conditions: intolernace, erythromycin
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES96031720
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0389B1SC 
Administered by: Private     Purchased by: Private
Symptoms: Conjunctivitis, Eczema, Pruritus, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 16FEB96 & 5MAR96 exp periorbital rash & itchy, irritated eczematous around the eyelids;tx w/med w/o resolution;exp required a MD visit;

VAERS ID:88160 (history)  Vaccinated:1995-12-01
Age:35.0  Onset:1996-03-01, Days after vaccination: 91
Gender:Female  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: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: MAR96 varicella antibody <.086 not converted;
CDC Split Type: WAES96031875
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 vax 2 doses of vax NOV95 & DEC95 & MAR96 a varicella titer was less than 0.86;no further details were provided;

VAERS ID:88313 (history)  Vaccinated:1996-01-03
Age:35.6  Onset:1996-04-09, Days after vaccination: 97
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: NONE
Preexisting Conditions:
Diagnostic Lab Data: 9APR96 ELISA 0.52
CDC Split Type: WAES96041201
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0445B1SC 
Administered by: Public     Purchased by: Private
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 2 dose of vax 30OCT95 & 3JAN96 & 9APR96 pt exp failure to seroconvert (ELISA 0.52);

VAERS ID:88497 (history)  Vaccinated:1995-09-01
Age:35.0  Onset:1996-04-21, Days after vaccination: 233
Gender:Female  Submitted:0000-00-00
Location:Unknown  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: IGM varicella negative
CDC Split Type: WAES96050053
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Headache, Infection, Influenza, Myalgia, Pruritus, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax AUG & SEP95 w/no rxn;21APR96 pt devel flu-like sx consisting of h/a, muscle aches, pain & t99.8;24APR96 devel rash which began as papule & went on to form vesicles on erythematous base;100 itchy lesion;breakthrough chicken pox

VAERS ID:88778 (history)  Vaccinated:1996-06-08
Age:35.2  Onset:1996-06-11, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:Texas  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: Allergy,sulfa; exp to scarlet fever
Diagnostic Lab Data: liver enzymes 5/24/96, nl;
CDC Split Type: WAES96061125
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1658B0SC 
Administered by: Other     Purchased by: Other
Symptoms: Conjunctivitis, Injection site hypersensitivity, Jaundice, Similar reaction on previous exposure to drug
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow)
Write-up: pt recv 2nd dose of vax;exp redness at inject site;devel yellowish discoloration in the whites of eyes;tired;

VAERS ID:89076 (history)  Vaccinated:1995-09-28
Age:35.6  Onset:1995-09-28, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:1996-08-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estratest
Current Illness: NONE
Preexisting Conditions: hysterectomy
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95100785
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0978A0  
Administered by: Private     Purchased by: Private
Symptoms: Chills, Injection site oedema, Lymphadenopathy, Malaise, Myalgia, Neck pain, Oedema, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), 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), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 28SEP95 & that day devel fever, chills, swelling @ inj site, swelling & soreness of inj arm & in the breast, along w/inflamed lymph glands;tx w/APAP;pt to ER on 30SEP95 w/malaise, neck pain & cont lymphadenopthy dx lymphadeniti

VAERS ID:89152 (history)  Vaccinated:1996-04-22
Age:35.9  Onset:1996-04-23, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1996-08-02
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: WAES96042397
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Arthritis, Influenza, Injection site inflammation, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (narrow)
Write-up: pt recv vax 22APR96 & 23APR96 pt exp inflammation @ the inj site, fever of 103, flu-like pain in joints arthritic pain;

VAERS ID:88447 (history)  Vaccinated:1995-08-03
Age:35.3  Onset:0000-00-00
Gender:Female  Submitted:1996-07-31
Location:North Carolina  Entered:1996-08-05, Days after submission: 5
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: FEB90 Varicella antibody positive-immune to varicella;16NOV95 amniocentesis nl male fetus;ultrasound results not reported;
CDC Split Type: WAES95101786
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Diabetes mellitus, Hypertension, Placental disorder
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: pt recv vax & became pregnant;LMP 31JUL95;estimated date of delivery 7MAY96;@ 33wk pt devel pregnancy-induced HTN, & @ 34wk gestational diabetes;tx w/meds;26APR96 pt exp placental abruption requiring Cesarean section;

VAERS ID:88898 (history)  Vaccinated:1992-12-01
Age:35.4  Onset:1993-01-10, Days after vaccination: 40
Gender:Female  Submitted:0000-00-00
Location:Indiana  Entered:1996-08-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1035AX1IMLA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Multiple sclerosis, Myasthenic syndrome
SMQs:, Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Optic nerve disorders (broad), Demyelination (narrow), Vestibular disorders (broad)
Write-up: 3 weeks p/vax dizziness, weakness on lt side dx w/multiple sclerosis APR94;

VAERS ID:88975 (history)  Vaccinated:1996-07-09
Age:35.1  Onset:1996-07-15, Days after vaccination: 6
Gender:Female  Submitted:1996-07-23, Days after onset: 8
Location:Georgia  Entered:1996-08-14, Days after submission: 22
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: NONE
CDC Split Type: GA96093
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1169B0SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6A810171IMRA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: rash started 18JUL96 on rt arm spread to chest, lt arm & body had itching went to MD was treated w/DPH & pred;phone call to pt today pt said was much improved;no other c/o noted;

VAERS ID:88993 (history)  Vaccinated:1994-11-08
Age:35.3  Onset:1994-11-15, Days after vaccination: 7
Gender:Female  Submitted:1996-07-10, Days after onset: 602
Location:Washington  Entered:1996-08-14, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: WA961257
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0598A0 RA
Administered by: Private     Purchased by: Other
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: itchy rash all over;MD said was d/t hep b rash appeared w/in wk & lasted a week or more;

VAERS ID:89325 (history)  Vaccinated:1996-08-16
Age:35.0  Onset:1996-08-19, Days after vaccination: 3
Gender:Male  Submitted:1996-08-21, Days after onset: 2
Location:Ohio  Entered:1996-08-27, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: laceration of finger
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: OH96115
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)PFIZER/WYETH4968044 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: non-allergic localized rxn to DT w/cellulitis to lt upper arm p/3 days

VAERS ID:89546 (history)  Vaccinated:1996-08-09
Age:35.0  Onset:1996-08-09, Days after vaccination: 0
Gender:Male  Submitted:1996-08-15, Days after onset: 6
Location:Texas  Entered:1996-09-03, Days after submission: 19
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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA478A6  A
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES6C81107  A
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)PFIZER/WYETH4958225  A
Administered by: Military     Purchased by: Military
Symptoms: Chills, Dyspnoea, Headache, Muscle twitching, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: gradual, but progress sx of fever, chills, diffuse h/a, gen muscular twitching & dyspnea;no rash, chest pain or LOC;IV NS, 02, epi, Solumedrol, DPH;

VAERS ID:89559 (history)  Vaccinated:1996-08-19
Age:35.5  Onset:1996-08-20, Days after vaccination: 1
Gender:Female  Submitted:1996-08-26, Days after onset: 6
Location:Idaho  Entered:1996-09-03, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: laceration 1 1/4cm rt thumb
Preexisting Conditions: allergic to codeine
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4968015 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Hyperhidrosis, Nausea, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: sx inc swelling, pain, nausea, sweats, & chills;tx off work 1 days, rest arm, heat w/heating pad to site, Naprosyn, return if any problems;

VAERS ID:90013 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:1996-07-25
Gender:Female  Submitted:1996-09-11, Days after onset: 48
Location:Oregon  Entered:1996-09-19, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96071639
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Abortion
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: pt recv vax & w/in several wk became pregnant;pt elected to have a therapeutic abortion on 25JUL96;no further info was provided;

