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Case Details (Sorted by Age)

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VAERS ID:178978 (history)  Vaccinated:2001-10-22
Age:33.0  Onset:2001-10-22, Days after vaccination: 0
Gender:Female  Submitted:2001-11-15, Days after onset: 24
Location:Texas  Entered:2001-12-13, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SC 
Administered by: Other     Purchased by: Private
Symptoms: Hypersensitivity, Pruritus, Vasodilation procedure
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Hypersensitivity (narrow)
Write-up: Red, itching, heat.

VAERS ID:179319 (history)  Vaccinated:2001-11-14
Age:33.0  Onset:2001-11-15, Days after vaccination: 1
Gender:Female  Submitted:2001-11-20, Days after onset: 5
Location:Texas  Entered:2001-12-21, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: TX01180
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0588AA1IM 
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0147AA IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The client attended a health clinic at a community center on 11/14/01 where she received a TD booster. She complained of swelling to the left arm, face and neck. She was seen be an RN at the office at 15:30. Her left arm had redness to the deltoid area of approx. 2" in diameter with moderate swelling. No swelling to face, neck or chest, as she had stated. Her arm was warm to touch. Advised her to apply warm and wet soaks.

VAERS ID:179664 (history)  Vaccinated:2001-11-30
Age:33.0  Onset:2001-12-01, Days after vaccination: 1
Gender:Male  Submitted:2001-12-03, Days after onset: 2
Location:Nebraska  Entered:2002-01-03, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Laceration on forth finger of left hand
Preexisting Conditions:
Diagnostic Lab Data: ER nurse did not document on chart lot # or exp. date. When we called them, this is what they gave us.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIESU0539AA  RA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Injection site warmth, Lymphadenopathy, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Patient experienced a baseball sized edema. The area was erythematic and hot to the touch. As of 12/03/2001, the swelling had decreased to the size of a ping pong ball. The lymph nodes in the right axilla were enlarged. Patient feels ok, but has concerns about the reaction. Treatment consisted of ice or heat applied to right deltoid for 10-15 minutes 2-3 X day, 10 mg of Claritin once a day and RTC if site increased in size, redness or drainage.

VAERS ID:179866 (history)  Vaccinated:2001-11-28
Age:33.0  Onset:2001-11-28, Days after vaccination: 0
Gender:Male  Submitted:2001-11-28, Days after onset: 0
Location:Michigan  Entered:2002-01-11, Days after submission: 44
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: Patient has a pacemaker
Diagnostic Lab Data: CPK Normal;EKG-ok;CBC-Normal; comprehensive increased Bili 1.5; SGOT increased 95;SGPT increased ; repeat liver enzymes ordered; urine trace (?) blood
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS218A61IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)AVENTIS PASTEURT1148 SCLA
MEN: MENINGOCOCCAL (MENOMUNE-A/C)CONNAUGHT LTD.UB056AB SCRA
RAB: RABIES (RABAVERT)CHIRON CORPORATION286011 IMRA
Administered by: 0     Purchased by: 0
Symptoms: Chest pain, Hyperhidrosis, Laboratory test abnormal, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: sweats, chills, aches, low grade temp, chest pain

VAERS ID:180263 (history)  Vaccinated:2000-11-14
Age:33.0  Onset:2000-11-14, Days after vaccination: 0
Gender:Female  Submitted:2000-12-12, Days after onset: 28
Location:Wisconsin  Entered:2002-01-22, Days after submission: 406
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: denies taking concomitant meds.
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 20000356061
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3360A42 LA
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Report 2000035606-1 describes flu-like symptoms in a 33 year old female who received the hepatitis-b vaccine for prophylaxis of hepatitis B. Reportedly, the vaccinee denies having allergies or medical history. She denies taking concomitant medications In July, 1999, August, 1999 and on 14-NOV-00 (left deltoid), the vaccinee received her first, second and third doses of the hepatitis-b vaccine, respectively. Since receiving her third dose of the hepatitis-b vaccine (starting on 14-NOV-00), the vaccinee experienced flu-like symptoms, fatigue and sore shoulder. As of 11-Dec-00, the outcome of the events is ongoing.

VAERS ID:180294 (history)  Vaccinated:2001-01-02
Age:33.0  Onset:2001-01-02, Days after vaccination: 0
Gender:Female  Submitted:2001-03-13, Days after onset: 70
Location:Massachusetts  Entered:2002-01-22, Days after submission: 315
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic to oysters
Diagnostic Lab Data:
CDC Split Type: 20010038911
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3369A61IM 
Administered by: Other     Purchased by: Private
Symptoms: Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Report 20010038911 described vomiting, diarrhea, and general malaise in a 33 year old female who received hepatitis B vaccine recombinant (Engerix-B) for prophylaxis of hepatitis B. The vaccinee is allergic to oysters. Reportedly she had no medical history and took no concomitant medications. On 01/02/2001, the vaccinee received her second 20 mcg IM dose of Engerix-B. Within twelve hours post-vaccination, the vaccinee experienced vomiting, general malaise, and diarrhea. Symptoms resolved on 01/02/2001. As of 03/13/2001, the outcome of the events is resolved. The reporter has reported these adverse events directly to VAERS.

VAERS ID:180301 (history)  Vaccinated:2001-02-05
Age:33.0  Onset:0000-00-00
Gender:Female  Submitted:2002-01-14
Location:Unknown  Entered:2002-01-23, 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: UNK
Current Illness:
Preexisting Conditions: Pregnancy (LMP-UNK)
Diagnostic Lab Data: Beta-human chorionic-positive
CDC Split Type: WAES01041197
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: 0     Purchased by: 0
Symptoms: Abortion spontaneous, Laboratory test abnormal
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: Information has been received from a RN concerning a 33 year old female who was vaccinated with a first and second dose of varicella virus vaccine live on 05-FEB-2001 and 28-MAR-2001, respectively. The pt informed the RN that she tested positive for pregnancy with a home pregnancy test. Unspecified medical attention was sought. In follow up the RN reported that the pt had an uncomplicated first trimester spontaneous abortion. The RN reported that neither the physician nor the pt thought that there was any relationship between the exposure and the miscarriage. No further information is available.

VAERS ID:180345 (history)  Vaccinated:2002-01-07
Age:33.0  Onset:2002-01-08, Days after vaccination: 1
Gender:Female  Submitted:2002-01-09, Days after onset: 1
Location:Idaho  Entered:2002-01-23, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0372L1 LL
Administered by: Private     Purchased by: 0
Symptoms: Myalgia, Pain, Rash, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Local reaction to MMR. left arm swelling erythema, pain, tenderness & rash. Ice pack applied. taking Advil. Local reaction resolved 1-14-02

VAERS ID:180366 (history)  Vaccinated:2001-02-06
Age:33.0  Onset:2001-02-06, Days after vaccination: 0
Gender:Female  Submitted:2001-03-28, Days after onset: 50
Location:Idaho  Entered:2002-01-24, Days after submission: 302
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: Vaccinee had seasonal allergies and took no concomitant medications. There was no illness at the time of the vaccination.
Diagnostic Lab Data:
CDC Split Type: 2001005414
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3369B61IMLA
Administered by: Public     Purchased by: Public
Symptoms: Contusion, Feeling hot, Injection site mass, Injection site oedema, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: The vaccinee had seasonal allgeries and took no concomitant medications. There was no illness at the time of the vaccination. No adverse events were reported following dose 1 of Engerix-B. On 6 February 2001, the vaccinee received her second IM-left deltoid dose of Engerix-B. 30 minutes later, she developed a hard lump (at the injection site). The lump was warm at bedtime and felt al ittle itchy. The vaccinee had "blood in arm the size of a fifty cent piece and the site was kind of blue." On 7 February 2001, the vaccinee still had a blue bruise. At noon, severe itching began and the area got redder and the "hard spot" grew to 1 to 1.5 inches in diameter. In the evening, the area was 6 to 8 inches long and three inches wide. The area was red, hard and hot. She experienced "swelling/pain in deltoid" (injection site). She treated herself with cool compresses and ibuprofen. On 8 February 2001, she was seen by a physician, who treated her with amoxicillin trihydrate/clavulanic acid (Augmentin). As of 27 March 2001, the outcome of the events was unknown.

VAERS ID:180408 (history)  Vaccinated:2001-04-30
Age:33.0  Onset:2001-05-01, Days after vaccination: 1
Gender:Female  Submitted:2001-06-12, Days after onset: 42
Location:Florida  Entered:2002-01-24, Days after submission: 226
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PB Tine test 04/30/2001
Current Illness: UNK
Preexisting Conditions: allergic to penicillin
Diagnostic Lab Data:
CDC Split Type: 20010141421
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Eye irritation, Eye swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Corneal disorders (broad), Hypersensitivity (narrow)
Write-up: Report 20010141421 described swelling and itching (eyes) in a 33 year old female who received hep B vaccine (Engerix-B) for the prophylaxis of hep B. This report was received from the vaccinee and has not been verified by a physician or other health care professional. The vaccinee is allergic to penicillin. Her medical history was not specified. She received the tuberculin tine test on 04/30/2001. On 04/30/2001, the vaccinee received her first left arm dose of Engerix-B. That evening, she experienced itching of the eyes. On 05/01/2001, she woke up with "marked" swelling of the eyes. She "consulted" with the physician and was told to call back if the situation worsened, or alternatively to seek emergency medical attention. On 05/02/2001, the swelling was "the same"; she went to see the physician. The physician consulted with an immunologist who reportedly said that swelling occur as a side effect of the vaccine; he advised that she receive no more immunizations with this vaccine. As of 06/11/2001, the outcome of the events was unknown.

VAERS ID:180432 (history)  Vaccinated:0000-00-00
Age:33.0  Onset:0000-00-00
Gender:Male  Submitted:2001-08-27
Location:Texas  Entered:2002-01-24, Days after submission: 150
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: Biltot:elevated-August 2001
CDC Split Type: 20010203732
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Blood bilirubin increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (narrow)
Write-up: Report 20010203732 described elevated bilirubin in a 33 year old male who received hep B vaccine (brand unspecified). This report was received from the vaccinee''s wife and has not been verified by a physician or other health care professional. The vaccinee''s allergies, and medical history were not specified. In August 2000, the vaccinee reportedly received an injection of hep b vaccine and a subcutaneous injection of hep a vaccine inactivated. Reportedly, the vaccinee subsequently developed an elevated bilirubin level, which he was currently. The consumer consulted a health care professional regarding the adverse event. Hep B vaccine was discontinued. As of 08/17/2001, the outcome of the adverse event was ongoing.

VAERS ID:180506 (history)  Vaccinated:2001-12-19
Age:33.0  Onset:2001-12-21, Days after vaccination: 2
Gender:Female  Submitted:2002-01-18, Days after onset: 28
Location:Maryland  Entered:2002-01-24, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.097K1SCLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt called 2 days post vaccination to report redness, swelling, heat and pain at the injection site. Pt states feels systemic itching without rash, no swollen glands.

VAERS ID:180831 (history)  Vaccinated:2000-04-10
Age:33.0  Onset:2000-04-11, Days after vaccination: 1
Gender:Female  Submitted:2000-04-18, Days after onset: 7
Location:Pennsylvania  Entered:2002-02-04, Days after submission: 657
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: U200000276
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0147AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: It was reported that a pt who rec''d TD adult vaccination on 4/10/00. Reportedly on 4/11/00, the pt developed a local reaction of redness, warmth and induration.

VAERS ID:180832 (history)  Vaccinated:2000-03-20
Age:33.0  Onset:2000-03-24, Days after vaccination: 4
Gender:Female  Submitted:2000-04-18, Days after onset: 24
Location:Pennsylvania  Entered:2002-02-04, Days after submission: 657
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: U200000277
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0147AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: It was reported that a pt rec''d TD adult vaccination on 3/20/00. Reportedly on 3/24/00, the pt developed a local reaction of redness, warmth, induration.

VAERS ID:181362 (history)  Vaccinated:2002-01-07
Age:33.0  Onset:2002-01-08, Days after vaccination: 1
Gender:Male  Submitted:2002-02-06, Days after onset: 29
Location:Unknown  Entered:2002-02-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes Mellitus II
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV063 SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Back pain, Chills, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt had chills times 1 day, N&V times 4 days and L extremity pain dorsum post vaccination. Sought medical care 3 days post vax with treatment with LMD with otc analgesic and anti-emesis. All conditions resolved with no further problems noted.

VAERS ID:181600 (history)  Vaccinated:2001-09-18
Age:33.0  Onset:2001-09-18, Days after vaccination: 0
Gender:Female  Submitted:2001-10-16, Days after onset: 28
Location:Ohio  Entered:2002-02-21, Days after submission: 128
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Alesse Birthcontrol pills, Celexa, Advair
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEUR0463AA  LA
Administered by: Private     Purchased by: Private
Symptoms: Hypoaesthesia, Inflammation, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Within seconds both arms, hands, fingers went completely numb. After injection had achy severe pain with burning from her shoulder down to her fingers. She have been diagnosed with RSD due to this injury (vaccine) and take nuerontin for nueropathic pain, receive stelute gangalion nerve blocks and now is in physical therapy. Her treatment started early but no one knows it has now almost been 5 month since the vaccine.

VAERS ID:181717 (history)  Vaccinated:2001-12-17
Age:33.0  Onset:2001-12-18, Days after vaccination: 1
Gender:Female  Submitted:2001-12-19, Days after onset: 1
Location:Wyoming  Entered:2002-02-26, Days after submission: 69
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Aspenia
Diagnostic Lab Data: NONE
CDC Split Type: WY0202
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40180575IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dyspnoea, Feeling hot, Hypersensitivity, Livedo reticularis, Pruritus, Sensation of heaviness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: On 12/18/01 at 08:00, woke up feeling weak and body felt heavy and felt feverish. At 08:30, began having hot flashes, breathing difficulty and needing to take deep breaths. At 14:00, face and hands turned red and started itching. At 15:30, went to MD''s office and was developing hives, mottling and itching over entire body. On 12/19/01, continued itching but redness resolving. Received Depo-Medrol 40mg, IM. Now am taking Zyrtec 10mg 1 Tab for allergic reaction.

VAERS ID:181935 (history)  Vaccinated:2002-02-01
Age:33.0  Onset:2002-02-07, Days after vaccination: 6
Gender:Female  Submitted:2002-02-13, Days after onset: 6
Location:California  Entered:2002-03-05, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin 1.25, Valium 5 mg
Current Illness: NONE
Preexisting Conditions: hysterectomy
Diagnostic Lab Data: Test for streps-negative
CDC Split Type: CA020015
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0705AA0IM 
Administered by: Public     Purchased by: Public
Symptoms: Malaise, Pain, Pharyngolaryngeal pain, Pyrexia, Rhinitis, Skin exfoliation, Vomiting
SMQs:, Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)
Write-up: Onset of sore throat, runny nose, body aches, malaise beginning 1 week after flu shot. fever 103 for three days, vomiting. Test for strep -negative. Red bumps on torso, peeling of hands. 10 days later progressed to ear infection. Eymin RX for ear infection.

VAERS ID:182139 (history)  Vaccinated:2002-02-12
Age:33.0  Onset:2002-02-12, Days after vaccination: 0
Gender:Female  Submitted:2002-02-13, Days after onset: 1
Location:Michigan  Entered:2002-03-08, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Unspecified reaction;Hep B (Mfr not specified);1;26.00;In Patient
Other Medications: Allegra qd; Albuterol prn; Levbid prn
Current Illness: NONE
Preexisting Conditions: Allergies to penicillin, sulfa, iodine, latex and peanuts
Diagnostic Lab Data: NONE
CDC Split Type: MI2002016
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM704A41IMRA
Administered by: Public     Purchased by: Public
Symptoms: Flushing, Hypotension
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Hypersensitivity (broad)
Write-up: Client stated she felt "funny/flushed". Client denied nausea, dizziness, weakness or breathing difficulty. At 15:42, client self-administered 50mg Benadryl po. At 16:00, BP was 120/70; pulse 80 and client stated she still felt "funny". At 16:45, client stated she felt "fine", no longer "flushed" or any other symptoms. Client stated the injection site was "sore". Ice pack applied X 30 minutes. At 17:20, BP was 110/70, pulse 80, no further complaints. Client left clinic without assistance. On 2/13/02, client saw PCP and had no further treatment needed, no tests done and she stated injection site still "sore" but no redness, swelling or warmth to the site.

VAERS ID:182210 (history)  Vaccinated:0000-00-00
Age:33.0  Onset:0000-00-00
Gender:Male  Submitted:2001-08-27
Location:Texas  Entered:2002-03-11, Days after submission: 196
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: UNK
Diagnostic Lab Data: biltot-elevated (Aug 2000)_
CDC Split Type: 20010203731
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Blood bilirubin increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (narrow)
Write-up: Report described elevated bilirubin in a 33 year old male who received hep A vaccine. This report was received from the vaccinee''s wife and has not been verified by a physician or other health care professional. The vacinee''s allergies, and medical history were not specified. In August 2000, the vaccinee reportedly received a subcutaneous injection of Havrix and an injection of hep B vaccine. It was not known whether the vaccinee ha dreceived previous doses of Havrix or hep B vaccine. Reportedly, the vaccinee subseuently developd an elevated bilirubin level, which he has currently. The consumer consulted a health care professional regarding the adverse event. Havrix was discontinued. As of 08/17/2001, the outcome of the adverse event was ongoing.

VAERS ID:182277 (history)  Vaccinated:2001-10-30
Age:33.0  Onset:2001-10-31, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Colorado  Entered:2002-03-13
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: asthmatic
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU0674AA5IMLA
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Swollen , hives, itchness all over body. Hives all over. Has retained over 40 lbs of water since shot was given on 30 Oct 01. ER visit 3 Nov 01

VAERS ID:182401 (history)  Vaccinated:2001-07-24
Age:33.0  Onset:2001-07-25, Days after vaccination: 1
Gender:Female  Submitted:2002-03-07, Days after onset: 225
Location:Unknown  Entered:2002-03-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES01072676
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia, Injection site pain, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a registered nurse concerning a 33 year old female who on 24 JUL 2001 was vaccinated with Hepatitis B vaccine recombinant (yeast) 1 ml intramuscularly. On 25 JUL 2001 the patient developed soreness at the injection site. The patient stated that she cannot lift the affected arm all the way up and the arm feels heavy. Unspecified medical attention was sought. Additional information has been requested.

VAERS ID:182407 (history)  Vaccinated:2001-08-15
Age:33.0  Onset:2001-08-15, Days after vaccination: 0
Gender:Female  Submitted:2002-03-07, Days after onset: 204
Location:Unknown  Entered:2002-03-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Decadron Tablets
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WAES01082392
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Feeling abnormal
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad)
Write-up: Information has been received from a 33 year old female with no past medical history and no known drug allergies who on 15 AUG 2001 was vaccinated with a dose of hepatitis b vaccine recombinant (yeast). Concomitant therapy that day included a dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) (MSD) and varicella virus vaccine live (site unknown) (MSD). Other concomitant therapy included unspecified steroids (manufacturer unknown). After being vaccinated, the patient began feeling tired and her head was "feeling heavy". It was reported that the patient''s symptoms were "decreasing" since she received the vaccines. The patient sought unspecified medical attention. Additional information has been requested.

VAERS ID:182787 (history)  Vaccinated:2001-11-29
Age:33.0  Onset:2001-12-01, Days after vaccination: 2
Gender:Female  Submitted:2001-12-03, Days after onset: 2
Location:New Mexico  Entered:2002-03-25, Days after submission: 112
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: allergic to pcn and bug bites
Diagnostic Lab Data: NONE
CDC Split Type: NM120101
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR0588A0IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM204A40IMLA
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEUR1153 SCLA
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt developed intense pruritis/urticaria. Treated with Benadryl then Tagamet.

VAERS ID:182929 (history)  Vaccinated:2002-03-26
Age:33.0  Onset:2002-03-26, Days after vaccination: 0
Gender:Female  Submitted:2002-03-27, Days after onset: 1
Location:Florida  Entered:2002-03-28, 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: Nexium, Ortho-Tryddine
Current Illness: NONE
Preexisting Conditions: Hay Fever
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5262A41 RA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Muscle spasms, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Nausea, Cramps, dizzy, vomiting

VAERS ID:183130 (history)  Vaccinated:2002-03-06
Age:33.0  Onset:2002-03-21, Days after vaccination: 15
Gender:Female  Submitted:2002-03-22, Days after onset: 1
Location:Florida  Entered:2002-04-03, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Pcn and environmental allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5250IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0742L SCLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Arthritis, Pain
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: "Arthritic" type pain in joints of fingers, toes, wrists, neck, lower back, top part of feet, arched of feet, left knee felt crippled (then both knee''s had moderate pain).

VAERS ID:183384 (history)  Vaccinated:2002-02-21
Age:33.0  Onset:2002-02-21, Days after vaccination: 0
Gender:Female  Submitted:2002-02-25, Days after onset: 4
Location:Minnesota  Entered:2002-04-11, Days after submission: 44
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: MN02003
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5231A62IMLA
Administered by: Public     Purchased by: Other
Symptoms: Aphthous stomatitis, Influenza like illness, Sinusitis, Viral infection
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: The pt went to MD about 1 hour after receiving shot. She had canker sores on left side of tongue that appeared. She received a steroid shot and then was on Prednisone and an antihistamine for 4 days. She didn''t have any difficulty breathing. She ended up back to the MD with flu symptoms, 2 weeks later and then ended up with a sinus infection. The MD suspected that she had a virus in her system on the day she received the vaccine.

