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Case Details (Sorted by Age)

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VAERS ID:154324 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:1999-09-29
Location:Connecticut  Entered:2000-06-15, Days after submission: 260
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: high cholesterol, allergy to Erythromycin
Diagnostic Lab Data: CT scan-neg; IVP-neg
CDC 'Split Type': 19990184981
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Subsequently post vax, the pt experienced isolated left flank muscle pain. A doctor visit was required. He was treated with an anti-inflammatory, which did not improve his symptoms.

VAERS ID:154363 (history)  Vaccinated:1999-06-14
Age:47.0  Onset:1999-07-11, Days after vaccination: 27
Gender:Male  Submitted:1999-08-20, Days after onset: 40
Location:Kansas  Entered:2000-06-15, Days after submission: 300
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 19990191551
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 27 days post 2nd and two months post 1st dose of vaccine, the pt experienced itching and rash of the hands (a glove-like effect to wrist) and swelling of lips. He was treated with Allegra and Hydrocortisone. The most recent information received on 8/20/99 reports the condition of the pt is ongoing.

VAERS ID:154448 (history)  Vaccinated:1999-08-04
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:1999-09-01
Location:Connecticut  Entered:2000-06-15, Days after submission: 288
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasacort, antihistamine (nos), Synthroid, Xanax
Current Illness:
Preexisting Conditions: Has a chemical sensitivity and gets giant hives. Has had Lyme disease 5 times in the last 15 years and viral syndrome, tested postive on 6/15/99 for Babesia and she had a bullseye rash on 6/19/99.
Diagnostic Lab Data:
CDC 'Split Type': 19990226701
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Fatigue, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: This is a spontaneous report by a 47 year old female pt who received her 1st dose of Lymerix on 7/7/99 and 15 days later on 7/22/99, she went to the ER due to a fever of 104.6 and joint pain. She was given medication (nos) to lower her temperature and a 21 day supply of doxycycline. The fever abated and the joint pain decreased. The pt received her 2nd dose on 8/4/99 and subsequently, she experienced fatigue, joint pain and malaise. Her joint pain is getting worse, and the bones in the top of her feet and hands also hurt. Today, she says the joint pain is getting much worse (not the same joint pain one gets with the flu). The most recent information, received on 8/31/99, reports the condition of the pt is ongoing.

VAERS ID:154480 (history)  Vaccinated:2000-04-02
Age:47.0  Onset:2000-04-02, Days after vaccination: 0
Gender:Female  Submitted:2000-06-11, Days after onset: 69
Location:Nevada  Entered:2000-06-16, 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: Premarin, Nasacort, Norvasc, aspirin
Current Illness:
Preexisting Conditions: PCN allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: A few hours post vax, pt developed hives on soft tissue of eyes. Pt experienced severe swelling.

VAERS ID:154524 (history)  Vaccinated:2000-05-21
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2000-05-01
Location:New Jersey  Entered:2000-06-16, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: HLA / DR4-pos
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM0845351IM 
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Back pain, Laboratory test abnormal, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: Pt experienced joint pain, in hands, elbows, and knees. Severe body pain which has increased throughout the year. Back pain, tingling in arms. The annual follow-up states lyme WB +; antibiotics no response. The follow up received on 12/20/02 states possible autoimmune arthritis in a 47 year old male hwo received Lyme disease vaccine recombinant for prophylaxis. This report was received from newspaper articles with follow-up info received via the litigation process and fromt he pt''s wife. Medical records were forwarded by the pt''s attorney. A physician has also directly submitted a report directly to VAERS. Alcohol abuse was documented on 1/8/97. Cocaine and "speed" abuse were also documented on an unspecified date. The pt has a history of lifting heavy objects "for years" with multiple episodes of low back pain. He developed sacro-ileitis on 6/18/93, after lifting a heavy object. Lumbar spine x-rays performed on 8/31/94 revealed "a small anterior bony spur seen at the level of L5. Narrowing of L5 S1 joint space is noted. Narrowing of L4 L5 joint space is also noted. These findings are felt to be related to degenerative disease." On 4/21/99 and 5/21/99, the pt received his first and second injections of LYMErix, respectively. The litigation alleges that the pt has experienced arthritic-like symptoms in various joints of his body. The newspaper article quotes the pt as developing the "same form of arthritis that afflicts his wife after getting the vaccine." Pt has subsequently tested HLA-DR3 positive and is "positive for Lyme disease." He is being treated by a physician for these events. The ligitation states that th ept has suffered great pain, discomfort and emotional distress as well as the evnts have "severely limited his employment options and opportunities." The pt''s wife stated that "her husband''s pain started slowly throughout late 1999 until he hurt his back on New Year''s Day (1/1/00) and has never been the same since. He used to workout and run. Now he just site around because of the pain. My husband was

VAERS ID:154714 (history)  Vaccinated:1996-05-28
Age:47.0  Onset:1998-06-11, Days after vaccination: 744
Gender:Female  Submitted:2000-05-24, Days after onset: 713
Location:Oregon  Entered:2000-06-19, Days after submission: 26
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': WAES00021745
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1431B SC 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Erythema, Oedema, Raynaud's phenomenon
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Two weeks post vax, pt experienced severe pain in all joints from the ankles up. Pt reported they were red, hot and painful. Pt was treated with prednisone and the symptoms improved. The symptoms have since returned and have worsened. Pt noted swelling and Raynaud''s type symptoms. Pts experience was considered an other medical event.

VAERS ID:154871 (history)  Vaccinated:1998-10-16
Age:47.0  Onset:1998-10-16, Days after vaccination: 0
Gender:Female  Submitted:1998-12-04, Days after onset: 49
Location:New Hampshire  Entered:2000-06-21, Days after submission: 564
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: PCN, Sulfur allergies
Diagnostic Lab Data:
CDC 'Split Type': U1998006530
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0980540 IMRA
Administered by: Other     Purchased by: Unknown
Symptoms: Ecchymosis, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: Several hours post vax, pt experienced hives and blotches resembling black and blue marks. From additional information received on 12/4/98, it was reported, "tightening of throat, was seen by physician at ER and states received a prescription for prednisone but did not fill it. Client took 2 Benadryl and gradually improved within 3-4 days." It was reported that the pt recovered from this experience.

VAERS ID:154897 (history)  Vaccinated:1998-10-20
Age:47.0  Onset:1998-10-22, Days after vaccination: 2
Gender:Female  Submitted:1998-12-01, Days after onset: 40
Location:Virginia  Entered:2000-06-21, Days after submission: 567
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': U199800711
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR0985870   
Administered by: Private     Purchased by: Private
Symptoms: Chills, Eyelid oedema, Headache, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: It was reported that a female received Fluzone SV 98-99 USP on 10/20/1998. Reportedly on 10/20/1998 the pt experienced fever, swollen eyes, chills, and headache. From additional information received on 11/30/98, it was reported that the reaction started within 48 hours of shot on 10/22/98, reported on 10/26/98. Reportedly the pt recovered from this experience.

VAERS ID:154937 (history)  Vaccinated:2000-06-10
Age:47.0  Onset:2000-06-11, Days after vaccination: 1
Gender:Female  Submitted:2000-06-11, Days after onset: 0
Location:Pennsylvania  Entered:2000-06-21, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: hx of high blood pressure
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV048B1SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site nodule, Injection site rash, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt noticed a rash measuring 100 mm x 110 mm across injection site area. Appears flushed and is warm to touch. Pt also has noticed a nodule present in left tricep from first vax, approximately size id 3.0 mm x 2.2 mm in size.

VAERS ID:154959 (history)  Vaccinated:1999-07-23
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2000-01-31
Location:D.C.  Entered:2000-06-21, Days after submission: 141
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Alupent
Current Illness:
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC 'Split Type': 20000025821
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM572A60IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt received vax on 07/23/1999. Subsequently the pt had pain at the injection site that lasted for 2 days. The arm was also sore. These events resolved for 2 weeks and then left arm soreness returned. Symptoms resolved on approximately 12/24/1999.

VAERS ID:154962 (history)  Vaccinated:2000-01-27
Age:47.0  Onset:2000-01-27, Days after vaccination: 0
Gender:Female  Submitted:2000-02-10, Days after onset: 14
Location:Missouri  Entered:2000-06-21, Days after submission: 131
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estratest
Current Illness:
Preexisting Conditions: allergic to eggs; seasonal allergies
Diagnostic Lab Data:
CDC 'Split Type': 20000036821
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM641A60IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Within 5 hours post vax pt experienced erythema, pain and pruritus at the injection site. Symptoms resolved without treatment.

VAERS ID:155133 (history)  Vaccinated:1998-11-05
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:1998-11-18
Location:North Carolina  Entered:2000-06-21, Days after submission: 580
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: insulin, Vasotec, Premarin, Prozac
Current Illness:
Preexisting Conditions: high blood pressure, insulin-dependent diabetes
Diagnostic Lab Data:
CDC 'Split Type': U1998007800
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0981790 IM 
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Hypotension, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Post vax, the pt experienced hives, shortness of breath, and throat closing. Reportedly the pt was given epinephrine and taken to ER. The pt also experienced hypotension and was given Benadryl at ER as well.

VAERS ID:155214 (history)  Vaccinated:1998-10-22
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2001-05-03
Location:Indiana  Entered:2000-06-22, Days after submission: 315
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': U1999001000
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0971890 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Reportedly, sometime, post vax, the pt experienced pain in her arm at the injection site, left deltoid. From additional info received on 03/12/1999, additional pt, responsible physician and vaccine administrator info were given. From follow-up correspondence received on 04/26/2001, it was reported, "No further info available regarding this pt or this case." This case is closed.

VAERS ID:155370 (history)  Vaccinated:2000-02-25
Age:47.0  Onset:2000-02-27, Days after vaccination: 2
Gender:Female  Submitted:2000-06-10, Days after onset: 103
Location:Michigan  Entered:2000-06-23, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergy to PCN
Diagnostic Lab Data: EMG-nml, S-rays-wnl, MRI-arthritis in neck
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES 1IMLA
Administered by: Public     Purchased by: 0
Symptoms: Arthritis, Bone pain, Hypoaesthesia, Injection site hypersensitivity, Injection site pain, Neck pain, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: On 2/27, pain in left neck, collar bone, shoulder and upper left arm. On 2/29, went back to work. On 3/10, had excruciating pain at collar bone and arm with numbness in left hand. Was out of work since 3/10. Taking Vicodin, 500mg, 2 every 4-6 hours. Have itching at injection site. Pharmacist, mother and I feel shot was given too high, near bone. Per follow-up, the pt still has numbness in left hand, twinges in upper forearm and above elbow. Pain still in shoulder. The annual follow-up states chronic numbness in left thumb, when damp or humid outside. Pain or discomfort in left upper shoulder at injection site. The pt also states that there should be mandatory vaccine lot number recordings because of what had happened to her.

VAERS ID:155494 (history)  Vaccinated:1999-11-18
Age:47.0  Onset:1999-11-18, Days after vaccination: 0
Gender:Female  Submitted:1999-12-15, Days after onset: 27
Location:Colorado  Entered:2000-06-27, Days after submission: 194
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Arthrotec, estrogen, Klonopin, Lortab
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ5738216NOV1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998259 IM 
Administered by: Private     Purchased by: Other
Symptoms: Anaphylactic reaction, Cough, Dyspnoea, Pharyngitis, Rhinitis, Tongue oedema
SMQs:, Anaphylactic reaction (narrow), Agranulocytosis (broad), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal infections (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Within minutes post vax, the pt developed an anaphylactic reaction characterized by narrowing of the pt''s airway, swollen tongue, and shortness of breath. The pt was treated in the ER. A week post vax the pt developed cold symptoms and a cough.

VAERS ID:155637 (history)  Vaccinated:2000-05-03
Age:47.0  Onset:2000-05-04, Days after vaccination: 1
Gender:Female  Submitted:2000-06-21, Days after onset: 48
Location:California  Entered:2000-06-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fion
Current Illness: NONE
Preexisting Conditions: PCN-rash, codeine-nausea and vomiting
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3139A20IMLA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Generalized arthralgias-NSAIDS

VAERS ID:155654 (history)  Vaccinated:1999-10-25
Age:47.0  Onset:1999-10-26, Days after vaccination: 1
Gender:Female  Submitted:1999-11-08, Days after onset: 13
Location:Pennsylvania  Entered:2000-06-28, Days after submission: 232
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': U1999008660
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7258AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: One day post vax, this pt experienced a "reddened area 5 cm x 3 cm at injection site. Also itching noted from left arm." The pt recovered.

VAERS ID:155863 (history)  Vaccinated:2000-06-20
Age:47.0  Onset:2000-06-21, Days after vaccination: 1
Gender:Male  Submitted:2000-06-22, Days after onset: 1
Location:Illinois  Entered:2000-06-30, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM651B61IMLA
Administered by: Public     Purchased by: Private
Symptoms: Cough, Dry throat, Fatigue, Feeling abnormal, Pain
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: 24 hours, post vax, pt had a scratch throat, fatigue, aches, uneasy feeling and a cough. Symptoms got worse for 4 days, but then pt began to recover. Pt took Tylenol.

VAERS ID:156046 (history)  Vaccinated:2000-06-15
Age:47.0  Onset:2000-06-17, Days after vaccination: 2
Gender:Female  Submitted:2000-06-19, Days after onset: 2
Location:Mississippi  Entered:2000-07-05, Days after submission: 16
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': MS00025
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1326J0IMLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU01388A IMRA
Administered by: Public     Purchased by: Other
Symptoms: Feeling hot, Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: Two days post vax pt noted extreme redness and warmth to site of injection. Four days post vax pt developed a 10 cm circular area of redness to right deltoid. Pt was treated with warm compresses and Advil for pain.

VAERS ID:156050 (history)  Vaccinated:2000-05-01
Age:47.0  Onset:2000-05-03, Days after vaccination: 2
Gender:Female  Submitted:2000-06-28, Days after onset: 56
Location:California  Entered:2000-07-05, 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: diabetes
Preexisting Conditions: diabetes
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4988148 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site pain, Vasodilation procedure
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Two days post vax pt experienced an immune response/allergic reaction to DT booster characterized by a reddened, tender area that felt hot to touch. Pt was treated with Claritin, Benadryl and Keflex.

VAERS ID:156331 (history)  Vaccinated:2000-04-28
Age:47.0  Onset:2000-04-28, Days after vaccination: 0
Gender:Female  Submitted:2000-07-10, Days after onset: 73
Location:Arizona  Entered:2000-07-11, Days after submission: 1
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Rhinocort, Biaxin
Current Illness:
Preexisting Conditions: Hashimoto''s recurrent sinus infection
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0115AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Anxiety, Arthralgia, Dyspnoea, Fatigue, Hyperthyroidism, Insomnia, Menopause, Musculoskeletal stiffness, Nausea, Pain, Paraesthesia, Restlessness, Throat tightness, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dystonia (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 (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hyperthyroidism (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: On 4/28/00, 2-3 hours post vax, the pt experienced a mild stiffening feeling in the muscle of left forearm. The following days, 4/29 and 4/30 the pt was weak, nauseous, short of breath, stayed in bed most of the time. Painful to lift left arm. Called MD, was told this sometimes happens, should improve, call back if worsens. Pt was much better by 5/1/00. On 5/3 or 5/4, the pt experienced stiffening in left forearm mostly before bed and upon waking. Occasional weakness and aching in both arms. A tendency in the left forearm to want to freeze into stiff position. This continues off and on until 6/26/00. On 5/17 and 5/18, a burning pain in the muscle on back right side of neck, stiff neck, could not turn to right. Continued for one full day. Next day, the pt experienced a sun burn feeling in that area. On 5/23 and 5/25, the pt experienced the same symptoms as on 4/29 and 4/30 except both arms are weak but can be raised over head. On 6/5/00, the pt had a doctor appointment. Blood work was ordered. 6/7/00 - brief severe nausea for 15-30 minutes. Mildly weak feeling and mildly nauseous rest of day. 6/8/00 - antsy feeling, stopped all caffeine. 6/11/00 - the pt states "want to climb out of my skin, hardly sleeping. Stopped taking my synthroid." on 6/12/00 diagnosed with hyperthyroid. On 6/16/00 continued restlessness, insomnia and nighttime episodes of burning and weakness in arms and chest. Diagnosed with menopause. 6/17/00 throat felt tight, uncomfortable to talk, short of breath. 6/18/00 pt went to ER due to severe cramping of diaphragm, stomach and surface abdominal muscles, severe burning sensation and tightness in throat, short of breath. Severe burning in left pectoral muscle (under left breast). Severe burning across back below shoulder blades. Cramping intense and constant. Extremely thirsty. Burning and cramping are both intense and constant. No diagnosis, but black widow spider suggested. Given valium, Benadryl and discharged. On 6/21/00, woke from deep sleep at home with crushing pain in center of chest, shou

VAERS ID:156741 (history)  Vaccinated:2000-06-23
Age:47.0  Onset:2000-06-30, Days after vaccination: 7
Gender:Male  Submitted:0000-00-00
Location:California  Entered:2000-07-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Pt has a history of "hives".
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUA232AA0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt developed hives one week, post vax. Treated with Benadryl and Claritin with no relief. PCP started him on Prednisone. Three days later, hives are still there, itching has subsided.

VAERS ID:157598 (history)  Vaccinated:1999-10-07
Age:47.0  Onset:1999-10-07, Days after vaccination: 0
Gender:Male  Submitted:2000-05-05, Days after onset: 211
Location:Texas  Entered:2000-07-20, Days after submission: 76
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': MPU1999004190
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E24B669GA IM 
Administered by: Other     Purchased by: Other
Symptoms: Dysphagia, Erythema, Injection site rash, Lymphadenopathy, Malaise, Pharyngeal oedema, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow)
Write-up: Two hours post vax pt experienced general malaise, enlarged lymph nodes under his chin and difficulty swallowing. Pt was treated with Benadryl IM and taken to the ER where he was treated with an unspecified medication. the reporter states that the vaccinee denied and difficulty breathing or swallowing, his lungs were clear and no complaints of nausea or vomiting; heart rate was 80 bpm. The vaccinee stated he had a rash at the injection site. 10 minutes after the initial onset pts blood pressure was 120/80 and heart rate 60 bpm. 10 minutes later vaccinee complained of difficulty swallowing and felt like it was getting worse the pt was given Benadryl IM. the vaccinee was seen by a physician who noted that his throat had redness and swelling. He was taken to the ER where he was treated with an unspecified medication. The vaccinee was followed up with 3.5 hours later when he was reported to be back at work and feeling okay. The vaccinee stated that something like this happened last year after vax.

VAERS ID:157701 (history)  Vaccinated:2000-01-22
Age:47.0  Onset:2000-01-23, Days after vaccination: 1
Gender:Male  Submitted:2000-07-03, Days after onset: 161
Location:California  Entered:2000-07-21, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0313SCLA
Administered by: Military     Purchased by: Military
Symptoms: Hypokinesia, Injection site erythema, Injection site oedema, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Redness, massive swelling of entire arm from near injection site, down arm to wrist. Pt could not bend arm. Entire arm was warm prescribed oral corticosteroids (prednisome) and Benadryl, 3 days. Pt is Aircrew (flyer) and was grounded and had follow-up with flight surgeon MD Allergist. Swelling was resolved after 3 to 4 days. Event was serious enough to warrant ER visit.

VAERS ID:157702 (history)  Vaccinated:1999-08-09
Age:47.0  Onset:1999-08-11, Days after vaccination: 2
Gender:Male  Submitted:2000-05-11, Days after onset: 274
Location:California  Entered:2000-07-21, Days after submission: 71
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
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0372SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness and swelling to 10cm.

VAERS ID:158053 (history)  Vaccinated:2000-04-16
Age:47.0  Onset:2000-05-01, Days after vaccination: 15
Gender:Male  Submitted:2000-06-13, Days after onset: 43
Location:Pennsylvania  Entered:2000-07-27, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Lyme disease
Diagnostic Lab Data:
CDC 'Split Type': 20000154641
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Post first vax no untoward effects. Post second vax early May experienced right knee joint pain. 05/22/2000 he experienced left knee joint pain. No treatment was given.

VAERS ID:158054 (history)  Vaccinated:1999-05-21
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2000-07-19
Location:Unknown  Entered:2000-07-27, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: HLA-DR4 = Positive
CDC 'Split Type': 20000156181
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthritis, Infection, Laboratory test abnormal, Pain
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Post first and second vax, litigation alleges the pt experienced arthritic-like symptoms in various joints of his body. The newspaper article quotes the pt as developing the same form of arthritis that afflicts his wife after getting vax. Pt has test HLA-DR4 positive and is positive for Lyme disease. He is being treated by MD for these events. The litigation states that the pt has suffered great pain, discomfort and emotional distress as well as the events have severely limited his employment options and opportunities. The litigation alleges that pt Lyme disease and arthritic symptoms associated with his HLA-DR4 positive status were triggered by his vax with Lymerix.

VAERS ID:158059 (history)  Vaccinated:2000-05-08
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2000-06-01
Location:New Jersey  Entered:2000-07-27, Days after submission: 56
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: red;LYMERIX;1;47.00;In Patient
Other Medications:
Current Illness:
Preexisting Conditions: breast cancer
Diagnostic Lab Data:
CDC 'Split Type': 20000160751
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 24 hours post vax, the pt experienced a 6 " diameter area of redness and hardness at the injection site. The consumer stated that the injection site was as hard as a rock. No treatment was given.