VAERS ID:90319 (history)  Vaccinated:1996-07-09
Age:35.6  Onset:1996-08-07, Days after vaccination: 29
Gender:Male  Submitted:1996-09-13, Days after onset: 37
Location:New York  Entered:1996-09-30, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0387B IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: pt recv vax 9JUL96 & devel bells palsy on 7AUG96;

VAERS ID:90446 (history)  Vaccinated:1996-08-27
Age:35.9  Onset:1996-09-17, Days after vaccination: 21
Gender:Female  Submitted:1996-09-25, Days after onset: 8
Location:Kansas  Entered:1996-10-01, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BCP, Synthroid, Zestril, Asthma inhaler
Current Illness: NONE
Preexisting Conditions: asthma, HTN
Diagnostic Lab Data: 6AUG96 mumps IgG Ab: negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0217D SCRA
Administered by: Public     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt devel bilat mumps following MMR vax;

VAERS ID:90455 (history)  Vaccinated:1996-08-15
Age:35.5  Onset:1996-08-31, Days after vaccination: 16
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1996-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.0379B SCLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Osteoarthritis, Pain
SMQs:, Arthritis (narrow)
Write-up: pt recv vax 15AUG96 & 3SEP called & c/o pain/swelling rt knee then lt knee;2SEP pt contacted in 6SEP-16SEP-20SEP pain persisted & spread to feet;advised n 20SEP to see MD;

VAERS ID:90891 (history)  Vaccinated:1996-06-06
Age:35.0  Onset:1996-06-20, Days after vaccination: 14
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1996-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD given 8JUN96;
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96062331
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0745B0SC 
Administered by: Public     Purchased by: Private
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: pt recv vax 6JUN96 & 8JUN96 pt recv PPD test;20JUN96 pt exp numbness & paresthesia in lt arm;paresthesia started to occur in the rt arm but resolved quickly;JUL96 paresthesia persisted in lt arm but was resolving;

VAERS ID:90997 (history)  Vaccinated:1996-02-24
Age:35.0  Onset:1996-02-24, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:North Carolina  Entered:1996-10-18
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: No relevant data;
CDC Split Type: WAES96072231
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Conjunctivitis, Eye pain
SMQs:, Severe cutaneous adverse reactions (broad), Glaucoma (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: pt inadvertently got varicella vaccine in eye on 24FEB96;pt exp a burning & red eye;

VAERS ID:90998 (history)  Vaccinated:1996-03-01
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Michigan  Entered:1996-10-18
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: 1996 IGG <10 ACU/ML;
CDC Split Type: WAES96072232
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 vax 26JAN96 & 1MAR96 & pt exp a failure to seroconvert (Igg <10 acu/ml);pt had no other adverse experiences;

VAERS ID:91055 (history)  Vaccinated:1996-04-18
Age:35.0  Onset:1996-08-11, Days after vaccination: 115
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1996-10-18
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: 11AUG96 Varicella antibody no antibodies;
CDC Split Type: WAES96082307
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 vax 18APR96 & 11AUG96 a titer revealed that no antibodies could be seen;

VAERS ID:91094 (history)  Vaccinated:1996-06-13
Age:35.3  Onset:1996-08-21, Days after vaccination: 69
Gender:Female  Submitted:0000-00-00
Location:New Hampshire  Entered:1996-10-18
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: 21AUG96 varicella antibody negative;
CDC Split Type: WAES96090650
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 2 doses of vax 15MAY96 & 13JUN96 & 21AUG96 a blood test revealed a negative titer;

VAERS ID:91133 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1996-10-18
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: varicella antibody negative
CDC Split Type: WAES96080476
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 vax & pt exp lack of response;

VAERS ID:91139 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:1996-07-24
Gender:Male  Submitted:0000-00-00
Location:New Hampshire  Entered:1996-10-18
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: varicella antibody 24JUL96 0.07 ELISA IGG
CDC Split Type: WAES96080750
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 & lab eval on 24JUL96 revealed a negative titer (IgG=0.07);

VAERS ID:91357 (history)  Vaccinated:1996-10-22
Age:35.3  Onset:1996-10-22, Days after vaccination: 0
Gender:Female  Submitted:1996-10-25, Days after onset: 3
Location:New York  Entered:1996-10-28, Days after submission: 3
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: CAT Scan, 5 x-rays
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L71072 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity, Hypotension, Injury, Neuropathy, Oedema, Paraesthesia, Paralysis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: allergic rxn w/in 5min post vax became lightheaded, fainted, felt surge of med, fell on ceramic potted plant, numbness, swelling-broke rt orbital bone-nerve damage, BP dec 90/60, entire body locked body partially paralyzed, teeth chattering

VAERS ID:91388 (history)  Vaccinated:1996-10-18
Age:35.8  Onset:1996-10-18, Days after vaccination: 0
Gender:Male  Submitted:1996-10-18, Days after onset: 0
Location:Pennsylvania  Entered:1996-10-28, Days after submission: 10
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: denies
Preexisting Conditions: denies
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F712210IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Hyperhidrosis, Hypotonia, Stupor, Urinary incontinence, Vasodilatation
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: pt slouched over & was unresponsive for approx 3min;pt incontinent of urine;pt then responded & stated was fine;BP 108/56, P60 regular;skin warm & clammy;AMED notified & responded;pt refused eval & stated was fine;

VAERS ID:91495 (history)  Vaccinated:1996-10-10
Age:35.7  Onset:1996-10-10, Days after vaccination: 0
Gender:Male  Submitted:1996-10-17, Days after onset: 7
Location:Missouri  Entered:1996-10-30, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4968172 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Haemorrhage, Injection site hypersensitivity, Injection site mass, Injection site oedema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: reddened area, raised & firm formed immed upon inj of flu vax;no report of diff breathing, itching or feeling of apprehension;bleeding @ inj site;

VAERS ID:92005 (history)  Vaccinated:1996-01-30
Age:35.0  Onset:1996-01-31, Days after vaccination: 1
Gender:Female  Submitted:1996-03-15, Days after onset: 44
Location:Michigan  Entered:1996-10-30, Days after submission: 229
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 960015651
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1943A22IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Diarrhoea, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax & exp hives on abd w/no itching;the same day pt exp stomach cramps & diarrhea;diarrhea lasted for one day;5FEB96 pt exp a rash on back, arms, inner thighs, & chest;itching occurred only on the front of trunk;ER or MD visit

VAERS ID:92024 (history)  Vaccinated:1996-02-16
Age:35.0  Onset:1996-02-17, Days after vaccination: 1
Gender:Male  Submitted:1996-02-28, Days after onset: 11
Location:New Jersey  Entered:1996-10-30, Days after submission: 245
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: family history of hearing loss
Diagnostic Lab Data:
CDC Split Type: 960025811
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1966A20IMA
Administered by: Private     Purchased by: Private
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)
Write-up: pt recv vax & w/in 24hr post vax pt exp tinnitus;no tx was given; sx persist;

VAERS ID:92033 (history)  Vaccinated:1995-08-24
Age:35.0  Onset:1995-09-24, Days after vaccination: 31
Gender:Female  Submitted:1996-03-05, Days after onset: 163
Location:West Virginia  Entered:1996-10-30, Days after submission: 239
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: allergy inject
Current Illness:
Preexisting Conditions: allergies
Diagnostic Lab Data:
CDC Split Type: 960028261
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Back pain, Eye pain, Insomnia, Muscle twitching, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 24AUG95 & exp chills, fever, muscle aches for 3 days p/vax;sx resolved;3-4 wk p/vax pt devel pain in rt elbow which progressed to back (like swollen muscle);fatigue, insomnia, burning eyes, twitch in eye, pain eye