VAERS ID:183679 (history)  Vaccinated:2002-03-15
Age:33.0  Onset:2002-03-18, Days after vaccination: 3
Gender:Male  Submitted:2002-05-13, Days after onset: 55
Location:New York  Entered:2002-04-19, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Azithromycin; Pentamidine; Fluconazole; Paroxatine hydrochloride; Amprenavir; Ritonavir; menivudine; Acyclovir; Stavudine; Didenosine
Current Illness:
Preexisting Conditions: HIV antibody positive, potitive hep B surface antige. He smoked one-half pack of cigarettes daily; he "rarely" used alcohol.
Diagnostic Lab Data: On 3/1802 ALT serum-667 U/L and AST serum 571 U/L; on 3/2202 ALT serum-217 U/L and AST serum-100 U/L
CDC Split Type: A0364825A
Vaccination
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Lot
Dose
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Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS 1IM 
Administered by: Private     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: The pt was infected with HIV and was Hep-B surface antigen positive. He did not received any concomitant vaccines. Concurrent medications were not specified; however, the physician stated that "nothing had changed with his medication regimen". In approx. 8/01, the pt received his 1st injection of Engerix-B without adverse event. On 3/15/02, the pt received his 2nd injection of Engerix-B. On 3/19/01, he complained of fever and muscle aches. Liver function tests performed on 3/19/01, revealed AST 571 U/L and ALT 667 U/L. Prior to this, the pt''s AST and ALT concentrations were normal. The results of serologic testing for other causes of viral hepatitis were not reported. He did not receive any treatment for the events. He returned to the physician on 3/27/02. At that time, the fever had subsided and the muscle aches had improved. Liver function tests revealed AST 100 U/L and ALT 217 U/L. This report of increased AST and ALT concentrations, is considered "Medically Serious". The follow up states the pt received hep A vaccine (Havrix). It was originally reported that the vaccinee received hep B vaccine (Engerix B); on follow up the vaccine administered was identified as Havrix. He smoked one-half pack of cigarettes daily; he "rarely" used alcohol. Concurrent medications included azithromycin 1200mg weekly beginning 3/27/02, Pentamidine 300mg daily beginning 11/3/00, Fluconazole; Paroxatine hydrochloride; Amprenavir; Ritonavir; menivudine. The physician stated that "nothing" had changed with his medication regimen; however, the physician reported that fluconazole therapy was added on 2/26/02 and discontinued on 3/13/00. On 7/5/01, the vaccinee received his first injection of Havrix without adverse event. On 3/18/01, three days post immunization, he complained of fever, anorexia, and muscle adches. Liver function tests performed on 3/18/01. He returned to the physician on 3/22/02. The fever, anorexia, and muscle aches had resovled. The physician considered the reported events to be possibly related to Havrix administra

VAERS ID:183778 (history)  Vaccinated:2001-11-21
Age:33.0  Onset:2001-11-23, Days after vaccination: 2
Gender:Female  Submitted:2002-03-15, Days after onset: 112
Location:Missouri  Entered:2002-04-23, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: Latex allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dyspnoea, Lethargy, Pneumonia
SMQs:, Anaphylactic reaction (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), Eosinophilic pneumonia (broad)
Write-up: Acute onset of shortness of breath and weakness. No hives or rash. Taken to the medical center. Unstable in ER with weak pulse and lethargic. Admitted to the hospital and was diagnosed pneumonia.

VAERS ID:183858 (history)  Vaccinated:2002-04-16
Age:33.0  Onset:2002-04-18, Days after vaccination: 2
Gender:Female  Submitted:2002-04-18, Days after onset: 0
Location:Ohio  Entered:2002-04-24, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0632SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site reaction, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Employee received anthrax vaccine on 04/10/2002. On 04/18/2002 at injection site she developed red and indurated (7cm), warm to touch and mild pain.

VAERS ID:183878 (history)  Vaccinated:2002-04-10
Age:33.0  Onset:2002-04-13, Days after vaccination: 3
Gender:Female  Submitted:2002-04-17, Days after onset: 4
Location:New York  Entered:2002-04-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Serevent, Albuterol
Current Illness: NONE
Preexisting Conditions: Allergic to pcn, codeine, food (strawberries, cashews, etc)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0520AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Injection site reaction, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pain, swelling, warmth, hardness, tenderness on right deltoid region.

VAERS ID:184268 (history)  Vaccinated:2002-04-09
Age:33.0  Onset:2002-04-09, Days after vaccination: 0
Gender:Male  Submitted:2002-04-09, Days after onset: 0
Location:Michigan  Entered:2002-05-07, 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: UNK
Current Illness:
Preexisting Conditions: NONE Known
Diagnostic Lab Data:
CDC Split Type: MI2002030
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM710A41IMLA
Administered by: Public     Purchased by: Public
Symptoms: Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Reports swelling above left clavicle post 05/02/2001 vaccine for Hepatitis A. Approximately 30 minutes after Hepatitis A given today (04/09/2002), swelling above left clavicle noted.

VAERS ID:184360 (history)  Vaccinated:2002-04-19
Age:33.0  Onset:2002-04-27, Days after vaccination: 8
Gender:Female  Submitted:2002-05-02, Days after onset: 5
Location:Maryland  Entered:2002-05-09, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40082840SCLA
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site oedema, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 4/29-cellulitis left deltoid with axillary lymph adenopathy 5/2-Revaluation-cellulitis resolved

VAERS ID:184460 (history)  Vaccinated:2002-04-30
Age:33.0  Onset:2002-04-30, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Wisconsin  Entered:2002-05-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Finger laceration
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD79 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Within hours of DT injection was having swelling and erythema at the injection site. 2 days after injection, had 4cm diameter X 1/2cm height area of induration that was warm and tender.

VAERS ID:184519 (history)  Vaccinated:2002-04-29
Age:33.0  Onset:2002-04-29, Days after vaccination: 0
Gender:Male  Submitted:2002-05-10, Days after onset: 11
Location:New York  Entered:2002-05-14, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: The pt developed dizziness and blurred vision.

VAERS ID:184664 (history)  Vaccinated:2002-03-07
Age:33.0  Onset:2002-03-14, Days after vaccination: 7
Gender:Female  Submitted:2002-04-04, Days after onset: 21
Location:Kentucky  Entered:2002-05-16, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OC''s
Current Illness: NONE
Preexisting Conditions: Nerve problems, stomach problems, sleep disturbance
Diagnostic Lab Data: CBC-normal
CDC Split Type: KY2002019
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0342AA IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Pneumonia, Pyrexia, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: The pt developed generalized weakness, tired, low grade fever off and on (99-99.4 deg. F). These symptoms began one week later. Pt also experienced no appetite and weight loss. On 03/24/2002 the pt was seen in ER with pneumonia and took Zithromax.

VAERS ID:184670 (history)  Vaccinated:2000-01-01
Age:33.0  Onset:2000-09-23, Days after vaccination: 266
Gender:Female  Submitted:2002-05-15, Days after onset: 599
Location:Unknown  Entered:2002-05-16, 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:
Current Illness:
Preexisting Conditions: Pregnancy NOS (LMP-2/7/00)
Diagnostic Lab Data:
CDC Split Type: WAES00064391
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Premature labour
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Information has been received from a physician concerning a 33 year old female who in January 2000 was vaccinated with one dose of varicella vaccine. Concomitant therapy included one dose of tetanus toxoid and one dose of MMR vaccine. It was noted that the pt received these vaccinations "just prior to conceiving." Approximate LMP 02/07/2000. On 06/26/2000, the pt was seen by a physician and an ultrasound was performed. The results indicated "a singleton fetus growing appropriately for gestational age at the 50-75th percentile. Amniotic fluid volume is normal. The placenta is anterior and unremarkable in appearance. No anomalies are identified." The reporting physician noted "would also like to see her follow-up ultrasound evaluation in 6 weeks, specifically to look at fetal limb lengths and to assess the appearance of the lens of the fetal eyes." Follow-up info received from a physician, indicated that on 08/07/2000 the pt had an ultrasound which revealed the following :weight 885 grams, gender: female, no anomalies, limbs, eyes and heart all OK. Follow-up information received from a physician revealed that on 09/23/2000, at 33 weeks, 2 days gestation,t he pt delivered a baby weighing 3lb. 15 oz. The physician''s notes indicated that the baby was healthy and normal. It was also noted that the pt had a previous preterm delivery as well. No further information is available.

VAERS ID:184671 (history)  Vaccinated:2000-07-01
Age:33.0  Onset:0000-00-00
Gender:Female  Submitted:2002-05-15
Location:South Carolina  Entered:2002-05-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Pregnancy
Diagnostic Lab Data: GBS-positive; heart-slightly tachcardiac
CDC Split Type: WAES00090435
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Guillain-Barre syndrome, Neoplasm malignant, Streptococcus test positive, Tachycardia
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Malignant tumours (narrow)
Write-up: Information has been received from a woman through the Pregnancy Registry concerning her approximately 33 year old female friend who in approximately July 2000 was vaccinated with varicella vaccine. Two days after vaccination, the pt became pregnant. Medical attention was sought. Follow-up information from a physician indicated that the 33 year old female pt, with a past history of bronchitis, a 1998 spontaneous vaginal delivery of an 8 pound infant, gestational diabetes, in 200 a spontaneous abortion, a remote history of abnormal Pap smears, normal since without STD''s, G3, P1, A1 at 34 6/7 weeks was given the EDC of 04/03/2001, by the LMP consistent with a 17 week scan who presented to labor and delivery for induction. Allergies to medications include penicillin, erythromycin and codeine. Current medication includes prenatal vitamins. The pregnancy was complicated with breast cancer with the left modified radical mastectomy performed on 02/01/2001, revealing poorly differentiated invasive dustal carcinoma with 3.5 cm greatest in diameter and positive lymph nodes. The pt needed chemotherapy two weeks postpartum so the decision was made for an early delivery. It was noted that the left mastectomy was healing well. The pt was GBS positive and will be given clindamycin secondary to allergy to penicillin. The pt desired an epidural for pain control. IV pain medications as needed in early induction. Her breast cancer was stable. She was to received chemotherapy two weeks postpartum. The pt was admitted to the labor and delivery. Sterile vaginal exam revealed a cervix that was fingertip, 2 long and high. A Cytotec induction was begun. Three Cytotec inductions had been placed. The pt had good contraction pattern and Pitocin was started. By mid-afternoon, sterile vaginal exam was 3 long and ballotable. Membranes were ruptured at approx. 3:30pm. The pt progressed through labor well and at 17:21 hr, delivered a 5lb. 8.8oz baby. On postpartum day one, the pt was doing well without complaints. She desired discharge to home. The baby would need to stay an additional day. The pt was discharged home on postpartum day two remaining afebrile meeting all goals. It was noted that the baby was given erythromycin 1 g at 17:25 and vitamin K 1 mg IM. Additional info has been requested.

VAERS ID:184705 (history)  Vaccinated:2001-02-09
Age:33.0  Onset:2001-02-21, Days after vaccination: 12
Gender:Female  Submitted:2002-05-15, Days after onset: 447
Location:Ohio  Entered:2002-05-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WAES01040251
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Rash erythematous, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 33 year old Asian female with no past medical history who on 02/09/2001 at 10:45 was vaccinated with a first dose of Varicella virus vaccine live, There was no concomitant medication or illness at the time of vaccination. On 02/21/2001, the patient was seen by a physician who noted Varicella lesions at the injection site with appeared as a red rash. The patient''s experience was considered to be disabling by the reporter as the patient was unable to work from 02/21/2001- until 02/27/2001 since she is a registered nurse and was not allowed to have patient contact. On 02/27/2002, the patient recovered. No further information is expected.

VAERS ID:184737 (history)  Vaccinated:2001-02-16
Age:33.0  Onset:2001-04-05, Days after vaccination: 48
Gender:Male  Submitted:2002-05-15, Days after onset: 405
Location:New York  Entered:2002-05-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Tuberculin test postive
Diagnostic Lab Data: Serum varicella zoster-negative
CDC Split Type: WAES01041163
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1614K1SCRA
Administered by: Private     Purchased by: Other
Symptoms: Laboratory test abnormal
SMQs:
Write-up: Information has been received from a registered nurse concerning a 33 year old male with a history of positive 13mm PPD tuberculosis test but who had normal chest films. On 11/11/2000, the pt''s serum varicella zoster virus antibody test was negative. On 01/18/2001, the pt was vaccinated with the first dose of varicella vaccine SC in left deltoid. On 02/16/2001, the pt was vaccinated with the second dose of varicella vaccine SC in the right deltoid. The nurse reported that the pt did not "seroconvert." On 04/05/2001, the pt''s serum varicella zoster virus antibody test was negative after two varicella vaccines.

VAERS ID:184786 (history)  Vaccinated:2001-03-28
Age:33.0  Onset:2001-04-16, Days after vaccination: 19
Gender:Male  Submitted:2002-05-15, Days after onset: 394
Location:New Jersey  Entered:2002-05-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WAES01041953
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0947K0SC 
Administered by: Private     Purchased by: Other
Symptoms: Back pain, Influenza like illness, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 33 year old male patient with no known allergies and no medical history who on 28 MAR 2001 was vaccinated with his first dose of varicella virus vaccine live, (Lot # 532044/0947K) in the PM subcutaneously in the left arm. There was no concomitant medication or illness at the time of vaccination. On 18 APR 2001 (also reported as 16 APR 2001) the patient developed a rash throughout the body with vesicles. The patient also had flu-like symptoms plys aches, especially in the back. The patient sought medical intervention. It was reported that the patient recovered on 20 May 2001.

VAERS ID:184859 (history)  Vaccinated:0000-00-00
Age:33.0  Onset:0000-00-00
Gender:Female  Submitted:2002-05-15
Location:Unknown  Entered:2002-05-20, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Diagnostic lab-varicella antibody titer-negative
CDC Split Type: WAES01050414
Vaccination
Manufacturer
Lot
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Laboratory test abnormal
SMQs:
Write-up: Information has been received from a physician concerning a 88 year old female who was vaccinated with first dose of varicella vaccine on an unspecified date, and second dose as scheduled on an unspecified date. Subsequently, the pt had a varicella antibody titer test which was negative for seroconversion. The pt sought medical attention. Follow-up info has been received from the physician who reported that the pt did not experience an adverse reaction. She just did not develope a positive antibody titer after immunization. No further info is expected.

VAERS ID:185372 (history)  Vaccinated:0000-00-00
Age:33.0  Onset:0000-00-00
Gender:Female  Submitted:2002-05-15
Location:Unknown  Entered:2002-05-24, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Serum varicella zoster-no seroconversion
CDC Split Type: WAES01081675
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Laboratory test abnormal
SMQs:
Write-up: Information has been received from a registered nurse on 08/15/2001 concerning a female with no known drug allergies who "about four years ago" was vaccinated with a second dose of varicella vaccine. There was no concomitant medication. It was reported on 08/15/2001 that recent titers did not show seroconversion. The pt sought unspecified medical attention. Additional info has been requested.

VAERS ID:185695 (history)  Vaccinated:2002-05-18
Age:33.0  Onset:2002-05-19, Days after vaccination: 1
Gender:Male  Submitted:2002-05-21, Days after onset: 2
Location:Pennsylvania  Entered:2002-05-30, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergy to Septra
Diagnostic Lab Data: UNK
CDC Split Type:
Vaccination
Manufacturer
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TTOX: TETANUS TOXOID (NO BRAND NAME)SANOFI PASTEURU0519AA1IM 
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Headache, Injection site reaction, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: On 5/18/02, member received TD and PPD. On 5/19/02, began to display symptoms of fever with chills. On 5/20/02, member states that he had severe fatigue that was a problem throughout the day with hot sensations around the site area for the TD shot plus a headache. On 5/21/02, member states symptoms still present but are going away.

VAERS ID:186192 (history)  Vaccinated:1999-06-08
Age:33.0  Onset:1999-06-12, Days after vaccination: 4
Gender:Male  Submitted:0000-00-00
Location:Unknown  Entered:2002-06-10
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: LBP/Bilateral Shoulder pain, short term memory loss, right ankle pain, depression with psychotic features
Diagnostic Lab Data: Elevated CPK; Sleep study - normal; Methacholine challenge - normal; EKG - normal; MRI brain - normal; MRI L-spine - mild disc bulges; EMG normal; GTT - WNL
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0332 RA
Administered by: Military     Purchased by: Military
Symptoms: Affect lability, Arthralgia, Blood creatine phosphokinase increased, Depression, Difficulty in walking, Dyskinesia, Dyspnoea, Hypercholesterolaemia, Hypertension, Hypertonia, Insomnia, Muscle spasms, Muscle twitching, Myalgia, Weight increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Dyslipidaemia (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (narrow), Dystonia (broad), Parkinson-like events (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Lipodystrophy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Debilitating myalgia and spasm. The pt experienced adverse clinical symptoms after each anthrax vaccine dose, then reproducible muscular pain, spasm and weakness began after the 3rd shot. He previously had received the anthrax vaccine during the Gulf war, but there is lack of documentation as to know how many doses and at what intervals. He had been experiencing symptoms of Gulf war illness which included joint pain and short term memory loss at the time he received the repeated series of anthrax doses. On 06/08/1999, 3-4 days after shot, the pt experienced painful cramping in legs and had difficulty walking. Had bilateral burning in the calves, as well as tightness and twitching in the back, neck and chest muscles. Went on sck call 10-15 days in the 6 month period between shot 3 and 4. Was diagnosed with muscle strain and given NSAIDS. Was unable to sleep, experienced fasciculations and muscular pain at night. Symptoms lessened but did not resolve. Muscle spasm, intermittent twitching, occasional muscle jerking in back, arms, hands, neck and legs. Insomnia, depression, hypercholesterolemia, exertional dyspnea, elevated CPK levels. An annual follow up report received 6/26/2003 adds: Continued to have continuous myalgias, paresthesias, arthralgias and muscle spasm. Walks with a cane. Is being medically discharged from the military. Muscle biopsy negative, EMG "bland myopathic process". The follow up received on 12/31/03 states pt continues to have debilitating myalgia, polyarthralgias and peripheral neuropathy. Ambulates with cane. Cannot perform duties within the military setting and is in the process of being medically separated from the service. 12/14/05 3-page correspondence from patient described muscle stiffness of calves. 6-page medical record described crying spells, weight gain, and hypertension.

VAERS ID:186205 (history)  Vaccinated:2002-04-29
Age:33.0  Onset:2002-04-30, Days after vaccination: 1
Gender:Male  Submitted:2002-05-02, Days after onset: 2
Location:Idaho  Entered:2002-06-10, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: ID02023
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1379L0SCLA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0386AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1154L0SCRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Fever of 103 deg F, 24 hrs after injection. Body aches, redness, swelling, warm to touch, three days following injections.

VAERS ID:186306 (history)  Vaccinated:2002-05-21
Age:33.0  Onset:2002-05-23, Days after vaccination: 2
Gender:Female  Submitted:2002-06-05, Days after onset: 13
Location:South Carolina  Entered:2002-06-11, 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: PPD
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURUO330AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1293L0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Received immunization vaccines, PPD, TD and varicella on 5/21/02. RTC on 05/23/02 for PPD to be read and revealed a red circular area, warm to the touch at the site of the Varicella.

VAERS ID:186506 (history)  Vaccinated:2002-05-18
Age:33.0  Onset:2002-05-27, Days after vaccination: 9
Gender:Female  Submitted:2002-06-06, Days after onset: 10
Location:Texas  Entered:2002-06-14, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Efexor 150 mg; Synthroid 50mg; vitamins-ginkoba
Current Illness: NONE
Preexisting Conditions: Hashiomoto Thyroididis; multi-nodular goider
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5252A21 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0023M2SCRA
Administered by: Public     Purchased by: Unknown
Symptoms: Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Started with low grade fever and rash on legs (upper right thigh, lower left shin) legs got infected. Everyday noticed new spots until eventually had it all over. Went to doctor 06/05/02 started on Prednisone 50 mg q da x 5 days, Augmentin 500/125 1 tab po twice day x 7 days. Aveno bath as needed fro itching. Improved today. Pt noted three different types of bmps, one looked like chicken pox, one looked like white head that wouldn''t pop bright red very small compact deep blister looking no bump on top deep-clear in color.

VAERS ID:186586 (history)  Vaccinated:2002-05-14
Age:33.0  Onset:2002-05-16, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:Ohio  Entered:2002-06-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xarnax
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1301L0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Fever, rash and red spots 16 hrs after vaccination then resolved. Then a rash 4 week later with fever with rash.

VAERS ID:186937 (history)  Vaccinated:2002-06-07
Age:33.0  Onset:2002-06-09, Days after vaccination: 2
Gender:Female  Submitted:2002-06-18, Days after onset: 9
Location:Virginia  Entered:2002-06-25, 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: Clonazapan; Paxil; Trazadone
Current Illness: Ruptured eardrum
Preexisting Conditions: Neurological problems (unspecified)
Diagnostic Lab Data: Blood work; MRI-scheduled
CDC Split Type:
Vaccination
Manufacturer
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DT: DT ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Dyspnoea, Loss of consciousness, Oedema, Pain
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Unable to breath, swollen, pain on whole right side (extremities), needed oxygen, was in and out of consciousness, excruciating pain.