VAERS ID:158065 (history)  Vaccinated:1999-05-11
Age:47.0  Onset:1999-05-11, Days after vaccination: 0
Gender:Male  Submitted:2000-06-02, Days after onset: 388
Location:New Jersey  Entered:2000-07-27, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Injection site soreness;Lyme (LYMErix);1;46;In Patient
Other Medications:
Current Illness:
Preexisting Conditions: In 1986, he had a bullseye rash at the site of a tick bite, had blood tests done, and received antibiotics. Six weeks later, he had another blood test and was negative for Lyme disease. He has had multiple tick bites.
Diagnostic Lab Data:
CDC 'Split Type': 2000016418
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM130B92IMRA
Administered by: Private     Purchased by: Other
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: In 1999, the vaccinee received his 1st dose of Lymerix. The day of the vaccination, he had injection arm soreness which lasted a few days and then resolved. In about May, 1999, the vaccinee received his 2nd dose of Lymerix and he had bilateral knuckle swelling which resolved after 1 month. On 5/11/00, the pt received his 3rd dose of Lymerix and he had redness at the injection site, about 6" in diameter and the injection site was hot to touch. These symptoms resolved on 5/16/00. The pt''s symptoms were treated with ice packs to the site. The most recent information, received on 5/16/00 reports the condition of the vaccinee as resolved. THe pt was not sure if he had a fever as he did not take his temperature. The vaccinee''s symptoms were treated with ice packs to the site. The most recent info, received on 8/20/00 reports that the events resolved. Please note that the event of "knuckle swelling" does not meet serious criteria, but is being sumbitted expeditiously for informational purposes.

VAERS ID:158124 (history)  Vaccinated:2000-06-09
Age:47.0  Onset:2000-06-09, Days after vaccination: 0
Gender:Male  Submitted:2000-06-14, Days after onset: 5
Location:Unknown  Entered:2000-07-28, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Queasy;LYMERIX;1;.00;In Patient
Other Medications: atenolol
Current Illness:
Preexisting Conditions: Lyme disease in summer of 1993 treated with antibiotics, has a prolapsed valve (nos),
Diagnostic Lab Data:
CDC 'Split Type': 20000176961
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IMRA
Administered by: Private     Purchased by: Other
Symptoms: Chills, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: In May, 2000, the pt received his 1st dose of Lymerix and within 1 hour, post vax, the vaccinee felt queazy. His queasiness lasted for 1-2 days and resolved. On 6/9/00 at 12:30, the pt received his 2nd Lymerix and within 40 minutes, post vax, he experienced chills and shaking. These symptoms seemed to be lessening but were unresolved. The most recent information, received on 6/9/00, reports the condition of the vaccinee as unresolved.

VAERS ID:158147 (history)  Vaccinated:2000-06-14
Age:47.0  Onset:2000-06-19, Days after vaccination: 5
Gender:Male  Submitted:2000-06-21, Days after onset: 2
Location:Pennsylvania  Entered:2000-07-28, Days after submission: 37
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': 20000186921
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Fatigue, Headache, Hyperhidrosis, Pyrexia, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: On 6/14/00, the pt received his 3rd dose of Lymerix and 5 days later, on 6/19/00, he developed a headache and fatigue. On 6/20/00, he developed a low-grade fever, sweating, sinus congestion and nasal stuffiness which, the vaccinee stated, made it "harder for him to breathe". The most recent information received on 6/20/00, reports the outcome of the event as unresolved.

VAERS ID:158311 (history)  Vaccinated:2000-06-12
Age:47.0  Onset:2000-06-12, Days after vaccination: 0
Gender:Male  Submitted:2000-06-28, Days after onset: 16
Location:Washington  Entered:2000-08-02, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM572B60IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Hyperhidrosis, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Approximately 20 minutes after receiving Hep A vaccine, the pt described having palpitations, shortness of breath, sweating which lasted approximately 1-1 1/2 hours.

VAERS ID:158331 (history)  Vaccinated:2000-07-12
Age:47.0  Onset:2000-07-12, Days after vaccination: 0
Gender:Female  Submitted:2000-07-27, Days after onset: 15
Location:Nevada  Entered:2000-08-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: heart murmur
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0310K IM 
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Dysphonia, Fatigue, Pharyngeal oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: The pt experienced hives, dizziness, hoarsness, felt like something was caught in throat, and fatigue.

VAERS ID:158525 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2000-07-27
Location:Indiana  Entered:2000-08-02, 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': WAES99101365
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a physician''s office concerning a male pt who was vaccinated with pneumococcal vaccine 23 polyvalent. Subsequently, the pt developed a fever, chills, redness at the injection site, and radiating pain up and down the arm from the injection site. Two of the pt''s family members had similar experiences following exposure to pneumococcal vaccine 23 polyvalent. Additional information has been requested.

VAERS ID:158537 (history)  Vaccinated:1999-10-18
Age:47.0  Onset:1999-10-19, Days after vaccination: 1
Gender:Male  Submitted:2000-07-27, Days after onset: 282
Location:Louisiana  Entered:2000-08-02, 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: Diabetes Mellitus; insect sting allergy and meperidine allergy.
Diagnostic Lab Data:
CDC 'Split Type': WAES99101686
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1095H1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Injection site induration, Injection site swelling, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a physician concerning a 47 year old white male who on 10/18/99, was vaccinated IM with a 2nd dose of pneumococcal vaccine 23 polyvalent, in the left deltoid. On 10/19/99, the pt woke up complaining of not being able to move his arm and a large swollen knot to the deltoid area approximately the size of a nickel. The pt noted "entire arm is swollen including fingers." The pt was seen by a physician and treated with Benadryl and alternating ice and heat compresses. On 10/20/99, the pt recovered. No further information is available.

VAERS ID:158643 (history)  Vaccinated:2000-02-25
Age:47.0  Onset:2000-02-26, Days after vaccination: 1
Gender:Female  Submitted:2000-07-27, Days after onset: 151
Location:Kansas  Entered:2000-08-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES99120307
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Skin discolouration
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from an RN concerning a 47 year old female who on 2/25/00 was vaccinated IM with the 1st dose of pneumococcal vaccine 23 polyvalent. On 2/26/00, the pt developed a red, hot and swollen arm "all the way to the elbow". The pt sought unspecified medical attention. Follow-up information received from the physician indicated that on 2/26/00, the pt developed a 6cm X 8cm macule on the left deltoid at the injection site with tenderness. On an unspecified date, the pt recovered. No further information is available.

VAERS ID:158658 (history)  Vaccinated:2000-03-23
Age:47.0  Onset:2000-04-01, Days after vaccination: 9
Gender:Female  Submitted:2000-07-27, Days after onset: 116
Location:New Jersey  Entered:2000-08-09, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Maxalt for migraines
Current Illness: NONE
Preexisting Conditions: hay fever allergy, migraines
Diagnostic Lab Data: Western blot-neg, anti-nuclear antibody-neg
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IM 
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Joint swelling, Pain, Sleep disorder
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow)
Write-up: In the beginning of April, the pt started noticing her hands were hurting. By the end of April, it was in her ankles, then her knee, now her hips. Doctor thinks it is arthritis due to vax. Per doc 197786, patient continues to have arthritic pain in numerous joints. The follow up received on 10/4/00 states, "I saw pt today in follow up and she continues to have a lot of discomfort in that knee. She finds that whenever she tries to exercise that it causes her problems and particularly keeps her awake at night. She is not currently taking any medications. In my previous letter to you I believe I enclosed a copy of her MRI which shows a partial tear in the posterior cruciate ligament but I do not believe it is anything that would be repaired at this time, though if the problem persists we may want her to see an orthopedic surgeon. There were significant degenerative changes present within the knee and the meniscus as a cause for her complaints. At this point I decided to try her on a NSAID to see if we can settle things down and chose Arthrotec 75mg bid with food. I will see her back in three weeks time." "I saw pt today in consultation. She is a pleasant 47 y/o lady who states that in March of this year she had her third injection of the Lyme vaccine. About 2 or 3 weeks alter hse began noticing for the very first time discomfort and some pain in the PIP joints of her fingers and subsequently pain and discomfort in the left knee. In fact it even feels swollen on occasion but is is the left knee that bothers her by far more than anything else. She has had some discomfort in her ankles and hips, but it is mostly the knee and PIP jints that have been giving her problem. She was seen by yourself and bloodwork was within normal limit, with the exception of her Lyme titer which did come up positive, but this was probably due to the vaccine. Her eSR, RA factor, and ANA were normal. She was started on Celebrex which she did not feel helped her much. She was then placed on Vioxx which did help a lot but also caused gastric

VAERS ID:158700 (history)  Vaccinated:2000-07-12
Age:47.0  Onset:2000-07-12, Days after vaccination: 0
Gender:Male  Submitted:2000-08-03, Days after onset: 22
Location:Washington  Entered:2000-08-09, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3231C60IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Cough, Dizziness, Dyspnoea, Flushing, Hyperhidrosis, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: The pt experienced facial flushing and sweating. Severe cough and dizziness. Tachycardia and shortness of breath were also experienced.

VAERS ID:159293 (history)  Vaccinated:2000-08-07
Age:47.0  Onset:2000-08-08, Days after vaccination: 1
Gender:Female  Submitted:2000-08-10, Days after onset: 2
Location:Alaska  Entered:2000-08-29, 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: ????????
Preexisting Conditions: Hypothyroidism; hysterectomy
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0138BA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site mass, Injection site oedema, Injection site pain, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt experienced swelling, erythema and pain at injection site. Fever of 102F, chills, malaise, axillary pain. Later the pts temperature was 99.9F and pt had induration 10 X 12 cm left deltoid. ??????????

VAERS ID:159392 (history)  Vaccinated:2000-08-08
Age:47.0  Onset:2000-08-19, Days after vaccination: 11
Gender:Female  Submitted:2000-08-25, Days after onset: 6
Location:California  Entered:2000-09-06, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': CA000089
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0138BA IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site abscess
SMQs:
Write-up: One day post vax pt developed abscess to left deltoid area, and was evaluated in ER. Pt seen in physician''s office 5 days post vax and given a prescription for Abx.

VAERS ID:160197 (history)  Vaccinated:2000-08-29
Age:47.0  Onset:2000-08-30, Days after vaccination: 1
Gender:Female  Submitted:2000-09-27, Days after onset: 28
Location:Texas  Entered:2000-09-28, 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: Prevacid
Current Illness: Puncture wound on sole of left foot
Preexisting Conditions: PUD, peripheral edema, history of asthma and HTN
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, 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 returned to clinic, after receiving TD. Over the course of 8 days, had developed erythema and edema, gradually increasing in size to more than 20cm in diameter. Treated as cellulitis with Duricef. Pt, however, did not take Duricef and recovered.

VAERS ID:161386 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2001-09-28
Location:Texas  Entered:2000-10-03, Days after submission: 360
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': WAES00053028
Vaccination
Manufacturer
Lot
Dose
Route
Site
MU: MUMPS (MUMPSVAX I)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Chills, Fatigue, Headache, Lymphadenopathy, Malaise, Meningitis
SMQs:, Noninfectious meningitis (narrow), Arthritis (broad)
Write-up: Post vax, the pt developed swollen glands, chills, malaise, headache, fatigue, and joint pain. The pt went to the ER because of viral meningitis. Follow-up info from a registered nurse indicated that the pt was released from the ER with a diagnosis of viral meningitis. It was indicated by the registered nurse that it was the pt who reported tat she had viral meningitis; this diagnosis was not confirmed by the registered nurse. Subsequently, the pt reported that she had "imporve a lot." Additional info has been requested.

VAERS ID:160347 (history)  Vaccinated:1999-04-04
Age:47.0  Onset:1999-06-04, Days after vaccination: 61
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:2000-10-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: HLA-DR1:Lyme Western Blot; IgG (+)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM  IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Laboratory test abnormal, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Two months post 2nd vax, the pt''s hip joints started to ache and muscles were tight in the spine. Shoulder pain was experienced also. .

VAERS ID:160352 (history)  Vaccinated:1999-05-04
Age:47.0  Onset:1999-05-06, Days after vaccination: 2
Gender:Female  Submitted:2002-10-02, Days after onset: 1245
Location:New Jersey  Entered:2000-10-05, Days after submission: 727
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM104A20IMRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Arthritis, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow)
Write-up: Two days post vax, the pt experienced joint pain. On 5/11/99, the pt''s feet were swollen bilaterally; severe hip, knee, and ankle pain. Not good since then. The follow up received on 1/31/01 states concurrent medical conditions included severe premenstrual syndrome, a penicillin allergy, a family history of rheumatoid arthritis, a history of fluid retention, arthritic pain in fingers and knee caps (1987) when taking megastrol and aldactaside, and the feeling of flu-like symptoms while on aldactaside. Aldactaside was discontinued on 6/4/97. Medical records from the pt''s cynacologist and gynecoendocrinologist indicated pt was complaining of multiple arthralgias at 5/6/99 visit. Lab tests revealed negative lab tests for antinuclear antibody and rheumatoid factor on 5/17/99. The pt had elevated eosinoophils 7.4%, elevated monocytes 0.4 thousand/cubic millimeter, and elevated globulins 3.4cm/dl. The information received on 1/31/01 did not provide an outcome. The adverse events of reactive arthritis and joint pain do not meet serious criteria, but are being submitted as an expedited report by special FDA request per the 6/28/00 letter. A follow up report received 10/10/2002 adds: (in May 1999) The symptoms were treated with an anti-inflammatory, steroids, celecoxib (Celebrex) 100 mg twice daily for 1.5 weeks and nabumotone (Relafen) 750 mg every 12 hours. The info received on 06/09/1999 reported the pain was less severe, but the swelling persisted. The info received on 01/31/2001 did not provide an outcome. In a news article published 06/25/2001, a reporter stated, "The stiffness and swelling has become so severe that she is dependent on anti-inflammatory drugs to keep her mobile". The pt stated, "I just keep moving. It doesn''t get rid of the pain, but it keeps me from stiffening." The outcomes of the flu-like symptoms and viral syndrome were not provided. The most recent info, received on 02/11/2002, did not provide the outcome of the reported events. The adverse event of "reactive arthritis" does not meet ICH se

VAERS ID:162237 (history)  Vaccinated:1999-10-04
Age:47.0  Onset:1999-10-04, Days after vaccination: 0
Gender:Female  Submitted:1999-11-12, Days after onset: 39
Location:California  Entered:2000-10-13, Days after submission: 335
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 sulfa
Diagnostic Lab Data:
CDC 'Split Type': U1999-007580
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0096EA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Dyspnoea, Hypersensitivity, Injection site pain, Pleuritic pain
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: It was reported that a 47 year old female received Fluzone SV ''99-''00 vaccination on 10/4/99, at 07:30. "Four hours after she began to experience pain at her left deltoid, which radiated over cap of shoulder and down axilla. It felt like a fractured rib with deep breathing and was difficult to breathe for 72 hours." On 10/8/99, the pt was "feeling 100 % recovered". No treatment was given. No additional information was provided from follow-up correspondence request.

VAERS ID:162271 (history)  Vaccinated:1999-10-20
Age:47.0  Onset:1999-10-20, Days after vaccination: 0
Gender:Female  Submitted:1999-11-01, Days after onset: 12
Location:Utah  Entered:2000-10-13, Days after submission: 346
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': U1999008050
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0159AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: It was reported that a 47 year old female received Fluzone SV ''99-''00 on 10/20/99. "One hour, post vax, she developed generalized urticaria and itching." No further information is available at this time.

VAERS ID:162300 (history)  Vaccinated:1999-10-22
Age:47.0  Onset:1999-10-23, Days after vaccination: 1
Gender:Male  Submitted:1999-12-15, Days after onset: 53
Location:New York  Entered:2000-10-13, Days after submission: 302
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': U1999008980
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0150AA IMRA
Administered by: Public     Purchased by: Other
Symptoms: Ecchymosis, Epistaxis, Rash macular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow)
Write-up: It was reported that a male pt received a Fluzone SV ''99-''00 vaccination on 10/22/99. Reportedly, the next day, post vax, the pt developed a red rash over his entire body, along with ecchymosis and nosebleeds. Correspondence received on 12/1/99, states that the pt began taking vitamin K after a few days with a decrease of gum and nose bleeds. The pt refused to see the doctor, but reported the symptoms on 11/8/99. A fine macular rash with large ecchymosis was noted.

VAERS ID:162536 (history)  Vaccinated:1999-09-29
Age:47.0  Onset:1999-10-02, Days after vaccination: 3
Gender:Male  Submitted:2000-03-21, Days after onset: 171
Location:Virginia  Entered:2000-10-13, Days after submission: 205
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': U2000001520
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0096BA IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Fatigue, Myalgia, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: 3 days post vax, the pt developed fatigue, palpitations, muscle and joint pain. The pt still suffers from these symptoms but now to a lesser degree.

VAERS ID:160541 (history)  Vaccinated:2000-10-11
Age:47.0  Onset:2000-10-12, Days after vaccination: 1
Gender:Female  Submitted:2000-10-13, Days after onset: 1
Location:Iowa  Entered:2000-10-16, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Local;UNK. UNCLASSIFIED VACCINE;;.00;In Patient
Other Medications: Estrogen, Zyrtec
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4665503IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: TD given in left deltoid on 10/11/00 at 08:00. Client called clinic stating that Wednesday the area was non-reactive and then Thursday, noticed swelling, redness and tenderness at site and continues to enlarge. Office measurement was 12cm X 10cm of induration and erythema.

VAERS ID:160667 (history)  Vaccinated:2000-03-21
Age:47.0  Onset:2000-03-21, Days after vaccination: 0
Gender:Female  Submitted:2000-04-18, Days after onset: 27
Location:Kansas  Entered:2000-10-18, Days after submission: 183
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, took ASA for aching
Current Illness:
Preexisting Conditions: PABA (rash), PCN analogs (all), Augmentin, Hashimoto''s Disease (thyroid), EES, Keflex
Diagnostic Lab Data: NONE
CDC 'Split Type': KS200019
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1970J0IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM651B60IMLA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Arthritis, Back pain, Feeling hot, Muscle spasms
SMQs:, Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Arthritis (narrow)
Write-up: Reports right deltoid, at site of Hep-B vaccine, fibrillated, starting 2 hours, post vax, until bedtime. By evening of the same day, she received vaccines, she noted "feeling of warmth" radiating down her spine, accompanied by arthritis-like aching. Her spinal discomfort disappeared after 1 week. The leg sensation persists and on 4/16/00, appeared also in right leg. The tendon under her right knee cap ached for 1 day, post vax.

VAERS ID:160731 (history)  Vaccinated:2000-10-12
Age:47.0  Onset:2000-10-13, Days after vaccination: 1
Gender:Female  Submitted:2000-10-16, Days after onset: 3
Location:Michigan  Entered:2000-10-19, 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: NTG, atenolol, Prevacid, Vioxx, Premarin, Levoxyl, Paxil, Talwin, droperidol, Fiorinal
Current Illness: NONE
Preexisting Conditions: Mitral Valve Prolapse; heart murmur, arthritis, Thyroidism
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E66330HA2IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Received vaccine on 10/12/00. Pt complained of redness, swelling burning sensation and tenderness at injection site. States approx. 3-4cm in size. Symptoms first noted on 10/13/00. Treated at hospital on Sunday, 10/15/00 with Keflex.

VAERS ID:160867 (history)  Vaccinated:2000-10-03
Age:47.0  Onset:2000-10-03, Days after vaccination: 0
Gender:Female  Submitted:2000-10-05, Days after onset: 2
Location:Missouri  Entered:2000-10-24, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Toprol XL
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': MO2000076
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM667B61IMLA
Administered by: Other     Purchased by: Public
Symptoms: Headache, Nausea, Neck pain, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Body aches, headache and fever 100.5. Developed chills and nausea later that evening. 10/5/2000 still having aches and neck pain, headaches, nausea. Yesterday felt much worse.

VAERS ID:160973 (history)  Vaccinated:2000-09-19
Age:47.0  Onset:2000-09-20, Days after vaccination: 1
Gender:Male  Submitted:2000-10-19, Days after onset: 29
Location:Michigan  Entered:2000-10-25, 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: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3233B60IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM654A40IMRA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES471039 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Pain
SMQs:
Write-up: Developed general body aching and chills approx. 36 hours, post vax, symptoms lasting approx. 48 hours.

VAERS ID:160995 (history)  Vaccinated:2000-10-12
Age:47.0  Onset:2000-10-13, Days after vaccination: 1
Gender:Female  Submitted:2000-10-19, Days after onset: 6
Location:Unknown  Entered:2000-10-26, 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: Atenolol, HCTZ
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': ND0013
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0333AA3IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Post vax, the pt developed erythema, edema-a localized reaction. It looked like hives around the injection site. Also, pain in arm.

VAERS ID:162893 (history)  Vaccinated:2000-06-23
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2000-07-12
Location:California  Entered:2000-10-26, Days after submission: 106
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fever, lower back pain;Lyme (LYMErix);1;0;In Patient
Other Medications: Lipitor; Orocept
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CBC with differential = ); SGOT = 45 U/L; SGPT = 96 U/L
CDC 'Split Type': 20000208081
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM146A91IMRA
Administered by: Private     Purchased by: Private
Symptoms: Alanine aminotransferase increased, Arthralgia, Aspartate aminotransferase increased, Back pain, Liver function test abnormal, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Four days subsequent to first dose of Lymerix, pt experienced fever of 103 degrees and lower back pain. The symptoms lasted for four days and resolved. Two days subsequent to receiving second dose of Lymerix, the pt experienced fever of 102.5 degrees, muscle and joint pain. The outcome is unresolved. Subsequent to an unspecified dose of Lymerix pt experienced elevated liver function tests with AST = 45 and ALT= 96. Pt will be worked up for hepatitis. No risk factors for pt were identified. The most recent information reports the outcome of the event as ongoing.

VAERS ID:161128 (history)  Vaccinated:2000-10-25
Age:47.0  Onset:2000-10-25, Days after vaccination: 0
Gender:Female  Submitted:2000-10-26, Days after onset: 1
Location:Nebraska  Entered:2000-10-31, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0403AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: 2 hours, post vax, had increased temperature, chills and body aches; temperature increased to 100.4F that lasted 2 hours and chills continued through evening. Had some body aches today, 10/26/00, and chills with decreased temperature.