VAERS ID:92035 (history)  Vaccinated:1995-11-08
Age:35.0  Onset:1995-11-08, Days after vaccination: 0
Gender:Male  Submitted:1996-03-01, Days after onset: 114
Location:New Hampshire  Entered:1996-10-30, Days after submission: 243
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: 960027501
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & exp total rash & fever which lasted for two weeks & worsened for tow days;pt was found to have perivascular lymphocytic dermatitis

VAERS ID:92971 (history)  Vaccinated:1995-08-16
Age:35.0  Onset:1995-08-17, Days after vaccination: 1
Gender:Female  Submitted:1995-09-20, Days after onset: 34
Location:North Carolina  Entered:1996-10-30, Days after submission: 406
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: 950094521
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1661A40 RA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & w/in 24hr post vax pt exp itching & a welt @ inj site;

VAERS ID:92975 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:1995-09-22
Location:Unknown  Entered:1996-10-30, Days after submission: 404
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: 950096081
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1394A60  
Administered by: Other     Purchased by: Other
Symptoms: Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)
Write-up: pt recv one dose for prophylaxis; w/in 24 hr exp nausea; w/in 48 hr exp vertigo; recovered w/in 3 days

VAERS ID:93031 (history)  Vaccinated:1995-11-03
Age:35.0  Onset:1995-11-03, Days after vaccination: 0
Gender:Female  Submitted:1995-11-08, Days after onset: 5
Location:Pennsylvania  Entered:1996-10-30, Days after submission: 357
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: 950118271
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1725A41IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax & exp an excessive sting while pt was injected w/pain @ site following;no tx was given;

VAERS ID:93074 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:1995-12-19
Location:Missouri  Entered:1996-10-30, Days after submission: 316
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: 950140861
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1  
Administered by: Other     Purchased by: Other
Symptoms: Malaise
SMQs:
Write-up: pt recv vax & w/in 24 hr pt did not feel well for a few days;event resolved;

VAERS ID:93174 (history)  Vaccinated:1996-02-27
Age:35.0  Onset:1996-02-28, Days after vaccination: 1
Gender:Male  Submitted:1996-03-06, Days after onset: 7
Location:Unknown  Entered:1996-10-30, 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: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 960029001
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1814A40IMA
Administered by: Other     Purchased by: Other
Symptoms: Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 27FEB96 & w/in 24 hr the morning of 28FEB96 pt exp a h/a which was severe enough to leave work;also exp achiness;

VAERS ID:93334 (history)  Vaccinated:1996-04-23
Age:35.0  Onset:1996-04-24, Days after vaccination: 1
Gender:Female  Submitted:1996-06-11, Days after onset: 48
Location:New Jersey  Entered:1996-10-30, Days after submission: 141
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loestrin, APAP
Current Illness:
Preexisting Conditions: allergies;
Diagnostic Lab Data:
CDC Split Type: 960058091
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1853A40IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Arthropathy
SMQs:, Arthritis (broad)
Write-up: pt recv vax & post vax exp stiffness & pain in the joints of the fingers of lt hand;tx advil;sx lasted for approx 3 wk to 1month;

VAERS ID:93455 (history)  Vaccinated:1996-07-17
Age:35.0  Onset:1996-07-18, Days after vaccination: 1
Gender:Female  Submitted:1996-08-07, Days after onset: 20
Location:New Jersey  Entered:1996-10-30, Days after submission: 84
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: 960107721
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1814A41IMRA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Nuchal rigidity
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: pt recv vax 17JUL96 24 hr post vax pt exp stiff neck, lightheadedness & dizziness;the stiff neck has resolved but still feels lightheaded & dizzy when pt sits;

VAERS ID:91837 (history)  Vaccinated:1996-10-03
Age:35.1  Onset:1996-10-04, Days after vaccination: 1
Gender:Female  Submitted:1996-10-18, Days after onset: 14
Location:Georgia  Entered:1996-10-31, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: cardiomyopathy/breast Ca
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4968173 IMA
Administered by: Private     Purchased by: Private
Symptoms: Oedema, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: erythema & swelling x 3 days 4 1/2cm diameter;

VAERS ID:91564 (history)  Vaccinated:1996-10-23
Age:35.9  Onset:1996-10-23, Days after vaccination: 0
Gender:Female  Submitted:1996-10-24, Days after onset: 1
Location:Colorado  Entered:1996-11-04, 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: Phen-phen
Current Illness: NONE
Preexisting Conditions: bee stings
Diagnostic Lab Data: NOT KNOWN
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F71321 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: pt c/o sweating, feeling lightheaded, 20-25 min p/vax;resp 18 nl, BP 140/80, P80;pt sweating profusely, cool towel applied to forehead, pt lay down on sofa, Vs retaken & same as above 911 called & pt taken to ER to be seen by MD;

VAERS ID:91589 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:1996-10-30
Location:California  Entered:1996-11-04, 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: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F71215  RA
Administered by: Other     Purchased by: Private
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax spotty erythema & itching;small vesicle @ inj site 2 days p/vax;

VAERS ID:91650 (history)  Vaccinated:1996-09-30
Age:35.9  Onset:1996-10-01, Days after vaccination: 1
Gender:Male  Submitted:1996-10-09, Days after onset: 8
Location:Hawaii  Entered:1996-11-05, Days after submission: 27
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:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)PFIZER/WYETH49680830IMRA
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 30SEP96 & 2OCT96 reports to clinic w/redness, swelling under rt arm & tenderness;local cellulitis tx w/ATB & ibuprofen;

VAERS ID:91738 (history)  Vaccinated:1996-10-30
Age:35.7  Onset:1996-10-30, Days after vaccination: 0
Gender:Female  Submitted:1996-10-31, Days after onset: 1
Location:Rhode Island  Entered:1996-11-06, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F712662IMA
Administered by: Private     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: large area of localized redness & swelling around inj site;

VAERS ID:91851 (history)  Vaccinated:1996-10-21
Age:35.1  Onset:1996-10-21, Days after vaccination: 0
Gender:Female  Submitted:1996-10-25, Days after onset: 4
Location:Massachusetts  Entered:1996-11-11, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mantou by Connaught lot# 241213 given 21OCT96;
Current Illness: NONE
Preexisting Conditions: hx of asthma, hayfever
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD58 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Headache, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: 1-2hr post vax nausea, chills, h/a, body aches often has rxn to meds;t98 & BP 120/80, pulse 78, resp 18;not short of breath, alert oriented;

VAERS ID:92359 (history)  Vaccinated:1996-10-10
Age:35.9  Onset:1996-10-11, Days after vaccination: 1
Gender:Female  Submitted:1996-10-17, Days after onset: 6
Location:Alaska  Entered:1996-11-25, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: latex allergy
Diagnostic Lab Data: NONE
CDC Split Type: AK9631
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH94681670 A
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Headache, Hyperhidrosis, Injection site hypersensitivity, Injection site oedema, Myalgia, Neck pain, 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), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: h/a started a few hrs p/vax then red swollen inj site, neck, joint muscle pain, fever, sweats;

VAERS ID:92391 (history)  Vaccinated:1996-07-08
Age:35.1  Onset:1996-07-09, Days after vaccination: 1
Gender:Female  Submitted:1996-07-11, Days after onset: 2
Location:South Dakota  Entered:1996-11-25, Days after submission: 137
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: SD96009
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6A81015 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Back pain, Myalgia, Nausea, Oedema peripheral, Pain, Pharyngitis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: sore arm, pain down lt back & armpit;gen body aches & t101, no appetite, nausea swelling arm & throbbins arm @ noc;sl sore throat;