VAERS ID:187828 (history)  Vaccinated:2002-07-13
Age:33.0  Onset:2002-07-13, Days after vaccination: 0
Gender:Female  Submitted:2002-07-15, Days after onset: 2
Location:Pennsylvania  Entered:2002-07-22, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Latex gloves, Celebrex, Percocet, Pyridium
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5292A21IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Headache, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 1/2 hour after receiving Hep B vaccine #2, had onset of headache over Right eye with body chills. Next day, complained of soreness at injection site. On 7/15/02 still complained of not feeling well with body aches.

VAERS ID:187923 (history)  Vaccinated:1995-01-01
Age:33.0  Onset:1998-12-01, Days after vaccination: 1430
Gender:Female  Submitted:2002-05-30, Days after onset: 1275
Location:Unknown  Entered:2002-07-23, Days after submission: 54
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: 12/98 diagnostic lab-measles titer was neg; 8/99 diagnostic lab-measles titer revealed lack of sero-conversion
CDC Split Type: WAES01112190
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 2SC 
Administered by: Other     Purchased by: Other
Symptoms: Laboratory test abnormal
SMQs:
Write-up: Information has been received on 11/15/01 from a physician concerning a 33 year old Hispanic female who "since 1995" was vaccinated with a 1st, 2nd and 3rd dose of MMRII. The pt received the 1st 2 doses from her physician "around 1995". A measles titer was done in 12/98 and was found to be negative. It was reported that another immunization was given on 2/1/99. A titer was drawn in 8/99 which again revealed lack of sero-conversion. It was noted that the pt did sero-convert on mumps and rubella. The pt sought unspecified medical attention. It was reported that the reporting physician opted not to give the pt a 4th dose. No further information is expected.

VAERS ID:188419 (history)  Vaccinated:2002-07-18
Age:33.0  Onset:2002-07-18, Days after vaccination: 0
Gender:Female  Submitted:2002-07-22, Days after onset: 4
Location:Indiana  Entered:2002-08-05, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Paxil
Current Illness: NONE
Preexisting Conditions: PCN, ASA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0340M0SCLA
Administered by: Private     Purchased by: Other
Symptoms: Pain in jaw, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad)
Write-up: Onset of low grade fever, afternoon 07/18/02and 07/19/02 and continues today - Onset swelling jaw 07/21/02, Denies difficulty swollen and breathing.

VAERS ID:188827 (history)  Vaccinated:2002-08-04
Age:33.0  Onset:2002-08-04, Days after vaccination: 0
Gender:Female  Submitted:2002-08-04, Days after onset: 0
Location:South Carolina  Entered:2002-08-13, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergic to sulfonamides
Diagnostic Lab Data: BP, P- 09:15 108/98/60P 09:30 118/76/76P 09:20 100/70/76P
CDC Split Type:
Vaccination
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MEN: MENINGOCOCCAL (MENOMUNE)SANOFI PASTEURUB185AB0SC 
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU0382AA0IM 
Administered by: Military     Purchased by: Military
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Pt passed out approx 5 min post vaccine administration of Tetanus-Diphtheria and Menomune.

VAERS ID:189110 (history)  Vaccinated:2002-08-15
Age:33.0  Onset:2002-08-15, Days after vaccination: 0
Gender:Female  Submitted:2002-08-15, Days after onset: 0
Location:Alabama  Entered:2002-08-20, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma, Mold, Grass, IVP dye per health history.
Diagnostic Lab Data: No labs done in ER.
CDC Split Type:
Vaccination
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MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.0531L SCRA
Administered by: Public     Purchased by: Private
Symptoms: Heart rate increased, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Received Attenuvax Booster vaccine. 30-40 minutes after administered complained of nausea, vomiting and pulse rate was elevated to 140. To ER; treated by ER physician epi and Benadryl.

VAERS ID:189188 (history)  Vaccinated:1999-03-17
Age:33.0  Onset:1999-03-29, Days after vaccination: 12
Gender:Male  Submitted:2002-08-05, Days after onset: 1224
Location:Unknown  Entered:2002-08-22, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Head CT-normal; multiple neurological examinations-all normal
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0364  
Administered by: Military     Purchased by: Military
Symptoms: Drug administration error, Headache
SMQs:
Write-up: Within 2 weeks of administered expired vaccine, severe headache onset. Frequent headaches since. No severe headaches prior to vaccine.

VAERS ID:189347 (history)  Vaccinated:2002-02-13
Age:33.0  Onset:2002-02-13, Days after vaccination: 0
Gender:Female  Submitted:2002-08-14, Days after onset: 181
Location:Virginia  Entered:2002-08-26, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: TSH and CBC-nml
CDC Split Type:
Vaccination
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS711A6 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt developed numbness in fingers and toes shortly after receiving Hep-A vaccine. Symptoms have persisted to this date.

VAERS ID:189431 (history)  Vaccinated:2002-06-11
Age:33.0  Onset:2002-06-17, Days after vaccination: 6
Gender:Female  Submitted:2002-08-21, Days after onset: 65
Location:Ohio  Entered:2002-08-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 14 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: nONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Stool cultures/stool for C Difficue Toxin-neg
CDC Split Type:
Vaccination
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1317L SC 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Diarrhoea, Gastroenteritis, Gastrointestinal disorder, Leukocytosis, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Diarrhea, fever, nausea and vomiting began 11 days MMR vaccine, 6 days after Varivax vaccine. The discharge summary states abdominal pain. Also states gastroenteritis and Crohn''s disease.

VAERS ID:189567 (history)  Vaccinated:2002-08-08
Age:33.0  Onset:2002-08-15, Days after vaccination: 7
Gender:Female  Submitted:2002-08-20, Days after onset: 5
Location:Michigan  Entered:2002-08-30, 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: Valtrax, oral birth control, Allegra
Current Illness:
Preexisting Conditions: Hearing loss; harpes (genital); pollen, grass, trees
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0125M0 LA
Administered by: Public     Purchased by: Private
Symptoms: Joint stiffness, Lymphadenopathy, Parotitis, Tenderness
SMQs:, Oropharyngeal infections (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Client received 1st MMR on 8/8/02. Symptoms started on 8/15/02 with c/o jaw stiffness, tenderness, (B) ear. Client noticed swollen lymph gland one day later under (R) ear. Symptoms persist today. Has dr''s appoint. today. 8/22/02 saw PMD toda. PMD diagnosed parotitis, severe infection and ordered client not to receive 2nd MMR.

VAERS ID:190975 (history)  Vaccinated:2001-07-30
Age:33.0  Onset:2002-07-30, Days after vaccination: 365
Gender:Male  Submitted:2002-10-03, Days after onset: 65
Location:Unknown  Entered:2002-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unk
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3214A40  
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Became red and itchy all over. Went to walk-in clinic and treated with Benadryl.

VAERS ID:191291 (history)  Vaccinated:2002-09-30
Age:33.0  Onset:2002-10-01, Days after vaccination: 1
Gender:Female  Submitted:2002-10-04, Days after onset: 3
Location:New York  Entered:2002-10-14, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0463AA  LA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness, warm at site, below injection site.

VAERS ID:191567 (history)  Vaccinated:2002-10-14
Age:33.0  Onset:2002-10-15, Days after vaccination: 1
Gender:Male  Submitted:2002-10-17, Days after onset: 2
Location:Ohio  Entered:2002-10-17
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:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE34102HA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Malaise, Pyrexia, Rash vesicular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: VACCINE ADMINISTERED ON 10/14/02. ON 10/15/02 THE PATIENT DEVELOPED FEVER, MALAISE AND CHILLS. LATE IN THE DAY, THE PATIENT DEVELOPED A VESICULAR RASH. ON 10/16/02, A GENERALIZED VESICULAR RASH WAS NOTED. ON 10/17/02, A RASH, MALAISE, AND CHILLS STILL PRESENT.

VAERS ID:191583 (history)  Vaccinated:2002-09-13
Age:33.0  Onset:2002-09-14, Days after vaccination: 1
Gender:Female  Submitted:2002-09-23, Days after onset: 9
Location:North Dakota  Entered:2002-10-21, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol inhaler prn, Flovent 110mg bid, Triphasil
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: ND0214
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0527AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Injection site pain, Oedema, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Phone call from pt on 9/16/02 states that on 9/14 was vomiting, R arm sore but shoulder and collar bone area red and swollen up to neck.

VAERS ID:191861 (history)  Vaccinated:2001-12-05
Age:33.0  Onset:2001-12-05, Days after vaccination: 0
Gender:Female  Submitted:2001-12-28, Days after onset: 23
Location:Unknown  Entered:2002-10-23, Days after submission: 298
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: U200101234
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0714AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: From correspondence received at manufacturer on 12/5/01 it was reported that a 33 year old female patient received a Fluzone SV 2001-2002 vaccination administered on 12/5/01. Patient developed a local reaction 2 hours after vaccination--3.5cm red swollen area.

VAERS ID:191958 (history)  Vaccinated:2002-10-16
Age:33.0  Onset:2002-10-16, Days after vaccination: 0
Gender:Female  Submitted:2002-10-16, Days after onset: 0
Location:Maryland  Entered:2002-10-25, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depeprovera
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4020024 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient was given flu shot at 13:58 and instructed to wait 20 minutes in the clinic rest area in case of any reactions. Patient came back at 14:15 with complaints of itching on the face, around the nose and at vaccine site. Vital signs checked: temperature 98.9; pulse 63; respiratory rate 20; BP 109/53. Benadryl 50mg PO given. No respiratory distress. Patient told to wait 30 minutes and was discharged.

VAERS ID:191997 (history)  Vaccinated:2002-10-15
Age:33.0  Onset:2002-10-15, Days after vaccination: 0
Gender:Female  Submitted:2002-10-22, Days after onset: 7
Location:West Virginia  Entered:2002-10-28, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0966BA2IM 
Administered by: Other     Purchased by: Private
Symptoms: Blindness transient
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Glaucoma (broad)
Write-up: On evening of receiving flu immunization developed temporary blindness in right eye. Symptoms resolved after starting medrol pack. No symptoms by evening of 10/16/02. Developed temporary blindness in right eye after vaccine 10/01 with symptoms lasting until 6/02. Connection not linked to vaccine until pt received vaccine this year and developed blindness.

VAERS ID:192085 (history)  Vaccinated:2002-10-21
Age:33.0  Onset:2002-10-21, Days after vaccination: 0
Gender:Female  Submitted:2002-10-24, Days after onset: 3
Location:Michigan  Entered:2002-10-29, 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: None
Current Illness: None
Preexisting Conditions: MVP, Allergy to Nickel; Vitromycin
Diagnostic Lab Data: Negative strept A screen.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Chest discomfort, Cough, Injection site induration, Pain, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 10/21/02 was at work. Received Td right arm. Received pneumovax and influenza vaccines left arm. 2 hours later felt general unease. By 8 PM was running a fever and left arm swollen, painful and hard to move. 10/22 Fever 103.5, chills, left arm still red, swollen. 10/23 fever 100.5 early morning--lost fever, heavy feeling in chest, slight coughing started 10/24. Feels light-headed, arm still very painful. Seen here; left arm with 3 indurated area left upper arm. Positive erythema of posterior pharynx. Negative strept screen. As per acknowledgement letter: as I wrote on my VAERS form, I did not give any of the vaccines (they were given at work) and therefore have no lot #''s or manufact.

VAERS ID:192466 (history)  Vaccinated:2002-10-27
Age:33.0  Onset:2002-10-31, Days after vaccination: 4
Gender:Female  Submitted:2002-11-01, Days after onset: 1
Location:Utah  Entered:2002-11-04, 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:
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TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Chills, Injection site oedema, Injection site reaction, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Fever, body aches, chills, pain, swelling toright arm with cellulitis.

VAERS ID:192676 (history)  Vaccinated:2002-10-30
Age:33.0  Onset:2002-10-30, Days after vaccination: 0
Gender:Female  Submitted:2002-10-31, Days after onset: 1
Location:Missouri  Entered:2002-11-06, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE37182KA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: One to two hours after receiving injection complained of generalized hives with sl difficulty breathing, took OTC Benadryl. No problems with breathing today 10/31/02 and only a few hives.

VAERS ID:192720 (history)  Vaccinated:2002-10-22
Age:33.0  Onset:2002-10-22, Days after vaccination: 0
Gender:Female  Submitted:2002-10-24, Days after onset: 2
Location:Kansas  Entered:2002-11-06, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: C/O headahe. Children have colds at home.
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU087AA IMRA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Headache, Hot flush, Laryngeal oedema, Nausea, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: 8:45am flu vaccination given, reports she had dull headache by 1 hr after injection, c/o weakness, nausea, flush fleeing. By 2 hrs report she had vomiting, increased headache. 10:50 pt describing symptoms, no SOB, hives, swelling of throat. Advised to take po Benadryl. 2:45pm reports feeling flushed. No headache. Did not take Benadryl.

VAERS ID:192798 (history)  Vaccinated:1968-10-28
Age:33.0  Onset:2002-10-29, Days after vaccination: 12419
Gender:Male  Submitted:2002-10-29, Days after onset: 0
Location:Unknown  Entered:2002-11-07, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: Pt to see provider at 1400 today
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0630SCLA
Administered by: Military     Purchased by: Military
Symptoms: Back pain, Renal pain
SMQs:, Retroperitoneal fibrosis (broad)
Write-up: On 10/29/02 @ approximately 11:30 hrs, pt awoke with "pain in his entire lower back. At approximately 17:00, the same day (10/24/02), pt states his pain was transferred to left kidney area. Pt states pain has been constant and is still currently there.

VAERS ID:192839 (history)  Vaccinated:2002-02-14
Age:33.0  Onset:2002-02-16, Days after vaccination: 2
Gender:Female  Submitted:2002-04-15, Days after onset: 57
Location:Virginia  Entered:2002-11-07, Days after submission: 206
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: U200200131
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HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER    
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEUR   LA
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUB126AB SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Feeling hot, Injection site erythema, Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: From telephone contact received at manufacturer on 2/21/02 it was reported that a 33 year old female patient received a YF-Vax dose given on 2/14/02 SQ in left arm. Patient also received Typhim VI also administered in left deltoid, a Hepatitis A vaccination and a Measles vaccination. Reportedly the patient developed a large local reaction 50mmx60mm, red, induration, hard and very warm and painful of the left arm. The local reaction started 2 days after dose was received. Four days after injection the reaction started to subside but then flared up again and is getting larger.

VAERS ID:192841 (history)  Vaccinated:2002-03-14
Age:33.0  Onset:0000-00-00
Gender:Male  Submitted:2002-05-24
Location:Virginia  Entered:2002-11-07, Days after submission: 167
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: U200200239
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YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEUR    
Administered by: Other     Purchased by: Other
Symptoms: Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: From telephone contact received at manufacturer, it was reported that a 33 year old male received Yellow Fever vaccine on 3/14/02. It was reported by a doctor that the patient was experiencing fevers of 102 degrees F and headaches. She states that patient is not immunosuppressed. It was suggested that the patient be seen by an infectious disease doctor.

VAERS ID:192879 (history)  Vaccinated:2002-11-02
Age:33.0  Onset:2002-11-03, Days after vaccination: 1
Gender:Female  Submitted:2002-11-05, Days after onset: 2
Location:Maryland  Entered:2002-11-08, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Coumadin, Celexa
Current Illness: None
Preexisting Conditions: Mitral valve replacement, Depression, Obesity
Diagnostic Lab Data: CBC with diff 11/5/02
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0872AB0 LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.3052L0 LA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Dizziness, Injection site erythema, Injection site pain, Laboratory test abnormal, Malaise
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad)
Write-up: 24 hours after innoculation, chills, malaise, erythema at injection site, dizzy. Left deltoid pain 24 hours post injection on 11/02/2002. 11/03/2002 pain, chilled and miserable. 11/04/2002 site started to get red, slight dizziness. Took tylenol and slept.

VAERS ID:193206 (history)  Vaccinated:2002-11-02
Age:33.0  Onset:2002-11-03, Days after vaccination: 1
Gender:Male  Submitted:2002-11-04, Days after onset: 1
Location:Indiana  Entered:2002-11-13, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUB315AA SCRA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Discovered small welt 11/3/02; 11/4/02 small welt spread to reddened area 6x6cm went to med. Rx Benadryl, Tylenol; return to clinic AM 11/5/02 reddened area now 12x12cm, sent to ER. Low grade temp.

VAERS ID:193241 (history)  Vaccinated:2002-10-21
Age:33.0  Onset:2002-10-21, Days after vaccination: 0
Gender:Female  Submitted:2002-10-21, Days after onset: 0
Location:New Mexico  Entered:2002-11-14, 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: None
Current Illness: None
Preexisting Conditions: Niacin
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0905FA8IM 
Administered by: Private     Purchased by: Private
Symptoms: Hot flush
SMQs:
Write-up: Within 10-15 minutes of injection, patient became hot and flushed all over. Took benadryl 25mg PO and symptoms subsided.

VAERS ID:193388 (history)  Vaccinated:2002-11-04
Age:33.0  Onset:2002-11-06, Days after vaccination: 2
Gender:Male  Submitted:2002-11-07, Days after onset: 1
Location:Unknown  Entered:2002-11-18, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Migraine
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0631SCLA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Erythema, Pruritus, Rash, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Patient received vaccination on Monday. On Tuesday, rash developed. By Wednesday rash had spread from under arm to elbow. Swelling, redness and tender to touch. Today rash is still spreading down arm. Patient is experiencing joint pain and itching still today. Burning at rash site also.

VAERS ID:193414 (history)  Vaccinated:2002-11-05
Age:33.0  Onset:2002-11-05, Days after vaccination: 0
Gender:Female  Submitted:2002-11-05, Days after onset: 0
Location:Washington  Entered:2002-11-18, 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: Effexor
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETHU0897012 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Pins and needles back of arm. Itchy skin. Some SOB; no fast or deep breathing. Treatment: Epinephrine right deltoid SC

VAERS ID:193476 (history)  Vaccinated:2002-11-14
Age:33.0  Onset:2002-11-14, Days after vaccination: 0
Gender:Female  Submitted:2002-11-14, Days after onset: 0
Location:Massachusetts  Entered:2002-11-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: Tuberculin PPD Aventis (L) C0834AB left forearm 11/12/2002
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0953AA EXP 06  LA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Flushing, Hyperhidrosis, Hyperventilation, Hypokinesia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Pt became weal, pale, diaphoretic, shallow breathing and dizzy- unable to converse, stand, or hold head up. BP 102/58 pulse- unable to feel at first Epinephrine given P58-64. Ambulance called- follow up at hospital.

VAERS ID:193891 (history)  Vaccinated:2002-10-25
Age:33.0  Onset:2002-11-07, Days after vaccination: 13
Gender:Female  Submitted:2002-11-15, Days after onset: 8
Location:Unknown  Entered:2002-11-26, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Blood work and ultrasound performed to confirm diagnosed of spontaneous abortion.
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 0SCRA
Administered by: Military     Purchased by: Military
Symptoms: Abortion
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: Pt received first anthrax vaccine on 10/25/02. Pt did not know she was pregnant at the time of vaccination. Pt had a spontaneous abortion on 11/7/02. Pt had a D&C procedure performed on 11/8/02. Pt was hospitalized for one day on 11/8/02 for D&C procedure.

VAERS ID:193900 (history)  Vaccinated:2002-11-16
Age:33.0  Onset:2002-11-17, Days after vaccination: 1
Gender:Male  Submitted:2002-11-18, Days after onset: 1
Location:D.C.  Entered:2002-11-26, 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: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0632SCLA
Administered by: Military     Purchased by: Military
Symptoms: Contusion, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)
Write-up: Left arm pain from anthrax shot. Has a localized reaction with bruising.

VAERS ID:193907 (history)  Vaccinated:2002-11-07
Age:33.0  Onset:2002-11-07, Days after vaccination: 0
Gender:Female  Submitted:2002-11-12, Days after onset: 5
Location:Tennessee  Entered:2002-11-26, 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: hyroxapam, glucophage, pulmacort, topomax, albuterol, prozac, triliptol, effexer
Current Illness: NONE
Preexisting Conditions: Diabetes, Asthma, Depression
Diagnostic Lab Data:
CDC Split Type: TN02049
Vaccination
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40200292IMLA
HEPA: HEP A (VAQTA)MERCK & CO. INC.0701M0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0210M0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Respiratory distress
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypersensitivity (broad), Respiratory failure (narrow)
Write-up: Respiratory distress increasing over next several minutes after vaccines. Per MD orderss - Epinphrine 1mg given SQ and 25mg Benadryl given IM. 911 called and oxygen via mask placed at 6L min. EMS takes over at this point. Patient to ER.