VAERS ID:161144 (history)  Vaccinated:2000-10-24
Age:47.0  Onset:2000-10-25, Days after vaccination: 1
Gender:Male  Submitted:2000-10-27, Days after onset: 2
Location:West Virginia  Entered:2000-10-31, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Laceration
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7397AB IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt experienced significant swelling, erythema with a 3cm by 4cm knot in the left deltoid and extreme tenderness. No fever.

VAERS ID:161273 (history)  Vaccinated:2000-10-26
Age:47.0  Onset:2000-10-28, Days after vaccination: 2
Gender:Male  Submitted:2000-10-28, Days after onset: 0
Location:Massachusetts  Entered:2000-11-02, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Codeine
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IM 
Administered by: Public     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Local reaction with cellulitis appearing about 36 hours, post vax, consisting of an area of induration and erythema measuring 2 1/2cm X 7 1/2cm; cellulitis with a 9cm streak going into axilla.

VAERS ID:161561 (history)  Vaccinated:2000-10-13
Age:47.0  Onset:2000-10-13, Days after vaccination: 0
Gender:Female  Submitted:2000-10-17, Days after onset: 4
Location:Washington  Entered:2000-11-07, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergies to hay and cedar; Osteoarthritis; Fibromyalgia
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.80929 IM 
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Headache, Injection site reaction, Nausea, Pruritus, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: One hour, post vax, I began to itch over the site. By the next Saturday morning, I had hives over the area. On Sunday morning, I had nausea and emesis that began with a headache and has continued up to now. Diarrhea began on Monday afternoon.

VAERS ID:161565 (history)  Vaccinated:2000-10-27
Age:47.0  Onset:2000-10-27, Days after vaccination: 0
Gender:Male  Submitted:2000-10-30, Days after onset: 3
Location:Wyoming  Entered:2000-11-07, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shoulder to the bone;UNK. INFLUENZA VACCINE;1;35.00;In Patient
Other Medications: Flomax, Aciphex
Current Illness: NONE
Preexisting Conditions: History of thimansol allergy from contact lens solutions.
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETHWY4008171 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: I had severe muscle pain and joint pains. Worst muscle pain was in shoulders and worst joint pain was in right ankle and right hip joint. No swelling. I have chills and low-grade fever. Symptoms started about 1-2 hours after injection and peaked about 12-15 hours later. Some mild pain persisted for 72 hours. Self treated with prednisone X 2 days. 1

VAERS ID:161609 (history)  Vaccinated:2000-11-01
Age:47.0  Onset:2000-11-01, Days after vaccination: 0
Gender:Female  Submitted:2000-11-02, Days after onset: 1
Location:Texas  Entered:2000-11-08, 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: allergies
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0402AA0IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4691330 RA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Post vax, the pt developed severe pain, swelling, red streaks across arm; sore under arm.

VAERS ID:161904 (history)  Vaccinated:2000-10-20
Age:47.0  Onset:2000-10-22, Days after vaccination: 2
Gender:Female  Submitted:2000-11-07, Days after onset: 16
Location:North Carolina  Entered:2000-11-14, 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: multiple vitamins, daily
Current Illness: NONE
Preexisting Conditions: Allergic to PCN, formaldehyde, and latex.
Diagnostic Lab Data: NONE
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0583K/0916K0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0649K/1018K0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Lymphoedema, Oedema peripheral, Serum sickness
SMQs:, Cardiac failure (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: On 10/22/00, began to feel "soreness'' behind knees. On 11/1/00, lymph glands started to swell. On 11/2/00, back of right knee very swollen and painful. Saw MD who dx''d as "serum sickness" (allergic reaction to MMR II vaccine) and was given anti-inflammatory meds and pain pills. From 11/3/00 to 11/5/00, complained of swelling to both thumbs, painful, right knee swelling decreased, but left knee swollen along with ankles and elbows.

VAERS ID:163364 (history)  Vaccinated:2000-03-13
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2000-03-27
Location:Colorado  Entered:2000-11-14, Days after submission: 232
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE Reported
Diagnostic Lab Data:
CDC 'Split Type': 2000008399-1
Vaccination
Manufacturer
Lot
Dose
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Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM3203A40IMLA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM639A40IM 
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dizziness, Headache, Nausea, Palpitations, Pharyngeal oedema, Pharyngolaryngeal pain
SMQs:, Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Ten hours post vax while relaxing in bed, the vaccinee experienced pounding heart, throbbing temples, dizziness, weakness, nausea. In addition her throat hurt and felt swollen. The episode lasted twenty minutes, after which things returned to normal. No treatment was given.

VAERS ID:163382 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2000-05-31
Location:Unknown  Entered:2000-11-14, Days after submission: 167
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': 20000160231
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Multiple sclerosis
SMQs:, Optic nerve disorders (broad), Demyelination (narrow)
Write-up: One month post vax, the pt was dx with multiple sclerosis which was reportedly confirmed by three physicians.

VAERS ID:163423 (history)  Vaccinated:2000-05-11
Age:47.0  Onset:2000-05-22, Days after vaccination: 11
Gender:Female  Submitted:2001-04-25, Days after onset: 338
Location:New York  Entered:2000-11-14, Days after submission: 161
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Zantac, Monistat, Excedrin
Current Illness:
Preexisting Conditions: Gastroesophageal reflux disease; allergic to bacteria, dust, mold, trees; headahces; vaginal yeast infection
Diagnostic Lab Data:
CDC 'Split Type': 20000229381
Vaccination
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2720C60IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Face oedema, Pharyngeal oedema, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: The evening of after receiving vax, the pt experienced swollen lips and generalized hives. She went to the ER eleven days later with shortness of breath and swollen throat. She is currently being seen by an allergist and dermatologist. She is being treated with prednisone and several antihistamines. The physician reported that the pt experienced "severe" generalized urticaria/angioedema beginning in July 2000. The severe urticaria occurred daily. Reportedly, she did well with prednisone burst therapy, bu tthe hives recurred whenever te prednisone was discontinued. The hives were eventually suppreased 6 months after onset. In approx Oct 2000, hives started to disappear. Reportedly, the physician stated that "the hives are probably leaving my system by now." The physician reported that the urticaria resolved in October 2000. The vaccinee reported on 02/07/2000 that she was still experiencing the same events "on and off." She is currently being seen by an allergist and dermatologist. Engerix-B was discontinued. The physician stated that the urticaria was possibly related to Engerix-B. A different physician stated that the event was idiopathic. As 04/24/2001, the outcome of the event was resolved.

VAERS ID:163455 (history)  Vaccinated:2000-05-11
Age:47.0  Onset:2000-05-11, Days after vaccination: 0
Gender:Female  Submitted:2000-09-01, Days after onset: 113
Location:New York  Entered:2000-11-14, Days after submission: 74
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Monistat
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 20000262251
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Face oedema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Five hours post vax the pt developed swollen lips. The next day the pt developed hives with itching all over her body. She was seen by an allergist and a dermatologist. She received prednisone 10 mg daily and her symptoms were slowly resolving. When the prednisone was stopped her symptoms returned within 24 hours (this happened twice). Other treatment drugs included Allegra one daily, Atarax 4-6 daily, Periactin 4 daily, and Zantac 2 daily. As of 08/28/2000 the outcome of the event is ongoing.

VAERS ID:161958 (history)  Vaccinated:2000-11-06
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2000-11-07
Location:Colorado  Entered:2000-11-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estraderm patch
Current Illness: NONE
Preexisting Conditions: Allergy to animal dander, Cleocin, Zoloft; menopausal
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0415AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Erythema, Hyperhidrosis, Nausea, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)
Write-up: Nausea, sweating, weakness, 10 minutes after injection and lasted approx. 20 minutes. Itching and redness in right hand and anticubital area, sometime, as above, redness subsided by mid-afternoon; itchy sensation and tenderness in right hand continued the day after injection. Right flank pain, approx. 3-4 hours, post vax, and still present the next day, but very mild; no fever, chills or other symptoms.

VAERS ID:162112 (history)  Vaccinated:2000-11-08
Age:47.0  Onset:2000-11-09, Days after vaccination: 1
Gender:Male  Submitted:2000-11-10, Days after onset: 1
Location:Michigan  Entered:2000-11-17, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Atypical chest pain
Preexisting Conditions: History of hives with IVP
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0330AA0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, 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 (broad)
Write-up: Pt reports vax site red, sore, swollen itchy. Painful, pt advised to see MD.

VAERS ID:162472 (history)  Vaccinated:2000-05-18
Age:47.0  Onset:2000-09-28, Days after vaccination: 133
Gender:Male  Submitted:2000-11-14, Days after onset: 47
Location:Minnesota  Entered:2000-11-22, 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: Arthrotec, Prevacid
Current Illness: NONE
Preexisting Conditions: Osteoarthritis-right knee
Diagnostic Lab Data: Was given test for rheumatoid arthritis-results nml
CDC 'Split Type':
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY144B92IM 
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Arthritis, Joint swelling
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow)
Write-up: Arthritic pain, swollen joint on right hand, pain in both ankles, big toe on right foot and also right elbow pain and swelling is ongoing. I am being treated by a rheumatologist and I am taking RX: Celebrex 200mg 2 X daily.

VAERS ID:162580 (history)  Vaccinated:2000-11-08
Age:47.0  Onset:2000-11-09, Days after vaccination: 1
Gender:Female  Submitted:2000-11-15, Days after onset: 6
Location:North Carolina  Entered:2000-11-24, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': NC00088
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0946K IMRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site mass, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt reported site of injection to be "swollen" and area red from "shoulder to elbow" and "knot" under skin at site of injection.

VAERS ID:162666 (history)  Vaccinated:2000-11-09
Age:47.0  Onset:2000-11-10, Days after vaccination: 1
Gender:Female  Submitted:2000-11-13, Days after onset: 3
Location:California  Entered:2000-11-28, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Interferon
Current Illness: hepatitis C Treatment
Preexisting Conditions: hepatitis C
Diagnostic Lab Data:
CDC 'Split Type': CA000118
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0409AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: The pt experienced a fever of 101, myalgia, arthralgias, sore arm at injection site, lasting 24 hours.

VAERS ID:162684 (history)  Vaccinated:2000-11-15
Age:47.0  Onset:2000-11-18, Days after vaccination: 3
Gender:Female  Submitted:2000-11-20, Days after onset: 2
Location:Florida  Entered:2000-11-28, 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: Depakote. TB, Pasteur Merieux Connaught, lot number CC018AA, right forearm,11/15/00.
Current Illness: NONE
Preexisting Conditions: Codeine
Diagnostic Lab Data: NONE
CDC 'Split Type':
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DTP: DTP (NO BRAND NAME)CONNAUGHT LABORATORIESU0316AA IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site vesicles
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Vaccine (Tetanus) given on 11/15/00, so was (TB tine test) Friday, 11/17/00. TB was checked it was negative, the Tetanus was swollen and red. On Saturday, 11/18/00, it blistered half the diameter of swelling.

VAERS ID:162812 (history)  Vaccinated:2000-11-15
Age:47.0  Onset:2000-11-15, Days after vaccination: 0
Gender:Female  Submitted:2000-11-16, Days after onset: 1
Location:Pennsylvania  Entered:2000-11-29, 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: Synthroid, Ortho-Novum
Current Illness: NONE
Preexisting Conditions: Hypothyroidism, aortic valve replacement
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0406AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pruritic macular rash over arms, legs, back and trunk. Treated with Benadryl and cimetidine, then prednisone.

VAERS ID:162855 (history)  Vaccinated:2000-04-01
Age:47.0  Onset:2000-04-25, Days after vaccination: 24
Gender:Male  Submitted:2000-05-06, Days after onset: 11
Location:Texas  Entered:2000-11-30, Days after submission: 208
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0312SCLA
Administered by: Military     Purchased by: Military
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: 4/28/2000 C/O numbness to right lateral lower extremities. Numbness still present

VAERS ID:163107 (history)  Vaccinated:2000-11-30
Age:47.0  Onset:2000-11-30, Days after vaccination: 0
Gender:Female  Submitted:2000-11-30, Days after onset: 0
Location:Oklahoma  Entered:2000-12-05, 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: Altace, Prednisone, Soma, Celebrex
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008180 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Complaining of itching at site, lower left arm and face, 5 minutes, post vax. Given Benadryl 25mg po and repeated, 1 hour later. She went to see her doctor. Her husband picked her up from work and took her to the doctor.

VAERS ID:163614 (history)  Vaccinated:2000-03-16
Age:47.0  Onset:2000-07-01, Days after vaccination: 107
Gender:Male  Submitted:2000-12-02, Days after onset: 154
Location:Wisconsin  Entered:2000-12-12, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Coumadin, Inderal, amitriptilene, Relafen
Current Illness: NONE
Preexisting Conditions: migraine headaches, aortic coarctation, artificial heart valve
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM118A21IM 
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: The pt experienced joint pain in the left elbow and left knee. Beginning in 7/00 and still occurring. It varies in intensity, sometimes can not ever pick up a gallon of milk.

VAERS ID:163841 (history)  Vaccinated:2000-11-04
Age:47.0  Onset:2000-11-04, Days after vaccination: 0
Gender:Female  Submitted:2000-12-08, Days after onset: 34
Location:New Jersey  Entered:2000-12-18, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: edema;UNK. INFLUENZA VACCINE;;45.00;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergy to bacitracin
Diagnostic Lab Data: NONE
CDC 'Split Type': NJ200024
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0346AA3IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Eye disorder, Injection site rash, Periorbital oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Corneal disorders (broad), Retinal disorders (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: The pt''s eyes began to itch on 11/5. By 11/6 the pt had full periorbital swelling and itching lasting 4 days. The pt also developed red rash at the vaccine site. Eventually had generalized facial edema.

VAERS ID:163903 (history)  Vaccinated:2000-12-04
Age:47.0  Onset:2000-12-04, Days after vaccination: 0
Gender:Female  Submitted:2000-12-11, Days after onset: 7
Location:California  Entered:2000-12-19, 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: necon; BC pills
Current Illness: NONE
Preexisting Conditions: Asthma
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 5IMLA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMRA
Administered by: Private     Purchased by: Other
Symptoms: Hypersensitivity, Injection site pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Arm became very sore and tender to touch and hives around shot site. Took Benadryl and applied ice. On 12/6/99, saw the doctor. Rx''d for Atarax. Missing informtion is unavailable.

VAERS ID:164316 (history)  Vaccinated:2000-12-01
Age:47.0  Onset:2000-12-01, Days after vaccination: 0
Gender:Female  Submitted:2000-12-22, Days after onset: 21
Location:Minnesota  Entered:2001-01-02, Days after submission: 11
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singulair, Pepcid, Beclovent, Serevent, Vancenase AQ
Current Illness: NONE
Preexisting Conditions: Asthma; benign arachnoid cyst in brain
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40081950IMRA
Administered by: Private     Purchased by: Other
Symptoms: Asthma, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: The pt experienced an asthma attack, difficulty breathing, brought under control with repeated doses of albuterol inhaler.

VAERS ID:164406 (history)  Vaccinated:2000-12-15
Age:47.0  Onset:2000-12-17, Days after vaccination: 2
Gender:Female  Submitted:2000-12-22, Days after onset: 5
Location:Arizona  Entered:2001-01-03, 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: E Barr, Porphyria, Asthma
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': AZ0035
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008220 IM 
Administered by: Public     Purchased by: Other
Symptoms: Abdominal pain, Fatigue, Injection site pain, Liver disorder, Malaise
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pts arm was sore and 24 hours later pt experienced fatigue and malaise. Two days post vax RU quadrant pain. the next day pt was seen in ER. Liver enlarged upon physical. Pt treated with Vicodan

VAERS ID:164461 (history)  Vaccinated:2000-12-12
Age:47.0  Onset:2000-12-12, Days after vaccination: 0
Gender:Female  Submitted:2001-01-02, Days after onset: 21
Location:New Hampshire  Entered:2001-01-04, 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: Premarin
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40081922IM 
Administered by: Other     Purchased by: Other
Symptoms: Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)
Write-up: The pt complained of vertigo and was unable to drive home. The pt also experienced nausea, vomiting. Vertigo is about 95% improved as of today.

VAERS ID:164601 (history)  Vaccinated:2000-12-19
Age:47.0  Onset:2000-12-19, Days after vaccination: 0
Gender:Female  Submitted:2000-12-21, Days after onset: 2
Location:New Hampshire  Entered:2001-01-10, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4735550 LA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient noted 1-2 days after vaccine that her left upper arm was swollen, hot, and red distally down the arm.

VAERS ID:164768 (history)  Vaccinated:2000-12-12
Age:47.0  Onset:2001-01-07, Days after vaccination: 26
Gender:Male  Submitted:2001-01-10, Days after onset: 3
Location:Pennsylvania  Entered:2001-01-17, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dilantin, Phenobarbital
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: Drug level NOS above therapeutic level Phenytoin (Dilantin) and Phenobarbital levels.
CDC 'Split Type': HQ5758910JAN2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  IM 
Administered by: Other     Purchased by: Other
Symptoms: Drug level increased
SMQs:, Drug abuse and dependence (broad)
Write-up: A pharmacy student reported that a 47 year old male received an injection of Flu Shield (''00-''01) on 12/12/00. On 1/7/01, the pt was hospitalized with elevated phenytoin (33 mcg/mL) and phenobarbital levels (no value provided).

VAERS ID:165280 (history)  Vaccinated:2000-10-29
Age:47.0  Onset:2000-10-30, Days after vaccination: 1
Gender:Male  Submitted:2000-11-03, Days after onset: 4
Location:New York  Entered:2001-01-29, Days after submission: 87
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pain, swelling~Tetanus Toxoid (unknown mfr)~~6~In Patient
Other Medications: Norvasc, Diavan
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0415AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Eye pain, Fatigue, Lymph node pain, Malaise
SMQs:, Glaucoma (broad), Arthritis (broad)
Write-up: The pt experienced tenderness to the left armpit, mild aches to the knees, elbows tiredness, eyes burning, general malaise. Pain started disappearing. 2 days later symptoms had resolved.

VAERS ID:165281 (history)  Vaccinated:2000-10-29
Age:47.0  Onset:2000-10-30, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:2001-01-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: synthroid
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0415AA0IM 
Administered by: Other     Purchased by: Other
Symptoms: Fatigue, Injection site erythema, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The pt complained of redness, tenderness, soreness for 3 days at the injection site. The pt also experienced mild aches, fatigue, no elevated temp.

VAERS ID:165333 (history)  Vaccinated:2000-12-22
Age:47.0  Onset:2000-12-22, Days after vaccination: 0
Gender:Female  Submitted:2001-01-22, Days after onset: 31
Location:Pennsylvania  Entered:2001-01-30, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho Novum birth control pills
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40082040IM 
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: 45 minutes post vax, the pt experienced itching on arm. 1 hour post vax, the pt experienced whole body itching, red flushing. Treated with Benadryl. 4 hours later was repeated because of symptoms.

VAERS ID:165392 (history)  Vaccinated:2000-09-26
Age:47.0  Onset:2000-10-04, Days after vaccination: 8
Gender:Female  Submitted:2000-12-27, Days after onset: 84
Location:New York  Entered:2001-01-30, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prempro, Humulin Insulin
Current Illness: UNK
Preexisting Conditions: Diabetes Mellitus NOS; Hormone replacement therapy
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ2076111OCT2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  IM 
Administered by: Other     Purchased by: Other
Symptoms: Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: A 47 year old female consumer reported that she received an influenza vaccine on 9/26/00. On 10/4/00, she experienced sneezing and nasal congestion.

VAERS ID:165421 (history)  Vaccinated:2000-10-30
Age:47.0  Onset:2000-10-31, Days after vaccination: 1
Gender:Female  Submitted:2000-12-27, Days after onset: 57
Location:Virginia  Entered:2001-01-30, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol, lorazepam, ranitidine, Zoloft
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ3202503NOV2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: A 47 year old female received an injection of Flu Shield ''00-''01 on 10/30/00. On 10/31/00, she reportedly developed swelling at the injection site.

VAERS ID:165603 (history)  Vaccinated:2001-01-21
Age:47.0  Onset:2001-01-21, Days after vaccination: 0
Gender:Female  Submitted:2001-01-23, Days after onset: 2
Location:Missouri  Entered:2001-02-06, 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: NONE
Current Illness: NONE
Preexisting Conditions: Hx of fainting or nearly fainting after shots esp. in Doctors office.
Diagnostic Lab Data: NONE
CDC 'Split Type': MO2001001
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008233 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Hypotension, Tinnitus
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad)
Write-up: Immediately after receiving vaccine client c/o ringing in ears and lightheadedness. Had client lie down, elevated feet and used ammonia inhalant. BP consistent 94/46. Felt better in approx 10 minutes and BP 100/60 after walking around before release 1/18/2000. Client had no further problem.

VAERS ID:165941 (history)  Vaccinated:1999-10-22
Age:47.0  Onset:2000-01-01, Days after vaccination: 71
Gender:Male  Submitted:2001-07-06, Days after onset: 551
Location:Unknown  Entered:2001-02-16, Days after submission: 139
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: HLA-DR4 positive.
Diagnostic Lab Data:
CDC 'Split Type': 20010035181
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Report 2001003518-1 describes arthritic symptoms in a 47 year old male who received Lymerix. This report was received from a lawyer and has not been verified by a physician or other health care professional. On 09/22/99 and 10/23/99, the vaccinee received his first and second doses of Lymerix, respectively. Reportedly, by January, 2000, he began experiencing "severe joint pain of acute onset which worsened through February, 2000." As of 02/01/01, these arthritic symptoms "have not resolved, despite the prescription of1 ofecoxib (Vioxx), Prednisone, Methotroxate, and hydroxychloroquine phosphate (Plaquenil)." The adverse event of "arthritic symptoms" does not meet ICH serious criteria, but is being submitted as an expedited report by special FDA request per the June 28, 2000 letter.