VAERS ID:92467 (history)  Vaccinated:1996-10-07
Age:35.0  Onset:1996-10-21, Days after vaccination: 14
Gender:Female  Submitted:1996-11-08, Days after onset: 18
Location:Oklahoma  Entered:1996-11-29, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
    Extended hospital stay? Yes
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI, spinal tap, echocardiogram
CDC Split Type: OK9641
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6F812022IMLA
Administered by: Other     Purchased by: Public
Symptoms: Hypokinesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 21OCT96 numbness began in rt hand AM then tingling in feet in PM;22OCT96 numbness in lt hand & going up legs;went to clinic;25OCT96 could not walk;had MRI & echo;28OCT96 referred to MD & adm to hosp;

VAERS ID:92468 (history)  Vaccinated:1996-11-08
Age:35.1  Onset:1996-11-08, Days after vaccination: 0
Gender:Female  Submitted:1996-11-19, Days after onset: 11
Location:Texas  Entered:1996-11-29, 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 anaphalactic rxn @ 34yr old w/allerby shot;
Other Medications: Tegretol;Paxil
Current Illness: NA
Preexisting Conditions: allergies:dust mites/mt cedar;neuro;sz disorder
Diagnostic Lab Data: NA
CDC Split Type: SA96013
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F712750IMA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Back pain, Cough, Headache, Injection site pain, Myalgia, Pharyngitis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: muscle aches, cough, sore throat, h/a, fatigue, fever 100, sx began on 8NOV96 have cont 19NOV96, also back pain;pain in inj site & entire rt arm;saw MD who states pt had a virus;

VAERS ID:93857 (history)  Vaccinated:1996-06-18
Age:35.5  Onset:1996-06-18, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1996-12-02
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: No relevant data;
CDC Split Type: WAES96070325
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Pain, Pharyngitis, Rash
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 18JUN96 & same day exp rash, sore throat & sore lymph nodes;

VAERS ID:92704 (history)  Vaccinated:1996-11-05
Age:35.0  Onset:1996-11-06, Days after vaccination: 1
Gender:Female  Submitted:1996-11-08, Days after onset: 2
Location:Nevada  Entered:1996-12-09, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diflucan noc a/vax
Current Illness:
Preexisting Conditions: allergy to sulfa (nausea)
Diagnostic Lab Data:
CDC Split Type: NV96032
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0159D0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pharyngitis, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: pt described intense itching on 6NOV96 approx 24hr p/vax devel red welt like eruption on feet, hands & under buttocks;tx w/DPH & steroid cream, OTC;seen by MD for pharyngitis & given DPH for hives;

VAERS ID:92835 (history)  Vaccinated:1996-10-28
Age:35.1  Onset:1996-10-28, Days after vaccination: 0
Gender:Female  Submitted:1996-12-03, Days after onset: 36
Location:Missouri  Entered:1996-12-13, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD by Connaught lot# 242813 given 28OCT96;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CST scan, chem profile, thyroid
CDC Split Type: MO96066
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F712390IMLA
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES5L710953IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dizziness, Hypertension, Muscle twitching
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Vestibular disorders (broad)
Write-up: 28OCT96 pt c/o high BP, lightheadedness, weakness, muscle twitching, dizziness;

VAERS ID:92927 (history)  Vaccinated:1996-04-10
Age:35.7  Onset:1996-04-15, Days after vaccination: 5
Gender:Female  Submitted:1996-12-13, Days after onset: 242
Location:Michigan  Entered:1996-12-17, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp foot pain, paresthesia, joint pain, lep swollen @ age 35 w/Hep B doses 1
Other Medications:
Current Illness: NONE
Preexisting Conditions: hepatitis B;Hepatitis C;arthritis;
Diagnostic Lab Data: 6JUN96 AST 78; ALT 151;Globulin 3.6;Occult Blood 10;RBC count 3-5;18JUL96 Rheumatoid factor 126;ESR 5; 1996 x-ray arthritis;6JUN96 Anti-HBS positive;Anti-HBC positive;Anti-HCV positive;
CDC Split Type: WAES96062237
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1239W2  
Administered by: Other     Purchased by: Other
Symptoms: Anxiety, Arthropathy, Hypertonia, Multiple sclerosis, Myalgia, Neuropathy, Paraesthesia, Rheumatoid arthritis, Similar reaction on previous exposure to drug
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Demyelination (narrow), Eosinophilic pneumonia (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt exp pain on bottom of feet & palms & in lower back;body aches, leg cramps;idiopathic peripheral polyneuropathy perdominantly sensory;? anxiety vs MS;puffiness in feet, muscle sapsms;knees rubbery & hot, anxiety arthralgia, RA;arthritis

VAERS ID:93126 (history)  Vaccinated:1996-11-22
Age:35.0  Onset:1996-11-22, Days after vaccination: 0
Gender:Female  Submitted:1996-12-13, Days after onset: 21
Location:Nebraska  Entered:1996-12-17, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.L12481  
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & had hives w/itching;took DPH every 4hr x 2 days p/calling nurse;denies SOB, dyspnea;

VAERS ID:93524 (history)  Vaccinated:1996-10-28
Age:35.0  Onset:1996-10-29, Days after vaccination: 1
Gender:Female  Submitted:1996-11-19, Days after onset: 21
Location:Minnesota  Entered:1997-01-02, Days after submission: 44
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: MN96054
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH496163 IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Hypokinesia, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax;sharp pain in lt arm; pain in certain arm positions as crossing to opposite shoulder and reaching behind back; to MD for baby visit;

VAERS ID:93908 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Virginia  Entered:1997-01-21
Life Threatening? Yes
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 (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anaphylactoid reaction, Asthma, Bone disorder, Face oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: anaphylactic rxn, facial swelling, periorbital swelling, wheezing;

VAERS ID:94014 (history)  Vaccinated:1996-12-03
Age:35.8  Onset:1996-12-10, Days after vaccination: 7
Gender:Female  Submitted:0000-00-00
Location:Illinois  Entered:1997-01-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: exposure, varicella;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96121161
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Infection, Malaise, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 3DEC96 & was exposed to varicella on 6DEC96 & 12DEC96 pt exp t102, devel a gen rash;16DEC96 pt had greater than 50 lesions on body & an additional 35 lesions on face;pt was hosp;

VAERS ID:94053 (history)  Vaccinated:1995-06-30
Age:35.0  Onset:1996-03-02, Days after vaccination: 246
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1997-01-23
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: 9JUL95 pregnancy tests positive;aminocentesis WNL;ultrasound WNL;varicella antibody 1MAY96 negative;
CDC Split Type: WAES95070574
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Foetal disorder
SMQs:, Foetal disorders (narrow)
Write-up: mom recv vax & became pregnant & child born w/post axial polydactyly;

VAERS ID:94143 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Massachusetts  Entered:1997-01-23
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: WAES96101068
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 vax in 1996 & exp lack of seroconversion;

VAERS ID:95071 (history)  Vaccinated:1995-10-18
Age:35.4  Onset:1995-10-18, Days after vaccination: 0
Gender:Female  Submitted:1996-12-02, Days after onset: 411
Location:North Carolina  Entered:1997-02-20, Days after submission: 80
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: CO6218
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.J11550 A
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Injection site hypersensitivity, Injection site mass, Nausea, Vasodilatation
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: 5"x5" redness & warmth & knot @ site w/lightheadedness & nausea;