VAERS ID:193924 (history)  Vaccinated:2002-11-04
Age:33.0  Onset:2002-11-05, Days after vaccination: 1
Gender:Female  Submitted:2002-11-06, Days after onset: 1
Location:Maryland  Entered:2002-11-26, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4020028 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient developed a red/itchy rash within 24 hours that progresed the next day. Patient treated with atanoy and prednisone

VAERS ID:194230 (history)  Vaccinated:2002-10-22
Age:33.0  Onset:2002-11-07, Days after vaccination: 16
Gender:Female  Submitted:2002-11-12, Days after onset: 5
Location:Maine  Entered:2002-12-02, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Environmental allergies: dust but no history of medical testing; hx asthma
Diagnostic Lab Data: Negative varicella titer on 8/2/02.
CDC Split Type:
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0258M SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Feeling hot, Injection site erythema, Injection site pain, Pruritus, Pyrexia, Rash maculo-papular, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Received Varivax vaccine right upper arm on 10/22/02. On Sunday 11/3/02, injection site became red, sore, itchy, hot. Developed low-grade fever and subsequent sites of macular papular itchy lesions scattered on torso, extremities, one on face. Excluded from work until lesions dried.

VAERS ID:194238 (history)  Vaccinated:2002-10-15
Age:33.0  Onset:2002-10-16, Days after vaccination: 1
Gender:Male  Submitted:2002-10-17, Days after onset: 1
Location:Unknown  Entered:2002-12-02, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0642SCLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Oedema, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: About 82mm area of erythema, swelling, tenderness. Zyrtec, Motrin .

VAERS ID:194259 (history)  Vaccinated:2002-10-09
Age:33.0  Onset:2002-10-10, Days after vaccination: 1
Gender:Male  Submitted:2002-10-11, Days after onset: 1
Location:Florida  Entered:2002-12-02, Days after submission: 52
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: HTN
Diagnostic Lab Data: BMP - normal
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Vomiting, diarrhea, nausea, general aches 1 day following flu shot/ anthrax vaccination (possible reaction) IV fluid administered / toradol given improvement.

VAERS ID:194499 (history)  Vaccinated:0000-00-00
Age:33.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:2002-12-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Pain in joints, arthritis.

VAERS ID:194985 (history)  Vaccinated:2002-11-28
Age:33.0  Onset:2002-11-28, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:New Jersey  Entered:2002-12-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Sulfa Drugs
Diagnostic Lab Data: NONE
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0661SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site reaction, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 20 cm X 13 cm Erythematous rash over right deltoid, Tx: Lidex cream and Claritin, 48 hours later rash completely gone and patient doing well

VAERS ID:195474 (history)  Vaccinated:2002-10-15
Age:33.0  Onset:2002-10-20, Days after vaccination: 5
Gender:Female  Submitted:2002-12-18, Days after onset: 59
Location:Kansas  Entered:2002-12-26, Days after submission: 8
Life Threatening? Yes
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: All negative
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0918AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: 10/20/02 Generalized tonic/clonic seizure

VAERS ID:195598 (history)  Vaccinated:2002-12-06
Age:33.0  Onset:2002-12-07, Days after vaccination: 1
Gender:Female  Submitted:2003-02-07, Days after onset: 62
Location:Arizona  Entered:2002-12-30, Days after submission: 39
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: UNK
Current Illness: UNK
Preexisting Conditions: Overweight; smoker; subdural haematoma
Diagnostic Lab Data: UNK
CDC Split Type: HQ5815917DEC2002
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4020006 IM 
Administered by: Private     Purchased by: Other
Symptoms: Abdominal pain, Back pain, Headache, Nervous system disorder
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: A pharmacist reported that a 33 year old female received an injection of Flu Shield on 12/6/02. *On 12/7/02,* she developed severe back pain. She was hospitalized on 12/12/02 because of her complaints of severe back pain, severe abdominal pain, and severe headache. She was worked up for "some sort of neurological problem," but as of 12/16/02, were unable to determine the cause of her severe pain. The reporter noted that the pt had neither a fever, nor any local reactions to the vaccine. *She recovered.* No further info was available as of the date of this report. *F/UP report on 2/12/03: Info received from the reporter indicated that the PT recovered and that the first symptom onset was 12/7/02.*

VAERS ID:195651 (history)  Vaccinated:2002-11-15
Age:33.0  Onset:2002-11-16, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:2002-12-31
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: Contraceptive pills (unspecified)
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PJP200200891
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE31902HA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Joint swelling, Pyrexia, Serum sickness, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: A report was received from a health care professional on 12/17/02 concerning a 32 year old female vaccinee who experienced serum sickness one day after receiving Fluvirin on 11/15/02. It was reported that the vaccinee had received an influenza vaccine for the past five years with the date of last vaccination reported as 2001. Concomitant medication reported included unspecified birth control pills. On the 11/16/02 the vaccinee developed hives and was treated with methylpredinisolone for seven days with improvement. After treatment with methylprednisolone was complete on approximately 11/23/02 the hives returned and the vaccinee was treated with prednisone (dose unk). On 12/6/02 the vaccinee began to experience swelling in the ankles, knees and shoulders and experienced a fever (temp unk). On 12/6/02 the vaccinee was hospitalized where the attending physician diagnosed serum sickness. The vaccinee was treated with unspecified IV steroids, methylprednisolone and ciprofloscin for five days. The vaccinee was discharged from hospital on 12/8/02. It was reported that the symptoms had improved but had not resolved. The reporter has assessed the relationship of the vaccine to the event as probable. Follow up on 02/27/2003: "A report was received from a health care professional which stated that the vaccinee had also experienced wrist swelling and had a fever of 101C approximately 2 weeks following vaccination. The vaccinee had recovered at the time of the report."

VAERS ID:195658 (history)  Vaccinated:2002-11-06
Age:33.0  Onset:2002-11-06, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Idaho  Entered:2002-12-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Aspirin
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO935BA  LA
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 1;25 pm left deltoid small amount of swelling noted hardened area around swelling. Bruise noted 3:45 pm, swelling reduced area not as hardened.

VAERS ID:195768 (history)  Vaccinated:2002-12-11
Age:33.0  Onset:2002-12-25, Days after vaccination: 14
Gender:Male  Submitted:2003-01-03, Days after onset: 9
Location:New Jersey  Entered:2003-01-03
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
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1317L0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Pruritus, Pyrexia, Rash, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 12-25-02 CHILLS AND TEMPERATURE 102. 12-26-02 GENERALIZED ITCHING, RED RAISED RASH- FIRST ON BACK, THEN CHEST, FACE AND NECK. FEW ON LOWER EXTREMITIES. FEW VESICLES NOTED ON BACK. LESIONS IMPROVING, DRIED AND FEELING BETTER 12-30-02. TEMP ONLY FOR 2 DAYS.

VAERS ID:195855 (history)  Vaccinated:2001-01-16
Age:33.0  Onset:2001-02-18, Days after vaccination: 33
Gender:Female  Submitted:2001-05-08, Days after onset: 78
Location:New York  Entered:2003-01-07, Days after submission: 609
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Transient hemianesthesia
Preexisting Conditions: NONE
Diagnostic Lab Data: Cat Scan; MRI
CDC Split Type: U200100482
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RAB: RABIES (IMOVAX)AVENTIS PASTEUR  IM 
Administered by: Private     Purchased by: Private
Symptoms: Hemiparesis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)
Write-up: It was reported that a female pt was given a post exposure series of Imovax Rabies for bat exposure. Pt experienced "flu-like" symptoms after the 2nd and 3rd doses. On 2/18/01, the pt developed numbness in left side of face, ear, arm and calf, no sensory perception in left side, now in right side. Was seen in ER on 2/18/01. She was referred to a Neurologist and ENT doctor. All reports were sent to PCP. Unresolved, getting worse. Per the Medical Safety Officer''s conversation with PCP on 2/28/01, it was stated that the neurologist evaluated the pt and made a dx of hemianesthesia. From additional correspondence received on 5/7/01, additional lab data was provided.

VAERS ID:195896 (history)  Vaccinated:2002-12-12
Age:33.0  Onset:2002-12-15, Days after vaccination: 3
Gender:Female  Submitted:2002-12-27, Days after onset: 12
Location:Unknown  Entered:2003-01-08, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EKG was done - Results within normal limits; Normal Syncrhym
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0650SCLA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Injection site mass, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Stabbing chest pain 3 days after vaccination. Chest felt heav; pain to the left arm, left amr went numb for 2 hours. Patient developed a lump without tenderness that lasted 5 days. No SOB, HA, dizziness, blurred vision, abdominal pain or nausea, vomiting, or diarrhea.

VAERS ID:195909 (history)  Vaccinated:2002-11-19
Age:33.0  Onset:2002-11-19, Days after vaccination: 0
Gender:Female  Submitted:2003-01-02, Days after onset: 44
Location:Pennsylvania  Entered:2003-01-08, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0909AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Pain
SMQs:, Arthritis (broad)
Write-up: Patient states the left arm "hurt badly" the evening of 11/19/02. The left arm continued to be painful over the next month. She states the pain is in the joint, so that it hurts to lift her arm over the head, put on clothing. She phoned health dept on 12/19/2002 and was advised to see a physician.

VAERS ID:195984 (history)  Vaccinated:2003-01-03
Age:33.0  Onset:2003-01-03, Days after vaccination: 0
Gender:Female  Submitted:2003-01-06, Days after onset: 3
Location:Virginia  Entered:2003-01-08, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pills
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURUB248AA SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.15056 SCRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURV10734  RA
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUB254AA SCLA
Administered by: Public     Purchased by: Public
Symptoms: Feeling hot, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: The afternoon of the shots felt warm and developed rash from head to chest. Temp 100.6 degrees in PM. Rash was gone by 6 pm. Called clinic and advised to take Benadryl.

VAERS ID:196052 (history)  Vaccinated:2002-12-19
Age:33.0  Onset:2002-12-19, Days after vaccination: 0
Gender:Female  Submitted:2003-01-10, Days after onset: 22
Location:North Carolina  Entered:2003-01-13, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0925AA   
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
TTOX: TETANUS TOXOID (NO BRAND NAME)AVENTIS PASTEURU0528AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site mass, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Arm swelled from flu shot at injection site. Hard lump about the size of a quarter at flu site injection. Still have the lump. Received Pneumovax a second before flu vax. Extremely painful could not sleep on arm for a month.

VAERS ID:196203 (history)  Vaccinated:2002-11-22
Age:33.0  Onset:2002-11-22, Days after vaccination: 0
Gender:Female  Submitted:2002-12-27, Days after onset: 35
Location:Virginia  Entered:2003-01-15, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: No allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0988BA IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Dizziness, Flushing, Hyperhidrosis, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: C/O dizziness, sweating, shakiness apprx. 15 mins after flu shot. Face flushed. No hives, SOB or wheezing. (Only went to ER because another client was also going) ER states was vasovagal Rx IV fluids

VAERS ID:196206 (history)  Vaccinated:2002-10-31
Age:33.0  Onset:2002-10-31, Days after vaccination: 0
Gender:Male  Submitted:2002-12-27, Days after onset: 57
Location:Virginia  Entered:2003-01-15, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0911AA IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Complained of tingling in fingers of left hand, shoulder and side mouth approximately 1 hour after shot. Neuromus v to hand/arm/mouth wnl; Resolved spontaneously within 5 hours.

VAERS ID:196482 (history)  Vaccinated:2002-11-04
Age:33.0  Onset:2002-11-06, Days after vaccination: 2
Gender:Female  Submitted:2003-01-09, Days after onset: 64
Location:Illinois  Entered:2003-01-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The subject had no medical history, concurrent conditions, or concurrent medications.
Diagnostic Lab Data: UNK
CDC Split Type: A0386557A
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5291A42 LA
Administered by: Private     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: A nurse described the occurrence of rash in a 33 y.o. female who was vaccinated w/Hep B vaccine recombinant (Engerix-B) for prophylaxis. The subject had no medical history, concurrent conditions, or concurrent medications. The subject received her 1st injection of Engerix-B in 1998. She received her 2nd injection on 10/02/02. "A few days" after the 2nd injection, she developed a "mild" rash that resolved after an unspecified period of time. On 11/4/02, the subject received her 3rd injection of Engerix-B (lot ENG5291A4). Two days later, she developed a rash on both forearms. She was seen by a physician. The reporting nurse considered the rash to be possibly related to Engerix-B administration. As of 12/5/02, the rash had "improved".

VAERS ID:196539 (history)  Vaccinated:2003-01-17
Age:33.0  Onset:2003-01-18, Days after vaccination: 1
Gender:Female  Submitted:2003-01-20, Days after onset: 2
Location:Unknown  Entered:2003-01-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None except local reaction
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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Dose
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSLAV0653SCLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Pt with 12cm by 16 cm erthematous, edematous swelling of lateral upper arm. This was the same arm that had received the Anthrax immunization 3 days prior.

VAERS ID:196526 (history)  Vaccinated:2003-01-11
Age:33.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Mississippi  Entered:2003-01-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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JEV: JAPANESE ENCEPHALITIS (JE-VAX)SANOFI PASTEUR  SC 
Administered by: Military     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up:

VAERS ID:196782 (history)  Vaccinated:2001-10-10
Age:33.0  Onset:2001-10-10, Days after vaccination: 0
Gender:Female  Submitted:2003-01-21, Days after onset: 468
Location:Georgia  Entered:2003-01-27, Days after submission: 6
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: Albuterol; Zithromax, erythromycin, Flonase
Current Illness:
Preexisting Conditions: Pregnancy NOS (LMP=8/30/01); cleft lip and palate
Diagnostic Lab Data: Chest x-ray - pneumonia; Ophthalmoscopy normal; Ultrasound 9 week, normal; Ultrasound normal; Serum alpha-fetoprotein normal; Serum varicella zoster negative
CDC Split Type: WAES01114271
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0468L   
Administered by: Other     Purchased by: Other
Symptoms: Cough, Pneumonia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Information has been received from a physician through a pregnancy registry concerning a 33 year old caucasian female with a repaired cleft palate/lip and no previous pregnancies who on 10/1/01 tested negative for varicella antibodies. On 10/10/01, the pt was vaccinated with a dose of varicella virus vaccine live (638902/0468L). Concomitant therapy included azithromycin, erythromycin, albuterol, and fluticasone propionate. The physician reported that the pt was three weeks pregnant at the time of vaccination and did not know. The pt''s date of last menstrual period was reported by the physician to be 8/30/01. The pt''s estimated delivery date was determined to be 6/24/02 according to her 9 week ultrasound on 11/20/01. On 1/9/02, serum alpha-feto protein screening was normal. On 1/22/02, an ultrasound was normal. On an unspecified date the pt had a fever and cough. On 3/12/02, a chest x-ray reveled pneumonia, and the pt was hospitalized for pneumonia. On 6/6/02, 37 weeks from LMP, the pt delivered a normal baby girl weighing 7 lbs. 4oz. Complications during labor and delivery included inadequate pelvis and signs and symptoms of pregnancy induced hypertension. The pt did not have any varicella or herpes zoster symptoms or local reaction post vaccination with varicella vaccine live. The infant had no symptoms of congenital varicella zoster syndrome. Additional info received via medical records indicate that the infant had congenital ptosis. The pt had mild palpebral fissure asymmetry (the right was a bit smaller than the left). The physician did not see any signs of anisocoria or EOM problems to suggest a neuro-ophthalmic lesion. Funduscopic exam was normal. The physician recommended reassurance. A review of the medical records indicated no other adverse symptoms were noted. No additional info is expected.

VAERS ID:196831 (history)  Vaccinated:2003-01-16
Age:33.0  Onset:0000-00-00
Gender:Male  Submitted:2003-01-27
Location:Georgia  Entered:2003-01-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0SCLA
Administered by: Military     Purchased by: Military
Symptoms: Lymphadenopathy
SMQs:
Write-up: Lymph node in left armpit, "extremely large". Seen at base medical facility. No RX. Is resolving and getting better.

VAERS ID:196919 (history)  Vaccinated:2003-01-04
Age:33.0  Onset:2003-01-04, Days after vaccination: 0
Gender:Male  Submitted:2003-01-19, Days after onset: 15
Location:Florida  Entered:2003-01-29, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 0SCLA
Administered by: Other     Purchased by: Military
Symptoms: Arthralgia, Chest pain, Headache
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)
Write-up: Pronounced joint and chest pain for 1 week after 1st dose. Mild headache for the first 3 days after dose 1. No treatment. Pt has recovered (so far).

VAERS ID:196989 (history)  Vaccinated:2002-02-09
Age:33.0  Onset:2002-02-16, Days after vaccination: 7
Gender:Female  Submitted:2003-02-27, Days after onset: 376
Location:Unknown  Entered:2003-01-30, 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: propranolol
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES0202USA01732
Vaccination
Manufacturer
Lot
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Site
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Headache, Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Information has been received on 2/18/02 from a physician concerning a 33-year-old female who was vaccinated with a dose of measles virus vaccine live. Concomitant therapy included propranolol, which the patient had been taking "for about 6 months." On 2/16/02 the patient developed a headache, that reportedly on 2/18/02 "seems to be getting better now." On 2/18/02, the patient reported to the physician because she had a papular rash on her face, trunk and arms and also had a fever. The patient was instructed by the physician to discontinue the propranolol. The physician had no explanation for the rash other than the measles virus vaccine live. It was noted on 2/18/02 that "no new medications were introduced recently." Additional information has been requested.

VAERS ID:197054 (history)  Vaccinated:2003-01-29
Age:33.0  Onset:2003-01-29, Days after vaccination: 0
Gender:Female  Submitted:2003-01-29, Days after onset: 0
Location:Kentucky  Entered:2003-01-31, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA Reports she had what she thinks was a migrane H/A.
Diagnostic Lab Data:
CDC Split Type: KY2003010
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5312861IMRA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt. reports about 20 min after recieving her 2nd Hep B shout developed a headache involving the top of her head. No visual disturbances. On pain scale of 1-10 with 1=lowest & 10=highest, rate of H/A a 7. Was pale B/P 130/90. She consulted by phone with Hopsital, thought R/T Hep B shot. No more Hep B shots. 2 hrs after took tylonal, H/A gon. Felt fine. C/O Nausea after H/A subsided.

VAERS ID:197060 (history)  Vaccinated:2003-01-19
Age:33.0  Onset:2003-01-29, Days after vaccination: 10
Gender:Male  Submitted:2003-02-01, Days after onset: 3
Location:Unknown  Entered:2003-02-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
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Dose
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710SCLA
Administered by: Military     Purchased by: Military
Symptoms: Rash maculo-papular, Rash pruritic, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Day 11 after smallpox immunization. Developed generalized maculopapular rash on trunk, upper extremities. Pruritic target lesions. Was seen and treated symptomatically with Atarax, Eucerin Cream.

VAERS ID:197061 (history)  Vaccinated:2003-01-27
Age:33.0  Onset:2003-01-27, Days after vaccination: 0
Gender:Male  Submitted:2003-02-01, Days after onset: 5
Location:Pennsylvania  Entered:2003-02-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Food (sunflower seeds), Downy fabric softner.
Diagnostic Lab Data: Allergic Reaction
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710IDLA
Administered by: Military     Purchased by: Military
Symptoms: Face oedema, Hypersensitivity, Hypoaesthesia oral, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: Numbness to Lips. Raised bumps (pinwheel) to head, neck,back and anticubital spaces. Swelling to facial region. Pt given epi 1:1000 1cc IM R deltoid. Pt continued and still continues to have adverse reactions with above symptoms, dispite current treatment of Singular, Allegria, Pepcid and Prednisone.

VAERS ID:197118 (history)  Vaccinated:2003-01-30
Age:33.0  Onset:2003-01-31, Days after vaccination: 1
Gender:Male  Submitted:2003-02-02, Days after onset: 2
Location:Nebraska  Entered:2003-02-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH    
Administered by: Military     Purchased by: Military
Symptoms: Chills, Headache, Injection site hypersensitivity, Malaise, Nausea, Pain, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Anthrax Vac given. Vac injected into L Shoulder. Burning sensation on injection. Pain and swelling in L shoulder, L upper arm next day. Fever, Chills, Malaise, Nausea, Headaches as well. No hospital or doctor treatment sought for symptoms. Symptoms cleared out after 3 days.

VAERS ID:197313 (history)  Vaccinated:2003-01-22
Age:33.0  Onset:2003-01-23, Days after vaccination: 1
Gender:Female  Submitted:2003-02-05, Days after onset: 13
Location:Indiana  Entered:2003-02-05
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: NKDA, No medical conditions
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5370A22IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Right upper arm urticaria-like reaction. Patient c/o itching.

VAERS ID:197317 (history)  Vaccinated:2003-01-31
Age:33.0  Onset:2003-02-02, Days after vaccination: 2
Gender:Male  Submitted:2003-02-05, Days after onset: 3
Location:Virginia  Entered:2003-02-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710IDLA
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Developed nausea vomiting and diarrhea on 2 Feb 2003. Evaluated in clinic on 3 Feb 2003 and received 3 liters of IV fluids for dehydration. Returned to work on 4 Feb 2003. Family members were ill with AGE on 1 Feb 2003. BP 140/70, pulse 90

VAERS ID:197487 (history)  Vaccinated:2003-02-01
Age:33.0  Onset:2003-02-09, Days after vaccination: 8
Gender:Female  Submitted:2003-02-10, Days after onset: 1
Location:Unknown  Entered:2003-02-10
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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CSF NORMAL; WBC NORMAL
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Headache, Lymphadenopathy, Pain, Photophobia
SMQs:, Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: HEADACHE, PHOTOPHOBIA, BODY ACHES; FATIGUE; LEFT AXILLARY ADENOPATHY

VAERS ID:197630 (history)  Vaccinated:2002-12-09
Age:33.0  Onset:2002-12-12, Days after vaccination: 3
Gender:Male  Submitted:2002-12-16, Days after onset: 4
Location:Florida  Entered:2003-02-12, Days after submission: 58
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: PCN allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0650SCLA
Administered by: Military     Purchased by: Military
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Shortness of breath, started 3 days after the anthrax vaccine. Left arm - no lesions / swelling at time of visit. Lungs CTA = tril? at time of visit.