VAERS ID:166158 (history)  Vaccinated:2001-02-13
Age:47.0  Onset:2001-02-14, Days after vaccination: 1
Gender:Unknown  Submitted:0000-00-00
Location:Alaska  Entered:2001-02-26
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: Blind
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIESC0256AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt has 1 1/2" diameter hard and painful swelling at injection site.

VAERS ID:166389 (history)  Vaccinated:2000-10-01
Age:47.0  Onset:2001-01-01, Days after vaccination: 92
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:2001-03-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: June 2000, Respiratory infection
Diagnostic Lab Data: CT Scan of lumbosacral spine; MRI of brain and cervical spine; EMG; Spinal Tap and Blood work, done in mid-December to mid-January-all wnl.
CDC 'Split Type': MPI2001002360
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E65630HA IM 
Administered by: 0     Purchased by: 0
Symptoms: Arthralgia, Drug interaction, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: Report received 2/13/00, from a physician, regarding adverse events possibly associated with Fluvirin. A 47 year old female pt received the vaccination at the end of October, 2000 and within 2 weeks, she developed severe arthritic symptoms; took ibuprofen, with relief; stopped the ibuprofen and relapsed. In mid-December, she developed ascending numbness, from feet to neckline and the sensation of "stocking/glove"; not complete loss of sensation. On 1/01/01, she noticed electrical-shocking spasms. She has been prescribed a 21 day course of Ceftin for Lyme Disease-like symptoms; is also being treated with Pamelor some compound (carisoprodol and aspirin preparation), and Motrin. The pt had received her 3rd and final dose of Lymerix vaccine in June of 2000. The reporting MD questions interaction between Lymerix and Fluvirin or the possibly that Fluvirin stimulated on autoimmune reaction to trigger Lyme-like reaction. Additional information has been requested.

VAERS ID:166646 (history)  Vaccinated:2000-11-13
Age:47.0  Onset:2000-11-13, Days after vaccination: 0
Gender:Female  Submitted:2001-01-31, Days after onset: 79
Location:Pennsylvania  Entered:2001-03-06, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: esophageal reflux, asthma, diabetes, allergy to sulpha, PCN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0406AA IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES459857 IMRA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Cough, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad)
Write-up: The pt experienced severe weakness, coughing, fever, chills. The pt required antibiotics.

VAERS ID:166813 (history)  Vaccinated:1999-10-13
Age:47.0  Onset:1999-10-20, Days after vaccination: 7
Gender:Male  Submitted:2001-02-16, Days after onset: 485
Location:Pennsylvania  Entered:2001-03-08, Days after submission: 20
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: atenolol 25mg
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Blood test done on 12/99 at hospital-showed high signs of Lyme Disease and was told not to get 3rd shot. Also seen by a neurologist.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY128A21IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain upper, Arthralgia, Chest pain, Dizziness, Fatigue, Feeling cold, Headache, Hyperhidrosis, Hypoaesthesia oral, Infection, Nausea, Pain, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: Pain on leg, numbness in crotch, face, mouth, arms, feet and rectum. Burning in feet, down inside of legs, testicles, sharp jabs of pain in chest, cold sweats, tired, light-headed, queasy sick, joint pain in all joints, headaches and numbness all over. All symptoms come and go from day to day. Symptoms have been less and milder since March 2000, but still have all the symptoms, to this day. (no treatment) 60 day follow up states patient experienced burning across shoulders, down arms, and hands. Patient has tingling in face and top of head and stomach pain.

VAERS ID:166839 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2001-03-01
Location:New Jersey  Entered:2001-03-08, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM  IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Muscle spasms, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Arthritis (broad)
Write-up: After receiving 3rd injection of LymeRix pt reported arthralgia lasting 2 to 4 weeks. End of October pt received Influenza vaccine pt experienced arthralgia then dysesthsias. Pt has experienced spasms.

VAERS ID:166879 (history)  Vaccinated:2001-02-02
Age:47.0  Onset:2001-02-15, Days after vaccination: 13
Gender:Male  Submitted:2001-03-07, Days after onset: 20
Location:New York  Entered:2001-03-09, Days after submission: 2
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: 02/15/01 AST - 719 U/L, ALT - 1694 U/L.
CDC 'Split Type': 20010052542
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3358A60IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS670B60IMRA
Administered by: Other     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased
SMQs:, Liver related investigations, signs and symptoms (narrow)
Write-up: Report 2001005254-1 describes elevation of AST and ALT in a 47 year old male who received Hep A vaccine (Havrix) for prophylaxis of Hep A. The vaccinee received Hep B vaccine (Engerix-B) on 02/02/01. On 02/02/01, the vaccinee received his first dose of Havrix. Thirteen days later, on 02/15/01, he was found to have elevated AST (719 U/L) and elevated ALT (1694 U/L). No symptoms were reported. This event is considered SmithKline Beecham medically serious. As of 02/26/01, the outcome of the adverse events is unresolved.

VAERS ID:166940 (history)  Vaccinated:2001-02-07
Age:47.0  Onset:2001-02-12, Days after vaccination: 5
Gender:Female  Submitted:2001-02-20, Days after onset: 8
Location:Massachusetts  Entered:2001-03-12, 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: Diluent/Chiron Behring/847011/IM/RA/1 previously
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION2730111IMRA
Administered by: Public     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: On 2/7/01, received RabAvert, 2nd injection of a series of 3. On 2/12/01 (5 days later), she developed hives. Series discontinued; treated for hives. No respiratory distress.

VAERS ID:167000 (history)  Vaccinated:1999-09-01
Age:47.0  Onset:2000-01-01, Days after vaccination: 122
Gender:Male  Submitted:2001-03-07, Days after onset: 431
Location:Unknown  Entered:2001-03-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Acromioclavicular joint arthritis (1996), allergic rhinitis, allergy desensitization, arthroscopic surgery left ankle (1996), left knee (1993), asthma, bronchitis, carpal tunnel syndrome (1990), cervical radiculopathy (1997), Cervical spine degenerative disc disease (1997), chronic archilles tendonitis and sinusitis, degenerative changes in left knee (1994) HLA-DR4 pos, left chondr
Diagnostic Lab Data: X-rays of wrists-showed "some mild degenerative changes"; Sed rate-44mm/hr; quantitative RA factor-307 iu/ml; antinuclear antibody titer was-neg; Lyme IgG and IgM by Western Blot analysis-neg; Testing for HLA-DR4 on 3/17/00-positive.
CDC 'Split Type': 20010057391
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Arthritis, Bone disorder, Fasciitis, Fatigue, Flushing, Hernia, Joint stiffness, Joint swelling, Myalgia, Nerve compression, Paraesthesia, Rheumatoid arthritis, Subcutaneous nodule, Tendonitis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Accidents and injuries (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (narrow)
Write-up: The pt received the 1st and 2nd injections of Lymerix in 8/99 and 9/99. The pt presented to his PMD on 1/31/00, approx. 4 months following receipt of the 2nd injection, with a 3 week history of wrist and ankle pain and a painful Achilles tendon. His pain was worse in the AM and relieved with Naprosyn. The pt also reported stiffness and swelling in his fingers for 1 week; the stiffness was worse at night. On physical exam, the pt had free range of motion with pain on flexion and extension of the ankles. The physician''s assessment was tendonitis and "? arthritis". The physician prescribed Naprosyn 500mg twice daily. The pt was been by his orthopedic surgeon on 2/7/00, "for both wrists and both heels." The orthopedic surgeon noted, "He has developed some symptoms in his wrist and hands of tightness, burning, tingling, awakens him at nighttime, difficulty when he shakes hands, occasional radiation proximally in the forearm." On physical exam of the left wrist, the pt had "tenderness dorsally over the scapholunate ligament (positive Phalen''s). There is no dorsal tenderness on the right, but Phalen''s is very positive. He has tenderness over the carpal canal. Both heels have been painful along the Achilles. He has had trouble with this off and on for many years. He had a very pronounced pes plano valus deformity. He has got palpable nodules in the Achilles tendon proper, but no large degenerative nodules with any erythema or warmth." The orthopedic surgeon''s impression was "Chronic Achilles tendonitis bilaterally, median nerve compression syndrome right greater than left." He was treated with wrist splints to be worn while he was doing desk work, naproxen and orthotics. The pt presented to his PMD on 2/28/00 with a chief complaint of joint pain, which was increasing and "has moved to all joints, but spares the hips and back." The pt also reported "some muscle pain, some fatigue and ? fevers-felt hot." On exam, physician''s assessment was joint pain and prescribed Vioxx and extropropoxyphena/paracatamol. The dx was record

VAERS ID:167138 (history)  Vaccinated:2001-02-05
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2001-02-21
Location:Michigan  Entered:2001-03-14, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Anti-inflammatory; Vioxx
Current Illness: NONE
Preexisting Conditions: Allergy to codeine and a history of arthritis.
Diagnostic Lab Data: UNK
CDC 'Split Type': MI2001018
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1047J0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Hypokinesia, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt called HD on 2/21/01 to report that the site of shot in left deltoid and shoulder and up into neck was red, warm, swollen and very painful to move arm. Referred to Dr on 2/21/01.

VAERS ID:167438 (history)  Vaccinated:2000-01-24
Age:47.0  Onset:2000-02-18, Days after vaccination: 25
Gender:Female  Submitted:2001-03-07, Days after onset: 383
Location:South Carolina  Entered:2001-03-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norvasc
Current Illness:
Preexisting Conditions: Concurrent conditions: aspirin allergy, Cephalexin allergy, sulfa allergy, muscular strain.
Diagnostic Lab Data:
CDC 'Split Type': WAES00021827
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0904J0IMLA
Administered by: 0     Purchased by: 0
Symptoms: Influenza like illness, Pyrexia, Rash erythematous, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Information received from a RN, post vaccine pt developed generalized fever,flu symptoms, a red polka dot rash and swelling on her L arm and both legs. It was noted that the pt was also being treated for a pulled muscle in the leg.

VAERS ID:167463 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2001-03-07
Location:Virginia  Entered:2001-03-15, 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: Augmentin, estrogenic preparations, Levaquin
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: urinalysis - opiates in urine - high
CDC 'Split Type': WAES00032522
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  IM 
Administered by: Public     Purchased by: Public
Symptoms: Drug level increased
SMQs:, Drug abuse and dependence (broad)
Write-up: Subsequently the pt tested positive for opiates in her urine. The reporter notes that the level of opiates in the urine was "high". The pt sought unspecified medical treatment. Follow-up information indicated that the pt was in a substance abuse program and tested positive for opiates in her urine. The pt was vaccinated the day the urine sample was taken and the pt had denied using drugs. No further information is available.

VAERS ID:167688 (history)  Vaccinated:1999-03-01
Age:47.0  Onset:2001-02-01, Days after vaccination: 703
Gender:Female  Submitted:2001-03-20, Days after onset: 47
Location:New York  Entered:2001-03-22, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: MRI - right knee arthritis and torn cartilage
CDC 'Split Type': 20010065331
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Arthritis, Arthropathy, Feeling hot, Tendonitis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Approximately 6 months post vax, the pt complained of pain in her left elbow. She was seen by an orthopedist who diagnosed her with tendonitis and prescribed unspecified anti-inflammatory medicine and exercises. Per the pt, the orthopedist "did not relate the complaint to Lymerix". The pt experienced joint warmth as well. Six months later, in 3/00, the right elbow became painful. At that time, the pt did not seek treatment. In 2/01, the pt complained of right knee pain and was seen by the physician. The pt stated that MRI of right knee confirmed arthritis under knee cap and torn cartilage". Per the pt, the bilateral elbow pain has not resolved as well as the knee pain. As of 3/13/01, the outcome of the events is ongoing.

VAERS ID:168048 (history)  Vaccinated:2001-02-05
Age:47.0  Onset:2001-02-06, Days after vaccination: 1
Gender:Female  Submitted:2001-03-02, Days after onset: 24
Location:Maine  Entered:2001-04-02, Days after submission: 30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Hematuria; Kidney Stones; Flank pain
Preexisting Conditions: Hypertension; headaches (migraines); Left adrenal mass
Diagnostic Lab Data:
CDC 'Split Type': ME01009
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0343AA6IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, 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: Large local reaction, 4" X 3" area, red, hot, swollen and tender.

VAERS ID:168597 (history)  Vaccinated:2001-03-23
Age:47.0  Onset:2001-03-24, Days after vaccination: 1
Gender:Female  Submitted:2001-04-04, Days after onset: 10
Location:Missouri  Entered:2001-04-11, 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': MO2001020
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM684D61  
Administered by: Public     Purchased by: Public
Symptoms: Influenza like illness
SMQs:
Write-up: This patient had flu like symptoms.

VAERS ID:168634 (history)  Vaccinated:2001-02-28
Age:47.0  Onset:2001-03-01, Days after vaccination: 1
Gender:Male  Submitted:2001-04-04, Days after onset: 33
Location:Colorado  Entered:2001-04-12, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER 3IMRA
Administered by: Private     Purchased by: 0
Symptoms: Arthritis, Skin disorder
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: The pt experienced a mild onset of arthritis, psoriasis. It has been 3 years since the prior vax.

VAERS ID:168845 (history)  Vaccinated:2000-02-26
Age:47.0  Onset:2000-02-28, Days after vaccination: 2
Gender:Female  Submitted:2000-12-01, Days after onset: 277
Location:Missouri  Entered:2001-04-18, Days after submission: 137
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 BIOSOLUTIONSFAV0311SCLA
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Headache, Influenza like illness, Injection site swelling, Insomnia, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: On 2/12/00, received 1st Anthrax vaccine and had mild flu-like illness, fatigue, headache and dry skin which occurred 2 days, post vax, and lasted 1 week. On 2/26/00, received 2nd Anthrax shot and had flu-like symptoms (more severe and overwhelming fatigue and severe headaches). Vomited X 2, unable to sleep for several days. Had large swelling at injection site involving entire upper arm. Symptoms have improved but are still present.

VAERS ID:169422 (history)  Vaccinated:2001-04-27
Age:47.0  Onset:2001-04-27, Days after vaccination: 0
Gender:Female  Submitted:2001-04-30, Days after onset: 3
Location:Ohio  Entered:2001-05-04, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Eosinophil count elevated; LFT''s-nml
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0472SCRA
Administered by: Military     Purchased by: Military
Symptoms: Eosinophilia, Hypersensitivity
SMQs:, Angioedema (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Pt had local reaction and went to ER, 24 hours later.

VAERS ID:169781 (history)  Vaccinated:2001-05-07
Age:47.0  Onset:2001-05-07, Days after vaccination: 0
Gender:Female  Submitted:2001-05-10, Days after onset: 3
Location:Pennsylvania  Entered:2001-05-11, 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: HCTZ, Pulmicort, chromium picolinate
Current Illness: NONE
Preexisting Conditions: congenital heart defects, tetralogy of fallot
Diagnostic Lab Data: tests - pending
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1820K1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Condition aggravated, Injection site erythema, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: The pt experienced erythema, arm tingling, numbness, right leg numbness and chills. The pt also experienced uncontrolled arrhythmia.

VAERS ID:170104 (history)  Vaccinated:2001-04-12
Age:47.0  Onset:2001-04-16, Days after vaccination: 4
Gender:Male  Submitted:2001-05-15, Days after onset: 29
Location:California  Entered:2001-05-22, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0377AA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left arm red, swollen, painful and numb. Symptoms began 4 days, post vax. Seen in ER. Treated with Cephalexin 500mg X 5 days and Prednisone 10mg 2 BID X 3 days.

VAERS ID:170421 (history)  Vaccinated:2001-05-16
Age:47.0  Onset:2001-05-17, Days after vaccination: 1
Gender:Female  Submitted:2001-05-24, Days after onset: 7
Location:Wisconsin  Entered:2001-05-31, 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: Synthroid, BC Pills
Current Illness: NONE
Preexisting Conditions: Hoshimotos Struma
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0365AA1IM 
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Feeling hot, Injection site erythema, Injection site induration, Joint range of motion decreased, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: On 5/17/01 the pt was achy all over, warm and tire, in the afternoon, increased pain, hot, red, firm to the touch at the injection site. On 5/18/01 the pt was unable to lift injected arm more than 90 degrees from torso. Pain, hot red, firmness continues. On 5/19/01 and 5/20/01 decrease in symptoms and increase in ROM. Treated with Tylenol, Aleve OTC medication.

VAERS ID:170479 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:2001-05-08
Gender:Male  Submitted:2001-05-14, Days after onset: 6
Location:Unknown  Entered:2001-06-01, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1067K IM 
Administered by: 0     Purchased by: 0
Symptoms: Influenza like illness, Pharyngitis, Rhinitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow)
Write-up: The pt experienced cold and flu symptoms.

VAERS ID:170942 (history)  Vaccinated:2001-01-22
Age:47.0  Onset:2001-02-08, Days after vaccination: 17
Gender:Female  Submitted:2001-05-30, Days after onset: 110
Location:Unknown  Entered:2001-06-01, 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: unk
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES01031028
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0105K   
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Infection, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash - Information has been received from a doctor of pharmacy concerning a 47 year old female who on 22 Jan 2001 was vaccinated with measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live second generation 632048/0105k. On 08 Feb 2001 the patient experienced red rash. The patient sought medical attention. The reporter noted that another woman received a vaccine dose from the same lot # and experienced a red rash waes 01031396.

VAERS ID:171189 (history)  Vaccinated:2000-03-28
Age:47.0  Onset:2000-03-28, Days after vaccination: 0
Gender:Female  Submitted:2001-05-15, Days after onset: 412
Location:Virginia  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: monopril, hydrochlorothiaride, aygestin, prilosec
Current Illness:
Preexisting Conditions: Medical History: varicella, varicella exposure , Concurrent conditions: drug allergy; drug allergy; gastroesophageal reflux disease; hypertension.
Diagnostic Lab Data: test; serum varicella zoster, normal range -, comment titer shown to be unequivoccal
CDC 'Split Type': WAES00040446
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0711J0SC 
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Dizziness, Gastrooesophageal reflux disease, Headache, Hot flush, Hypersensitivity, Hypertension, Infection, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Headache; arthralgia; chills, fever, nausea, malaise, hot flashes, dizzness - Information has been received from a registered nurse concerning a 47 year old female patient with hypertension, gastroesophageal reflux disease and allergies to acetaninophen (-) oxyondone hydrochloride (percocet) and trazadol) hydrochloride (ultram). It was noted that the patient also has a reported history of varicella however, her titer was shown to be unequivocal. Additionally, it was noted that the patient was exposed to varicella in the hospital and was consequantly vaccinated in the left deltoid with a first dose of varicella virus vaccine live on 28 Mar 2000 (631169/0711J). concomitant therapy included fosinopril sodium salt (monopril) norethindrone acetate (Aygestin), omeprarole (prilosec) and hydrochlorothlaride (manufacturer unkown). On 38 Mar 2000 the patient developed a headache that became serve. She also experienced dizziness, chills, hot flashes, her temperature increased to 99.4 and aching joints especially in her right knee, left elbow with the greatest pain in her right shoulder. Additionally, it was noted that the patient experienced nauses and malaise. Follow up information from a registered nurse reported that on an unspecified date the patient recovered.

VAERS ID:171671 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:2000-08-11
Gender:Female  Submitted:2001-05-15, Days after onset: 277
Location:Unknown  Entered:2001-06-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: varicella
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES00082867
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Blister, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Information has been received from a RN with a history of natural varicella during childhood, who on 08/03/2000 was inadvertently splashed on the right arm when administering a does of varicella virus vaccine live. The nurse did not wipe the vaccine off right away. On 08/11/2000 the nurse developed 6-7 vesicles on her right arm. Additionally, it was reported that the nurse felt itchy that evening. It was noted that the veiscles lasted 5-7 days and resolved without complications. The nurse indicated that she did not see a physician. No further information is available.