VAERS ID:95262 (history)  Vaccinated:1997-01-21
Age:35.5  Onset:1997-01-21, Days after vaccination: 0
Gender:Female  Submitted:1997-01-24, Days after onset: 3
Location:South Carolina  Entered:1997-02-24, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt devel flu like sx, strep throat & sz on 9DEC96 w/dose 1 Hep P vax;
Other Medications: PCN
Current Illness: strep throat-rx x 7 dasy
Preexisting Conditions: sz disorder since 1981;food allergy-choclate
Diagnostic Lab Data:
CDC Split Type: SC97005
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2098B61IMA
Administered by: Other     Purchased by: Public
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & exp rash w/urticaria over entire body;onset 3hr post vax;

VAERS ID:95323 (history)  Vaccinated:1997-02-04
Age:35.0  Onset:1997-02-04, Days after vaccination: 0
Gender:Female  Submitted:1997-02-13, Days after onset: 9
Location:Texas  Entered:1997-02-28, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6F812044IMRA
Administered by: Public     Purchased by: Public
Symptoms: Abortion, Eye disorder, Face oedema, Facial palsy, Lacrimal disorder, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Lacrimal disorders (narrow), Termination of pregnancy and risk of abortion (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: 4FEB97 pt recv vax & w/in hr had severe redness, hardness & little red bumps around inj site,warm to touch, high fever & feeling achy all over;10FEB97 rt side of face pulled to lt, unable to close rt eye;taken to ER dx Bell''s palsy;

VAERS ID:95690 (history)  Vaccinated:1996-10-24
Age:35.2  Onset:1996-10-24, Days after vaccination: 0
Gender:Female  Submitted:1996-10-24, Days after onset: 0
Location:Minnesota  Entered:1997-03-06, Days after submission: 133
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: 896313005L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4968205 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: approx 2hr p/vax pt devel an area of numbness the size of a hand @ the inj site;

VAERS ID:95786 (history)  Vaccinated:1996-10-09
Age:35.0  Onset:1996-10-11, Days after vaccination: 2
Gender:Female  Submitted:1996-10-14, Days after onset: 3
Location:Illinois  Entered:1997-03-06, Days after submission: 143
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: 896295019L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  IM 
Administered by: Other     Purchased by: Other
Symptoms: Influenza, Pharyngitis, Pyrexia
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow)
Write-up: pt inadvertently recv 1ml of flu vax instead of .5ml;2 days p/vax pt devel a fever of 102, sore throat & flu sx;addtl info recv 13NOV96,indicated that the pt recovered;@ that time the reporter stated that the pt husband devel similar sx;

VAERS ID:95909 (history)  Vaccinated:1996-01-02
Age:35.0  Onset:1996-01-02, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Arkansas  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: spastic colon;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96011904
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax 2JAN96 & 12hr p/vax pt exp sever abd cramps & passed out d/t pain;

VAERS ID:96007 (history)  Vaccinated:1996-04-09
Age:35.0  Onset:1996-04-09, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:1997-03-11
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: WAES96051020
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Anxiety, Dyspnoea, Hypertension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad)
Write-up: pt recv vax 9APR96 & that day pt exp SOB, inc BP & anxiousness;pt was treated w/DPh;pt recovered;

VAERS ID:96069 (history)  Vaccinated:1996-03-09
Age:35.1  Onset:1996-03-09, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1997-03-11
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, sulfa
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96072156
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Pain, Similar reaction on previous exposure to drug
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax 9MAR96 & exp pain @ inj site which extended the length of the arm & into the chest wall;the pain lasted 2 days;

VAERS ID:96089 (history)  Vaccinated:1996-08-07
Age:35.0  Onset:1996-08-09, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Louisiana  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergy, PCN; allergy, codeine;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96080934
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dizziness, Malaise
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: pt recv vax 7AUG96 & 9AUG96 pt exp fatigue, malaise & dizziness;

VAERS ID:96148 (history)  Vaccinated:1996-07-08
Age:35.0  Onset:1996-07-08, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Oregon  Entered:1997-03-11
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, eggs
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96100705
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1622B2  
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Asthenia, Dizziness, Dyspepsia, Headache, Myalgia, Pollakiuria, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax & that evening pt exp a gen h/a;9JUL96 pt exp diarrhea, & urinated every 20min for 7hr;later that same evening pt exp chills;10JUL96 pt exp aches, joint pain, fever 102;dizziness & vomiting;11JUL96 exp upset stomach;weakness

VAERS ID:96157 (history)  Vaccinated:1996-08-01
Age:35.6  Onset:1996-08-08, Days after vaccination: 7
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: allergy, iodine
Diagnostic Lab Data: 1996 ESR elevated;sl, mildly elevated liver func test;
CDC Split Type: WAES96101063
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Hepatic function abnormal, Migraine, Myalgia, Pyrexia, Red blood cell sedimentation rate increased, Serum sickness, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax AUG96 & 7-10 days p/vax pt devel a hypersensitivity rxn consisting of a possible serum-sickness like rxn, flu-like sx, a look as if were getting a migraine, trembling hands, & exp fever, h/a, aches & pains & weakness;

VAERS ID:96165 (history)  Vaccinated:1996-09-24
Age:35.0  Onset:1996-09-24, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Arizona  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96101643
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)
Write-up: pt recv vax 24SEP96 & 18hr p/vax pt exp metallic taste;

VAERS ID:96508 (history)  Vaccinated:1997-02-25
Age:35.8  Onset:1997-02-28, Days after vaccination: 3
Gender:Female  Submitted:1997-03-13, Days after onset: 13
Location:Michigan  Entered:1997-03-27, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIES6K81366 IMRA
Administered by: Private     Purchased by: Public
Symptoms: Asthenia, Malaise, Myalgia, Thinking abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: malaise, fatigue, myalgia, mild obtundation;

VAERS ID:96519 (history)  Vaccinated:1997-01-15
Age:35.8  Onset:1997-01-27, Days after vaccination: 12
Gender:Female  Submitted:1997-03-21, Days after onset: 53
Location:Vermont  Entered:1997-03-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: PCN0env. allergy-hayfever
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1130B0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Mouth ulceration, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: 28JAN97 pt devel pustules on forehead, chin, lower throat & rt arm;29JAN97 devel cold sore on rt lower lip;30JAN97 3x3 patch pustules x 5 or rt lower abd;27JAN97 gen pruritus lasting x 1wk;

VAERS ID:96606 (history)  Vaccinated:1997-02-27
Age:35.9  Onset:1997-02-28, Days after vaccination: 1
Gender:Female  Submitted:1997-03-10, Days after onset: 10
Location:Wisconsin  Entered:1997-03-31, Days after submission: 21
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: WI97007
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1471B1SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6A810150IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Oedema, Paraesthesia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: pt recv vax 27FEB97 18 to 20hr later pt devel inc pain & swelling @ site area & numbness from site inc to fingers-up under arm & extending to below lt ear;

VAERS ID:96608 (history)  Vaccinated:1997-03-08
Age:35.4  Onset:1997-03-09, Days after vaccination: 1
Gender:Female  Submitted:1997-03-12, Days after onset: 3
Location:New York  Entered:1997-03-31, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NY97010
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES440711 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthropathy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: 9MAR97 AM felt aching all over;10MAR97 stiff joints;no fever;

VAERS ID:97058 (history)  Vaccinated:1997-03-24
Age:35.4  Onset:1997-03-25, Days after vaccination: 1
Gender:Female  Submitted:1997-04-09, Days after onset: 14
Location:Iowa  Entered:1997-04-18, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control pills
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: IA97016
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2141A42 LA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6J81325  RA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: reporter states 26MAR97 pt c/o warmth, swelling & discomfort in lt deltoid which began 25MAR97 in late afternoon;advised pt to use cold compress & APAP & contact MD if problems persists;28MAR & 7APR pt called MD w/cont problem;dx cellulitis

