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Found 475569 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:78680 (history)  Vaccinated:1995-10-20
Age:46.8  Onset:1995-10-22, Days after vaccination: 2
Gender:Female  Submitted:1995-10-27, Days after onset: 5
Location:Mississippi  Entered:1995-11-06, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': MS95048
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4H61118  LA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & began having reddness, tenderness on 22OCT95 got progressively worse;27OCT95 presented to clinic area on arm red approx 7cm or 7 in diameter; red, hot & had to touch

VAERS ID:78899 (history)  Vaccinated:1995-10-31
Age:46.8  Onset:1995-11-01, Days after vaccination: 1
Gender:Female  Submitted:1995-11-03, Days after onset: 2
Location:Maryland  Entered:1995-11-13, 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: Birth control pills; ovum novem 28
Current Illness: NONE
Preexisting Conditions: MVP
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Injection site inflammation, Pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: inflamed rt arm about 3 1/2-4inches in diameter;was very warm to touch & sore;began 24hrs p/vax lasted 4 days

VAERS ID:78936 (history)  Vaccinated:1995-11-02
Age:46.6  Onset:1995-11-03, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1995-11-13
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: allergies-bee stings
Diagnostic Lab Data:
CDC 'Split Type': NYS96002
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Unknown
Symptoms: Oedema peripheral, Pruritus, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: #4 Rabies vax 2NOV95;3NOV95 lt arm warm & swollen from elbow to shoulder; very itchy

VAERS ID:78947 (history)  Vaccinated:1995-11-06
Age:46.9  Onset:1995-11-07, Days after vaccination: 1
Gender:Female  Submitted:1995-11-07, Days after onset: 0
Location:California  Entered:1995-11-14, 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: Keflex;Estroderm patches;Xanax
Current Illness: paronychia infect rt great toe
Preexisting Conditions: allergic to sulfa, PCN, Ceclor; mitral valve prolapse; IBS; panic attacks;migraines
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)PFIZER/WYETH4958009 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Convulsion, Injection site pain, Myalgia, Pain, Pyrexia, Rash, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow)
Write-up: fever of 101 oral, local tenderness, erythema & body aches;pt states had convuls the noc recvd inj;tx is APAP q 4 hrs for fever & body aches;Vicodin for pain;heating pad to rt arm & f/u visit in 3 days or sooner if sxs worsen

VAERS ID:78957 (history)  Vaccinated:1995-11-06
Age:46.7  Onset:1995-11-06, Days after vaccination: 0
Gender:Female  Submitted:1995-11-08, Days after onset: 2
Location:North Carolina  Entered:1995-11-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Verapmil
Current Illness: NONE
Preexisting Conditions: NKDA, HTN
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49582283IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site reaction, Skin nodule, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 6NOV95 flu vax given immed rxn @ site finger size welt @ site which inc to nickle size;pt took DPH;7NOV95 area warm, red & swollen, seize of quarter;18NOV area red, swollen, warm & dark red area to center 2 1/2inches x 4 inches in diameter

VAERS ID:81322 (history)  Vaccinated:1994-05-09
Age:46.0  Onset:1994-07-01, Days after vaccination: 53
Gender:Female  Submitted:1994-10-11, Days after onset: 102
Location:Unknown  Entered:1995-11-14, Days after submission: 399
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:
Diagnostic Lab Data:
CDC 'Split Type': 940091731
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 2IMA
Administered by: Other     Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Myelitis, Neuropathy, Oedema peripheral, Paraesthesia
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recvd vax May94 & 2mon p/vax pt hospitalized 5 days w/neuropathy, trouble walking, lt sided weakness, swelling in extremity & hypersensitivity in extremity;sxs affected T4 down;dx acute transverse myelitis & GBS

VAERS ID:81595 (history)  Vaccinated:0000-00-00
Age:46.0  Onset:0000-00-00
Gender:Female  Submitted:1994-10-11
Location:Unknown  Entered:1995-11-14, Days after submission: 399
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: glaucoma medication
Current Illness:
Preexisting Conditions: fibrocystic breast, glaucoma, high blood pressure
Diagnostic Lab Data: liver enzymes elevated 2 wks post dose 3; liver enzymes nl; ESR elevated 2 wks post dose 3; gallbladder ultrasound nl;
CDC 'Split Type': 940091041
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 2  
Administered by: Other     Purchased by: Other
Symptoms: Hepatic function abnormal, Red blood cell sedimentation rate increased
SMQs:, Liver related investigations, signs and symptoms (narrow)
Write-up: pt recvd vax & 2 wks p/vax exp elevated liver enzymes & elevated sedimentation rate;liver function tests returned to nl;

VAERS ID:81607 (history)  Vaccinated:1994-01-27
Age:46.0  Onset:1994-06-27, Days after vaccination: 151
Gender:Male  Submitted:1994-12-02, Days after onset: 158
Location:Connecticut  Entered:1995-11-14, Days after submission: 347
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: in pt--nonresponder w/Recombivax HB dose 3
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 940091801
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 3IMA
Administered by: Other     Purchased by: Other
Symptoms: Hypertonia
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: pt recvd vax & w/in 4hrs pt exp intermittent stiffness in deltoid muscle;sx have almost resolved,only sl stiffness remains;