VAERS ID:170578 (history)  Vaccinated:1999-05-04
Age:47.0  Onset:1999-05-06, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:2001-06-06
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Biaxin (Roxithromycin + Clarithromycin)
Current Illness: NONE
Preexisting Conditions: Agitated Depression, Allergic Bronchitis, Allergy to PCN, Anxiety, Arthritic pain, Atrophy of thigh, cardiac murmurs, ceserean section, depression, flu-like symptom, fluid retention, headache, insomnia, lateral epicondylitis, leg pain, lumbosacral sprain, premature ventricular beat, premenstrual syndrome, sciatica, tubal ligation. Medical history included reactive depression (1980
Diagnostic Lab Data: Eosinophils, Blood: 7.4%; Globulins: 3.4 mg/dL; Lyme antibody screen: 1.34; Monocytes, Blood: 600/cu mm; Rheumatoid factor: Negative; Antinuclear antibody screen: Negative, including anti-centromere; Lyme Western Blot IgG: Negative;
CDC 'Split Type':
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM104A20SC 
Administered by: Private     Purchased by: Private
Symptoms: Amnesia, Arthritis, Confusional state, Disturbance in attention
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Arthritis (narrow)
Write-up: Follow up information was received from a nurse practitioner. Medical records were received as part of litigation proceedings. Additional information was received from a newspaper reporter. In 1977, the patient began to experience discomfort in her legs. Atrophy of the lateral aspect of her right thigh was noted. Although she is left handed and left side dominant, her left thigh was smaller than her right thigh. The physician stated, "Lesion may be bilateral." The physician recommended consideration of electromyelogram, exercise, and weight loss. Surgical history included two full-term cesarean sections and tubal ligation. The subject''s mother had "similar ankle problems involving Achilles tension and very probably had enteropathic arthritis." On 05/04/1999, the patient received her first 30-mcg injection of LYMErix (Lot: LY104A2). Approximately one to two weeks later, the patient reportedly experienced joint pain in her hips, knees, and ankles; flu-like symptoms; ankle edema; swollen feet; a viral syndrome; and stiffness (NOS). She "could scarcely walk up and down stairs." The patient reported that she saw a rheumatologist and underwent unspecified blood tests and x-rays. The patient stated that the rheumatologist said she had "reactive arthritis". On 05/20/1999, the subject was seen by her primary care physician. The medical record noted that the subject had experienced +1 ankle edema: "possible reaction to LYMErix vaccine." The subject''s medications were celecoxib (Celebrex) 100mg twice daily and nabumetone (Relafen) 750 mg twice daily. The subject was referred to a rheumatologist. On 05/27/1999, the infectious disease specialist wrote a letter to a nurse which stated that the patient presented now with arthralgia and myalgia. "The subjects history is significant in that she received a Lyme vaccine on 05/04/1999 and subsequently developed polymyalgia and arthralgia predominantly of the knees and ankles...Physical examination (revealed) no other demonstrated muscle tenderness or joint swellin

VAERS ID:172854 (history)  Vaccinated:2001-03-28
Age:47.0  Onset:2001-03-28, Days after vaccination: 0
Gender:Female  Submitted:2001-04-03, Days after onset: 5
Location:Alaska  Entered:2001-07-03, Days after submission: 91
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- felt perfectly well
Preexisting Conditions: NONE
Diagnostic Lab Data: NONe
CDC 'Split Type': AK200126
Vaccination
Manufacturer
Lot
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES40368AA3IMLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Infection, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Received TD booster 03/28/01. Within 10 hours developed fever to 101 and severe headache that lasted about 48 hours. Arm so sore had decreased range of motion for 4 days. At time of injection, felt nerve hit with pain down to middle finger (+) nausea.

VAERS ID:173062 (history)  Vaccinated:2001-06-11
Age:47.0  Onset:2001-06-12, Days after vaccination: 1
Gender:Female  Submitted:2001-06-22, Days after onset: 10
Location:Georga  Entered:2001-07-09, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Injury R foot
Preexisting Conditions: Fibrocystic Breast disease diagnosed 15 yrs ago
Diagnostic Lab Data: Mammogram/Ultrasound - inflammation of lymph nodes also Lymphadenopathy R axilla.
CDC 'Split Type': GA01061
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0342AA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site induration, Injection site pain, Injection site swelling, Lymphadenitis, Lymphadenopathy, Mastitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Functional lactation disorders (narrow)
Write-up: Pt states she stepped on a sewing needle & injured her R foot on 6/8/01 and she called the 24 hr nsg at Hosp and she was told to get a Td shot within 72 hrs, to use betadine to clean the wound and apply Neosporin oint which she did. The nsg called her back on Sun 6/11/01 to check on he & remind her to get a Td vaccine. States she came to HD on Mon 6/11/01 for the Td. Pt states her R arm awakened her at 2pm Tues 6/12/01 & it was very painful, swollen, hard, and had deep pain. She took a general brand of ibuprofen 2 tablets and applied warm compresses to her R arm. Her oral temp was taken and it was 101.0F. She repeated the ibuprofen tablets every 4-6 hrs, and laid down. Her fever broke but her R arm was still painful. She did not to to work due to the fever. She went to work on 6/13/01 and her R arm was still painful and later on Wed her R underarm and her R breast were very painful, she then called her PP''s office and was advised by the staff to have a mammogram done. She applied hot soaks to both breast at home on Wed she worked part of the day on Wed and Thur. On 6/14/01 pt called the Hlth dept and spoke to a female and was told to switch out with the warm compresses and apply cold compresses. The mammogram and ultrasound results showed inflammation of the lymph nodes and R breast and he films were given to her to take to her Physician. On 6/20/01 she was seen and examined and determined that her lymph nodes were infected and believed it was a result of the tetanus shot, and advised her to see her PP. She was diagnosed with Lymphadenopathy R axilla and prescribed Keflex for infection. Dr advised her to still follow up with adverse reaction to the tetanus shot.

VAERS ID:173242 (history)  Vaccinated:2001-06-25
Age:47.0  Onset:2001-07-07, Days after vaccination: 12
Gender:Female  Submitted:2001-07-11, Days after onset: 4
Location:Massachusetts  Entered:2001-07-12, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1312K   
Administered by: Private     Purchased by: 0
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Vaccine given 6/25/01, on 7/7, developed fine rash see over body with low grade temp

VAERS ID:173368 (history)  Vaccinated:2001-07-05
Age:47.0  Onset:2001-07-07, Days after vaccination: 2
Gender:Female  Submitted:2001-07-09, Days after onset: 2
Location:Nevada  Entered:2001-07-16, 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: Synthroid, Vicoprofen, Estratest
Current Illness: NONE
Preexisting Conditions: Graves'' Disease
Diagnostic Lab Data: NONE
CDC 'Split Type':
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HEPA: HEP A (VAQTA)MERCK & CO. INC.0030L0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Back pain, Feeling cold, Feeling hot, Migraine without aura, Neck pain, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Neck, back and head began throbbing and "spasms" at 14:00. Felt "hot and cold" about 15:00. At 16:00, body aches started. "This was not one of my normal headaches." Began vomiting at 19:00. Went to ER at 22:00, due to pain and vomiting. Given shot to stop vomiting and IV fluids. No temperature per pt. Missed work on 7/8/01 and possibly today, 7/9/01. Released from ER after IV and injection. Pt states nausea and weakness continue but no vomiting. "I feel like my liver''s been attacked. I used to drink, so I know." "Everybody ate the same thing I did and nobody else got sick. I''m the only one."

VAERS ID:173320 (history)  Vaccinated:2001-07-09
Age:47.0  Onset:2001-07-10, Days after vaccination: 1
Gender:Female  Submitted:2001-07-11, Days after onset: 1
Location:Ohio  Entered:2001-07-17, 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: BCP-Lo-Ovral
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0476SCLA
Administered by: Other     Purchased by: Military
Symptoms: 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: Approximately 24 hours after receiving an anthrax injection, the patient developed an itchy, red, raised area approximately the size of a 50 cent piece, at the injection site.

VAERS ID:173431 (history)  Vaccinated:2001-06-30
Age:47.0  Onset:2001-06-30, Days after vaccination: 0
Gender:Female  Submitted:2001-07-12, Days after onset: 12
Location:Utah  Entered:2001-07-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins and L Tyrosine
Current Illness: NONE
Preexisting Conditions: Allergies to molds, pollens, grasses, cherries, avocados, cod fish, fresh carrots, etc.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5190A20IMLA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM687A60IMLA
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIESU0382AA1IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR112120IMRA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Delirium, Dizziness, Dyskinesia, Dyspnoea, Hypoaesthesia, Joint stiffness, Nausea, Pain, Pallor, Panic reaction, Pyrexia, Sensation of heaviness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (narrow), Anticholinergic syndrome (narrow), Dementia (broad), Dyskinesia (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: Immediately after vax the patient experienced paleness and slight dizziness. Ten minutes later the patient felt like crying, a deep aching pain began to spread throughout her body and experienced an intense feeling of heaviness. 30 minutes post-vax the patient developed joint stiffness. 60 minutes post-vax the patient experienced difficulty breathing, a frantic feeling, nausea, and numbness in her hands. 90 minutes post-vax the patient experienced slight delirium and flailing arms. 2 and 1/2 hours post-vax she experienced a high fever and weakness. Treated with Vitamin C.

VAERS ID:173483 (history)  Vaccinated:2001-07-16
Age:47.0  Onset:2001-07-17, Days after vaccination: 1
Gender:Female  Submitted:2001-07-18, Days after onset: 1
Location:Pennsylvania  Entered:2001-07-20, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Hep B (unknown mfr);Vomiting, shakes/tremors, weakness, headache, numbness and extreme tiredness;;0;In Patient
Other Medications: Atenolol 25mg, (blood pressure med)
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0448L IM 
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Headache, Hypoaesthesia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Vomiting, shakes/tremors, weakness, headache, numbness and extreme tiredness.

VAERS ID:173883 (history)  Vaccinated:2001-06-05
Age:47.0  Onset:2001-06-05, Days after vaccination: 0
Gender:Female  Submitted:2001-07-16, Days after onset: 41
Location:Indiana  Entered:2001-08-02, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergic to Darvacet pain killers.
Diagnostic Lab Data: NONE
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1071K IMRA
Administered by: Public     Purchased by: Private
Symptoms: Cold sweat, Dizziness, Dyspnoea, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: When I tried to get up, the room got black and I just about passed out. My heart was racing, I was clammy and sweaty and it was hard to breathe. This lasted about 2 hours. I recovered slowly. I called my husband and he came home from work. They didn''t warn me of any of this kind of reaction and neither did my doctor. He should have.

VAERS ID:173958 (history)  Vaccinated:1999-09-22
Age:47.0  Onset:1999-09-25, Days after vaccination: 3
Gender:Male  Submitted:2001-07-26, Days after onset: 670
Location:California  Entered:2001-08-07, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Arthrinol; Cytotec
Current Illness: Psoriatic arthritis
Preexisting Conditions: Psoriatic arthritis only
Diagnostic Lab Data: EMG testing-physical changes
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4998301 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Laboratory test abnormal, Muscle atrophy, Parkinson's disease, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad)
Write-up: Not reported to doctor until last immunization; arthralgia, muscle atrophy, tremor, Parkinson''s. Slow to onset, 2 days, post injection of opposite sides arthralgia and declined progress to neuro specialist. Sees rheumotologist and neurologist.

VAERS ID:174222 (history)  Vaccinated:2000-11-28
Age:47.0  Onset:2000-11-28, Days after vaccination: 0
Gender:Male  Submitted:2001-07-30, Days after onset: 243
Location:Unknown  Entered:2001-08-07, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: allopurinol and prednisone
Current Illness:
Preexisting Conditions: Crohn''s disease and penicillin allergy
Diagnostic Lab Data:
CDC 'Split Type': WAES00120119
Vaccination
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IM 
Administered by: 0     Purchased by: 0
Symptoms: Blood pressure decreased, Dizziness, Hyperhidrosis, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Information has been received from a wife concerning her 47 year old husband who was vaccinated on 11/28/00. 5 minutes after the vaccination, the pt experienced hot and cold sweat, nausea, and was dizzy. The physician''s office also noted that the pt''s blood pressure dropped. The wife states the the physician felt that the pt''s experiences were related to the vaccination.

VAERS ID:174038 (history)  Vaccinated:2001-07-09
Age:47.0  Onset:2001-07-09, Days after vaccination: 0
Gender:Female  Submitted:2001-08-01, Days after onset: 23
Location:Oklahoma  Entered:2001-08-08, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Norvasc; Estrogen
Current Illness: Needle stick
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0386AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Cellulitis, Injection site erythema, Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: On 7/11/01, presented to ER with complaint of left arm pain and redness. She had previously had TD on 7/9/01 in left arm at 12:40. Dx''d with local medication reaction with secondary cellulitis. Treated with Prednisone 50mg po every day; Keflex 500mg po bid; ibuprofen prn and ice to affected area. On 8/1/01, presented to health office at 13:00 today with complaint of pain in left elbow that radiates to left hand. Noted approx. a 2cm in diameter, hardened area in left arm where pt reports she was given her TD shot. Referred to PCP.

VAERS ID:174883 (history)  Vaccinated:2001-08-17
Age:47.0  Onset:2001-08-17, Days after vaccination: 0
Gender:Female  Submitted:2001-08-28, Days after onset: 11
Location:New York  Entered:2001-08-31, 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: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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RAB: RABIES (RABAVERT)CHIRON CORPORATION2860111SCRA
Administered by: Public     Purchased by: 0
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Urticaria of torso. Treated with Benadryl 50mg po Tid.

VAERS ID:174926 (history)  Vaccinated:2001-08-21
Age:47.0  Onset:2001-08-22, Days after vaccination: 1
Gender:Female  Submitted:2001-08-23, Days after onset: 1
Location:Unknown  Entered:2001-09-04, 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: Laceration on left leg
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESUO755AA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt noted itching and swelling on 8/22/01. She used ice since vax on 8/21/01. Left upper arm was very swollen (twice the size of other upper arm), red and warm from top of shoulder to elbow laterally.

VAERS ID:175158 (history)  Vaccinated:2001-06-11
Age:47.0  Onset:2001-06-12, Days after vaccination: 1
Gender:Female  Submitted:2001-08-16, Days after onset: 65
Location:Colorado  Entered:2001-09-06, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Finger laceration
Preexisting Conditions: Possible allergy to Cipro
Diagnostic Lab Data: NONE
CDC 'Split Type': CO01013
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES40382AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site mass, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: At the time the vaccine was administered, there was a burning experience by the pt. A 2" hard lump (raised) developed at the site. Pt''s arm was swollen and painful for 2 weeks. They symptoms persisted and have slowly improved. There is now a "dent" at the site and the arm is still "sore". Pt is seeing own MD (X 3) for continued evaluation of injection site.

VAERS ID:175382 (history)  Vaccinated:2001-08-07
Age:47.0  Onset:2001-08-07, Days after vaccination: 0
Gender:Female  Submitted:2001-08-16, Days after onset: 9
Location:Kansas  Entered:2001-09-14, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0383AA IMRA
Administered by: Public     Purchased by: Private
Symptoms: Eye swelling, Headache, Oedema, Pain, Stomach discomfort
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: On 08/07/01, started with Headache then her eyes started swelling. Her right arm started hurting and got swollen around 5 PM day of vaccine. Also had "upset stomach". Given Naprosyn for pain and IM Benadryl, on 08/08/01 followed by po Benadryl.

VAERS ID:175421 (history)  Vaccinated:2001-07-26
Age:47.0  Onset:2001-07-28, Days after vaccination: 2
Gender:Male  Submitted:2001-09-12, Days after onset: 46
Location:New Jersey  Entered:2001-09-17, 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: Hytrin (Terazosin), Hydrochlorothiazide, Vitamins, Coumadin, Atenolol.
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 20010203811
Vaccination
Manufacturer
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DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM 2  
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Back pain, Joint stiffness, Listless, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad)
Write-up: The vaccinee received his 1st injection of Lymerix on 07/27/00. On 07/30/00, three days post-immunization, he experienced soreness and stiffness of his back, buttocks, and hip joints. He also experienced muscle weakness and was listless. No diagnostic evaluation was performed. The events resolved after approximately two weeks without treatment. The reporter considered these events to be mild in intensity and possibly related to Lymerix administration. The vaccinee received his 2nd injection of Lymerix on 09/07/00. On 09/09/00, two days post-immunization, he again experienced soreness and stiffness of his back, buttocks, and hip joints. He also experienced muscle weakness and was listless. He did not seek medical attention. The events resolved after approximately two months, without treatment. The reporter considered the events to be severe in intensity and possibly related to Lymerix administration. The vaccinee received his 3rd injection of Lymerix on 07/26/01. On 07/28/01, two days post-immunization, the vaccinee again experienced soreness and stiffness of his back, buttocks, and hip joints. He also experienced muscle weakness and was listless. No diagnostic evaluations were performed. The events resolved after approximately one week, without treatment. The reporter considered the events to be mild in intensity and possibly related to Lymerix administration.

VAERS ID:175533 (history)  Vaccinated:2001-08-14
Age:47.0  Onset:2001-08-14, Days after vaccination: 0
Gender:Male  Submitted:2001-08-16, Days after onset: 2
Location:Michigan  Entered:2001-09-19, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD / Connaught / C0578AA
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESEJN200A0SCLA
Administered by: Private     Purchased by: Other
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: 40 minutes post vax, the pt called stating left arm numbness, shoulder and left facial numbness. Pt waited 30 minutes without side effects. The pt was advised to go to the ER, but pt did not go. Symptoms resolved the following evening.

VAERS ID:176201 (history)  Vaccinated:2001-09-17
Age:47.0  Onset:2001-09-19, Days after vaccination: 2
Gender:Female  Submitted:2001-09-26, Days after onset: 7
Location:Colorado  Entered:2001-10-10, 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: Lisinopril and Synthroid
Current Illness: NONE
Preexisting Conditions: Hypertension and Hypothyroidism
Diagnostic Lab Data:
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0383AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Four to five cm urticavial lesion on right deltoid two cm below injection site. Treated with ice packs and OTC Benadryl.

VAERS ID:176465 (history)  Vaccinated:2001-03-21
Age:47.0  Onset:2001-04-04, Days after vaccination: 14
Gender:Female  Submitted:2001-09-24, Days after onset: 173
Location:Virginia  Entered:2001-10-18, 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:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': VA01030
Vaccination
Manufacturer
Lot
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1726J SCRA
Administered by: Public     Purchased by: Public
Symptoms: Cough, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Post vax, the patient developed a nonproductive cough, rash and fever.

VAERS ID:176538 (history)  Vaccinated:2001-10-01
Age:47.0  Onset:2001-10-02, Days after vaccination: 1
Gender:Female  Submitted:2001-10-16, Days after onset: 14
Location:New Hampshire  Entered:2001-10-22, 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: Lotenseon prem; pro
Current Illness: NONE
Preexisting Conditions: hypertension
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0599BA0IM 
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Diarrhoea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Cramps. Diarrhea, within 24 hours and lasted about 2 to 5 days.

VAERS ID:176750 (history)  Vaccinated:2001-09-21
Age:47.0  Onset:2001-09-21, Days after vaccination: 0
Gender:Male  Submitted:2001-09-27, Days after onset: 6
Location:California  Entered:2001-10-25, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0592AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever, chills times 3 days, acetaminophen 500 mg every 8 hours.

VAERS ID:176790 (history)  Vaccinated:2001-10-19
Age:47.0  Onset:2001-10-20, Days after vaccination: 1
Gender:Female  Submitted:2001-10-23, Days after onset: 3
Location:Pennsylvania  Entered:2001-10-29, 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: Propandol; Wellbutrin, Multivitamin
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0675BA IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Diarrhoea, Headache, Myalgia, Oedema
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Injection received 10/19/2001, at 1600 pm. On 10/20/2001 at 2:30 pm, noticed swelling and redness at left arm area. Also consist of biceps muscle aching. Described as the size of a 50 cent piece. On 10/20/2001, also developed headache and diarrhea which lasted approximately 1 day and then resolved.

VAERS ID:176815 (history)  Vaccinated:2001-09-04
Age:47.0  Onset:2001-09-04, Days after vaccination: 0
Gender:Female  Submitted:2001-10-18, Days after onset: 44
Location:Maryland  Entered:2001-10-29, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin and Klonopin
Current Illness: NONE
Preexisting Conditions: Sulfa drugs
Diagnostic Lab Data: Travel for prohylaxis
CDC 'Split Type':
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS207A41 LA
Administered by: Unknown     Purchased by: Other
Symptoms: Fatigue, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt had sweating and weakness 10 minutes after injection. Also nausea within 24 hours.

VAERS ID:177098 (history)  Vaccinated:2001-10-22
Age:47.0  Onset:2001-10-22, Days after vaccination: 0
Gender:Female  Submitted:2001-10-24, Days after onset: 2
Location:Ohio  Entered:2001-11-01, 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: UNK
Current Illness: NONE
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0946K0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Injection site swelling, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt''s right arm became swollen to elbow, 3.5" greater than left arm, from vax given 10/22/01. Temperature was 99.2. Pt had redness near elbow. Doctor ordered Medrol dose pack and swelling was down on 10/24/01.

VAERS ID:177214 (history)  Vaccinated:2001-10-23
Age:47.0  Onset:2001-10-23, Days after vaccination: 0
Gender:Female  Submitted:2001-10-24, Days after onset: 1
Location:California  Entered:2001-11-06, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Medq-Myselene (seizures), Procardia (Increased BP).
Current Illness: NONE
Preexisting Conditions: Seizure disorder and hypertension.
Diagnostic Lab Data:
CDC 'Split Type': CA010122
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO592AA IMLA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4769510IMLA
Administered by: 0     Purchased by: Public
Symptoms: Depression, Pain, Pyrexia, Swelling, Vomiting
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), Depression (excl suicide and self injury) (narrow)
Write-up: Swelling, painful, vomited last night, chills, fever and pain under left armpit. Saw MD (states increased stress lately).

VAERS ID:177253 (history)  Vaccinated:2001-10-22
Age:47.0  Onset:2001-10-27, Days after vaccination: 5
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:2001-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor
Current Illness: MS Hx
Preexisting Conditions: MS
Diagnostic Lab Data: NONE
CDC 'Split Type':
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5239AV1IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Headache, Influenza like illness, Muscle twitching, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Arthritis (broad)
Write-up: HA, fever, flu like symptoms, eye twitching, joint pain same S and S after last hep B on 09/06/2001

VAERS ID:177322 (history)  Vaccinated:2001-10-15
Age:47.0  Onset:2001-10-29, Days after vaccination: 14
Gender:Female  Submitted:2001-10-31, Days after onset: 2
Location:South Carolina  Entered:2001-11-07, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0673BA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Asthenia
SMQs:, Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: Post vaccination the patient developed aching in all joints, especially arms and no energy.

VAERS ID:177492 (history)  Vaccinated:2000-11-15
Age:47.0  Onset:2000-11-16, Days after vaccination: 1
Gender:Female  Submitted:2001-01-21, Days after onset: 66
Location:Pennsylvania  Entered:2001-11-09, Days after submission: 292
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': U200100170
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0345AC IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: It was reported that a 47 year old female patient received a Fluzone SV vaccination on 11/15/2000. Reportedly on 11/16/2000, the patient complained of redness, swelling, itching and warmth at the site of injection. The vaccine was administered in the upper arm, below the deltoid.