VAERS ID:97498 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Illinois  Entered:1997-04-18
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: varicella antibody 0.22;
CDC Split Type: WAES97010892
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: pt recv vax & 8mo post vax pt was tested for seroconversion;lab eval revealed varicella titer 0.22 & a low level of antibody was detected;

VAERS ID:97669 (history)  Vaccinated:1996-10-01
Age:35.8  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:1997-04-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNKNOWN
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97010091
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax OCT96 & approx 2 wk p/vax pt devel a mild rash w/spots in the hair, stomach & chest areas;

VAERS ID:97772 (history)  Vaccinated:1997-02-13
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:2000-06-16
Location:Georgia  Entered:1997-04-18, Days after submission: 1155
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pregnancy (LMP = 10/31/1996)
Preexisting Conditions: exposure, varicella;
Diagnostic Lab Data: 1997 Amniocentesis performed for risk of chr. aber; ultrasound, normal at 28 weeks; serum varicella zoster, negative
CDC Split Type: WAES97021761
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Amniocentesis, Erythema, Injection site erythema, Injection site hypersensitivity, Injection site oedema, Injection site pain, Pregnancy, Swelling, Ultrasound abdomen normal, Varicella zoster serology negative, Wrong drug administered
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Normal pregnancy conditions and outcomes (narrow), Hypersensitivity (narrow)
Write-up: pt recv varicella vax instead of varicella zoster immune globulin 2 16wk of pregnancy;pt devel swelling, redness & soreness @ the inj site;@ the time of the report, the pt had no other adverse exp;An amniocentesis was performed; This is in follow-up to report(s) submitted on 04/16/1997; 10/16/1997; 01/16/1998. Information has been received from a man concerning his 36-year-old Caucasian wife who on 13FEB97, at 15 weeks of pregnancy, was vaccinated with VARIVAX instead of VZIG. It was noted that the patient and her son were exposed to another child who developed chickenpox, and she took her son to the pediatrician''s office for administration of VARIVAX. The pediatrician consulted with the woman''s obstetrician, who recommended that she receive VZIG, since she was seronegative. At the pediatrician''s office, the woman was inadvertently administered VARIVAX. In February 1997, she developed swelling, redness and soreness at the injection site. At the time of the report, the patient had no other adverse experience. An amniocentesis was performed at 18 weeks of pregnancy for routine evaluation of risk for chromosome aberrations based on maternal age, and not based on perceived risk from the vaccination, according to a physician. At 28 weeks, an ultrasound was normal. During the pregnancy, the patient was placed on therapy with ZOVIRAX. The estimated date of delivery was 04AUG97. On 04AUG97, the woman delivered by scheduled Cesarean ection a healthy son with an Apgar score of 9.9. No further details were provided. This is a correct report. A negative serum varicella zoster virus antibody test was added to Box 12.

VAERS ID:97831 (history)  Vaccinated:1997-01-24
Age:35.7  Onset:1997-02-05, Days after vaccination: 12
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1997-04-18
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: No relevant data;
CDC Split Type: WAES97030279
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 24JAN97 & 5FEB97 pt exp one lesions on labia;pt was to be cultured for herpes simplex;

VAERS ID:97838 (history)  Vaccinated:1997-02-17
Age:35.9  Onset:1997-02-28, Days after vaccination: 11
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:1997-04-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97030580
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0242D0  
Administered by: Other     Purchased by: Other
Symptoms: Acne, Dermatitis bullous, Injection site hypersensitivity, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & pt devel a rash @ the inj site which covered an area the size of an egg;

VAERS ID:98757 (history)  Vaccinated:1995-11-03
Age:35.0  Onset:1995-11-05, Days after vaccination: 2
Gender:Male  Submitted:1997-02-06, Days after onset: 459
Location:Puerto Rico  Entered:1997-04-18, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6307
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5J61007   
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Dehydration, Gastritis, Pyrexia, Ventricular extrasystoles
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: moderte dehydration, abd pain, gastritis, PVC''s, fever 99.5;

VAERS ID:97109 (history)  Vaccinated:1997-03-24
Age:35.7  Onset:1997-04-06, Days after vaccination: 13
Gender:Female  Submitted:1997-04-14, Days after onset: 7
Location:Florida  Entered:1997-04-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Wellbutrn SR, Ativan, Birth control pills, sinus tablet-OTC
Current Illness: NONE
Preexisting Conditions: allergies: augmentin codeine;history MVP
Diagnostic Lab Data: unk
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0767D0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Chest pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt c/o extremities fatigue, sore muscles & aching all over & chest pain 2-3 days;pt referred to pvt MD;

VAERS ID:97174 (history)  Vaccinated:1997-04-11
Age:35.7  Onset:1997-04-11, Days after vaccination: 0
Gender:Male  Submitted:1997-04-16, Days after onset: 5
Location:South Dakota  Entered:1997-04-22, Days after submission: 6
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: states heart skips a beat-no med benign condition
Diagnostic Lab Data: NONE
CDC Split Type: SD97013A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7B91518 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypertonia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax & noted spasms in lower back by 5:30PM;had major spasms of back later Friday PM;pt having little spasms in arms & legs;arm where inj given remains sore & stiff;pt cont to have little twinges;

VAERS ID:98027 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:1996-11-05
Location:Unknown  Entered:1997-04-28, Days after submission: 173
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unspecified pain med
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896326003L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)PFIZER/WYETH  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Myalgia, Tendon disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (narrow)
Write-up: pt recv vax 10yr ago & immed exp myalgia, fibromyalgia, arthralgia, & tendinitis;these sx persist as of the date of this report;

VAERS ID:97305 (history)  Vaccinated:1997-04-23
Age:35.5  Onset:1997-04-25, Days after vaccination: 2
Gender:Female  Submitted:1997-04-25, Days after onset: 0
Location:California  Entered:1997-05-01, 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: Norvasc, E-mycin, TAP, vicodin
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.M0361 SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1248D SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES441211 IMLA
Administered by: Military     Purchased by: Private
Symptoms: Dizziness, Dyspnoea, Injection site oedema, Injection site pain
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: dizziness, SOB, nausea, local swelling & tenderness x 2d;epi given;

VAERS ID:97306 (history)  Vaccinated:1997-04-11
Age:35.3  Onset:1997-04-19, Days after vaccination: 8
Gender:Female  Submitted:1997-04-28, Days after onset: 9
Location:California  Entered:1997-05-01, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.1289B0SCRA
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 19APR97 swelling & erythema @ inj site, t101;

VAERS ID:97976 (history)  Vaccinated:1997-05-05
Age:35.7  Onset:1997-05-05, Days after vaccination: 0
Gender:Female  Submitted:1997-05-08, Days after onset: 3
Location:California  Entered:1997-05-13, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1627B IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pharyngitis, Rash maculo-papular, Rhinitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: runny nose, sore throat, rash on back (blotchy);pt was treated w/DPH;c/o rash under lt arm pit;

VAERS ID:98126 (history)  Vaccinated:1997-05-05
Age:35.3  Onset:1997-05-05, Days after vaccination: 0
Gender:Female  Submitted:1997-05-07, Days after onset: 2
Location:Nevada  Entered:1997-05-20, 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: seen in ER (mom);
CDC Split Type: NV97016
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)CONNAUGHT LABORATORIES6F81444 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0113D1 RA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES075503PO 
Administered by: Private     Purchased by: Public
Symptoms: Dizziness, Dyspnoea, Paraesthesia, Somnolence, Tremor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: pt recv vax & mom was holding pt;p/inj syringe came apart & scant amount splashed on mom face;reporter noticed mom rubbing face;mom states was okay;mom c/o dizziness, numbness in face & SOB;feel groggy since happened;shaky;