VAERS ID:197717 (history)  Vaccinated:2003-01-30
Age:33.0  Onset:2003-02-01, Days after vaccination: 2
Gender:Female  Submitted:2003-02-11, Days after onset: 10
Location:Minnesota  Entered:2003-02-13, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: DEPO PROVERA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC Split Type: U200300066
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0817AA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis
SMQs:
Write-up: It was reported that a 33 year old female pt received TD ADS ADULT, lot number U0817AA, given IM in the left deltoid and DEPO PROVERA, given IM in the left deltoid on 1/30/03. The vaccinations were given approximately one inch apart. On 2/1/03, pt went to the hospital ER, where they treated her with IV antibiotics. On 2/2/03, pt went to another ER where she was admitted. It was reported that the pt is still there. Pt is said to have cellulitis. It is unknown if pt recovered. Pt had no illness at the time of vaccination. Reported on 02/20/2003: "From follow-up #1 received on 02/06/2003, it was reported that the patient developed "cellulitis of arm" after the Tetanus and Depo-Provera (lot number JP1204) injection. No additional information was provided. Follow up on 07/07/2003: "From additional information received on 06/25/2003 from the reporter, it was stated that there is no new medical information. The "patient returned to her previous clinic and has not been back since. We did not receive the hospital discharge summary on this patient". No further information is anticipated, this case is considered closed." Follow up on 12/05/03: "From follow up #1 received on 02/06/03, it was reported that the pt developed "cellulitis of arm" after the Tetanus and Depo-Provara (Lot # JF1204) injection. No additional information was provided."

VAERS ID:197814 (history)  Vaccinated:2003-02-09
Age:33.0  Onset:2003-02-10, Days after vaccination: 1
Gender:Male  Submitted:2003-02-14, Days after onset: 4
Location:Virginia  Entered:2003-02-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0736SCRA
Administered by: Military     Purchased by: Unknown
Symptoms: Oedema, Pain, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Right arm swelling, became painful in the elbow, and itchy. Spread to lower forearm and neck. Taken to ER and received fexofenadine (180mg) and Augmentin (875mg)

VAERS ID:197980 (history)  Vaccinated:2002-10-28
Age:33.0  Onset:2002-11-14, Days after vaccination: 17
Gender:Male  Submitted:2002-10-28, Days after onset: 17
Location:Illinois  Entered:2003-02-20, Days after submission: 115
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: Blood work, physical exam, R/O (no spinal tab needed)/ MRI x2
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0872AB0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: PT experienced mild case of Guillain Barr, syndrome.

VAERS ID:198019 (history)  Vaccinated:2002-11-18
Age:33.0  Onset:2002-12-01, Days after vaccination: 13
Gender:Female  Submitted:2002-12-04, Days after onset: 3
Location:Washington  Entered:2003-02-20, Days after submission: 78
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WA021893
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0774M SCLA
Administered by: Unknown     Purchased by: Private
Symptoms: Oedema, Pain, Vasodilation procedure
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Received MMR. 14 days later developed pain, swelling and redness in right wrist.

VAERS ID:198059 (history)  Vaccinated:2003-02-11
Age:33.0  Onset:2003-02-17, Days after vaccination: 6
Gender:Female  Submitted:2003-02-20, Days after onset: 3
Location:Tennessee  Entered:2003-02-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: CBC WNL
CDC Split Type: TNSP501
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200760  
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Nausea, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)
Write-up: Day 6 post vaccination - nausea/vomiting, low grade fever (100); lt neck-supraclavicular node-tender. Day 8 post vacc - nausea; lt supraclavicular node enlarged; red; very tender; low grade fever. Discussed with CDC CIL.

VAERS ID:198063 (history)  Vaccinated:2003-01-09
Age:33.0  Onset:2003-01-16, Days after vaccination: 7
Gender:Female  Submitted:2003-01-24, Days after onset: 8
Location:Georgia  Entered:2003-02-20, 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:
Preexisting Conditions: URI; yeast infection
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0652 RA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200711 LA
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Headache, Injection site pain, Neck pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Pt c/o headaches, fatigue and pain in L upper arm later radiating to L neck area. Symptoms started on day 7 and lasted x 2 days. Pt given 24 hrs quarters to rest, given Toradol 60mg IM.

VAERS ID:198064 (history)  Vaccinated:2003-01-30
Age:33.0  Onset:2003-02-08, Days after vaccination: 9
Gender:Male  Submitted:2003-02-20, Days after onset: 12
Location:Virginia  Entered:2003-02-20
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: Biopsy of lesion showed no organisms,with mixed skin flora. CBC,UA, ESR,CRP,HSV,Varricella, viral culture negative. , immune raji 44.8
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETHUNKNOWN IDLA
Administered by: Military     Purchased by: Military
Symptoms: Myalgia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: This re-vaccinee developed scattered, non-pruritic papules and pustules on anterior and posterior shoulders on day 10 after smallpox vaccine. No other symptoms evident except mild , generalized myalgias. Had had axillary LAD on day 5-9 but was resolved at time of rash eruption. All sx resolved without treatment.

VAERS ID:198194 (history)  Vaccinated:2003-02-20
Age:33.0  Onset:2003-02-22, Days after vaccination: 2
Gender:Male  Submitted:2003-02-23, Days after onset: 1
Location:Colorado  Entered:2003-02-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: URI
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Injection site swelling, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 33 y/o male with new onset erythematous rash 3 days s/p smallpox vaccine administration. Rash is erythematous, blanching rash with slightly raised scale on bilateral arms and right cheek. Rash is quite pruritic. Pt is afebrile, and in otherwise good health. NO history of skin disorders other than dry skin in winter.

VAERS ID:198212 (history)  Vaccinated:2003-01-18
Age:33.0  Onset:2003-01-18, Days after vaccination: 0
Gender:Male  Submitted:2003-02-16, Days after onset: 29
Location:Minnesota  Entered:2003-02-24, 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: Just getting over severe cold/virus at time of vaccination
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU0818AA1IMRA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUB135AA1SCLA
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Influenza like illness, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Flu like symptoms: fatigue, muscle aches, low temp. Duration of attack two wks from time of vaccination.

VAERS ID:198315 (history)  Vaccinated:2003-02-07
Age:33.0  Onset:2003-02-24, Days after vaccination: 17
Gender:Female  Submitted:2003-02-24, Days after onset: 0
Location:Maryland  Entered:2003-02-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: dermatitis NOS: evaluated by Dermatology for clearance for vaccine; prev. hx of parapsoriasis
Diagnostic Lab Data: Unknown if recovered, because patient still to be followed clinically. No labs done at this time. COVER/STANDARD PRECAUTIONS; RTC if spread or start to look like vaccine site
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710IDRA
Administered by: Military     Purchased by: Military
Symptoms: Blister, Injection site erythema, Injection site vesicles, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: 7 feb: vaccine given 13 feb: eval for take; + take; small red vessicular area several days later developed large red area of deltoid, upper arm... did not seek care 24 feb seen for multiple small vessicles itching in various areas of neck, arms, legs, abdomen. There were only 1-2 2-3mm red vessicles in each area, with no central necrosis or umbilication, clear vessicular fluid. None looked like the vaccine site

VAERS ID:198374 (history)  Vaccinated:2002-10-30
Age:33.0  Onset:2002-10-30, Days after vaccination: 0
Gender:Female  Submitted:2003-02-19, Days after onset: 112
Location:Michigan  Entered:2003-02-26, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0910AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Had some nausea and vomiting x 1. Arm a little sore. Left arm size of quarter. Tenderness. 10/31/2002 Feeling better. Case closed.

VAERS ID:198381 (history)  Vaccinated:2002-11-11
Age:33.0  Onset:2002-11-11, Days after vaccination: 0
Gender:Female  Submitted:2003-02-19, Days after onset: 100
Location:Michigan  Entered:2003-02-26, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0910AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: After receiving IM shot for flu c/o pain going up left side. Tenderness at site. Spoke with pt on 2/5/03 arm fine, no adverse relations. Case closed.

VAERS ID:198472 (history)  Vaccinated:2003-02-20
Age:33.0  Onset:2003-02-26, Days after vaccination: 6
Gender:Male  Submitted:2003-02-27, Days after onset: 1
Location:Colorado  Entered:2003-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Possible self-innoculation to right collarbone. Very limited, single pustule, with bordering erythema.

VAERS ID:198845 (history)  Vaccinated:1997-02-07
Age:33.0  Onset:1997-02-23, Days after vaccination: 16
Gender:Male  Submitted:2003-03-04, Days after onset: 2200
Location:Unknown  Entered:2003-03-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alopecia
SMQs:
Write-up: Full loss of facial hair. Partial progressive loss of pubic hair. Occasional loss of eye lashes.

VAERS ID:198846 (history)  Vaccinated:1997-02-12
Age:33.0  Onset:1997-02-23, Days after vaccination: 11
Gender:Male  Submitted:2003-03-04, Days after onset: 2200
Location:Unknown  Entered:2003-03-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
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: Alopecia
SMQs:
Write-up: Full loss of facial hair. Partial progressive loss of pubic hair. Occasional loss of eye lashes.

VAERS ID:198847 (history)  Vaccinated:1997-02-13
Age:33.0  Onset:1997-02-23, Days after vaccination: 10
Gender:Male  Submitted:2003-03-04, Days after onset: 2200
Location:Unknown  Entered:2003-03-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (JE-VAX)AVENTIS PASTEUR    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alopecia
SMQs:
Write-up: Full loss of facial hair. Partial progressive loss of pubic hair. Occasional loss of eye lashes.

VAERS ID:198923 (history)  Vaccinated:2003-01-09
Age:33.0  Onset:2003-01-09, Days after vaccination: 0
Gender:Male  Submitted:2003-02-26, Days after onset: 48
Location:Unknown  Entered:2003-03-06, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Itching, urticaria. Rx: Benadryl

VAERS ID:199122 (history)  Vaccinated:2003-02-18
Age:33.0  Onset:2003-02-22, Days after vaccination: 4
Gender:Male  Submitted:2003-03-05, Days after onset: 11
Location:Idaho  Entered:2003-03-10, 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: Wellbutrin AC
Diagnostic Lab Data: Strep culture positive
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710SCLA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Bacterial infection, Cough, Erythema, Fatigue, Headache, Hyperhidrosis, Lymphadenopathy, Nausea, Pharyngolaryngeal pain, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)
Write-up: Pt reported temp 100.3, some L side anterior cervical LN redness, went home and slept unusual called in MN 0000 Sat and had fatigue, sore throat, nausea and vomiting,sweats, fever, chills. Placed on quarters Sat rx''d with motrin, tylenol helped with headache. Presented to ED on Sun. strep test positive. Begun on Amoxil 500mg TID on Sun. continue with Motrin and Tylenol. Placed on quarters on Sun. Today symptoms are improving, felt decreased energy persisting. Today feels ?, but not normal. Today temp is up and he was wondering if his cough may be something in his chest. Pt has dysphoresis.

VAERS ID:199124 (history)  Vaccinated:2003-03-03
Age:33.0  Onset:2003-03-03, Days after vaccination: 0
Gender:Male  Submitted:2003-03-05, Days after onset: 2
Location:Delaware  Entered:2003-03-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)SANOFI PASTEUR248AA1SC 
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEUR254AA1SC 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Pain, Pain in jaw
SMQs:, Osteonecrosis (broad), Arthritis (broad)
Write-up: Severe aching in left jaw, joint 11 hrs post vax. Persisted for about 12 hrs. Required a trip to ER in middle of night for pain.

VAERS ID:199173 (history)  Vaccinated:2002-12-26
Age:33.0  Onset:2002-12-26, Days after vaccination: 0
Gender:Male  Submitted:2003-02-19, Days after onset: 55
Location:Idaho  Entered:2003-03-11, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: N/A
CDC Split Type: ID03013
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS733A61IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Dizziness, Eye oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Ten hrs after 2nd Hep A, PT''s eyes started itching and he developed sclera edema. Stated he was light headed, skin felt "funny", rather cold to touch. He took Benadryl and went to a friend''s house to be observed. After he slept he felt fine.

VAERS ID:199249 (history)  Vaccinated:2003-03-07
Age:33.0  Onset:0000-00-00
Gender:Male  Submitted:2003-03-11
Location:Unknown  Entered:2003-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0701IMRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710IDLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Feeling hot, Oedema, Pruritus, Rash erythematous
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Vital signs stable. Pt had large erythematous rash that extended down his post. aspect of right arm, 24 hours after vaccination. Area was warm to the touch. Another area of eyrthema was noted on medial aspect of same arm that was also edematous and warm. Both areas had blanching erythema and was not tender. Pt reported purrtis. Pt denied any airway problems. Pt treated with antihistamines and instructed to follow up in 1 week.

VAERS ID:199265 (history)  Vaccinated:2003-02-08
Age:33.0  Onset:2003-02-15, Days after vaccination: 7
Gender:Male  Submitted:2003-02-16, Days after onset: 1
Location:Unknown  Entered:2003-03-11, 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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200711 LA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Rash, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt reports rash on upper back, chest, arms. Multiple <1cm macular erythematous lesions on upper back, chest, arms, no pustules.

VAERS ID:199286 (history)  Vaccinated:2003-02-28
Age:33.0  Onset:2003-03-10, Days after vaccination: 10
Gender:Male  Submitted:2003-03-11, Days after onset: 1
Location:California  Entered:2003-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710 LA
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Pyrexia, Rash erythematous, Rash papular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 33 y/o male presented to clinic 11 days post vaccination with pruritic papular rash to trunk-discrete erythematous papules approx. 15 chest/approx. 15 back-present x 2 day, also c/o fever x 4 days previous. No treatment.

VAERS ID:199471 (history)  Vaccinated:2003-02-25
Age:33.0  Onset:2003-02-27, Days after vaccination: 2
Gender:Unknown  Submitted:2003-03-13, Days after onset: 14
Location:Texas  Entered:2003-03-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Skin ulcer, Vaccination complication
SMQs:
Write-up: satellite lesions on trunks and chest since leaving smallpox site unbandaged; suspect self innoculation; referral to Dermatology Clinic

VAERS ID:199508 (history)  Vaccinated:2002-02-26
Age:33.0  Onset:2002-02-26, Days after vaccination: 0
Gender:Female  Submitted:2003-03-07, Days after onset: 374
Location:New York  Entered:2003-03-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Diabetes Mellitus NOS
Preexisting Conditions:
Diagnostic Lab Data: BP 120/90, blood glucose within normal limits.
CDC Split Type: WAES0203USA00897
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.6410711069L1IM 
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Diarrhoea, Dizziness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Info has been rec''d concerning a pt with diabetes mellitus who was vaccinated with her 2nd hepatitis vaccine. (lot #641071/1069L) IM. The pt complained of weakness and was feeling nauseated, dizzy, and queasy within 10 min of receiving the 2nd dose. The pt''s vital signs were BP 120/98, P 64 and R 20. The pt was given a finger stick and her glucose was found to be within normal limits. The pt was advised to sit and rest and take ice chips and later "something bland". She was advised to lie down and rest. It was noted that the pt did not have breakfast and was given tea and toast. The pt felt better and went home at 12 Noon and was told to see her own physician if the symptoms persisted. Later, the pt had vomiting and diarrhea. She then called her doctor, who ordered treatment that was unavailable at the local pharmacy, then kaolin (Kaopectate) was ordered. The pt improved and the symptoms subsided. The doctor recommenced that she not receive the 3rd dose. It was reported that the pt recovered on 2/2/02. No further information is expected.

VAERS ID:199613 (history)  Vaccinated:2003-03-04
Age:33.0  Onset:2003-03-04, Days after vaccination: 0
Gender:Female  Submitted:2003-03-12, Days after onset: 8
Location:Missouri  Entered:2003-03-14, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BC Pills (Trivora)
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MO200327
Vaccination
Manufacturer
Lot
Dose
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Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200760IDLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Headache, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad)
Write-up: Smallpox vaccine 3-4-03-started with N/V, dizziness, severe headache, excessive sleep-mid cycle BCP but that night started menses. All symptoms started 8 hours after vaccination.

VAERS ID:199642 (history)  Vaccinated:2003-02-24
Age:33.0  Onset:2003-02-27, Days after vaccination: 3
Gender:Female  Submitted:2003-03-15, Days after onset: 16
Location:Maryland  Entered:2003-03-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IDUN
Administered by: Public     Purchased by: Public
Symptoms: Aphthous stomatitis, Discomfort, Nasal congestion, Skin ulcer, Swelling, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Vaccinee developed small red tender/painful spot under tongue on day 3 post-smallpox vaccination. Over next two days, lesion progressed from what was described as bubble like into an ulcer. Mouth lesion progressed much faster than vaccination site lesion. Appearance and progression consistent with aphthous ulcer, although vaccinee did not report history of similar mouth lesions. No fever. Mild "sinus congestion" reported. Brief episode of bilateral hand "puffiness" and knee discomfort which resolved in less than a day. Aside from vaccination site, no other skin lesions. No history of skin disorders/eczema/atopic dermatitis. Mouth lesion resolved by day 11. Vaccinee had documented major reaction. No other unusual symptoms reported.

VAERS ID:199916 (history)  Vaccinated:2003-03-13
Age:33.0  Onset:2003-03-13, Days after vaccination: 0
Gender:Male  Submitted:2003-03-18, Days after onset: 5
Location:Texas  Entered:2003-03-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020077 PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Dysphonia, Pharyngeal oedema, Respiratory distress
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Hypersensitivity (narrow), Respiratory failure (narrow)
Write-up: 12 hours after vaccine delivery(primary recipent)with swelling of soft palate, uvula, and hoarseness. No other signs of anaphylaxis-hypotension, urticaria, wheezing, etc. Did self-treat with bronchodilators(Ventolin/Atrovent)at home with some respiratory distress. Works in ER, went to see physician; large uvula, swollen tonsils, some edema of soft palate remaing. No wheezing, vaccine site clean, no derm lesions, normal vital signs. Place on antihistamines--chose atarax to avoid somnolence of benadryl. Offered urticaria dosing of alternating benadryl (4-6mg/kg/day)--physician and patient chose atarax alone. Spoke with CDC about use of corticosteriods if fails antihistamines. CDC concurred with use needed, use traditional dosing but limit # of days once symptoms resolve. Exposure to adults at work with respiratory illness. Never with symptoms like this before, no history of aeroallergens, no consistent use of medications, no current medications. No contraindication to vaccine delivery. No family history angioedema. Only intermittently with wheeze-Nebmask 1-2 times/quarter. No known vaccine adverse events . No known sensitivity to phenol, thimerosal, polymyxin, neomycin, or streptomycin. Works with many aerolized medications on a daily basis, no problems.

VAERS ID:199967 (history)  Vaccinated:2003-02-05
Age:33.0  Onset:2003-02-11, Days after vaccination: 6
Gender:Male  Submitted:2003-03-19, Days after onset: 36
Location:Virginia  Entered:2003-03-20, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Hay fever
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURU0824AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Prolonged pain L shoulder following injection.

VAERS ID:200001 (history)  Vaccinated:2002-11-21
Age:33.0  Onset:2002-11-22, Days after vaccination: 1
Gender:Female  Submitted:2002-12-02, Days after onset: 10
Location:Georgia  Entered:2003-03-21, Days after submission: 109
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Erythromycin; Depakote 500mg; Klonopin 1mg TID
Current Illness: NONE
Preexisting Conditions: Penicillin, Codeine and Sulfur and bee sting allergies; Bipolar disorder
Diagnostic Lab Data: On 11/15/02, MMR Titer with neg immunity to Rubeola 0.71; states she has had 3 MMR vaccinations before.
CDC Split Type: GA03012
Vaccination
Manufacturer
Lot
Dose
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Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0434M3SCLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pruritus, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Reports having itching in area on 11/22/02. Saw vesicles around area on 11/25/02 and reported. Client states redness and swelling began on 12/2/02; 4cm X 11 1/2cm (3 1/2" X 4 1/2"), left mid upper arm. Client reports she has used ice and Eucerin Cream when area started itching and began using ice soaks when area started hurting on 11/28/02. Above symptoms gone after 48 hours. At ER, was given Keflex 500mg TID, Naproxen and Allegra and to follow-up with PMD in 4 days, (12/05/02).

VAERS ID:200018 (history)  Vaccinated:2003-03-17
Age:33.0  Onset:2003-03-19, Days after vaccination: 2
Gender:Male  Submitted:2003-03-21, Days after onset: 2
Location:Unknown  Entered:2003-03-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0732IMRA
Administered by: Military     Purchased by: Military
Symptoms: Discomfort, Injection site erythema, Injection site hypersensitivity, Injection site swelling, Pain, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Large local reaction to anthrax vaccine #3. Upper arm is grossly swollen; erythematous, flat, well demarcated patch that is circumfrential around the vaccine site; maximum diameter $g10 cm; pt reports itching and some pain; mild muscle disformort and "tingling reported" - because of prior reaction history this dose given shallow IM per DOD recommendations. Reports similar, but much larger, reaction to vaccination #2 - (FAV 065 - given 13 Jan 2003).