VAERS ID:177549 (history)  Vaccinated:2001-01-04
Age:47.0  Onset:2001-01-05, Days after vaccination: 1
Gender:Female  Submitted:2001-05-03, Days after onset: 117
Location:Pennsylvania  Entered:2001-11-09, Days after submission: 190
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergic to penicillin, sulfa, stinging insects, and all diagnostic contrast dyes.
Diagnostic Lab Data:
CDC 'Split Type': U200100288
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0466AA IM 
Administered by: Other     Purchased by: Public
Symptoms: Hypoaesthesia, Myalgia, Neuropathy peripheral, Pain, Rash erythematous, Rash pruritic
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: It was reported that the patient experienced a local reaction the next day after the vaccination with a slightly raised, red rash the size of your hand. It was painful, itchy and she had some neuritis and numbness the length of her arm, radiating from the vaccination site. The patient also had muscle soreness. The patient was treated with Benadryl and Excedrin, which alleviated her symptoms. From additional correspondence received on 04/20/2001, it was reported that the patient recovered from this experience. This case is closed.

VAERS ID:177623 (history)  Vaccinated:2001-10-22
Age:47.0  Onset:2001-10-23, Days after vaccination: 1
Gender:Female  Submitted:2001-10-25, Days after onset: 2
Location:Mississippi  Entered:2001-11-12, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS01055
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0601AA IMLA
PNC: PNEUMO (PREVNAR)LEDERLE LABORATORIES4722100IMRA
Administered by: Public     Purchased by: 0
Symptoms: Contusion, Injection site inflammation, Joint range of motion decreased, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Post vax the patient developed a very inflamed area 7-8 cm /809 cm in diameter, bruised in the middle. The right arm was very sore and could not be picked up without using the left arm. The patient was treated with Benadryl and ice packs.

VAERS ID:177743 (history)  Vaccinated:2001-10-30
Age:47.0  Onset:2001-10-31, Days after vaccination: 1
Gender:Female  Submitted:2001-11-07, Days after onset: 7
Location:New Jersey  Entered:2001-11-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Chronic hepatitis C-controlled.
Diagnostic Lab Data: Labs done in ER - and do not have results.
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0597AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Fever to 101 marked myalgia low back pain.

VAERS ID:177725 (history)  Vaccinated:2001-10-16
Age:47.0  Onset:2001-10-18, Days after vaccination: 2
Gender:Female  Submitted:2001-11-07, Days after onset: 20
Location:Massachusetts  Entered:2001-11-16, Days after submission: 9
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa, Motrin, Darvocet-N
Current Illness: NONE
Preexisting Conditions: Fibroids, headaches, high cholesterol
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0671CA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dysphonia, Erythema, Heart rate increased, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Hypersensitivity (narrow)
Write-up: Pt developed severe hives, itching and redness all over body. She had hoarseness and fast heartbeat. Benadryl was administered after 8 hours.

VAERS ID:177927 (history)  Vaccinated:2001-11-07
Age:47.0  Onset:2001-11-07, Days after vaccination: 0
Gender:Female  Submitted:2001-11-08, Days after onset: 1
Location:Alabama  Entered:2001-11-19, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: local reaction;UNK. INFLUENZA VACCINE;;.00;In Patient
Other Medications: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO690AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Developed Swelling around injection site extending to an area of approximately 2.5 inches in circumference, pain at site, extending to left side of neck, left upper extremity "tightness" reported. Treatment: took OTC Benadryl.

VAERS ID:177934 (history)  Vaccinated:2001-10-26
Age:47.0  Onset:2001-10-26, Days after vaccination: 0
Gender:Female  Submitted:2001-10-30, Days after onset: 4
Location:Florida  Entered:2001-11-19, 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: Laceration right second finger
Preexisting Conditions: Allergy to Iodine; Diabetes
Diagnostic Lab Data:
CDC 'Split Type':
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TTOX: TETANUS TOXOID (NO BRAND NAME)AVENTIS PASTEURUO464AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Swelling and increased temperature over the left arm deltoid area.

VAERS ID:177944 (history)  Vaccinated:2001-11-08
Age:47.0  Onset:2001-11-09, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:West Virginia  Entered:2001-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic Rhinitis
Preexisting Conditions: Allergies and COPD.
Diagnostic Lab Data: NONE
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0526L IMLA
Administered by: 0     Purchased by: 0
Symptoms: Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: The patient developed a large area of erythema with urticaria on the left arm from the elbow, past the shoulder with swelling.

VAERS ID:178316 (history)  Vaccinated:2001-11-06
Age:47.0  Onset:2001-11-15, Days after vaccination: 9
Gender:Male  Submitted:2001-11-22, Days after onset: 7
Location:Pennsylvania  Entered:2001-11-28, Days after submission: 6
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zocor
Current Illness: NONE
Preexisting Conditions: Hypercholesterolemia
Diagnostic Lab Data: No spinal fluid cells. Arreflexia, weakness, spinal fluid protein increased.
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Unknown
Symptoms: CSF test abnormal, Guillain-Barre syndrome, Hyporeflexia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: Flu shot. Guillian Barre Syndrome, onset diagnosis 11/22/2001. Now in hospital on treatment. Per 1 year follow up: It is unknown if pt has recovered. Last seen 01/08/2002. Residual symptoms presented at 01/08/2002. Hyporeflexia and mild distal sensation. Follow up 12/13/2001: Phone # of comany who gave on original report."

VAERS ID:178438 (history)  Vaccinated:2001-11-09
Age:47.0  Onset:2001-11-09, Days after vaccination: 0
Gender:Female  Submitted:2001-11-13, Days after onset: 4
Location:Kentucky  Entered:2001-11-30, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Arinzide, 4-Dur 20 mg, Prenarn 12.5, Multivitamin, Calcium 1,000 mg/day
Current Illness:
Preexisting Conditions: Hypertension
Diagnostic Lab Data:
CDC 'Split Type': KY2001089
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0676AA IMLA
Administered by: Private     Purchased by: 0
Symptoms: Hypersensitivity, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Angioedema (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: About 1 hours after shot given, arm started (aching whole arm) and up into neck, site of where shot was given, was red and hard knot (2-3 inches) arm and neck ached all day Saturday, seemed somewhat better, but still had large, red, knot. Accidently rubbed arm against clothes dryer and arm, neck, and back around left shoulder blade started hurting like a stiff neck, used icy hot and heating pad on back and neck helped a little. Neck, back and arm are still hurting today, but a little better.

VAERS ID:178574 (history)  Vaccinated:2001-08-13
Age:47.0  Onset:2001-08-13, Days after vaccination: 0
Gender:Female  Submitted:2001-08-15, Days after onset: 2
Location:Tennessee  Entered:2001-12-04, Days after submission: 111
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Connaught PPD, vitamins
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': TN01059
Vaccination
Manufacturer
Lot
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Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0227L0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site swelling, Injection site warmth, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt noted heat and swelling on left arm where injection was given. Pt broke out in a rash on left side of face, chest and back. She took Tylenol and went to bed. The day of report she noted increased swelling and was advised to see private MD.

VAERS ID:178879 (history)  Vaccinated:2001-11-13
Age:47.0  Onset:2001-11-27, Days after vaccination: 14
Gender:Female  Submitted:2001-12-04, Days after onset: 7
Location:Florida  Entered:2001-12-11, 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
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Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1509K0 LA
Administered by: Private     Purchased by: 0
Symptoms: Lymphadenopathy
SMQs:
Write-up: Enlarged lymph nodes to the neck. Laterally and posteriarly also to the left axilla.

VAERS ID:179190 (history)  Vaccinated:2001-10-18
Age:47.0  Onset:2001-10-19, Days after vaccination: 1
Gender:Female  Submitted:2001-10-30, Days after onset: 11
Location:Georga  Entered:2001-12-18, Days after submission: 49
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD on 10/18/01 in left forearm
Current Illness: NONE
Preexisting Conditions: Allergy to codeine; history of spinal fusion for herniated disc secondary to trauma
Diagnostic Lab Data:
CDC 'Split Type': GA01101
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0761L0IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1383K0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt has a 2cm X 1cm red, raised, itching wheal on upper, posterior aspect of right upper arm. It was 1st noticed by the pt on 10/19/01. On 10/23/01, it was measured by clinic nurse and it was 2cm X 1 1/2cm. It was treated with topical application of hydrocortisone cream. On 10/15/01, PPD was placed on left forearm. PPD-OMM on 10/18/01. Temperature was 100.5F-101F on 10/19/01 until 10/21/01.

VAERS ID:179227 (history)  Vaccinated:2001-11-15
Age:47.0  Onset:2001-11-15, Days after vaccination: 0
Gender:Female  Submitted:2001-11-15, Days after onset: 0
Location:Kansas  Entered:2001-12-19, 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: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU06735A IMLA
Administered by: Other     Purchased by: Private
Symptoms: Blood pressure increased, Hyperventilation, Musculoskeletal stiffness, Thirst
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Found pt lying on floor in room, c/o being thirsty & appears to be hyperventilating. c/o tightness and extremities stiffening up. .5 of epinephrine given & 911 called BP 92/50, 180/102 post epi. EMS on seen & taken to hospital at 07:40.

VAERS ID:179254 (history)  Vaccinated:2001-12-09
Age:47.0  Onset:2001-12-12, Days after vaccination: 3
Gender:Male  Submitted:2001-12-12, Days after onset: 0
Location:Illinois  Entered:2001-12-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESUO369AA7IMRA
Administered by: Public     Purchased by: Public
Symptoms: Decreased appetite, Erythema, Injection site induration, Oedema, Pain, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Redness and swelling and induration right deltoid. Pain in neck, shoulders, right arm and fever. Decreased appetite.

VAERS ID:179314 (history)  Vaccinated:2001-11-06
Age:47.0  Onset:2001-11-11, Days after vaccination: 5
Gender:Male  Submitted:2001-12-14, Days after onset: 33
Location:New York  Entered:2001-12-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol; Naproxen; Ecotrin; Vitamin B1; Multivitamins
Current Illness: NONE
Preexisting Conditions: History of CVA; history of MI; chronic cervical spine problems
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE04851KA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Neck pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: About 5 days, post vax, the pt developed neck pain radiating into his left scapula, left deltoid and left axilla. No symptoms in the days immediately following the administration of the vaccine. Still symptomatic.

VAERS ID:179378 (history)  Vaccinated:2001-11-14
Age:47.0  Onset:2001-11-22, Days after vaccination: 8
Gender:Male  Submitted:2001-12-12, Days after onset: 20
Location:Maryland  Entered:2001-12-26, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40082570  
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The pt developed a 2cm tender, red and warm area around the site of the vaccinia vaccination; treated with Augmentin 875mg BID X 5 days.

VAERS ID:179391 (history)  Vaccinated:2001-11-05
Age:47.0  Onset:2001-11-13, Days after vaccination: 8
Gender:Male  Submitted:2001-11-28, Days after onset: 15
Location:Georga  Entered:2001-12-26, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec; Nasonex
Current Illness: NONE
Preexisting Conditions: Allergies to Ampicillin and sulfa
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4008284  LA
Administered by: Other     Purchased by: Public
Symptoms: Cellulitis, Injection site erythema, Pain, Rash pustular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: A 47 year old male vaccinated on 11/5/01 (signed in to clinic at 08:40, 17th pt of the day). Recheck on 11/13/01 revealed 1.5cm scabbing pustule with 14cm surrounding erythema and tenderness of left axilla. The nurse noted ''obvious reaction to tape''. Recheck on 11/14/01 revealed same area of erythema, no fever. (No central clearing in area of gauze, as would be typical for simple tape reaction). Pt empirically started on cephalexin 500mg BID. Next day, erythema noted to be much improved and the pt stated that he was feeling better. On 11/20/01, sent e-mail stating "Rash is almost gone. No further problems". Clinical dx: possible cellulitis, r/o vigorous primary response to vaccine.

VAERS ID:179394 (history)  Vaccinated:2001-11-06
Age:47.0  Onset:2001-11-15, Days after vaccination: 9
Gender:Male  Submitted:2001-11-28, Days after onset: 13
Location:Georga  Entered:2001-12-26, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergy to penicillin
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4008284  LA
Administered by: Other     Purchased by: Public
Symptoms: Cellulitis, Erythema, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: A 47 year old male was vaccinated at 10:45 on 11/6/01. On 11/13/01 recheck, noted to be c/w primary response. On 11/15/01 recheck because of "increased redness, swelling and tenderness of site that revealed 1.5cm primary response with 3" X 4" surrounding erythema and induration with sharply defined borders. Temperature noted to be 99.1F. Pt empirically begun on cephalexin 500mg BID. Recheck on 11/16/01 revealed a temperature of 97.8F and 1.5cm scab surrounded by 1.25-1.5cm of induration with faint erythematous border. Border was not sharply defined at this point. On 11/19/01 recheck, reveal "trace scattered induration at margin of primary response" with "very faint scattered erythema mostly distal to primary response site". Clinical dx: probable cellulitis, r/o vigorous primary response to vaccine.

VAERS ID:179449 (history)  Vaccinated:2001-12-07
Age:47.0  Onset:2001-12-08, Days after vaccination: 1
Gender:Male  Submitted:2001-12-18, Days after onset: 10
Location:Michigan  Entered:2001-12-27, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': MI2001101
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40180374IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Oedema, Pain, Rash maculo-papular
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 12/08/2001 Left deltoid swollen and sore. Left ear and left side of neck swollen, painful and reddened. red, raised rash on left, neck and into hair, still apparent on 12/11/2001. No swelling on deltoid area or shoulder. Afebrile. Referred to physician.

VAERS ID:179489 (history)  Vaccinated:2001-12-14
Age:47.0  Onset:2001-12-14, Days after vaccination: 0
Gender:Female  Submitted:2001-12-17, Days after onset: 3
Location:Pennsylvania  Entered:2001-12-27, 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: E-Vista
Current Illness:
Preexisting Conditions: Codeine (ionic contrasts)
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0912L0IM 
Administered by: Private     Purchased by: Other
Symptoms: Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad)
Write-up: The pt developed tingling of her tongue, face and neck 1/2 hour later. She states that it is itchy around her mouth and face. Rx''d Benadryl and Claritin and it improved within a few hours.

VAERS ID:179550 (history)  Vaccinated:2001-12-12
Age:47.0  Onset:2001-12-12, Days after vaccination: 0
Gender:Female  Submitted:2001-12-26, Days after onset: 14
Location:California  Entered:2001-12-28, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levaquin, ibuprofen, Flovent and Serevent.
Current Illness: Bronchitis with RAD
Preexisting Conditions: Asthma, recent LBP-work injury.
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4749410 LA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever, chills, right hip pain. Started immediately after; so severe almost went to ER. Lasted approximately 24 hours. Rest and ibuprofen.

VAERS ID:179567 (history)  Vaccinated:2001-06-01
Age:47.0  Onset:2001-08-01, Days after vaccination: 61
Gender:Female  Submitted:2001-12-03, Days after onset: 124
Location:Wisconsin  Entered:2001-12-28, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin
Current Illness: UNK
Preexisting Conditions: Need for prophylaxis against rabies
Diagnostic Lab Data:
CDC 'Split Type': EM20011115
Vaccination
Manufacturer
Lot
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Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Alopecia
SMQs:
Write-up: A 47 year old female experienced hair loss coincident with RabAvert therapy. The pt received her 1st dose of post-exposure RabAvert on 6/1/01. She noticed hair loss at the beginning of August. The pt reported that the hair loss was severe and bald spots on her scalp were noticeable. In the beginning, the bald spots were the size of a dime, however as of 9/18/01, one bald spot was the size of a half-dollar and the 2nd one was the size of a quarter. The pt''s physician treated her condition with an injection of corticosteroid into the scalp area (8-10 injections per spot).

VAERS ID:179717 (history)  Vaccinated:2000-10-13
Age:47.0  Onset:2001-03-01, Days after vaccination: 139
Gender:Male  Submitted:2001-12-31, Days after onset: 305
Location:Pennsylvania  Entered:2002-01-07, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Lyme disease diagnosed 1997. 8/22/02 Review of hospital records indicates loss of appetite and weight loss of 25 lbs since 3/02, loss of sleep, and fatigue.
Diagnostic Lab Data: Can be supplied by MD. 8/22/02 Review of more complete hospital record indicates ESR elevated at 54, shoulder tendonopathy on x-ray, sl. scoliosis and degenerative changes on lower cervical spine and L5-S1 per x-rays.
CDC 'Split Type':
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM145A92IM 
Administered by: Private     Purchased by: Private
Symptoms: Anaemia, Arthralgia, Bone disorder, Chest pain, Congenital anomaly, Dyspnoea, Hypokinesia, Musculoskeletal stiffness, Pyrexia, Red blood cell sedimentation rate increased, Tendon disorder
SMQs:, Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Congenital, familial and genetic disorders (narrow), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: During the past year, I started to be less mobile. I could not turn my head, my back would not bend and I became very ill with a fever and chest and joint pain. The stiffening started shortly after the last shots and the fever began 5 months after the last shot. My fevers lasted almost 3 months. I went through many tests to try to find out what was wrong. 7/23/02 Hospital d/c summary notes add diagnosis of anemia. 8/22/02 Review of more complete hospital records indicates additional symptom of exertional dyspnea.

VAERS ID:179822 (history)  Vaccinated:2002-01-03
Age:47.0  Onset:2002-01-04, Days after vaccination: 1
Gender:Female  Submitted:2002-01-07, Days after onset: 3
Location:Florida  Entered:2002-01-09, 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: Abrasions to left leg
Preexisting Conditions: Allergy to PCN and sulfa
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0539AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, 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: The pt''s right deltoid was swollen, hot, red and extremely painful lasting 2-3 days.

VAERS ID:179945 (history)  Vaccinated:2001-10-29
Age:47.0  Onset:2001-10-31, Days after vaccination: 2
Gender:Female  Submitted:2001-12-14, Days after onset: 44
Location:New Jersey  Entered:2002-01-14, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0600AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: The pt developed a rash, 2 days post vax. It was erythematous, maculopapular and pruritic. It resolved with diphenhydramine.

VAERS ID:180300 (history)  Vaccinated:2001-01-25
Age:47.0  Onset:2001-01-28, Days after vaccination: 3
Gender:Female  Submitted:2001-02-16, Days after onset: 19
Location:Georga  Entered:2002-01-22, Days after submission: 340
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': 20010042091
Vaccination
Manufacturer
Lot
Dose
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0  
Administered by: Other     Purchased by: Other
Symptoms: Musculoskeletal stiffness, Shoulder pain
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Report 20010042091 describes pain in the shoulders and neck of a 47 year old female who received an injection of hepatitis B vaccine (Engerix-B). Concurrent medical conditions and medications were not specified. The pt received her first injection of Engerix-B vaccine on 01/25/2001. "A couple of days later" (exact date not provided), she experienced pain and stiffness across the back of her neck to the base of her skull, then both sides of her neck. The pain and stiffness persisted as of 02/16/2001. The pt planned to be evaluated by her physician.

VAERS ID:180318 (history)  Vaccinated:2001-11-01
Age:47.0  Onset:2001-11-01, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:2002-01-23
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ultram; Pemadex; Prinivil; Levoxyl; Elavil; Zocor; Sonata; Cardizem; Toprol; Flexeril; Catapress-TTS;
Current Illness: Hypertension
Preexisting Conditions: Sulfa; PCN; Iodine; Aspirin; Altase; lasix allergies
Diagnostic Lab Data: CSF-gram positive cocci diplococci on 11/7/01
CDC 'Split Type': MO2002002
Vaccination
Manufacturer
Lot
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0995L0IM 
Administered by: Private     Purchased by: Private
Symptoms: Bacterial infection, Dizziness, Ear pain, Headache, Injection site pain, Neck pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad)
Write-up: On 11/1/01, the pt had immediate pain at the injection site with a headache and a fever of 104F. 6 hours, post vax, she had chills, continued headache, vomiting, ear pain, neck pain and felt faint. On 11/07/01, she saw a doctor and was hospitalized.

VAERS ID:180381 (history)  Vaccinated:2000-10-17
Age:47.0  Onset:2000-11-22, Days after vaccination: 36
Gender:Female  Submitted:2001-06-01, Days after onset: 190
Location:New York  Entered:2002-01-24, Days after submission: 237
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac, premarin, Entex
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: anti-HBS antibodies:<2 (positive, $g10) 11/22/2000, 36.2 (positive, $g10) 03/20/2001.
CDC 'Split Type': 20010077051
Vaccination
Manufacturer
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3222A20IMLA
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Report 20010077051 describes a 47 year old female who did not seroconvert following receipt of an injection of hepatitis B vaccine (Engerix-B). Concurrent medical conditions were not specified. Concurrent medications included fluoxetine (Prozac), conjugated estrogens (Premarin), and phenylephrine/phenylpropanolamine/guaifenesin (Entex). The vaccinee received hepatitis B vaccine (lot 1382J) on 04/14/2000 and a second injection lot 0510J on 05/16/2000. On 10/17/2000, she received 1.0ml of Engerix B pediatric, rather than 0.5ml of engerix B adult. On 11/22/2000, 36 days following receipt of Engerix-B, antibodies against hepatitis B surface antigen were < 2 (positive, $g10).