VAERS ID:98938 (history)  Vaccinated:1995-08-14
Age:35.6  Onset:1995-08-14, Days after vaccination: 0
Gender:Female  Submitted:1996-02-21, Days after onset: 191
Location:New York  Entered:1997-05-22, Days after submission: 455
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896138020L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49580131IMRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt devel an inj site rxn characterized by redness & induration p/vax;

VAERS ID:99801 (history)  Vaccinated:1996-06-24
Age:35.2  Onset:1996-07-01, Days after vaccination: 7
Gender:Male  Submitted:0000-00-00
Location:Virginia  Entered:1997-06-02
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: WAES96070785
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection, Orchitis, Pyrexia, Sialoadenitis
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow)
Write-up: pt recv vax 24JUN96 & 1JUL96 pt devel orchitis & fever;MD felt devel mumps;

VAERS ID:99975 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1997-06-02
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: rubella antibody- failure to seroconvert;
CDC Split Type: WAES96082492
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 2  
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 3 doses of vax & reporting MD noted that pt did not administer the vax;pt exp failure to seroconvert for rubella using an EISA test;

VAERS ID:99987 (history)  Vaccinated:1996-08-29
Age:35.6  Onset:1996-09-05, Days after vaccination: 7
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1997-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Demulen
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96091100
Vaccination
Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0317D SC 
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Headache, Injection site oedema, Malaise, Nuchal rigidity, Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: "pt recv vax 29AUg96 & 5SEP96 pt exp fever, macular rash on trunk, swelling @ the site of inj, arthralgia in thumb & knee, h/a, neck stiffness & felt like had a hangover;13SEP96 had completely recovered;"

VAERS ID:98641 (history)  Vaccinated:1997-04-08
Age:35.0  Onset:1997-04-09, Days after vaccination: 1
Gender:Female  Submitted:1997-05-26, Days after onset: 47
Location:New York  Entered:1997-06-03, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6F81204  LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Pyrexia, Vasodilatation
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: 24hr p/vax lt deltoid pt noted pain @ inj site & 3 red lines;APAP for fever;patch sl warm & tender;

VAERS ID:99029 (history)  Vaccinated:1997-05-05
Age:35.4  Onset:1997-05-14, Days after vaccination: 9
Gender:Male  Submitted:1997-06-12, Days after onset: 29
Location:Texas  Entered:1997-06-16, Days after submission: 4
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: NONE
Preexisting Conditions: NKDA
Diagnostic Lab Data: low platelets 112;
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1524D0 LA
Administered by: Private     Purchased by: Private
Symptoms: Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad)
Write-up: low platelet count 112 collected on 14MAY97;pt recv vax 5MAY97;

VAERS ID:99524 (history)  Vaccinated:1997-06-16
Age:35.3  Onset:1997-06-16, Days after vaccination: 0
Gender:Female  Submitted:1997-06-26, Days after onset: 10
Location:California  Entered:1997-06-30, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: denied
Current Illness: denied
Preexisting Conditions: denied
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2214A40IMLA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Hyperhidrosis, Hypertension, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: c/o chills-pale, skin w/d-afeb;BP 138/98;no rash;no swelling;no diff breathing;

VAERS ID:101371 (history)  Vaccinated:1995-08-10
Age:35.3  Onset:1995-08-10, Days after vaccination: 0
Gender:Male  Submitted:1997-03-31, Days after onset: 599
Location:Maryland  Entered:1997-07-22, Days after submission: 112
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: only hx is poss asthma like condition many years ago
Diagnostic Lab Data:
CDC Split Type: CO6052
Vaccination
Manufacturer
Lot
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Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST. 5IMA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: severe itching w/in 20min of 1st post exposure booster dose;devel blotchy rash all over body 1PM;started w/significant itching of hands & toes then evolved into bumps all over;went to ER but rash was already starting to resolve;

VAERS ID:101448 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:1997-03-31
Location:California  Entered:1997-07-22, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6431
Vaccination
Manufacturer
Lot
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Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST. 3IMA
Administered by: Other     Purchased by: Other
Symptoms: Visual disturbance
SMQs:, Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad)
Write-up: eyes got 25% worse (inc near sighted) p/3rd dose in post exposure rabies series in SEP94;series was d/c;

VAERS ID:100593 (history)  Vaccinated:1997-03-19
Age:35.0  Onset:1997-03-31, Days after vaccination: 12
Gender:Female  Submitted:0000-00-00
Location:Indiana  Entered:1997-07-23
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: WAES97040268
Vaccination
Manufacturer
Lot
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 19MAR97 & on 31MAR97 pt devel a rash consisting of ten chickenpox lesions;

VAERS ID:100960 (history)  Vaccinated:1995-09-30
Age:35.6  Onset:1997-03-13, Days after vaccination: 530
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1997-07-23
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 positive;13MAR97 varicella antibody negative;
CDC Split Type: WAES97052060
Vaccination
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Lot
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0437B1  
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 2 doses of vax & lab eval on 13MAR97 revealed a lack of seroconversion;pt reported a prev drawn titer was positive;

VAERS ID:100988 (history)  Vaccinated:1997-01-16
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1997-07-23
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: 1997 titer negative;
CDC Split Type: WAES97052290
Vaccination
Manufacturer
Lot
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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 vax 16JAN97 pt exp failure to seroconvert based on lab values;

VAERS ID:101067 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1997-07-23
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: WAES97060244
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Injection site mass, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & devel a rash & a golf ball hard knot @ inj site; the area was very hot;the rash was very a small rash & did not resemble varicella;

VAERS ID:101148 (history)  Vaccinated:1996-07-03
Age:35.0  Onset:1997-06-07, Days after vaccination: 339
Gender:Male  Submitted:0000-00-00
Location:Virginia  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97061439
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0390B1SC 
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 28MAY96 & 7JUN97 pt devel a fever then devel lesions on chest, back, legs, neck, arms, mouth & poss on throat;

VAERS ID:100756 (history)  Vaccinated:1997-07-21
Age:35.1  Onset:1997-07-23, Days after vaccination: 2
Gender:Female  Submitted:1997-07-25, Days after onset: 2
Location:California  Entered:1997-07-28, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: oral contraceptives
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.2214A40IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Anorexia, Asthenia, Diarrhoea, Pharyngitis, Pyrexia
SMQs:, Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: 21JUL pt recv vax 23JUL97 stated afternoon sudden abd cramping then diarrhea x2, sl loss of appetite, sl sore throat;24JUL97 feeling better but tired then 25JUL97 better no diarrhea but feeling tired;temp on 17JUL97 but no diarrhea or GI sx

VAERS ID:101322 (history)  Vaccinated:1997-06-05
Age:35.0  Onset:1997-06-20, Days after vaccination: 15
Gender:Female  Submitted:1997-08-04, Days after onset: 45
Location:New Jersey  Entered:1997-08-08, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE-PCN, compazine, DIlantin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0997D SCA
Administered by: Private     Purchased by: Other
Symptoms: Amnesia, Asthenia, Chills, Convulsion, Hyperthyroidism, Nausea, Paraesthesia, Weight decreased
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyperthyroidism (narrow), Generalised convulsive seizures following immunisation (narrow)
Write-up: sz;wt loss-fever & chills, inc thyroid function test;

VAERS ID:101684 (history)  Vaccinated:1997-06-25
Age:35.5  Onset:1997-06-25, Days after vaccination: 0
Gender:Female  Submitted:1997-08-14, Days after onset: 50
Location:Virginia  Entered:1997-08-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: miscarriage
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97071713
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Abortion
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: pt recv vax & then became pregnant;pt LMP was 19MAY97;pt had a miscarriage on 26JUL97;No further details were provided;