VAERS ID:200065 (history)  Vaccinated:2003-03-13
Age:33.0  Onset:2003-03-15, Days after vaccination: 2
Gender:Male  Submitted:2003-03-20, Days after onset: 5
Location:California  Entered:2003-03-24, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness: NONE
Preexisting Conditions: Diabetes type I
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1196M0IMRA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0823AA IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site induration, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Fever 101.3 injection/warmth at slight with induration on RUA.

VAERS ID:200290 (history)  Vaccinated:2003-02-12
Age:33.0  Onset:2003-02-12, Days after vaccination: 0
Gender:Female  Submitted:2003-03-18, Days after onset: 34
Location:Washington  Entered:2003-03-26, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: FB-cut to scalp
Preexisting Conditions: History of migraine headache; right shoulder repair
Diagnostic Lab Data: Head CT; also had FB in scalp; Lab work-Lytes, BUN, CR, Glucose; CBC; ESR
CDC Split Type:
Vaccination
Manufacturer
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TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0816AA IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Injection site swelling, Injection site warmth, Injury, Joint range of motion decreased, Migraine, Pruritus, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt given TD on 2/12/03. Complains of migraine headache also on 2/13/03. Returns to clinic with nausea, warm and swollen at injection site; pain radiating to armpit and shoulder. Gave her a Depo-Medrol shot. On 2/14/03 she returned with vomiting, nausea and itching. Headache continues. Gave her Phenergan. On 3/3/03, pain still present in arm. On 3/5/03, arm still bad with decreased ROM.

VAERS ID:200532 (history)  Vaccinated:2001-02-08
Age:33.0  Onset:2001-02-13, Days after vaccination: 5
Gender:Male  Submitted:2003-03-29, Days after onset: 774
Location:California  Entered:2003-03-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Indomethacin for Reactive Arthritis
Current Illness: None
Preexisting Conditions: Reactive Arthritis from 1992, in legs, feet and sacroiliac
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
DT: DT ADSORBED (NO BRAND NAME)BSIUNKNOWN0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Condition aggravated, Joint range of motion decreased, Pain, Radiculitis brachial
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Brachial Neuritis (self-diagnosis). Both arms and both wrists sore. Was unable to lift arms above head. Appeared within about 1 week. Mostly cleared up in next 2 weeks. Pain persists in left wrist for 2+ years, but could be due to pre-existing Reactive Arthritis

VAERS ID:200498 (history)  Vaccinated:2003-02-28
Age:33.0  Onset:2003-03-12, Days after vaccination: 12
Gender:Male  Submitted:2003-03-21, Days after onset: 9
Location:Missouri  Entered:2003-03-31, Days after submission: 10
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Troponia up to 20; Cardiac cath negative; Positive EKG''s; PPD
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV072   
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4020040   
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5305A6   
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM746A2   
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURW0620   
MEN: MENINGOCOCCAL (MENOMUNE)SANOFI PASTEURUB273AA   
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Laboratory test abnormal, Myocarditis
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Smallpox related myocarditis, chest pain, Troponin up to 20 day 12 of smallpox. See executive summary 3/13/03.

VAERS ID:200667 (history)  Vaccinated:2003-01-31
Age:33.0  Onset:2003-02-07, Days after vaccination: 7
Gender:Female  Submitted:2003-03-25, Days after onset: 46
Location:Wisconsin  Entered:2003-04-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020071   
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site hypersensitivity, Injection site inflammation, Injection site oedema, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Inflammatory reaction at site of smallpox vaccination (swelling, redness, itching, axilla tenderness).

VAERS ID:200726 (history)  Vaccinated:2003-03-17
Age:33.0  Onset:2003-03-23, Days after vaccination: 6
Gender:Male  Submitted:2003-03-26, Days after onset: 3
Location:Maryland  Entered:2003-04-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Caough
Preexisting Conditions: NONE
Diagnostic Lab Data: All negative (CBC,Sed Rate)
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0702 RA
Administered by: Military     Purchased by: Other
Symptoms: Anxiety, Intention tremor, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Fine intention tremor, mylagias, restlessness (anxiety)

VAERS ID:200775 (history)  Vaccinated:2003-03-17
Age:33.0  Onset:2003-03-17, Days after vaccination: 0
Gender:Female  Submitted:2003-03-26, Days after onset: 9
Location:Minnesota  Entered:2003-04-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Miletonor?, TCN, Differinger
Current Illness: NONE
Preexisting Conditions: Sensitive to anesthesia
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEUR6082AA1IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: PT developed malaise transient fever, nausea and arthralgia.

VAERS ID:200800 (history)  Vaccinated:2003-03-17
Age:33.0  Onset:2003-03-17, Days after vaccination: 0
Gender:Female  Submitted:2003-03-25, Days after onset: 8
Location:Kansas  Entered:2003-04-02, 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: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: KS200317
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0940M0 LA
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 03/17/2003 09:20am received Hep B #1. 30 mins later left arm sore and nauseated feeling. Felt better next day but still sore. Nausea stayed for 3 days. Hep B site still sore today 03/25/2003.

VAERS ID:200844 (history)  Vaccinated:2003-03-21
Age:33.0  Onset:2003-03-22, Days after vaccination: 1
Gender:Female  Submitted:2003-04-01, Days after onset: 10
Location:Florida  Entered:2003-04-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Iron Supplement
Current Illness: NONE
Preexisting Conditions: Anemia-Iron deficet
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0380AB IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site pain, Injection site warmth, Joint range of motion decreased, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Per pt, left upper arm, swollen, red, hot with radiation to axilla and swollen left axillary nodes. Could not close arm. Given Keflex PO and then IM as worsens. Seen our office 04/01/2003 at 3:15. Left deltoid quarter size area of induration and tenderness only. All of them Sx resolved.

VAERS ID:200945 (history)  Vaccinated:2003-03-18
Age:33.0  Onset:2003-03-28, Days after vaccination: 10
Gender:Female  Submitted:2003-03-31, Days after onset: 3
Location:West Virginia  Entered:2003-04-04, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Motrin, Ativan
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770 RA
Administered by: Public     Purchased by: Other
Symptoms: Chest pain, Myalgia, Pain, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Went to ER because of muscle aches, tenderness in right axillary and substernal chest pain. Pain was worse w/palpitation. Dx''d as muscular / skeletal pain. Sent home w/muscle relaxants and pain med.

VAERS ID:200971 (history)  Vaccinated:2003-03-07
Age:33.0  Onset:2003-03-09, Days after vaccination: 2
Gender:Male  Submitted:2003-03-13, Days after onset: 4
Location:Unknown  Entered:2003-04-07, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0692SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: EDGM and pain (approx 10in x 5in) extending from anthrax site to below elbow. Tx: Cipro 500mg x five days bid.

VAERS ID:201022 (history)  Vaccinated:2002-10-15
Age:33.0  Onset:2002-10-15, Days after vaccination: 0
Gender:Female  Submitted:2003-04-07, Days after onset: 174
Location:Pennsylvania  Entered:2003-04-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: HIV positive x 8 years
Preexisting Conditions: HIV positive x 8 years, asthma
Diagnostic Lab Data: All cultures were negative, lab values were esentiallynormal.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERNOT KNOWN0  
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURERNOT KNOWN0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Agitation, Headache, Malaise, Mental impairment, Musculoskeletal stiffness, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: One hour after receiving hepatitis B vaccine and flu vaccine, patient became agitation, with mental status changes with no clear cause, headache with a stiff neck, overall malaise, myalgia and a fever. Patient admitted for observation. Given acetaminophen and tests were performed to rule out an infectious process.

VAERS ID:201035 (history)  Vaccinated:2003-04-04
Age:33.0  Onset:2003-04-05, Days after vaccination: 1
Gender:Male  Submitted:2003-04-07, Days after onset: 1
Location:Pennsylvania  Entered:2003-04-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Allergy to Smallpox vaccine
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0733SCRA
Administered by: Military     Purchased by: Military
Symptoms: Face oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: No adverse reactions at time of vaccine. Pt awoke next am at 0600 with swelling to face. Hives to neck, trunk, and arms were also present.

VAERS ID:201182 (history)  Vaccinated:2003-03-17
Age:33.0  Onset:2003-03-25, Days after vaccination: 8
Gender:Male  Submitted:2003-03-25, Days after onset: 0
Location:Texas  Entered:2003-04-09, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710  
Administered by: Military     Purchased by: Military
Symptoms: Chills, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Myalgia, fever like chills, inability to work. 2 hrs to discomfort after smallpox vax.

VAERS ID:201358 (history)  Vaccinated:2003-03-27
Age:33.0  Onset:2003-04-04, Days after vaccination: 8
Gender:Male  Submitted:2003-04-10, Days after onset: 5
Location:Alaska  Entered:2003-04-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CBC, Chem 7 UA all with in normal limits
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200711IDLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt presented to local ED with fever to 104 with headache and myalgias (10 day out from Smallpox vaccination). W/u exam all normal, pt followed up in 24 hours with significant resolution of symptoms.

VAERS ID:201573 (history)  Vaccinated:2003-04-01
Age:33.0  Onset:2003-04-01, Days after vaccination: 0
Gender:Male  Submitted:2003-04-08, Days after onset: 6
Location:Utah  Entered:2003-04-16, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0722IM 
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site reaction, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Vax administered on 4/1/03. PT with erythema at inject site on 4/2/03. Gradually increase in size since then. On 4/3/03 ED for cellulitis - abx (antibiotics) started.

VAERS ID:202140 (history)  Vaccinated:2003-03-12
Age:33.0  Onset:2003-04-09, Days after vaccination: 28
Gender:Female  Submitted:2003-04-23, Days after onset: 14
Location:Texas  Entered:2003-04-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: mitral valve prolapse
Diagnostic Lab Data: Echo 4/21/03
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200721IDLA
Administered by: Public     Purchased by: Unknown
Symptoms: Cardiac disorder, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Went to PCP for physical on 4/9/03. Audible murmur detected. Had echocardiogram on 4/21/03 "tricuspid insufficiency". PCP does not think related to Smallpox vaccine. Referred to cardiologist (appt. 4/24/03) Remembers around day 9 of vaccine becoming short of breath. No other cardiac symptoms

VAERS ID:202269 (history)  Vaccinated:2003-03-25
Age:33.0  Onset:2003-03-29, Days after vaccination: 4
Gender:Female  Submitted:2003-04-28, Days after onset: 29
Location:Illinois  Entered:2003-04-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Wellbutrin, Zoloft, Prevacid, Flonase inhaler, Claritin D
Current Illness: NONE
Preexisting Conditions: Hiatal hernia, irritable bowel, hypothyroidism, migraines
Diagnostic Lab Data: 3/29 WBC 7.3-CBC WNL EKG_NSR, RATE 82 Cardiac enzymes _WNL. Chemistry_WNL CXR-WNL D.Dimer-.43 (normal<0.37)
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Chest pain, Dizziness, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: 3/29 Onset at 1400, left anterior chest pain. SOB. Dizzy. Afebrile 3/29 Treatment in ER: GI Cocktail 3/31 left chest discomfort continues-pain under left breast. 4/3 Having less chest discomfort now.

VAERS ID:202454 (history)  Vaccinated:2003-03-20
Age:33.0  Onset:2003-03-30, Days after vaccination: 10
Gender:Male  Submitted:2003-05-01, Days after onset: 31
Location:Oregon  Entered:2003-05-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: General Cold Symptoms
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710SCLA
Administered by: Military     Purchased by: Military
Symptoms: Anorexia, Cellulitis, Chills, Injection site pain, Injection site reaction, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient was weak, no/little appittite, chills, feverish, tenderness to surrounding immunization area. Tenderness and aching to left armpit. Treated for local cellalitis reacton and immunization site at civilian ER.

VAERS ID:202508 (history)  Vaccinated:2003-04-16
Age:33.0  Onset:2003-04-20, Days after vaccination: 4
Gender:Male  Submitted:2003-05-01, Days after onset: 11
Location:Kentucky  Entered:2003-05-02, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: EKG, Cardiac Enzymes, 2DEcho with Doppler, All test negative and normal.
CDC Split Type: KY2003061S
Vaccination
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Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200760IDLA
Administered by: Public     Purchased by: Other
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Sudden onset of continuous sharp stabbing chest pain late evening of 4/20/03. (Vaccine given 10am of 4/16/03) lasting for 2 hours, then subsided. Informed site monitor next day 4/21/03. Taken to ER-EKG neg., no pain. 9am onset of some pain at 12:20pm and back to ER. No treatment. Cardiac evaluation done. Pain subsided 1 hour. Non-cardiac, atypical chest pain. Pleuric.

VAERS ID:202548 (history)  Vaccinated:2003-03-28
Age:33.0  Onset:2003-03-28, Days after vaccination: 0
Gender:Male  Submitted:2003-04-11, Days after onset: 13
Location:Georgia  Entered:2003-05-05, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: Chest x-ray
CDC Split Type: GA03032
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.MSD0819M0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.MSD1146M0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site rash, Injection site swelling, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Severe swelling and rash at site in left arm. Rash moved upward in arm and chest area. Also complained of itching of nose and throat area. Reaction occur 10-12 hr after injection. Client treatment with IM and oral antibiotics.

VAERS ID:202657 (history)  Vaccinated:2003-04-21
Age:33.0  Onset:2003-04-29, Days after vaccination: 8
Gender:Male  Submitted:2003-05-05, Days after onset: 6
Location:Maryland  Entered:2003-05-05
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: Biopsy of lesion reported taken by dermatology clinic on 5/2/03 - specimen reportedly sent to state health lab
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770SCLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Myalgia, Rash erythematous, Rash vesicular, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: 33 yo male s/p day 8 vaccination reports onset that date of approx 6 0.3-0.4 cm erythematous vesicles on his back; lesions non-tender, non-pruritic. Pt otherwise reports (+) major take at vax site, occasional frontal HA relieved with Tylenol, mild generalized myalgias and mild (L) axillary tenderness.

VAERS ID:202750 (history)  Vaccinated:2003-04-25
Age:33.0  Onset:2003-04-30, Days after vaccination: 5
Gender:Female  Submitted:2003-05-06, Days after onset: 6
Location:Texas  Entered:2003-05-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular, Combivent, Advair, Lorcet 10, Protonix, Albuterol, Ambien
Current Illness: None
Preexisting Conditions: Chronic Asthma, Back pain associated with Disc herniation. Reports that she had encephalitis at the age of 6 months of age associated with chickenpox disease.
Diagnostic Lab Data: None
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETHYO200770  
Administered by: Public     Purchased by: Public
Symptoms: Blister, Encephalitis, Fatigue, Headache, Lymphadenopathy, Pyrexia, Rash papular, Rash pustular
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (narrow), Hypersensitivity (narrow)
Write-up: Client reports a reaction to the paper tape as early as 4/26/03, which began to blister. She has been more gentle when removing the tape and not placed it on the same location repeatedly. On 4/30/03 she had onset of headache about bedtime and rates the pain at "5-6" on a scale of 1-10, "low grade temp and fatigue". She took Lorcet 10, 2 po and went to bed. Upon waking 5/01/03 she had headache "10+", stayed home from work, experienced fatigue and states she felt worse than she has ever felt before. Looking back she believes she should have called 911. She took Lorcet 10, 2 po and Ambien. For 5/02/03 she rates her headach @ "4" daily through 5/05/03. Today her headache is at "5" and began having lymphadenopathy to Left axillary region 5/02 - 5/05 and then bilaterally thru today 5/06. Her paper tape reaction is "almost completely healed". She saw the facilities medical director on 5/02/03 for skin assessment and c/o headache. She told the doctor about AE encephalitis and he was not concerned with this case. She was seen by ER on 5/05/03 and he also reportedly was not concerned with that as an adverse effect of vaccination as reported by this client. Today 5/06/03 she states that she has had "pustules, papules, ''zits''" on her breasts and back that she relates to stress. She states they do not look like her arm. Dr. assessed these as well on 5/05/03. Client has no history of headaches and continues to experience pain but is back at work. It is reported that she is one to never miss work.

VAERS ID:202929 (history)  Vaccinated:2003-04-14
Age:33.0  Onset:2003-04-19, Days after vaccination: 5
Gender:Female  Submitted:2003-05-12, Days after onset: 23
Location:Georgia  Entered:2003-05-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazadone
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EKG, CKR & LABS all reported normal
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200410IM 
Administered by: Other     Purchased by: Public
Symptoms: Chest pain, Dyspnoea, Hyperventilation
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: 5 days post vaccinia vaccination on 04/19/2003 awoke at 04:30 with "severe" mid sternal chest pain which lasted approximately 10 min. Said had episodes of pain off and on throughout the day also some short of breath with activity and high in pain with deep breathing. To hospital ER 04/19/2003 approximately 22:00 EKG, Labs, and CKR- all normal states diagnosed with dostochondritis and start anti inflammatory meds.

VAERS ID:203070 (history)  Vaccinated:2003-01-29
Age:33.0  Onset:2003-01-31, Days after vaccination: 2
Gender:Female  Submitted:2003-02-10, Days after onset: 10
Location:Ohio  Entered:2003-05-14, Days after submission: 92
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Folic Acid supplement
Current Illness: NONE
Preexisting Conditions: PCN allergy, Endometriosis
Diagnostic Lab Data: MRI ordered by Chiropractor to evaluate vision and neck problems and questions possible pinches. MRI 02/10/2003 @ 14:00
CDC Split Type:
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0632 SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Lymphadenopathy, Neck pain, Rash, Visual disturbance
SMQs:, Anaphylactic reaction (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 01/31/2002: Visual disturbance, flashing lights x 1 day, neck pain. 02/09/2003: Rash to stomach and chest, swollen glands in neck, lump in back of neck to Left side midway between ear and midline of neck at base of neck.

VAERS ID:203098 (history)  Vaccinated:2003-04-18
Age:33.0  Onset:2003-04-28, Days after vaccination: 10
Gender:Female  Submitted:2003-05-02, Days after onset: 4
Location:Rhode Island  Entered:2003-05-14, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0572M0SCRL
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Injection site erythema, Injection site reaction, Rash papular
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 2-4cm papules in R upper arm. Erythema, possible cellulitis. Prescribed dicloxicillin 250 6hr x 5d.

VAERS ID:203189 (history)  Vaccinated:2003-05-07
Age:33.0  Onset:2003-05-08, Days after vaccination: 1
Gender:Male  Submitted:2003-05-15, Days after onset: 7
Location:Missouri  Entered:2003-05-15
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: unknown
Diagnostic Lab Data:
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 2SCUN
Administered by: Military     Purchased by: Military
Symptoms: Discomfort, Erythema, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: 18 X 18 cm area of swelling and erythema on posterior arm Given Kenalog 0.1% topical and Ibuprofen 800mg Q8 hours prn w/ food for discomfort

VAERS ID:203313 (history)  Vaccinated:2003-03-10
Age:33.0  Onset:2003-03-12, Days after vaccination: 2
Gender:Female  Submitted:2003-05-16, Days after onset: 64
Location:Missouri  Entered:2003-05-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS753D60IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Discomfort, Fatigue, Musculoskeletal discomfort
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Complaint of fatigue, muscle and joint discomfort, effecting mostly her back, neck and shoulders which began 48 hours after receiving immunization. Self-medicated with ibuprofen p.r.n., symptoms resolved in three to four weeks time.

VAERS ID:203296 (history)  Vaccinated:2003-05-05
Age:33.0  Onset:2003-05-06, Days after vaccination: 1
Gender:Male  Submitted:2003-05-12, Days after onset: 6
Location:Maine  Entered:2003-05-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Propranolol 20 mg BID, aspirin 81 mg a day
Current Illness: NONE
Preexisting Conditions: hypertension, obesity
Diagnostic Lab Data:
CDC Split Type:
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0829AA0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Diffuse hives starting morning after vaccine (awoke with them). No other new medicines.

VAERS ID:203611 (history)  Vaccinated:2003-05-13
Age:33.0  Onset:2003-05-15, Days after vaccination: 2
Gender:Male  Submitted:2003-05-16, Days after onset: 1
Location:Utah  Entered:2003-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase nasal spray
Current Illness: NONE
Preexisting Conditions: Patient on Flonase for allergic rhinitis
Diagnostic Lab Data: NONE
CDC Split Type:
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0823AA1 LA
Administered by: Public     Purchased by: Public
Symptoms: Feeling hot, Hypersensitivity, Injection site oedema
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Swollen, tender, red, hot area at injection site. Keflex started 500mg RO BID x 7 days. Follow up on Monday-to urgent care of worse.

VAERS ID:203630 (history)  Vaccinated:0000-00-00
Age:33.0  Onset:2003-05-20
Gender:Female  Submitted:2003-05-23, Days after onset: 3
Location:Wisconsin  Entered:2003-05-23
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:
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 33 YO F NOT VACCINATED; NON-ITCHY RASH; NO HISTORY OF CONTACT WITH VACINEES; FINAL DX: RASH NOT ASSOCIATED WITH VACCINIA.