VAERS ID:180383 (history)  Vaccinated:2000-11-17
Age:47.0  Onset:2001-01-08, Days after vaccination: 52
Gender:Male  Submitted:2001-06-05, Days after onset: 147
Location:New York  Entered:2002-01-24, Days after submission: 233
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Accolate
Current Illness:
Preexisting Conditions: Asthma
Diagnostic Lab Data: Anti-HBS antibodies: <2 (positive, $g10).
CDC 'Split Type': 20010078551
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3223A20IMLA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Report 20010078551 describes a 47 year old male who did not seroconvert following recipt of an injection of hep B vaccine. Conucrrent medical conditions included asthma. Concurrent medications included zafirlukast (Accolate). The vaccinee received hep B vaccine on 05/15/2000 and a second injection on 06/16/2000. On 11/17/2000, he received Engerix B ped., rather than of Engerix B adult. On 01/08/2001, 52 days following receipt of the second injection of Engerix B, antibodies against hep B surface antigen were < 2 (positive, $g10). Outcome of this event was not provided. The reporter indicated that the failure to seroconvert following receipt of Engerix B ped. could be associated with lack of efficacy, or could be associated with the pre-existing asthma, or to therapy with Accolate.

VAERS ID:180407 (history)  Vaccinated:2001-06-06
Age:47.0  Onset:2001-06-07, Days after vaccination: 1
Gender:Female  Submitted:2001-06-08, Days after onset: 1
Location:Indiana  Entered:2002-01-24, Days after submission: 230
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: Allergic to sulfa
Diagnostic Lab Data:
CDC 'Split Type': 20010139701
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3384B62IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Dizziness, Fatigue, Headache, Musculoskeletal stiffness, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad)
Write-up: On 6/6/01, the pt received her 3rd left deltoid adult dose of Engerix-B. On 6/7/01, the vaccinee experienced headache, stiff neck, dizziness, vomiting, chills and fatigue. All symptoms resolved except for fatigue and stiff neck. As of 6/8/01, the adverse events were resolving "slowly".

VAERS ID:180517 (history)  Vaccinated:2001-12-11
Age:47.0  Onset:2002-01-17, Days after vaccination: 37
Gender:Male  Submitted:2002-01-18, Days after onset: 1
Location:California  Entered:2002-01-24, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.5239A41IMRA
Administered by: Private     Purchased by: Private
Symptoms: Bronchospasm, Decreased appetite, Dizziness, Fatigue, Feeling hot, Headache, Insomnia, Muscular weakness, Musculoskeletal stiffness, Pain, Palpitations, Vertigo, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Pt experienced fatigue, weakness, headache, weight loss of 8 lbs, sensation of warmth, light headed, poor appetite, vertigo, neck pain, shoulder pain, stiffness, insomnia, bron spasms, palpitations and muscle weakness. Pt saw his MD on 1/17/2002. Pt will have blood work on 1/21/2002.

VAERS ID:180528 (history)  Vaccinated:2001-10-10
Age:47.0  Onset:2001-10-17, Days after vaccination: 7
Gender:Female  Submitted:2001-11-14, Days after onset: 28
Location:Arizona  Entered:2002-01-25, Days after submission: 72
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': 20010267721
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Chills, Headache, Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Report 20010267721 describes (skin) bumps on a 47 year old female who received hep B vaccine recombinant (Engerix-B). This report was received from the vaccinee and has not been verified by a physician or other healthcare professional. Medical history, concurrent conditions, and concurrent medications were not specified. Reportedly, on 10/10/2001, the vaccinee received her first intramuscular injection of Engerix-B. Reportedly, on 10/17/2001, she developed "chicken pox-like bumps" on her forearms and scalp. Reportedly also, the vaccinee had chills and a headache which subsequently subsided. Reportedly, she then experienced new red bumps with little raised heads which were very small (1/4 inch in diameter). Some of the bumps were behind her ear. Reportedly, some of the bumps left a scab. The vaccinee stated that she has been awakened by itching. The vaccinee stated that one of her two sons experienced the same events, but his symptoms lasted for only two weeks. His bumps have healed but he has scars because he scratches. As of 11/09/2001, the vaccinee''s events were ongoing.

VAERS ID:180577 (history)  Vaccinated:2001-02-21
Age:47.0  Onset:2001-02-21, Days after vaccination: 0
Gender:Female  Submitted:2001-07-04, Days after onset: 132
Location:North Carolina  Entered:2002-01-28, Days after submission: 208
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho-cyclen Prevacid MVI
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR60436AA0IMLA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM684C60IMRA
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURT01870SCLA
JEV: JAPANESE ENCEPHALITIS (JE-VAX)AVENTIS PASTEUREJN196B0SCRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1448K0SCLA
Administered by: Private     Purchased by: Other
Symptoms: Chills, Injection site induration, Nausea, Pneumonia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: Approx. 48 hrs after vaccine, pt reports shaking chils with nausea and induration at injection site that developed that night of the vaccine. Symptoms lasted a week then resolved completely. Pt also had pneumonia in April.

VAERS ID:180770 (history)  Vaccinated:2002-01-22
Age:47.0  Onset:2002-01-22, Days after vaccination: 0
Gender:Female  Submitted:2002-01-25, Days after onset: 3
Location:New Hampshire  Entered:2002-01-31, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0710K0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Approximately 12 hours after administration of pneumovax into left deltoid, client''s arm swelled significantly, requiring an ER visit. Client put on cephalexin p.o..

VAERS ID:180817 (history)  Vaccinated:2000-03-17
Age:47.0  Onset:2000-03-18, Days after vaccination: 1
Gender:Female  Submitted:2000-04-14, Days after onset: 26
Location:Georga  Entered:2002-02-04, Days after submission: 661
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: Fibrocystic breasts
Diagnostic Lab Data:
CDC 'Split Type': U200000157
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0147AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: It was reported that a 47 year old female received a TD Adult on 3/17/00. Reportedly, on 3/18/00, the pt complained of left deltoid soreness and left extremity swelling. The symptoms have reportedly subsided. From correspondence received on 4/10/00, additional pt and responsible physician information was provided.

VAERS ID:180855 (history)  Vaccinated:2001-10-21
Age:47.0  Onset:2001-10-22, Days after vaccination: 1
Gender:Female  Submitted:2001-10-24, Days after onset: 2
Location:New York  Entered:2002-02-04, Days after submission: 103
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins, Melatonin
Current Illness: NONE
Preexisting Conditions: Arhythemia, no meds
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0599BA IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1456K0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Anorexia, Chest pain, Muscular weakness, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Monday-soreness, put on ice pack, achiness on arm, weakened. Tuesday, wiped out chest aching, nausea, loss of appetite.

VAERS ID:180900 (history)  Vaccinated:2001-10-25
Age:47.0  Onset:2001-10-26, Days after vaccination: 1
Gender:Female  Submitted:2002-01-28, Days after onset: 94
Location:Michigan  Entered:2002-02-05, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURV0575AA IMRA
Administered by: Public     Purchased by: Private
Symptoms: Contusion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)
Write-up: Pt stated her arm bruised after receiving flu vaccine. was instructed to apply ice.

VAERS ID:180908 (history)  Vaccinated:2001-12-07
Age:47.0  Onset:2001-12-11, Days after vaccination: 4
Gender:Female  Submitted:2002-01-28, Days after onset: 48
Location:Michigan  Entered:2002-02-05, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0600AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Client c/o sore arm and sore neck. On 12-17-01, symptoms resolved and client felt sore neck was due to a "bug".

VAERS ID:180942 (history)  Vaccinated:2002-01-25
Age:47.0  Onset:2002-01-26, Days after vaccination: 1
Gender:Male  Submitted:2002-02-05, Days after onset: 10
Location:Unknown  Entered:2002-02-06, 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: Ambien; Human Insulin; Salbutamol; Flovent; enalapril
Current Illness:
Preexisting Conditions: Diabetes Mellitus; Elevated ALT and AST
Diagnostic Lab Data: Labs on 1/29/02 revealed AST-(in the 500''s) and ALT-614 U/L
CDC 'Split Type': 20020020031
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatitis C virus
SMQs:, Liver related investigations, signs and symptoms (narrow)
Write-up: Report 20020020031 describes hepatitis C in a 47 year old male who received hepatitis A vaccine inactivated (Havrix). The vaccinee received an injection of Havrix on 01/25/2002; it was not known if he had received previous injections of Havrix. At the time of immunization, "AST was inthe 400s" and ALT concentration was 528 U/L. the vaccinee was hospitalized on 01/26/2002, one day post-immunization, with a diagnosis of hepatitis C. Laboratory analysis performed on 01/29/2002 revealed AST "in the 500s" and ALT 614 U/L.

VAERS ID:181145 (history)  Vaccinated:2002-02-06
Age:47.0  Onset:2002-02-07, Days after vaccination: 1
Gender:Female  Submitted:2002-02-07, Days after onset: 0
Location:Florida  Entered:2002-02-11, 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: cat bile right hand
Preexisting Conditions: allergy -PCN
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0518AA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Nausea, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Client call at 1:20 pm, states "had a rash in her chest, face and arms, her BP 130/100 and felt nauseated", assess by MD. Treatment: Tylenol and fluids, to come back if increases in nausea and/or emesis

VAERS ID:181673 (history)  Vaccinated:2002-01-02
Age:47.0  Onset:2002-01-09, Days after vaccination: 7
Gender:Female  Submitted:2002-02-05, Days after onset: 27
Location:Texas  Entered:2002-02-25, 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: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE done
CDC 'Split Type': SA0202
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO712AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives and rash

VAERS ID:181853 (history)  Vaccinated:2002-01-07
Age:47.0  Onset:2002-01-08, Days after vaccination: 1
Gender:Female  Submitted:2002-01-15, Days after onset: 7
Location:Washington  Entered:2002-03-01, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: localized reaction/fever;DTaP (Certiva);;10.00;In Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4722090IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 1-8-02, Local swelling and redness Left deltoid 7 cm diameter around injection site. Pt reports '';low grade" fever and chills. No other symptoms reported. Swelling completely resolved by 1/12/02

VAERS ID:181933 (history)  Vaccinated:2001-10-30
Age:47.0  Onset:2001-10-31, Days after vaccination: 1
Gender:Female  Submitted:2002-02-21, Days after onset: 113
Location:California  Entered:2002-03-05, 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: EMG; Nerve conduction velocity test
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0592AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Hypokinesia, Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: The pt''s right arm was very swollen, painful, red and could not lift arm over her head, the next day, post vax. Has had to have follow-up with a Neurologist. He wanted to let you know it was due to flu vaccine. Not yet recovered.

VAERS ID:182129 (history)  Vaccinated:2002-02-25
Age:47.0  Onset:2002-02-26, Days after vaccination: 1
Gender:Male  Submitted:2002-02-27, Days after onset: 1
Location:Nebraska  Entered:2002-03-08, 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: Vitamins
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1374L IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0580L IMRA
Administered by: Private     Purchased by: Private
Symptoms: Blister, Injection site erythema, Injection site hypersensitivity, Musculoskeletal stiffness, Pain, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Right deltoid given Varivax -redness and stiffness measured 4 X 3 1/4 Left forearm given PPD -reaction measured 4 3/4 x 3 1/4-itchy pain and big blisters in center Pt was given Ceftin x 8days & diprolene Lotion BID

VAERS ID:182221 (history)  Vaccinated:2001-10-19
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2002-03-06
Location:Pennsylvania  Entered:2002-03-12, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': U200200157
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR0599BA   
Administered by: Private     Purchased by: 0
Symptoms: Encephalitis, Influenza like illness
SMQs:, Noninfectious encephalitis (narrow)
Write-up: It was reported that a 47 year old male pt received a Fluzone SV vaccination on 10/19/2001 at a hospital. Reportedly 6 weeks later, the pt developed cognitive changes and had "flu-like" illness at end of December. On 01/21/2002, pt was admitted to intensive care unit at hospital. The reported diagnosis was acute disseminating encephalomyelitis(ADEM), unresolved, pt remains hospitalized.

VAERS ID:182283 (history)  Vaccinated:2000-08-25
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:2002-03-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: x-ray
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM146A91IMRA
Administered by: Private     Purchased by: Private
Symptoms: Hypokinesia, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pain and difficulty noted in elbow and hand.

VAERS ID:182370 (history)  Vaccinated:2001-03-15
Age:47.0  Onset:2001-03-30, Days after vaccination: 15
Gender:Male  Submitted:2002-03-07, Days after onset: 342
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': WAES01051541
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 47 year old male who on approximately 03/15/2001 was vaccinated with hep b vaccine recombinant. Two weeks post vaccination, on approximately 03/30/2001, the pt experienced chronic urticaria. The physician stated that no other symptoms were noted. Unspecified medical attention was sought and the pt''s outcome was unknown. Additional info has been requested.

VAERS ID:182492 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2002-03-07
Location:Unknown  Entered:2002-03-14, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES01120562
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Fatigue
SMQs:
Write-up: Information has been received from a physician concerning a 47 year old male who was vaccinated with hep b vaccine recombinant. Subsequently the pt experienced fatigue aproximately 2-3 days after receiving therapy. The pt reported that he falls asleep without warning. 10 days after therapy was administered the pt was still experiencing fatigue. On 12/04/2001 the pt was seen by a physician and there was no change in his condition. Additional info has been requested.

VAERS ID:182866 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2002-05-08
Location:Louisiana  Entered:2002-03-27, Days after submission: 41
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': U200200204
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)AVENTIS PASTEUR    
Administered by: Other     Purchased by: Other
Symptoms: Guillain-Barre syndrome, Muscle spasms
SMQs:, Peripheral neuropathy (narrow), Dystonia (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: Information has been received on 03/18/2002 concerning a 47 year old female who was vaccinated with Imovax Rabies post exposure series 4 years ago for a rabid dog bite. The pt now has nerve damage and spasms. The pt has been diagnosed with Guillain Barre syndrome by a neurologist. From follow up e-mail correspondence received at manufacturer on 5/8/02 it was made aware that correction needed to be made to the latest received date. The initial info was received on 3/18/02, not 3/19/02 as previously reported.

VAERS ID:183110 (history)  Vaccinated:1999-05-08
Age:47.0  Onset:1999-06-20, Days after vaccination: 43
Gender:Female  Submitted:2002-04-01, Days after onset: 1016
Location:New Jersey  Entered:2002-04-03, Days after submission: 2
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
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALSLY104AZ   
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Arthritis, Hypokinesia, Joint stiffness, Joint swelling, Pain
SMQs:, Systemic lupus erythematosus (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow)
Write-up: Lot of arthritic symptoms, painful joints and swelling. Difficulty with mobility, very stiff.

VAERS ID:183138 (history)  Vaccinated:2002-03-21
Age:47.0  Onset:2002-03-22, Days after vaccination: 1
Gender:Male  Submitted:2002-03-25, Days after onset: 3
Location:Texas  Entered:2002-04-03, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Kidney stones
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURERTD771 RA
Administered by: Other     Purchased by: Other
Symptoms: Headache, Injection site erythema, Injection site oedema, Injection site pain, Injection site reaction, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Employee complained of pain, swelling, erythema on right deltoid, malaise, headache, aching in both lower legs. Fever (99 deg. F. for three days). Employee states took Advil, given Tylenol on 03/25/2002.

VAERS ID:183482 (history)  Vaccinated:2002-01-07
Age:47.0  Onset:2002-01-07, Days after vaccination: 0
Gender:Female  Submitted:2002-04-04, Days after onset: 87
Location:New York  Entered:2002-04-10, 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: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM524A21IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Moderate swelling on the left arm from the elbow to the shoulder. Pain in the erythematous area. Reaction after 8 hours and lasted for 8 days. No fever or discharge at the injection site.

VAERS ID:183365 (history)  Vaccinated:2001-11-09
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2001-12-17
Location:Illinois  Entered:2002-04-11, Days after submission: 114
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: Neurological history and examination
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU0686AB0IM 
Administered by: Military     Purchased by: Unknown
Symptoms: Radiculitis brachial
SMQs:
Write-up: Pt developed brachial plexitis a few weeks following his influenza vaccine

VAERS ID:184114 (history)  Vaccinated:2001-12-12
Age:47.0  Onset:2001-12-15, Days after vaccination: 3
Gender:Female  Submitted:2002-02-04, Days after onset: 51
Location:Minnesota  Entered:2002-05-01, Days after submission: 85
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hytrin
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNk
CDC 'Split Type': HQ0084823JAN2002
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4018036 IM 
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Hypoaesthesia, Injection site erythema, Injection site oedema
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)
Write-up: The brother-in-law of a 47 year old female reported that his sister-in-law received a dose of flu shield on 12/12/2001 and developed an injection site reaction characterized by redness and swelling 3-4 days post-vaccination. She also experienced dizziness, "fluctuating" blood pressure, and facial numbness. The reporter indicated that the redness and swelling at the injection site resolved; however, as of 01/22/2002, the dizziness, fluctuating blood pressure, and facial numbness persisted. NO further info was available at the date of this report.

VAERS ID:186082 (history)  Vaccinated:2001-08-09
Age:47.0  Onset:2001-08-09, Days after vaccination: 0
Gender:Female  Submitted:2002-05-28, Days after onset: 292
Location:New York  Entered:2002-06-05, 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: UNK
Current Illness: NONE
Preexisting Conditions: Medical History: Anaphylaxis, concurrent concitions: allergy to insect sting, Penicillin allergy, specific allergy (drug)
Diagnostic Lab Data: Cardiac Monitoring - 08/09/01 - RRR w/o murmur, gallop or run.; Clinical Serology test - 3/01/02-results have not been returned; Vital signs- 08/09/01 -Improved over 30 minutes.
CDC 'Split Type': WAES0112USA01321
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0031L0IM 
Administered by: Private     Purchased by: Private
Symptoms: Dysphonia, Hypersensitivity, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Initial and follow up reports have been received from a licensed practical nurse concerning a 47 year old adult female homemaker who on 08/09/01 was vaccinated IM in the left deltoid with the first dose of Hepatitis A virus vaccine inactivated. On 08/09/01 at 14;23, immediately post-vaccination, the patient developed hoarseness and her throat tightened. There were no other symptoms. Subsequently, 20 minutes later, the patient started to "feel better" and her voice returned. She denied SOB, lip or tongue swelling, or any fever or chills. Her vital signs improved over 30 minutes and she was noted to have been a little hoarse, but had no stridor and her lungs were completely clear. It was reported that due to the mild allergic reaction, the patient could not be administered dose two. Her heart had a regular rate and rhythm and was without murmur when she galloped or ran It was noted that serology testing was performed in 03/02, but that results have not been returned. The patient recovered from the experience. Unspecified medical attention was sought. The reporter considered the mild allergic reaction to be another important medical event. No further information is available.

VAERS ID:186152 (history)  Vaccinated:1999-12-06
Age:47.0  Onset:2000-11-01, Days after vaccination: 331
Gender:Male  Submitted:2002-06-06, Days after onset: 581
Location:Maryland  Entered:2002-06-07, Days after submission: 1
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: NONE
Diagnostic Lab Data: MRI 2/01-results not provided; X-ray 5/01-"Arthritis is much worse".
CDC 'Split Type': A0366516A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALSLY130A91IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Difficulty in walking, Monarthritis
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (narrow)
Write-up: The vaccinee reportedly had no pre-existing medical conditions. Reportedly, he "never had arthritis before and none in family history". He reported that he believed injections of Lymerix on 10/25/99 (lot LY130B9) and 12/6/99 (lot LY130A9). He stated that on 12/7/99, he received influenza virus vaccine (Fluzone; lot 40436AA). He stated that he first noticed "severe" pain in his right hip in 11/00. Reportedly, an X-ray was performed in 11/00 that showed arthritis. The vaccinee stated that he received his third injection of Lymerix (lot LY145A9) on 12/8/00. On that date, he also received an injection of influenza virus vaccine (Fluzone; lot 4036AA0). The vaccinee reported that he underwent MRI in 2/01; results were not provided. The vaccinee reported that an X-ray performed in 5/01 "showed arthritis is much worse". The vaccinee''s attorney alleged that "as a result of (the vaccinee''s) use of (Lymerix), he developed severe autoimmune arthritis in the right hip first dx''d in 11/00 and has been seen by an orthopedic surgeon and a rheumatologist and hip joint replacement is anticipated." The vaccinee reported that he "can only walk with crutches". On a VAERS form that he completed, the vaccinee indicated that the event resulted in permanent disability. Follow up on 12/12/2003: "The following information was provided by the pt''s medical records. The pt was referred by his orthopaedic physician for physical therapy evaluation and therapy. Treatment noted dates 12/05/2000, indicated that the pt had a diagnosis of osteoarthritis in his right hip. The hip pain onset began in August 2000. His physical therapy treatment included moist heat, cold packs, electric muscle stimulation, soft tissue mobilization, ultrasound, and exercises. He was prescribed Celebrex and was subsequently switched to Vioxx with good results. By 12/15/2000, the pt reported that his hip pain was improving. The most recent information received on 11/26/03 did not provide the outcomes of the reported events."

VAERS ID:187001 (history)  Vaccinated:2002-05-14
Age:47.0  Onset:2002-05-14, Days after vaccination: 0
Gender:Female  Submitted:2002-05-17, Days after onset: 3
Location:New York  Entered:2002-06-26, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Rash;Rabies (Rabie-Vax);1;47;In Patient
Other Medications: Levoky
Current Illness: NONE
Preexisting Conditions: Erythromycin allergy; thyroid disorder
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION2860112IMLA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: Vac adm 9am-approx 6pm started with joint pain. At approx 4am next day, felt mentally "dizzy, out of it." Given Prednisone and Benadryl at ER-MD felt it was a medication intolerance rather than drug allergy.

VAERS ID:187067 (history)  Vaccinated:2002-06-07
Age:47.0  Onset:2002-06-07, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Oregon  Entered:2002-07-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Abdomen pain;Hep A (unknown mfr);2;0;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': OR200222
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURUO376AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Dizziness, Feeling abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: 2 hour post, pain in abdomen, 4 hours nausea and vomiting over the past 4 days. Pt has had dizziness, fuzzy feeling in his head.