VAERS ID:101747 (history)  Vaccinated:1997-02-05
Age:35.1  Onset:1997-02-05, Days after vaccination: 0
Gender:Male  Submitted:1997-03-04, Days after onset: 27
Location:Alaska  Entered:1997-08-19, Days after submission: 167
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: Codeine
Diagnostic Lab Data: NONE
CDC Split Type: AK97009
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0309D0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Tachycardia, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad)
Write-up: 1hr p/vax pt exp face flushing & heart racing lasting for 3hr;took a nap & woke up feeling fine;

VAERS ID:102106 (history)  Vaccinated:1997-07-29
Age:35.9  Onset:1997-07-29, Days after vaccination: 0
Gender:Female  Submitted:1997-08-13, Days after onset: 15
Location:Michigan  Entered:1997-09-02, 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: Efsexor
Current Illness: NONE
Preexisting Conditions: allergic to Demoral
Diagnostic Lab Data: NA
CDC Split Type: MI97087
Vaccination
Manufacturer
Lot
Dose
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Site
RAB: RABIES (NO BRAND NAME)MICHIGAN DEPT PUB HLTHRV1541IMRA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Headache, Paraesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: cont vomiting, h/a, aching joints, & numbness in both hands for one day 30JUL97;cont to have numbness in lt hand (fingertips) as of 13AUG97;

VAERS ID:102734 (history)  Vaccinated:1996-08-22
Age:35.7  Onset:1996-08-22, Days after vaccination: 0
Gender:Female  Submitted:1997-08-05, Days after onset: 348
Location:Ohio  Entered:1997-09-24, Days after submission: 50
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6793
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.L07920SCRA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Injection site pain, Myalgia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 22AUG96 & it was reported that that same day pt exp n/v, severe h/a, myalgia & inj site discomfort;pt was seen @ ER & treated;

VAERS ID:102880 (history)  Vaccinated:1997-07-18
Age:35.3  Onset:1997-08-04, Days after vaccination: 17
Gender:Male  Submitted:1997-09-18, Days after onset: 45
Location:New York  Entered:1997-09-30, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0348E0SC 
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection, Pyrexia, Somnolence
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: pt recv vax 18JUL97 & 4AUG97 pt returned to office low grade temp 100, lethargy;pt scattered lesion few dx w/chickenpox;

VAERS ID:103014 (history)  Vaccinated:1997-09-26
Age:35.2  Onset:1997-09-29, Days after vaccination: 3
Gender:Female  Submitted:1997-09-30, Days after onset: 1
Location:Illinois  Entered:1997-10-07, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7F91679 IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: cellulitis @ inj site;

VAERS ID:103170 (history)  Vaccinated:1997-08-28
Age:35.0  Onset:1997-09-15, Days after vaccination: 18
Gender:Female  Submitted:1997-10-10, Days after onset: 25
Location:California  Entered:1997-10-15, Days after submission: 5
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: 10SEP97 pregnancy positive;
CDC Split Type: WAES97091285
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Abortion
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: pt recv vax 28AUG97 & a pregnancy test was positive on 10SEP97 (LMP 7AUG97);expected date of delivery was 14MAY98;15SEP97 had miscarriage;

VAERS ID:103187 (history)  Vaccinated:1997-10-03
Age:35.5  Onset:1997-10-03, Days after vaccination: 0
Gender:Female  Submitted:1997-10-06, Days after onset: 3
Location:Kentucky  Entered:1997-10-15, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt had similar rxn p/14JUN95 vax mom stated similiar rxn as baby w/burning
Other Medications:
Current Illness:
Preexisting Conditions: TCN allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1444D1SC 
Administered by: Private     Purchased by: Unknown
Symptoms: Dizziness, Neck pain, Pain, Pyrexia, Rash, Similar reaction on previous exposure to drug
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recv vax 3OCT97 & onset of sx same day 6PM pt devel rash, dizzy, fever, sore neck, glands hurt, feels bad since Saturday AM;

VAERS ID:103587 (history)  Vaccinated:1997-06-20
Age:35.0  Onset:1997-07-01, Days after vaccination: 11
Gender:Male  Submitted:0000-00-00
Location:Virginia  Entered:1997-10-20
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: WAES97070978
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 20JUN97 & JUL97 pt exp a varicella-like gen rash & itching;the rash consisted of central, raised vesicular appearing lesions w/approx 10 swells total;

VAERS ID:103638 (history)  Vaccinated:1997-03-17
Age:35.2  Onset:1997-07-01, Days after vaccination: 106
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1997-10-20
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: JUL97 Titer negative;
CDC Split Type: WAES97071706
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 vax 17MAR97 & JUL97 pt G98 titer test was negative;

VAERS ID:103649 (history)  Vaccinated:0000-00-00
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:1997-10-20
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 negative;
CDC Split Type: WAES97071774
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 2 doses of vax & lab values indicated that pt had undetectable antibody levels;

VAERS ID:103710 (history)  Vaccinated:1997-07-24
Age:35.1  Onset:1997-08-09, Days after vaccination: 16
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1997-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: postpartum
Preexisting Conditions: postpartum
Diagnostic Lab Data: No relevant dta;
CDC Split Type: WAES97080733
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Nuchal rigidity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: pt recv vax 24JUL97 & 9AUG97 pt exp gen itching, a stiff neck & soreness in the joints of hand & wrist;

VAERS ID:103724 (history)  Vaccinated:1997-07-19
Age:35.1  Onset:1997-07-25, Days after vaccination: 6
Gender:Male  Submitted:0000-00-00
Location:Michigan  Entered:1997-10-20
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: NONE
Diagnostic Lab Data: 1AUG97 varicella antibody negative;
CDC Split Type: WAES97080911
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 vax 19JUL97 & approx 25JUL97 lab eval revealed a negative varicella IGG test;

VAERS ID:103818 (history)  Vaccinated:1997-07-17
Age:35.0  Onset:1997-07-27, Days after vaccination: 10
Gender:Female  Submitted:0000-00-00
Location:New Mexico  Entered:1997-10-20
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: 27JUL97 ALT 60 elevated;AST 54 elevated;
CDC Split Type: WAES97090630
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM  SC 
Administered by: Other     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow)
Write-up: pt recv vax 17JUL97 & 27JUL97 pt devel elevated liver enzymes, ALT was 60 & AST was 54;

VAERS ID:103336 (history)  Vaccinated:1997-10-13
Age:35.8  Onset:1997-10-14, Days after vaccination: 1
Gender:Male  Submitted:1997-10-14, Days after onset: 0
Location:New Hampshire  Entered:1997-10-21, 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: Insulin;Pancrease;Albuterol;Vit K;Aerobid;
Current Illness: NONE
Preexisting Conditions: cystic fibrosis diabetic sinusitis;
Diagnostic Lab Data:
CDC Split Type: NH97024
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F81888 IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4331820IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Lymphadenopathy, 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: severe swelling, erythema, lymphadenopathy;rt deltoid site of inj of pneumococcal vax & flu vax w/fever & pain;

VAERS ID:103879 (history)  Vaccinated:1997-10-12
Age:35.1  Onset:1997-10-14, Days after vaccination: 2
Gender:Female  Submitted:1997-10-23, Days after onset: 9
Location:Washington  Entered:1997-10-28, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: flu-like illness, somnolence, fever 1 day prior to vax
Preexisting Conditions: PMM-partial nephrectomy in childhood, migraine HA
Diagnostic Lab Data: EEG-lt frontal temporall pseudoperiodic ? triphasic complex-diffuse slowing MRI & CT were nl;viral serologies & CSF PCR have all been negative;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   A
Administered by: Other  &n