VAERS ID:204008 (history)  Vaccinated:2003-05-15
Age:33.0  Onset:2003-05-25, Days after vaccination: 10
Gender:Male  Submitted:2003-05-30, Days after onset: 5
Location:Alabama  Entered:2003-05-30
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
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710IDLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema multiforme, Rash macular, Skin ulcer
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Erythema multiforme at day 10 on back; resolved within a few days. No vesicle, only classic iris lesions and macules.

VAERS ID:204014 (history)  Vaccinated:2002-04-29
Age:33.0  Onset:2002-04-29, Days after vaccination: 0
Gender:Female  Submitted:2003-05-27, Days after onset: 393
Location:Maryland  Entered:2003-06-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 60 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol Sinus
Current Illness:
Preexisting Conditions: Sinusitis
Diagnostic Lab Data:
CDC Split Type: WAES0205USA01112
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug administration error, Premature baby, Unintended pregnancy
SMQs:, Neonatal disorders (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a physician through the pregnancy registry concerning a 33 year old female with a history of sinusitis and no known drug allergies who on 4/29/02 was vaccinated with a dose of varicella virus vaccine live. Concomitant therapy included acetaminophen/pseudoephedrine HCl that was used twice during the past month. On 5/8/02 it was reported that the patient is now pregnant with her LMP 4/8/02. Her estimated delivery date was determined to be 1/13/03. Unspecified medical attention was sought. On 5/10/02 it was reported that the physician will not be following the patient''s pregnancy. On 5/13/03, it was reported that the physician did not have any pregnancy outcome information and had only seen the patient in the clinic one time. On 5/16/03 information was received from the physician who had spoken to the patient''s husband (the patient was out of the country). It was reported that on 10/29/02 at 29 weeks gestation the patient delivered an approximately 3lb 6oz infant. It was reported that there was no infection and that the baby was hospitalized for 2 months to grow and is doing well now. Upon internal review, the patient delivered at 29 weeks gestation was determined to be an other important medical event (OMIC). No further information is available.

VAERS ID:204157 (history)  Vaccinated:2001-07-01
Age:33.0  Onset:2003-01-21, Days after vaccination: 569
Gender:Male  Submitted:2003-05-28, Days after onset: 126
Location:Illinois  Entered:2003-06-03, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Serum hepatitis A (01/21/2003): negative titer
CDC Split Type: 0302USA01293
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0408L1  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a person in a doctor''s office concerning a 33 year old male with no past medical history who in January 2001 and on July 2001 was vaccinated with a first (lot @ 634178/1330K) and second dose (lot @ 636384/0408L) of hepatitis A virus vaccine inactivated, respectively. There were no concomitant medications. On 02/11/2003 it was reported that a "titer was drawn 2 to 3 weeks ago." The titer was negative. The patient sought unspecified medical attention. Additional information has been requested.

VAERS ID:204207 (history)  Vaccinated:2003-05-28
Age:33.0  Onset:2003-05-30, Days after vaccination: 2
Gender:Female  Submitted:2003-05-30, Days after onset: 0
Location:Virginia  Entered:2003-06-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Zofran allergy
Diagnostic Lab Data:
CDC Split Type: VA03009
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0032N1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 36 hours after injection developed generalized itching at injection site, also hives. Denies SOB or edema. Denies food allergy. Refer to PCP. Self-administered Benadryl.

VAERS ID:204302 (history)  Vaccinated:2002-04-09
Age:33.0  Onset:2002-05-20, Days after vaccination: 41
Gender:Female  Submitted:2003-05-30, Days after onset: 375
Location:Pennsylvania  Entered:2003-06-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Ibuprofen, Levaquin, Sudafed, Cold-Eeze (zinc gluconate). Tubersol (Aventis Pasteur) 4/5/2002
Current Illness: Upper respiratory tract infection
Preexisting Conditions: Depression, Migraine
Diagnostic Lab Data: Serum measles IgG (04/04/02) 0.96 - equivocal. Serum measles IgG (05/20/02) 0.87 - lower than baseline.
CDC Split Type: WAES0206USA01183
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1093L SC 
Administered by: Private     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: Information has been received from a registered nurse concerning a 33 year old female nurse with a history of migraines and depression who on 04/04/2002 tested "equivocal" for a measles (rubeola) titer with a value of 0.96. On 04/05/2002 the pt was vaccinated with a third dose of tuberculin (TUBERSOL). On 04/09/2002 the pt was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) (lot #640634/1093L) SC in the left arm. It was reported that the pt had an afebrile upper respiratory illness at the time of vaccination. Concomitant therapy included bupropion HCl (WELLBUTRIN), levofloxacin (LEVAQUIN), pseudoephedrine HCl (SUDAFED), ibuprofen and zinc gluconate (COLD-EEZE). On 05/20/2002, a repeat rubeola titer was performed with a value of 0.87. The repeat titer post vaccination was lower than the baseline titer. Unspecified medical attention was sought. It was reported that the pt was to receive no further intervention. No additional info is expected.

VAERS ID:204593 (history)  Vaccinated:2003-05-22
Age:33.0  Onset:2003-05-28, Days after vaccination: 6
Gender:Female  Submitted:2003-06-05, Days after onset: 8
Location:Utah  Entered:2003-06-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: none
Diagnostic Lab Data: na
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)BSIU0827AA1IMLA
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS23BA61IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injection site inflammation, Lymphadenopathy, Pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Arm was red and inflammed and painful. Pain radiated from her arm up her neck with swollen lymph node.

VAERS ID:205063 (history)  Vaccinated:2003-06-07
Age:33.0  Onset:2003-06-07, Days after vaccination: 0
Gender:Male  Submitted:2003-06-10, Days after onset: 3
Location:Michigan  Entered:2003-06-18, 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: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0713SCLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURW090923IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness in area of anthrax, injection about baseball size

VAERS ID:205351 (history)  Vaccinated:2003-05-04
Age:33.0  Onset:2003-05-05, Days after vaccination: 1
Gender:Male  Submitted:2003-06-24, Days after onset: 50
Location:Pennsylvania  Entered:2003-06-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: no
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0732IMRA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Headache, Hypoaesthesia, Injection site oedema, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 24 y/o male recieved Antrhax vaccine #3. On day 2 developed pruritis, erythema and swelling extending from site of injection to elbow. Mild H/A x 1 day, experienced mild numbness tingling in the tricep muscle. Afebrile, denies myalgia, arthralgia.

VAERS ID:205400 (history)  Vaccinated:2003-04-18
Age:33.0  Onset:0000-00-00
Gender:Female  Submitted:2003-05-04
Location:Oklahoma  Entered:2003-06-25, Days after submission: 52
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0714  
Administered by: Military     Purchased by: Military
Symptoms: Oedema, Skin ulcer
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Joint swelling, after shot along with hive-like lesions throughout leaving hyperpigmented areas. 1st 2 symptoms gone, 3rd improving. 1st shot about 4 years ago. Last about 3 weeks ago.

VAERS ID:206036 (history)  Vaccinated:2003-06-25
Age:33.0  Onset:2003-06-26, Days after vaccination: 1
Gender:Male  Submitted:2003-06-27, Days after onset: 1
Location:Wisconsin  Entered:2003-07-10, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Azmacort, Albuterol
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0838AA IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURW13660 LA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Myalgias, low grade temp, chills. Advil and Tylenol as of 6/27.

VAERS ID:206145 (history)  Vaccinated:2003-06-05
Age:33.0  Onset:0000-00-00
Gender:Female  Submitted:2003-07-10
Location:North Dakota  Entered:2003-07-14, Days after submission: 4
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: Ibuprofen
Current Illness: NONE
Preexisting Conditions: Cervical cancer, past miscarriages, pharyngitis
Diagnostic Lab Data: CRP, creatinine kinase, urine, albumin, CBC-normal Discharge summary states lab tests abnormal. msv
CDC Split Type: ND0310
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0736AA   
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Dizziness, Dyspnoea, Encephalitis, Influenza like illness, Laboratory test abnormal, Memory impairment, Neuropathy, Pain, Paraesthesia, Throat tightness, Tremor, Vertigo, Vomiting, Weight increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Throat constriction, flu-like symptoms first 5 days pain in right hand occasionally, trouble breathing after discharged, arm pain and jaw achy, left leg pain at times. Tx-Precnisone, Xanax. The follow up received on 11/20/03 states loss of short term memory, weight gain, sore joints, numbness and tingling in extremities, being seen at neurology clinic, and moving to another state. Discharge summary states vertigo, encephalitis, dizzy, vomiting, neuropathy and tremor. msv

VAERS ID:206292 (history)  Vaccinated:2002-11-22
Age:33.0  Onset:2002-11-22, Days after vaccination: 0
Gender:Female  Submitted:2003-07-08, Days after onset: 227
Location:Utah  Entered:2003-07-16, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0932AA  LA
Administered by: Other     Purchased by: Private
Symptoms: Bursitis
SMQs:
Write-up: Left shoulder bursitis 2 hours vaccine administered too high in arm.

VAERS ID:206340 (history)  Vaccinated:2003-06-20
Age:33.0  Onset:2003-06-20, Days after vaccination: 0
Gender:Female  Submitted:2003-07-16, Days after onset: 26
Location:Colorado  Entered:2003-07-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURUW23AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Feeling hot, Influenza like illness, Injection site mass, Myalgia, Skin burning sensation
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)
Write-up: On 06/20/2003, pt. received a TD immunization for facial burns. On June 25th, she presented to ED fpr a recheck of the burns, but also c/o flu-like symptoms (muscle aches). Injection site with a 2 cm nodule, mild erythema and warmth.

VAERS ID:206341 (history)  Vaccinated:2003-03-05
Age:33.0  Onset:2003-04-21, Days after vaccination: 47
Gender:Female  Submitted:2003-07-16, Days after onset: 86
Location:Hawaii  Entered:2003-07-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: PCR from a touch prep of the lesion taken on 4/23/03 was negative for vaccinia nucleic acid. This test was performed by the Department of Health State Laboratory.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IDLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site vesicles, Migraine
SMQs:
Write-up: Approximately six weeks after vaccination, patient developed multiple small vesicles at her vaccination site that remained for two weeks. She had no pruritus, induration, swelling, or drainage at this area. No treatment was needed other than a dressing over the vesicles until they resolved. In the 8 weeks post-vaccination, patient experience five migraine headaches. Normally she only has about one migraine per year. She self-treated the headaches and has not had any further.

VAERS ID:206537 (history)  Vaccinated:2003-06-10
Age:33.0  Onset:2003-06-20, Days after vaccination: 10
Gender:Male  Submitted:2003-07-18, Days after onset: 28
Location:Maryland  Entered:2003-07-23, 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: Raynaud''s syndrome (1995), MVP (1991), lactose intolerance (childhood)
Diagnostic Lab Data: CPK not ordered because the pt''s vigorous physical exercise regimen and reported generalized muscle soreness.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0707SCRA
Administered by: Military     Purchased by: Military
Symptoms: Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Onset of weakness left shoulder approx 4 days after receipt of AVA booster SC in skin over right deltoid. Pt reported to clinic on 07/01/03. Examination revealed 4+15 weakness of abduction at 45 degrees of right shoulder extension. No sensory loss. DTRs normal. Plantars, no tingling, numbness. Spine WNL.

VAERS ID:206626 (history)  Vaccinated:2003-07-22
Age:33.0  Onset:2003-07-24, Days after vaccination: 2
Gender:Female  Submitted:2003-07-24, Days after onset: 0
Location:New York  Entered:2003-07-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Depakote
Current Illness: None
Preexisting Conditions: Penicillin sensitivity
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0528AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Fatigue, Injection site oedema, Injection site warmth, Malaise, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Injection site left deltoid was firm, warm,tender,and edematous measuring 6cm x 6cm.Left supraclavicular area edematous, spongy,and tender 48 hrs following tetanus injection pt.sought treatment. Also complained of general malaise and fatigue. She was afebrile: temp. oral 97.8

VAERS ID:206752 (history)  Vaccinated:2003-07-22
Age:33.0  Onset:2003-07-22, Days after vaccination: 0
Gender:Female  Submitted:2003-07-23, Days after onset: 1
Location:California  Entered:2003-07-29, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0835M2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Dizziness, Hyperhidrosis, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad)
Write-up: Patient began feeling lightheaded and nausea, followed by intense sweating. Small amount of vomit. Proceeded to feel full body arthralgia, primarily acute in lower limbs. Patient stated it was painful to walk. She received some relief from ibuprofen and heat. Continues to have bone pain below the waist on day follow up. Refer to ER since clinic MD not available.

VAERS ID:206820 (history)  Vaccinated:2003-07-15
Age:33.0  Onset:2003-07-17, Days after vaccination: 2
Gender:Female  Submitted:2003-07-21, Days after onset: 4
Location:Michigan  Entered:2003-07-30, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: ASA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0193N   
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Malaise, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: 5 inch round indurated area tender with erythema at injection site. Accompanying malaise and generalized myalgias.

VAERS ID:206852 (history)  Vaccinated:2003-06-26
Age:33.0  Onset:2003-07-26, Days after vaccination: 30
Gender:Female  Submitted:2003-07-30, Days after onset: 4
Location:Pennsylvania  Entered:2003-07-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IDRA
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Injection site reaction, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Received Smallpox vaccination on 06/26/2003. Uneventful course after vaccination. Scab remained intact on day 28 check. On day 33, scab continues to be intact and a faint red rash has developed on patient''s abdomen. She was to be seen by family physician on 07/29/03. Unable to contact as of yet today to determine treatment and or diagnosis of rash.

VAERS ID:206956 (history)  Vaccinated:2003-07-25
Age:33.0  Onset:2003-07-29, Days after vaccination: 4
Gender:Female  Submitted:2003-07-29, Days after onset: 0
Location:Indiana  Entered:2003-08-04, 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: Vioxx, Minocycline, ASA, Compazine
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5444A41IMLA
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Few welts starting 7/26/03. 7/29/03 onset of neck and check swelling with itching. On 7/29/03 Epinephrine 0.3 mg given SQ. Solumedrol 250 mg IV. Benadryl 50 mg IV. Prednisone 60 mg PO.

VAERS ID:207244 (history)  Vaccinated:2002-11-13
Age:33.0  Onset:2002-11-13, Days after vaccination: 0
Gender:Female  Submitted:2003-07-30, Days after onset: 258
Location:Arizona  Entered:2003-08-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Penicillin allergy; Type II diabetes mellitus
Diagnostic Lab Data: NONE
CDC Split Type: WAES0211USA01579
Vaccination
Manufacturer
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0172M0SCRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Info has been received from a hospital pharmacy employee and a licensed practical nurse concerning a 33 year old female with an allergy to penicillin and type II diabetes mellitus who on 11/13/2002 was vaccinated with a 1st dose of pneumococcal vaccine 23 polyvalent (Lot #642720/0172M) subcutaneously in her right arm. That same day, the pt had a reaction that involved her "left arm" becoming "swollen and red." The nurse reported that diagnostic and laboratory tests were not performed. On 11/15/2002, the pt had recovered. The hospital pharmacy employee also provided info regarding other pts'' experiences (WAES #0212UA01104). The pt sought unspecified medical attention. Additional info is not expected.

VAERS ID:207358 (history)  Vaccinated:2003-01-08
Age:33.0  Onset:2003-01-10, Days after vaccination: 2
Gender:Female  Submitted:2003-07-30, Days after onset: 200
Location:Georgia  Entered:2003-08-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: WBC COUNT: 6.1; WBC COUNT: 18.9;
CDC Split Type: 0301USA01280
Vaccination
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Chills, Laboratory test abnormal, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Information has been received from a medical assistant concerning a 33 year old female who on 01/08/2003 was vaccinated with a dose of pneumococcal vaccine 23 polyvalent. On 01/10/2003 the patient returned to the physician''s office with cellulitis, body aches and chills. It was reported that on 01/08/2003 the patient''s white blood cell count was 6.1. On 01/10/2003 the patient''s white blood cell count had increased to 18.9. On 01/13/2003 the patient contacted the office and reported that her condition had improved but she still had some itching in the area of the cellulitis. Additional information has been requested.

VAERS ID:207490 (history)  Vaccinated:2003-07-21
Age:33.0  Onset:2003-07-21, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Wisconsin  Entered:2003-08-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EKG WNL; CPK: increased 468; Glucose increased 140; PPD
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
MEN: MENINGOCOCCAL (MENOMUNE)SANOFI PASTEURUB414AA  RA
Administered by: Military     Purchased by: Military
Symptoms: Blood creatine phosphokinase increased, Blood glucose increased, Chest pain, Heart rate increased, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Rash with increased heart rate and chest pains.

VAERS ID:207828 (history)  Vaccinated:2002-08-23
Age:33.0  Onset:0000-00-00
Gender:Female  Submitted:2003-08-13
Location:Georgia  Entered:2003-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ceftin and Claritin
Current Illness: None known
Preexisting Conditions: asthma
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
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Site
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURERUB225AA SCRA
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUB231AA SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site necrosis, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Presented on 9/17/02 with induration and pain and a depression in the right arm at site of yellow fever injection-on the lateral lower deltoid. She was treated by a dermatologist with Advil and heat to the arm.

VAERS ID:207919 (history)  Vaccinated:2003-08-09
Age:33.0  Onset:2003-08-13, Days after vaccination: 4
Gender:Female  Submitted:2003-08-15, Days after onset: 2
Location:Unknown  Entered:2003-08-15
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: X-ray taken of (L) deltoid and unremarkable.
CDC Split Type:
Vaccination
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TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)SANOFI PASTEURUO5533AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Infection, Injection site inflammation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Patient received 0.5cc of Tetanus Toxoid inj IM (L) deltoid for dirty metal cut injury to RLE (leg) on 9 Aug 03. On day 4, pt presented with 8 Cm of erythematous, inflammed area over on deltoid. Pt topical antibiotic and antiseptic agent for deltoid and oral antibiotic Keflex 250mg q6h x 7 days for RLE infection on 13 Aug. Pt recovering.

VAERS ID:208137 (history)  Vaccinated:2003-07-23
Age:33.0  Onset:2003-07-23, Days after vaccination: 0
Gender:Male  Submitted:2003-08-19, Days after onset: 27
Location:Michigan  Entered:2003-08-21, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergies
Diagnostic Lab Data: Lumbar puncture; CT scan negative; West Nile virus negative.
CDC Split Type: 03AV0024
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0750SCLA
Administered by: Other     Purchased by: Private
Symptoms: Diarrhoea, Headache, Meningitis, Musculoskeletal stiffness, Nausea, Photophobia, Pyrexia, Stomach discomfort, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: 33 year old male received his first dose AVA on 7/23/03. He developed headache later that day. By 7/31/03 the headache had become increasingly worse. Other symptoms included photophobia, vomiting, diarrhea and fever. Patient went to clinic on 7/31/03 and again on 8/1/03. He was kept for several hours observation and treated with IV fluids, tigan and demerol. Vitamin B-12 and Vitamin C shots were also administered. Patient was told he had an infectious process, possibly flu and sent home on Keflex 500mg TID, Motrin 500mg for headache. Patient went to hospital 8/4/03 for continued headache, nausea/vomiting, and fever. CT scan and spinal tap performed. Patient admitted with diagnosis of viral meningitis. Treated with IV fluids and symptom management. Discharged 8/8/03. The hospital and clinic physicians told patient and family that the events were not related to the vaccine. On 8/12/03 and 8/15/03 the patient returned to his physician for unresolved nausea and headache and was given IV fluids and dietician consult for vitamin supplementation. Patient returned to work 8/18/03 - still with slight headache and stiff neck, also some stomach upset. Patient reported that tests for West Nile virus were negative. Patient continues on Keflex 500mg TID and Motrin PRN. Follow up on 10/31/2003: "Additional information received 10/14/2003: Patient fully recovered and did not have any adverse events with subsequent anthrax vaccinations. "

VAERS ID:208158 (history)  Vaccinated:1999-09-02
Age:33.0  Onset:1999-09-03, Days after vaccination: 1
Gender:Male  Submitted:2003-08-21, Days after onset: 1448
Location:California  Entered:2003-08-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergic to PCN, Actifed, and E-mycin No birth defects No Medical conditions
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0431SCLA
Administered by: Military     Purchased by: Military
Symptoms: Shoulder pain
SMQs:, Rhabdomyolysis/myopathy (broad), Tendinopathies and ligament disorders (broad)
Write-up: 06/26/99- received anthrax #1 06/27/99- developed bilat shoulder pain, which lasted about six weeks and was completely resolved. 09/02/99- received anthrax #2 09/03/99- bilat shoulder pain reappeared- quality of pain similar to the pain he experienced with his first anthrax vaccine but the intensity was much more severe- no other associated sxs- pain interfered with his ADL, sleep, and with his performance at work- bilat shoulder pain slowly went away over the next several months and it completely dissipated by 02/00.

VAERS ID:208373 (history)  Vaccinated:2003-07-30
Age:33.0  Onset:0000-00-00
Gender:Male  Submitted:2003-08-26
Location:Wisconsin  Entered:2003-08-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tobradex eye drops Advil
Current Illness: Injury: Severe Corneal abrasion and eye irritation. Black fleck washed from eye. (The Manufacturer is incorrect on your dro
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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DT: DT ADSORBED (NO BRAND NAME)AVENTIS PASTEURU8041AA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Had significant pain in deltoid region of arm which was severe enough to prompt return visits to clinic. Also has shooting "tingles" of pain down the arm and lingering numbness in middle 3 fingers of Lt hand.