VAERS ID:187130 (history)  Vaccinated:2002-06-11
Age:47.0  Onset:2002-06-11, Days after vaccination: 0
Gender:Male  Submitted:2002-06-21, Days after onset: 10
Location:Virginia  Entered:2002-07-02, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': VA02022
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5257A42IMLA
Administered by: Public     Purchased by: Public
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt was given injection of hep B vaccine (20mcg/cc) in left deltoid muscle in the AM of 06/11/02. Pt states he began feeling tingling and numbness in 4th and 5th digits of left hand 5 to 10 minutes after the injection. Pt states no improvement as of today 06/21/02 and states possible workman''s comp. claim.

VAERS ID:187496 (history)  Vaccinated:2002-03-14
Age:47.0  Onset:2002-03-22, Days after vaccination: 8
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:2002-07-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prevacol. Allegra, ASAS, Multi-vitamin, Vite, Clacium
Current Illness: NONE
Preexisting Conditions: Congenital knee cap defect (repaired surgically); bronchial asthma; hypercholesterolemia; peri-menipausal; allergies to animals, dust, pollen, trees and a past hyeprsensitivity to "many medications"
Diagnostic Lab Data:
CDC 'Split Type': MA0205
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.5242A40 RA
Administered by: Public     Purchased by: Unknown
Symptoms: Eye oedema, Hypersensitivity, Hypoaesthesia, Influenza like illness, Oedema, Pain, Pharyngolaryngeal pain, Pyrexia, Rash, Rash macular, Viral infection
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Received hep B #1 on 03/14/02. Reports that on 03/22/02 developed a flu-like illness (temp, sore throat, achiness). PCP dx as viral illness. On 03/23/02 developed hives (PCP attributed to recent use of Zithromax or codeine in cough med). A few days later developed swelling of eyes and lips. Seen at ER and Rx for allergic reaction. Hives came and went for 1 1/2 weeks. MD thought possibly etiology was post-viral. She reports that she asked 2 MD''s if they thought it was related to hep B vaccine and she reports they did not feel vaccine connected. Approx 4/15/02 experienced tightening through shoulder blades, PCP thought possibly connected to Prevacol (had recently increased dose, and previously had a problem with Lipitor). Had other symptoms that had come and gone: Right arm and hand swelling, ache in knees, toes and fingers. Had experience a flat pink to red blotchy rash that starts 2 inches above elbows and extends down ventral side of arms. Rash seems to come and go, more apparent after showering. 06/15/02 experienced "total numbness from back to arms and legs" was seen at ER, currently experiencing a "crawling" sensation under her skin that comes and goes, and also reports periodically experiencing a numbness on the left side of face along jawline. At time of 04/24/02 hep B #2 vacicnation, she circled "NO" to screening questions regarding medical or allergy changes or problems with previous hep B dose. Case has had various diagnostics done and she reports everything (including Lyme Disease) came up negative. She is scheduled for an MRI of the brain and neck 06/28/02. After researching her symptoms on the internet, she has found several reports that list some of her symptoms as possible reactions to hepatitis vaccine, and she is concerned that the symptoms she is experiencing could be long term effects from the hepatitis vaccine. She reports that after her second hep b immunization on 04/24/02, she did not recognize any significant increase or change in symptoms.

VAERS ID:188456 (history)  Vaccinated:2001-10-12
Age:47.0  Onset:2001-11-12, Days after vaccination: 31
Gender:Female  Submitted:2002-07-30, Days after onset: 259
Location:Unknown  Entered:2002-08-05, 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: Mephyton
Current Illness:
Preexisting Conditions: Unk
Diagnostic Lab Data:
CDC 'Split Type': WAES01120056
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.   LA
Administered by: Other     Purchased by: Other
Symptoms: Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a licensed practical nurse concerning a 47 year old female patient who on 10/12/01 was vaccinated in the left arm with a dose of pneumococcal vaccine 23 polyvalent. Concomitant therapy on 10/12/01 included an injection of phytonadione (dose not reported) in the right arm and a dose of influenza virus vaccine (manufacturer not reported) in the left arm. It was unknown if there were any other concomitant therapies. It was reported that the patient was treated for abut 17 days by her primary physician (event onset approximately 11/12/01), and that cellulitis was ruled out. The patient presented to the reporters office on 11/29/01 with a red rash on her left arm. Additional information has been requested.

VAERS ID:188632 (history)  Vaccinated:2002-07-29
Age:47.0  Onset:2002-07-29, Days after vaccination: 0
Gender:Female  Submitted:2002-08-08, Days after onset: 10
Location:Arkansas  Entered:2002-08-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I take Synthriod and estrate(hormone replacement)
Current Illness:
Preexisting Conditions: mold, mildew,pecan trees, candida
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0352M0IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Diarrhoea, Headache, Hypoaesthesia, Oedema, Pain, Vision blurred, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: an hour or so after shot, vomiting, diarrha, then a pain in the back of my head like someone shot me, this headache has been off and on for a week and two days now, swelling in my arms and legs , chest pain, dizziness, blurred vision, disorinated, pain in my arms going from my elbows downward, numbness in the side of my face.My lips numb at times. Pt had bad headaches for 3 weeks after the shot. Pt still have blurred vision though.

VAERS ID:188749 (history)  Vaccinated:2002-01-16
Age:47.0  Onset:2002-01-16, Days after vaccination: 0
Gender:Female  Submitted:2002-07-30, Days after onset: 194
Location:Oklahoma  Entered:2002-08-12, 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: UNK
Current Illness:
Preexisting Conditions: Concurrent conditions; Hypertension NOS; low back pain; Type 2 diabetes mellitus
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0201USA03094
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.641116/1160L1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Feeling hot, Injection site erythema, Injection site oedema, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a pharmacist concerning a 47 yr old Native American woman with hypertension,Type 2 diabetes mellitus and low back pain and no other known medical history who on 01/16/2002, at 0900 was vaccinated IM in the left deltoid with a second dose of pneumococcal vaccine 23 polyvalent (lot number 641116/1160L) also reported as 1106L-invalid. It was reported that the pt experienced a quick onset of swelling, redness, pain, and warmth at the injection site. The pt returned to the clinic on 01/17/2002 for a precription for pain and was advised to use a cold pack occasionally to the site. The pt returned again to the clinic on 01/21/2002 and the symptoms had resolved. Another pt (WAES0201USA02698) had a similar experience with vaccination with the same lot. The reporter "questioned the stability" of the lot. The records of testing prior to release of this lot been checked by GMP Compliance and found to be satisfactory. The lot complies with the standards of the Center for Biologics Evaluation and research and was released.

VAERS ID:189295 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:2000-02-21
Gender:Female  Submitted:2002-08-21, Days after onset: 911
Location:Unknown  Entered:2002-08-23, 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: Loestrin Fe; Calcium salt; Naproxen sodium
Current Illness: Unk
Preexisting Conditions: Upper quadrant pain, shoulder pain, sinusitis, stiff joint, swollen gland in neck, thumb sprain, tonsellectomy, toothache, upper respiratory infection, viral syndrome, weight loss, wheeze
Diagnostic Lab Data: B. Microti: IgM - <1:16; B. Burgdorferigenomic - negative; B. Burgdorferiplasmid - negative; B Microti, IgG - 1:40; BabesiaPCRwholeblood - negative; BabesiaWestern BlotIgM/IgG - negative; BabesiabyPCR - negative; Bartonella henselae qualita
CDC 'Split Type': A0364941A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Other     Purchased by: Other
Symptoms: Amnesia, Arrhythmia, Arthritis, Back pain, Chest discomfort, Chills, Confusional state, Cough, Erythema, Fatigue, Night sweats, Paraesthesia, Pyrexia, Sinus headache
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (broad), Arthritis (narrow)
Write-up: Report A0364941A describes confusion in a 47 year old female who received Lyme disease vaccine recombinant OspA (LYMErix). This report was received as part of the litigation proceedings and medical records were provided. The patient is allergic to erythromycin (nausea and vomiting), codeine (lightheadedness and stomach upset), and bees. The medical history included fibroid uterus, ovarian cyst, endometrioma, menorrhagia, dysmenorrhea, monilial vaginitis, abortion/miscarriage, intersegmental dysfunction with lumbalgia and lumbar sprain (4/10/1986), pain, chronic low back pain, left shoulder pain with positive signs of impingement and rotator cuff tendonitis (since 2/24/1997), facial lesion with possible rosacea (4/21/1999), right ulnar collateral ligament sprain (11/29/1999), plantar warts, biliary disorder, chest pain, coughing, upper respiratory infection, viral syndrome, wheezing, epigastric pain and burning, fever, joint pain, lower and right upper quadrant pain, reflux symptoms, gastritis, nausea, nocturnal perspiration, polyarthritis, stiff joint, pulmonary lower lobe infiltrate, sinusitis, and swollen glands in neck. The surgical history included tonsillectomy, appendectomy, right partial ostectomy 5th met and right proximal interphalangeal joint (PIPJ) 5th partial ostectomy (8/18/93), and laparoscopic cholecystectomy. On 3/1/96, a CAT scan of the abdomen revealed an ill-defined discoid 8mm density in the posterior aspect of the left lower lobe. The patient consumed alcohol once to twice weekly. In 1992 the patient had Lyme disease test of antibodies IgM and IgG with negative results. Concurrent medications included ethinylestradiol with iron (Loestrin-Fe 1.5/30), calcium, and naproxen sodium (Anaprox-DS). On an unspecified date, the vaccinee received an injection of LYMErix; it was not known if the vaccinee had received previous injections of YMErix. In a statement of injuries, the vaccinee''s attorney alleged that the vaccinee suffers from severe back pain and hip pain, knee pain, memory loss and confusion

VAERS ID:189387 (history)  Vaccinated:2002-08-05
Age:47.0  Onset:2002-08-05, Days after vaccination: 0
Gender:Male  Submitted:2002-08-20, Days after onset: 15
Location:Texas  Entered:2002-08-27, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
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TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD772IMRA
Administered by: Public     Purchased by: Private
Symptoms: Cellulitis, Injection site pain, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Employee received a dose of Deptheria/Tetanus on 8/05/2002 and began having arm pain at injection site. Employee reported to medical on 08/08/2002 with marked cellulitis just distal to site. From 1 in below to elbow.

VAERS ID:190593 (history)  Vaccinated:2000-03-13
Age:47.0  Onset:2000-03-14, Days after vaccination: 1
Gender:Male  Submitted:2002-08-21, Days after onset: 889
Location:Texas  Entered:2002-09-25, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: N/A
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0475 RA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Local reaction - 8'' in diameter at greatest width, Red, swelling & pain.

VAERS ID:190655 (history)  Vaccinated:2001-09-18
Age:47.0  Onset:2001-10-16, Days after vaccination: 28
Gender:Female  Submitted:2002-10-10, Days after onset: 359
Location:Maryland  Entered:2002-09-26, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: The subject was in "excellent health" prior to Sept. 01.
Diagnostic Lab Data: Adolase--normal; Antinuclear antibody--normal; Complete metabolic panel--normal; Creatine Phosphokinase, Serum--normal; Erythrocyte Sedimentation Rate--normal; Folate--normal; Full blood count--normal; Glucose, Blood--normal; Potassium--nor
CDC 'Split Type': A0381235A
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS144B72IMLA
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Hypoaesthesia, Myalgia, Polyneuropathy
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: A physician reported the occurrence of sensory polyneuropathy in a 47 year old female who was vaccinated with Lyme disease vaccine recombinant OspA (LYMErix) for prophylaxis. The subject was in "excellent health" prior to September 2001. The subject received no concurrent medications. *The subject experienced no adverse events following previous vax''s. On 8/8/00, 11/3/00, and 9/18/01, the subject received her 1st, 2nd, and third LYMErix injections, respectively. 28 days following the 3rd LYMErix injection, on 10/14/01,* she experienced "extreme" fatigue, muscle pain, (mostly in her trunk which varied in intensity), and sensory polyneuropathy characterized by burning and numbness in *her arms, trunk, and legs.* These events occurred sometimes at the same time. The physician stated that the subject''s laboratory studies and magnetic resonance imaging (MRI) of the brain and the spinal cord were all normal. Lyme titer was positive. A Western blot was sent by the local hospital to a tertiary hospital, which returned the Western blot saying that "it was unable to interpret the results due to Lyme vaccine." The subject has reportedly been seen by a neurologist, a rheumatologist, a "spinal specialist", and two rehabilitation specialists who have referred the subject back to the vaccine provider. The events have gotten progressively worse and has resulted in disability. As of 9/18/02, the subject was unable to work due to extreme fatigue and muscle pain and was unable to drive or to get out of bed without help. *As of 10/1/02, the MD reported the events of sensory poolyneuropathy and paresthesia, fatigue, and muscle pain persisted. The reporting MD stated that the events were possibly related to LYMErix administration.*

VAERS ID:190678 (history)  Vaccinated:2002-07-29
Age:47.0  Onset:2002-08-02, Days after vaccination: 4
Gender:Female  Submitted:2002-09-12, Days after onset: 41
Location:Louisiana  Entered:2002-09-26, 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: paxil, inderal Rependal
Current Illness: NONE
Preexisting Conditions: obesity
Diagnostic Lab Data: NONE
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0524AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site induration, Injection site reaction, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Hard, raised lesion on upper Rt arm. Warm to the touch. Afebrile dx with cellulitis to Rt upper arm 2 days Td injection. Keflex 500mg po Q 6 x 10d, warm compresses to Rt upper arm good for 30 min x 3d, Ibuprofen 800mg po tid x 7d.

VAERS ID:190700 (history)  Vaccinated:2001-06-01
Age:47.0  Onset:2001-11-01, Days after vaccination: 153
Gender:Female  Submitted:2002-09-23, Days after onset: 325
Location:New York  Entered:2002-09-27, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Protonix, Lipitor, Prozac
Current Illness: NONE
Preexisting Conditions: Allergic to penicillin and Compozine/GERD; Hypercholesterolemia, bulemia (controlled), depression and panic attacks.
Diagnostic Lab Data:
CDC 'Split Type':
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY144B92 LA
Administered by: Private     Purchased by: Other
Symptoms: Chest pain, Insomnia, Memory impairment, Pain
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad)
Write-up: Pain in hips and legs worse at night. Have cut work hours to help. Pain in other parts like chest, head, and arms and ankles. No pain medication helps. insomnia- difficult to get deep sleep. Memory loss. 60 day follow up states: No pt has not recovered from adverse events. Still have difficulty sleeping due to pain in hips and legs. Have had to reduce activity and work hours due to pain.

VAERS ID:190974 (history)  Vaccinated:2002-09-17
Age:47.0  Onset:2002-09-17, Days after vaccination: 0
Gender:Male  Submitted:2002-09-26, Days after onset: 9
Location:Florida  Entered:2002-10-03, 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: Sick call - 09/18/2002- clinic
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0630SC 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Influenza like illness
SMQs:, Arthritis (broad)
Write-up: Flu- like symptoms, joint aches, became bed ridden, went on military sick call, 2 days Quarters prescribed.

VAERS ID:191129 (history)  Vaccinated:2002-09-20
Age:47.0  Onset:2002-09-22, Days after vaccination: 2
Gender:Male  Submitted:2002-09-29, Days after onset: 7
Location:North Carolina  Entered:2002-10-08, 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: Lanoxin, Spironolactone, Captopril, Amniodarone, Coumadin, Zocor, Celexa, Prilosec, Nitroglycerin
Current Illness: None
Preexisting Conditions: Penicillin, Nembital, Band-Aids, Latex, Nasal septoplasty, Nasal Polypectomy, Chest pain, Sinus surgery,
Diagnostic Lab Data:
CDC 'Split Type': NC02094
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEUR40520AA2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dyskinesia, Hemiparesis, Hypoaesthesia, Muscle contractions involuntary, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dyskinesia (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)
Write-up: 9/22/02 Patient had low grade fever, left arm weakness, muscle spasms, uncontrollable movement, numbness in left arm, hand and fingers. Also had muscle contraction in left jaw.

VAERS ID:191381 (history)  Vaccinated:2002-09-27
Age:47.0  Onset:2002-09-28, Days after vaccination: 1
Gender:Female  Submitted:2002-10-04, Days after onset: 6
Location:Wisconsin  Entered:2002-10-16, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0111M0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on arms and legs 16 hrs after vaccine administration.

VAERS ID:191545 (history)  Vaccinated:2002-09-16
Age:47.0  Onset:2002-09-16, Days after vaccination: 0
Gender:Female  Submitted:2002-09-18, Days after onset: 2
Location:South Carolina  Entered:2002-10-18, Days after submission: 30
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: Tylax, seasonal environmental allergies
Diagnostic Lab Data:
CDC 'Split Type':
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5305B62IMLA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM728E61IMRA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain upper, Back pain, Chills, Diarrhoea, Drug toxicity, Face oedema, Headache, Hyperhidrosis, Nausea, Neck pain, Pain, Vision blurred
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Drug abuse and dependence (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Muscle contraction when needle was inserted w/ radial pain down to finger tips on left arm when med was injected. Within two hours-chills, sweats, headache, diarrhea w/ stomach cramps, neck muscles were stiff and later (3hrs) neck was painful and difficult to move. I took two Tylenol extra strength and went to bed at 8pm. I woke up at 2am w/ headache and took 2 Tylenol. Sleep was restless because of lower back pain. It took several minute to get out of bed because of the pain in my lower back. I took 2 Tylenol at 7am and continued getting ready for work. I looked in the mirror and saw that my face was swollen and my face looked reddish-orange w/ bags under my eyes. I never have bags under my eyes. I got to work at 8am and the symptoms increased. Headache, nausea, back lower pain and blurred vision. I left work to get ginger ale and saltines which did not help. I called my doctor who referred me to a market for a homeapathic-remedy for toxic reaction to the hep B injection. I purchased milk thistle and took 1 at 1:30 pm. Within one hour, blurred vision began to subside symptoms diminished over the next week. Upon examination by by MD on 10/4 at 8:55am, he mentioned there were definite signs of a toxic reaction.

VAERS ID:191866 (history)  Vaccinated:2001-12-12
Age:47.0  Onset:2001-12-12, Days after vaccination: 0
Gender:Female  Submitted:2001-12-28, Days after onset: 16
Location:Michigan  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': U200101270
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR0708AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: It was reported that a 47 year old female patient received a Fluzone SV 2001-2002 vaccination, administered on 12/12/01. The patient experienced itching immediately and redness (8cm) at the injection site.

VAERS ID:192015 (history)  Vaccinated:2002-10-09
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2002-10-27
Location:Louisiana  Entered:2002-10-28, 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: None
Diagnostic Lab Data:
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TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Extreme soreness to arm and fever as high as 102-103 lasting 2 days. Vaccine was given as results from high water from hurricane.

VAERS ID:192277 (history)  Vaccinated:2002-10-23
Age:47.0  Onset:2002-10-23, Days after vaccination: 0
Gender:Female  Submitted:2002-12-12, Days after onset: 50
Location:Ohio  Entered:2002-10-31, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Prevacid
Current Illness: NONE
Preexisting Conditions: Allergy sulfa, hypothyroid-on replacement, GERD
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO881AA   
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Nausea, Rash macular, Swelling face, Vertigo, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Hypersensitivity (narrow)
Write-up: Sudden onset vertigo, nausea, vomiting followed by facial swelling and red blotches went to ER given o2 and Phenergan.

VAERS ID:192452 (history)  Vaccinated:2002-10-09
Age:47.0  Onset:2002-10-15, Days after vaccination: 6
Gender:Female  Submitted:2002-10-28, Days after onset: 13
Location:New York  Entered:2002-11-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ?
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0815AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site nodule, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Swelling, pruritis L upper arm 1cm firm nodule at injection site. Shot given 10/09/2002- pt seen 10/15/2002 Pain , erythema at injection site. Itchy achy arm with red rash.

VAERS ID:192459 (history)  Vaccinated:2002-10-23
Age:47.0  Onset:2002-10-24, Days after vaccination: 1
Gender:Female  Submitted:2002-10-29, Days after onset: 5
Location:Texas  Entered:2002-11-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ;Influenza (unknown mfr);1;45;In Patient
Other Medications:
Current Illness: Heart and lung
Preexisting Conditions: Sarcoibosis
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Unknown
Symptoms: Asthenia, Back pain, Chills, Headache, Hyperhidrosis, Pharyngolaryngeal pain, Pyrexia, Sluggishness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: 10/24/02-sluggish. 10/25/02-weak, fever (Motrin). Headaches, chills, cold sweat, back ache, and sore throat, no energy.

VAERS ID:192525 (history)  Vaccinated:2002-11-01
Age:47.0  Onset:2002-11-01, Days after vaccination: 0
Gender:Female  Submitted:2002-11-04, Days after onset: 3
Location:New York  Entered:2002-11-04
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':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURAVENTIS UO933AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Erythema, Headache, Injection site reaction, Joint range of motion decreased, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Sever local reaction. Arm in which shot was administered quickly ballooned up and turned bright red over a patch approximately 8 inches in length. Extreme pain and restricted mobility for two days, accompanied by unremitting severe headache and dizziness.

VAERS ID:192528 (history)  Vaccinated:2002-10-03
Age:47.0  Onset:2002-10-03, Days after vaccination: 0
Gender:Female  Submitted:2002-11-04, Days after onset: 32
Location:New Mexico  Entered:2002-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy to Amoxicillin. Seasonal allergies -- spring.
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE34682HA3IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Flu shot given RUA and covered with Band Aid. When Band Aid removed at bedtime, employee noted a wheal, approximately 10 mm, "like a positive TB skin test." Subsided by next morning.

VAERS ID:192541 (history)  Vaccinated:2002-10-28
Age:47.0  Onset:2002-10-28, Days after vaccination: 0
Gender:Female  Submitted:2002-10-30, Days after onset: 2
Location:Utah  Entered:2002-11-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4020015 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Feeling hot, Injection site erythema, Injection site mass, Injection site pain