VAERS ID:82135 (history)  Vaccinated:1995-01-26
Age:46.6  Onset:1995-01-27, Days after vaccination: 1
Gender:Male  Submitted:1995-02-20, Days after onset: 24
Location:Florida  Entered:1995-11-14, Days after submission: 267
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recvd Engerix-B vax 22DEC94;
Current Illness: NONE
Preexisting Conditions: pt recvd series 10yrs ago unk vaccine
Diagnostic Lab Data:
CDC 'Split Type': 950013991
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1436A41IMA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: pt recvd vax & w/in 24hrs p/vax exp muscle & joint aches & nausea;these sx were not treated & lasted 4 days;

VAERS ID:82551 (history)  Vaccinated:1995-07-12
Age:46.0  Onset:1995-07-20, Days after vaccination: 8
Gender:Male  Submitted:1995-07-31, Days after onset: 11
Location:Unknown  Entered:1995-11-14, Days after submission: 106
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: polio
Diagnostic Lab Data:
CDC 'Split Type': 950070461
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1593A42IMA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Myalgia, Pyrexia, Tongue disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: pt recvd vax & 8 days p/vax exp myalgia,chills,fever,arthralgia of finger joints & jaw & irritated tongue;sx cont

VAERS ID:82596 (history)  Vaccinated:1995-08-18
Age:46.0  Onset:1995-08-18, Days after vaccination: 0
Gender:Female  Submitted:1995-08-25, Days after onset: 7
Location:Massachusetts  Entered:1995-11-14, Days after submission: 81
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergic to sulfa
Diagnostic Lab Data:
CDC 'Split Type': 950082961
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1441A40IMA
Administered by: Private     Purchased by: Private
Symptoms: Hypoaesthesia, Paraesthesia oral, Vasodilatation
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: pt recvd vax & 15mins post vax pt exp numbness,warmth,& tingling around mouth;ER MD was required;tx w/DPH;sx subsided in 45mins;

VAERS ID:79116 (history)  Vaccinated:1995-11-03
Age:46.9  Onset:0000-00-00
Gender:Female  Submitted:1995-11-09
Location:Minnesota  Entered:1995-11-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Welbuterin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH5F61014   
Administered by: Private     Purchased by: Other
Symptoms: Headache, Myalgia, Oedema peripheral, Pain, Urticaria, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: approx 30hrs p/vax arm of inj became puffy, red, painful & then broke out in hives-2 to 3 days-body aches (24 hrs), h/a, unable to work;

VAERS ID:79106 (history)  Vaccinated:1995-11-07
Age:46.3  Onset:1995-11-10, Days after vaccination: 3
Gender:Male  Submitted:1995-11-10, Days after onset: 0
Location:Ohio  Entered:1995-11-17, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: laceration of lt index finger
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49481731 LA
Administered by: Other     Purchased by: Other
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: induration @ site of inj

VAERS ID:79541 (history)  Vaccinated:1995-11-13
Age:46.8  Onset:1995-11-13, Days after vaccination: 0
Gender:Female  Submitted:1995-11-13, Days after onset: 0
Location:Louisiana  Entered:1995-11-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Bronfed, Beconase inhaler, vits
Current Illness: NONE
Preexisting Conditions: environmental allergies only, asthma hx
Diagnostic Lab Data:
CDC 'Split Type': LA951104
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E2725HB0IMRA
TTOX: TETANUS TOXOID (NO BRAND NAME)LEDERLE LABORATORIES4293100IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Hypoglycaemia, Hypotension, Pain, Pallor, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 1348 weak p/vax;1350 dizzy c/o diaphoretic, pale conscious answering questions appropriately-BP 100/70, 76P, R12; 2sec nailbed capillary refill-placed supine 1355; c/o tingling of hands; 1410 BP 90/70; poss hypoglycemic attack; arm sore

VAERS ID:79556 (history)  Vaccinated:1995-10-30
Age:46.2  Onset:1995-10-30, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Minnesota  Entered:1995-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH5F610140IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Bronchitis, Chills, Cough, Diarrhoea, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: 1930 severe bronchitis like cough got worse until about 2130 then stopped abruptly;then chills, fever, nausea, diarrhea for a few hrs; by AM just h/a

VAERS ID:79589 (history)  Vaccinated:1995-11-04
Age:46.5  Onset:1995-11-07, Days after vaccination: 3
Gender:Male  Submitted:1995-11-17, Days after onset: 10
Location:Indiana  Entered:1995-11-20, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp rxn @ 44yrs w/flu vax
Other Medications: Vasotec
Current Illness: NONE
Preexisting Conditions: HTN, (birth defect)
Diagnostic Lab Data: Blood test (WBC)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Chills, Cough, Malaise, Myalgia, Photophobia, Sinusitis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad)
Write-up: pt started feeling bad 6NOV, 7NOV, 8NOV acute sinusitis 11NOV went to MD rx Vantin; 14NOV started feeling bad, chills, cough, phlegm, body ache, light sensitive