VAERS ID:208405 (history)  Vaccinated:2003-08-22
Age:33.0  Onset:2003-08-23, Days after vaccination: 1
Gender:Male  Submitted:2003-08-26, Days after onset: 3
Location:Texas  Entered:2003-08-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: SA0310
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0764IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: 32 hours after injection, left arm became sore, red, warm and began to swell. By 08/24 all signs and symptoms were more pronounced and all of left arm swollen. Took Motrin and Allegra. 08/26 PM: All signs and symptoms subsiding.

VAERS ID:208457 (history)  Vaccinated:2003-07-16
Age:33.0  Onset:2003-07-24, Days after vaccination: 8
Gender:Male  Submitted:2003-08-27, Days after onset: 34
Location:North Carolina  Entered:2003-08-27
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: Diverticulitis, Hep A as a child, Childhood Asthma, Varicella (age 10yo), Herpes Zoster (31 yo)
Diagnostic Lab Data: Per patient report: Positive monospot Positive strept culture
CDC Split Type:
Vaccination
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Dose
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETHUNKNOWN0IDRA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Fatigue, Headache, Lymphadenopathy, Musculoskeletal stiffness, Myalgia, Pharyngolaryngeal pain, Pruritus, Rash papular, Sepsis, Sinusitis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Reports severe fatigue 9 days after smallpox vaccination, 11 days after anthrax vaccination. Also reports myalgias bilateral lower extremities. Seen at clinic and was prescribed antibiotics. The next day, he felt worse and noted R axillary and R side knots (presumed lymphadenopathy), erythematous, pruritic, papules over this area. Also reported mild sore throat, stiff neck, and a headache. Was seen at medical center and diagnosed with mononucleosis on 7/26/03. Since that time, he reports his fatigue has worsened, headaches slightly improved,and lymphadenopathy/rash has resolved. Over the past month, he reports that he has been diagnosed with acute sinusitis and strept throat. He is currently being treated with penicillin. Patient is concerned that the vaccinations somehow contributed to a weakening of his immune system and subsequent development of mononucleosis, sinusitis, and strept throat.

VAERS ID:208573 (history)  Vaccinated:2003-08-18
Age:33.0  Onset:2003-08-19, Days after vaccination: 1
Gender:Female  Submitted:2003-08-21, Days after onset: 2
Location:Texas  Entered:2003-09-02, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0763SC 
Administered by: Military     Purchased by: Military
Symptoms: Injection site oedema, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: After receiving the Anthrax vaccination on the 18th of Aug, my arm began to swell and the swelling gradually spread down to my elbow. I went to see my primary care (form is torn here) on the 20th of August and he gave me Ibuprofen (form torn here)..(arm) is still sore and the swelling is going down.

VAERS ID:208655 (history)  Vaccinated:2003-07-31
Age:33.0  Onset:2003-08-02, Days after vaccination: 2
Gender:Female  Submitted:2003-08-07, Days after onset: 5
Location:Texas  Entered:2003-09-03, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: muscle aches;Hep B (unknown mfr);1;33;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Tachycardia
Diagnostic Lab Data: NONE
CDC Split Type: TX03091
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0154N1IMRA
Administered by: Public     Purchased by: Other
Symptoms: Dysphagia, Lymphadenopathy
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)
Write-up: 8/2/03 Lymph nodes began to swell, pt experiences difficulty swallowing, was driven to hospital ER. Received Benadryl IM.

VAERS ID:208864 (history)  Vaccinated:2003-08-29
Age:33.0  Onset:2003-08-29, Days after vaccination: 0
Gender:Female  Submitted:2003-09-02, Days after onset: 4
Location:Virginia  Entered:2003-09-05, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0833AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth, Loss of consciousness, Pyrexia, Urinary tract infection
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: 08/29/03 Td given, pt noted redness at injection site. 8/30/03 Temp 101.2 T, redness at injection site at right arm spreading down right arm to midforearm area and hot to touch, "passed out" in AM of 8/30/03. To MD, Tx with antibiotic for UTI. 8/31/03 Applied ice and Benadryl cream and oral Benadryl. 09/02/03 to health dept. to report reaction, right shoulder hot to touch with redness to mid forearm. Diagnosed with UTI on 8/30/03.

VAERS ID:208926 (history)  Vaccinated:2003-09-02
Age:33.0  Onset:2003-09-02, Days after vaccination: 0
Gender:Male  Submitted:2003-09-05, Days after onset: 3
Location:New Mexico  Entered:2003-09-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0703SCLA
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU0844AA1IMLA
Administered by: Military     Purchased by: Military
Symptoms: Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad)
Write-up: RECEIVED VACCINATION ON 2 SEPT 03 IN THE EARLY AFTERNOON. BY NIGHT, HE BEGAN TO RUN A LOW GRADE FEVER OF 100.3 AND C/O TINGLING ALL OVER HIS BACK. NEXT MORNING HE WAS FINE. THE REASON I AM REPORTING THIS IS BECAUSE I HAD 2 ODD REACTIONS FROM THIS SAME LOT, SAME VIAL.

VAERS ID:208936 (history)  Vaccinated:2003-08-15
Age:33.0  Onset:2003-08-17, Days after vaccination: 2
Gender:Female  Submitted:2003-09-08, Days after onset: 22
Location:Texas  Entered:2003-09-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroid meds from France. Name unknown.
Current Illness: none
Preexisting Conditions: Hypothyroidism
Diagnostic Lab Data: No labs performed. Physical examination only.
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSSAV0778SCLA
Administered by: Unknown     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash that started two days after vaccine was administered and is still present 9/8/03

VAERS ID:209002 (history)  Vaccinated:2003-08-26
Age:33.0  Onset:2003-09-03, Days after vaccination: 8
Gender:Male  Submitted:2003-09-08, Days after onset: 5
Location:Washington  Entered:2003-09-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0771 RA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710IMLA
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Injection site erythema, Malaise, Pain, Pyrexia, Skin ulcer
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Immunized with smallpox vaccine 26 AUG 2003. Developed fever, malaise, fatigue, soreness, vesicular lesions and erythema around innoculation site on 03 SEP 2003. Developed progressive vesicular lesions on 06 SEP 2003 on face, scalp, anterior chest above nipple line, on back above scapulae, symmetric in distribution. No ocular or mucosal lesions. Developed one vesicular lesion on posterior aspect of Left thigh on 07 SEP 2003.

VAERS ID:209007 (history)  Vaccinated:2003-09-07
Age:33.0  Onset:2003-09-07, Days after vaccination: 0
Gender:Male  Submitted:2003-09-09, Days after onset: 2
Location:California  Entered:2003-09-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: SLIGHT COUGH
Preexisting Conditions: NONE
Diagnostic Lab Data: n/a
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH    
Administered by: Military     Purchased by: Military
Symptoms: Injection site swelling, Lymphadenopathy, Pruritus, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Raised swolen area at injection site approx inch diameter. Lymph node swelling and itching in armpit of same arm. Patient indicated a need for additional sleep the following day. Patient is unsure of the the brand of vaccine. Patient is only 2 days into the vaccine.

VAERS ID:209228 (history)  Vaccinated:2003-08-06
Age:33.0  Onset:2003-08-15, Days after vaccination: 9
Gender:Female  Submitted:2003-09-12, Days after onset: 28
Location:Illinois  Entered:2003-09-12
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: CSF white count = 6, predominantly lymphocytes; MRI of C-spine revealed 2 cm long lesion of increased T2 signal with mild contast enhancement in the spinal cord at a level of about C3
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0705IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURW09090IMRA
Administered by: Military     Purchased by: Military
Symptoms: Hypoaesthesia, Laboratory test abnormal
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: About 2 weeks after the vaccine he developed numbness up to his chest.

VAERS ID:209560 (history)  Vaccinated:2003-07-11
Age:33.0  Onset:2003-07-11, Days after vaccination: 0
Gender:Male  Submitted:2003-08-21, Days after onset: 41
Location:Wisconsin  Entered:2003-09-24, Days after submission: 34
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: History of seizure disorder due to auto accident.
Diagnostic Lab Data: Temperature: 96.9F, B/P: 148/59, Pulse: 89; Respiratory: 18;
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Blood pressure decreased, Coma, Convulsion, Drooling, Headache, Heart rate decreased, Respiratory rate decreased
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow)
Write-up: Tonic Seizure, drooling, unresponsive, headache. Treatment: Tylenol 1000 mg, Dilantin 300 mg.

VAERS ID:209835 (history)  Vaccinated:2003-09-05
Age:33.0  Onset:2003-09-12, Days after vaccination: 7
Gender:Female  Submitted:2003-09-23, Days after onset: 11
Location:Florida  Entered:2003-09-30, 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:
Vaccination
Manufacturer
Lot
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Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0029M1LA 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Initial reticulated rash in first several days and 1 wk later polyarthralgia x 2 and wks. No fevers.

VAERS ID:209922 (history)  Vaccinated:2003-09-12
Age:33.0  Onset:2003-09-19, Days after vaccination: 7
Gender:Female  Submitted:2003-09-30, Days after onset: 11
Location:Maryland  Entered:2003-09-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Arthralgia, Joint range of motion decreased, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Joint pain in hands, stiffness in left arm, unable to lift arm over head.

VAERS ID:209867 (history)  Vaccinated:2003-02-19
Age:33.0  Onset:2003-02-27, Days after vaccination: 8
Gender:Male  Submitted:2003-03-07, Days after onset: 8
Location:South Carolina  Entered:2003-10-01, Days after submission: 207
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: CBC - WNL
CDC Split Type:
Vaccination
Manufacturer
Lot
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710  
Administered by: Military     Purchased by: Military
Symptoms: Cow pox, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt noticed pruritic rash on neck on 02/27/03. Presented to MD and diagnosed with generalized vaccinia on 03/03/03.

VAERS ID:209900 (history)  Vaccinated:2003-09-22
Age:33.0  Onset:2003-09-23, Days after vaccination: 1
Gender:Male  Submitted:2003-09-24, Days after onset: 1
Location:Oklahoma  Entered:2003-10-01, 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: HTN, hypercholesterolemia
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0287N0LA 
Administered by: Public     Purchased by: Other
Symptoms: Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: 9/23/03 Pain and swelling day after. Seen by physician and given Prednisone and Ibuprofen for pain. T 97 P58 R18 Bp 118/78.

VAERS ID:209940 (history)  Vaccinated:2003-03-01
Age:33.0  Onset:2003-03-01, Days after vaccination: 0
Gender:Male  Submitted:2003-07-25, Days after onset: 145
Location:Texas  Entered:2003-10-02, Days after submission: 69
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0712SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: On 03/01/03 had redness, itching, swelling in bicep area moving down left each day for 3 days with swelling increasing to forearm area. Lasted 4-5 days.

VAERS ID:210038 (history)  Vaccinated:2003-01-29
Age:33.0  Onset:2003-09-17, Days after vaccination: 231
Gender:Male  Submitted:2003-10-03, Days after onset: 16
Location:Mississippi  Entered:2003-10-03
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: Skin biopsy Viral and bacterial cultures Vaccinia PCR (negative)
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710  
Administered by: Military     Purchased by: Military
Symptoms: Injection site reaction, Injection site swelling, Oedema peripheral, Skin ulcer
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient received primary smallpox vaccine on 1/29/03. On Day 14, he developed a large local reaction with swelling of the upper arm and extending to the elbow. He was evaluated and dx. with a robust reaction to the vaccine. The symptoms were self-limiting and resolved in 2-3 days. Six months later, he noticed a change in the appearance of the vaccine scar. The scar became raised with a papule lesion about the size of a dime. In september, he noted a scant amount of serious drainage from the lesion. He presented to KFB medical center for evaluation on 22 September 2003. Denies, fever, lymphadenopathy,swelling, redness,streaking or rashes. PCR for vaccinia, viral and bacterial cultures obtained. Underwendt skin bisopsy by dermatology.

VAERS ID:210185 (history)  Vaccinated:2003-03-13
Age:33.0  Onset:2003-03-14, Days after vaccination: 1
Gender:Male  Submitted:2003-10-07, Days after onset: 206
Location:Washington  Entered:2003-10-07
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: N/A
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0701  
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site hypersensitivity, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: RED, ITCHY, AND SWELLING AT THE SITE OF VACCINATION.

VAERS ID:210193 (history)  Vaccinated:1999-04-12
Age:33.0  Onset:0000-00-00
Gender:Male  Submitted:2003-10-10
Location:New York  Entered:2003-10-09, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: ANA Rheumatoid test: non-reactive; HLA DR 4 positive; X-rays and MRI on lower back.
CDC Split Type:
Vaccination
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS120A91 GM
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Back pain, Hypoaesthesia, Laboratory test abnormal, Musculoskeletal stiffness
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Stiffness in neck and shoulders, loss of strength in hands and forearms. Numbness in hands. pain in lower back and hips.

VAERS ID:210269 (history)  Vaccinated:2003-10-09
Age:33.0  Onset:2003-10-10, Days after vaccination: 1
Gender:Female  Submitted:2003-10-10, Days after onset: 0
Location:Pennsylvania  Entered:2003-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: allergic airway disease, atopy, penicillin allergy, migraine
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1141AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abasia, Chills, Dizziness, Headache, Myalgia, Nausea, Pyrexia, Tinnitus, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: 12:30 AM 10/10/03 patient woke with fever 103 F, shaking chills, and severe myalgia especially of vaccine site but also other major muscle groups. 7:00 AM 10/10/03 patient attempted to stand, developed acute onset pounding headache, dizziness,nausea and tinnitus - unable to walk or stand due to symptoms 7:45 AM 10/10/03 patient obtained glass of water and 600 mg ibuprofen 9:00 AM 10/10/03 fever down to 99.7 F, patient feeling much better. Still sore and dizzy, but able to function.

VAERS ID:210418 (history)  Vaccinated:2003-01-08
Age:33.0  Onset:2003-02-14, Days after vaccination: 37
Gender:Male  Submitted:2003-10-14, Days after onset: 241
Location:New Jersey  Entered:2003-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergic Rhinitis Anxiety
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSUNKNOWN0SC 
Administered by: Military     Purchased by: Military
Symptoms: Dermatitis atopic, Eczema, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Service member received Anthrax #1 on 08 Jan 03 and one month later developed a rash on bilateral elbows, knees, between fingers, and in the genital area. This was initially diagnosed as contact dermatitis. When it started recurring in the same areas, he was diagnosed with eczema/atopic dermatitis. Rx: Kenalog creme Continues to have monthly recurrences. Denies any similar occurrences prior to receipt of Anthrax.

VAERS ID:210420 (history)  Vaccinated:2003-09-30
Age:33.0  Onset:2003-10-01, Days after vaccination: 1
Gender:Female  Submitted:2003-10-14, Days after onset: 13
Location:Ohio  Entered:2003-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0526AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Began having pain and mild erythema at the vaccine site a day or two after the vaccination. It persisted until a visit today.

VAERS ID:210456 (history)  Vaccinated:2003-10-04
Age:33.0  Onset:2003-10-05, Days after vaccination: 1
Gender:Male  Submitted:2003-10-07, Days after onset: 2
Location:Washington  Entered:2003-10-16, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0763 LA
Administered by: Military     Purchased by: Other
Symptoms: Injection site inflammation, Injection site oedema, Injection site warmth, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Inflammation, heat, swelling over injection site and down arm to elbow. Patient complained of "tingling" in 4th /5th digits but sensation intact. Treatment with medrol dosepak.

VAERS ID:210595 (history)  Vaccinated:2003-10-15
Age:33.0  Onset:2003-10-16, Days after vaccination: 1
Gender:Male  Submitted:2003-10-16, Days after onset: 0
Location:Utah  Entered:2003-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None done at time of report.
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1122AA1IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Chills, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad)
Write-up: Vaccine given in early afternoon. Pt. went home and laid down. Reported rigors and extreme muscle tremors all night. Currently complaining of joint aches and "locked knees." Fiancee administered tylenol and benedryl.

VAERS ID:210577 (history)  Vaccinated:2003-10-06
Age:33.0  Onset:2003-10-07, Days after vaccination: 1
Gender:Female  Submitted:2003-10-09, Days after onset: 2
Location:California  Entered:2003-10-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.0101N SCLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site induration, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Patient reports increased redness of area of immunization with induration/itch, of injection. Today with improved symptoms. PG ? and rash ? and ? 2 cm area. Slight induration, no ? tenderness.

VAERS ID:210666 (history)  Vaccinated:2003-10-03
Age:33.0  Onset:2003-10-05, Days after vaccination: 2
Gender:Female  Submitted:2003-10-18, Days after onset: 13
Location:Florida  Entered:2003-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi Vitamin
Current Illness:
Preexisting Conditions: Dx. of Asthma at 17 years of age.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1068AA   
Administered by: Private     Purchased by: Unknown
Symptoms: Anorexia, Chest pain, Cough, Dyspnoea, Eye pain, Fatigue, Headache, Influenza like illness, Muscle twitching, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad)
Write-up: 2 days after recieving vaccine I began to experience a mild cough, a "twitchy" feeling that didn''t go away. After appr. 12 days, I started to experience shortness of breath, severe fatigue, feeling like I had a moderate case of the flu, along with mild headache, dry cough, chest pain, sore eyes, muscle weakness, and loss of appetite. A prescription for Z-Pack was called in, and I am on this medication at the present time.

VAERS ID:211027 (history)  Vaccinated:2003-04-17
Age:33.0  Onset:0000-00-00
Gender:Male  Submitted:2003-10-24
Location:Unknown  Entered:2003-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None noted
Preexisting Conditions: None
Diagnostic Lab Data: Patient was evaluated by a hand surgeon who made the diagnosis of Dupuytren''s contractures.
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH  IMUN
Administered by: Military     Purchased by: Military
Symptoms: Dupuytren's contracture, Skin ulcer
SMQs:
Write-up: Patient has bilateral nodular lesions in the hands consistent with Dupuytren''s contractures and less impressive lesions on the feet which suggest plantar fibromatosis. He states his symptoms started after his 5th Anthrax vaccine, administered on 17 April 2003. He denies any family hx of Dupuytren''s.

VAERS ID:210996 (history)  Vaccinated:2003-10-20
Age:33.0  Onset:2003-10-20, Days after vaccination: 0
Gender:Male  Submitted:2003-10-20, Days after onset: 0
Location:Connecticut  Entered:2003-10-27, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergy to ibuprofen
Diagnostic Lab Data:
CDC Split Type:
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5447B60 RA
Administered by: Other     Purchased by: Public
Symptoms: Pruritus, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Within 30-45 minutes after receiving the first of a 3 shot series of Hepatitis B vaccine, pt developed hives on his face, was very itchy and also had tightness in his throat. Benadryl 50 mg PO given, and sent to a medical facility for follow up.

VAERS ID:211511 (history)  Vaccinated:2003-10-14
Age:33.0  Onset:2003-10-15, Days after vaccination: 1
Gender:Unknown  Submitted:2003-10-31, Days after onset: 16
Location:New Hampshire  Entered:2003-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1134BA0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Asthma, Chest discomfort, Dyspnoea, Hypersensitivity, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: 24 hours after the administration of the vaccine 10/14/03 the employee complained of asthma type symptoms including shortness of breath and chest tightness. He was seen in the ER on 10/15/03, oxygen was administered and he was released. Employee reported on 10/28/03 that following the ER visit he developed hives on chest, back, arms and hands. States he has been taking benedryl prn for symptoms. Employee denied egg allergy at the time of vaccination but stated on 10/28/03 that he did have a sensitivity to chicken feathers. Employee states that he is still experiencing mild asthma type symptoms. He was advised to follow up with his MD.

VAERS ID:211589 (history)  Vaccinated:2003-10-24
Age:33.0  Onset:2003-10-24, Days after vaccination: 0
Gender:Male  Submitted:2003-11-03, Days after onset: 10
Location:Unknown  Entered:2003-11-03
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: No significant illnesses
Diagnostic Lab Data: Flu vaccine was by powerject Pharm
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER7651417IMRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710SCLA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Chest discomfort, Dizziness, Dyspnoea, Pruritus, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Within 1 hour of vaccination with both smallpox and flu vaccine, he began to feel shortness of breath and then progressed to throat and chest tightness. Mild dizziness and weakness. No syncope or hives noted. some pruritus

VAERS ID:211596 (history)  Vaccinated:2003-11-03
Age:33.0  Onset:2003-11-03, Days after vaccination: 0
Gender:Female  Submitted:2003-11-03, Days after onset: 0
Location:New York  Entered:2003-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR41076AA1IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Shortness of breath

VAERS ID:211635 (history)  Vaccinated:2003-10-09
Age:33.0  Onset:2003-10-09, Days after vaccination: 0
Gender:Female  Submitted:2003-10-16, Days after onset: 7
Location:Alabama  Entered:2003-11-04, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Multiple allergies, allergy shots 2 x/week
Diagnostic Lab Data:
CDC Split Type: AL0326
Vaccination
Manufacturer
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