VAERS ID:79745 (history)  Vaccinated:1995-11-14
Age:46.4  Onset:1995-11-14, Days after vaccination: 0
Gender:Male  Submitted:1995-11-15, Days after onset: 1
Location:Massachusetts  Entered:1995-11-27, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: HTN-heart murmur(congenital)
Diagnostic Lab Data:
CDC 'Split Type': MA9524
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1377A10IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES3949580IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site mass, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 15NOV95 induration rt upper arm around inj site;4" diameter;pain from rt shoulder down to lt fore arm; no redness noted;

VAERS ID:82206 (history)  Vaccinated:1994-10-28
Age:46.0  Onset:1994-10-28, Days after vaccination: 0
Gender:Female  Submitted:1995-09-20, Days after onset: 327
Location:California  Entered:1995-11-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': CO5790
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F510150IMLA
Administered by: Private     Purchased by: Other
Symptoms: Hypokinesia, Injection site reaction, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: arm pain radiating to shoulder;no local rxn;pain not severe;treated w/PT for 1month & NSAID w/o improvement;has limited range of motion;no sensory deficit;1FEB95 f/u MRI can 24JAN95 showed localized rxn in bone @ inj site;

VAERS ID:82686 (history)  Vaccinated:1994-09-29
Age:46.0  Onset:1994-09-29, Days after vaccination: 0
Gender:Male  Submitted:1995-09-20, Days after onset: 356
Location:Oregon  Entered:1995-11-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': CO5575
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F51015   
Administered by: Public     Purchased by: Other
Symptoms: Asthma, Dyspnoea, Influenza, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: wheezing,couldn''t get breath;seen in ER & given bronchodilator by nebulizer,then discharged;following day had low grade fever & flu-like sx;

VAERS ID:82731 (history)  Vaccinated:1994-10-14
Age:46.7  Onset:1994-10-17, Days after vaccination: 3
Gender:Female  Submitted:1995-09-20, Days after onset: 338
Location:Wisconsin  Entered:1995-11-29, Days after submission: 70
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: Nallergy to dust, pollen & mold
Diagnostic Lab Data:
CDC 'Split Type': CO5627
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F510230IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: lower extremity joint pains & achy feeling;

VAERS ID:82788 (history)  Vaccinated:1994-10-19
Age:46.6  Onset:1994-10-20, Days after vaccination: 1
Gender:Female  Submitted:1995-09-20, Days after onset: 335
Location:Pennsylvania  Entered:1995-11-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Theophylline
Current Illness: NONE
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC 'Split Type': CO5647
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F510260IMA
Administered by: Other     Purchased by: Other
Symptoms: Headache, Injection site oedema, Muscle spasms, Vomiting
SMQs:, Acute pancreatitis (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: h/a w/cramps in feet & calves following by vomiting for 7hrs;swelling @ site;

VAERS ID:82212 (history)  Vaccinated:1994-10-05
Age:46.0  Onset:1994-10-15, Days after vaccination: 10
Gender:Female  Submitted:0000-00-00
Location:Indiana  Entered:1995-12-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES94100607
Vaccination
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RUB: RUBELLA (MERUVAX II)MERCK & CO. INC. 0  
Administered by: Public     Purchased by: Public
Symptoms: Back pain, Ear pain, Headache, Pharyngitis, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax 5OCT94 & 15OCT94 exp a scratchy throat, intermittent bilat ear pain, lower back pain, & h/a;16OCT94, fever of 100.6;17OCT94 temp 100.4;18OCT94 awoke w/scattered red rash which looked like measles on face which spread to abd

VAERS ID:79946 (history)  Vaccinated:1995-10-26
Age:46.5  Onset:1995-10-30, Days after vaccination: 4
Gender:Male  Submitted:1995-11-20, Days after onset: 21
Location:Illinois  Entered:1995-12-11, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NNE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': IL950131
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F611490 LA
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax 26OCT denies fever, no localized rxn, devel rash groin area, which progressed stomach & back;seen by MD 3x & family given cortisone inj w/improvement of rash; pt denied any allergy to eggs-able to eat eggs in baked/cooked foods

VAERS ID:80053 (history)  Vaccinated:0000-00-00
Age:46.0  Onset:0000-00-00
Gender:Male  Submitted:1995-11-29
Location:Missouri  Entered:1995-12-13, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958124 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Pruritus, Rash, Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 27NOV95 pt called & stated had broken out in a rash or hives w/in 1 hrs of vax;stated started to itch, skin was red & splotchy but not bumpy or pebbly like hives;took DPH the next day & rash went away;

VAERS ID:80165 (history)  Vaccinated:1995-11-21
Age:46.1  Onset:1995-11-23, Days after vaccination: 2
Gender:Female  Submitted:1995-11-27, Days after onset: 4
Location:North Dakota  Entered:1995-12-19, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE known
Other Medications: NONE
Current Illness: cold
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': ND95026
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES429310 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: a big patch of red, irregular shape border redder, itch to touch only;warm to touch; this area was anterior side of arm, 5 to 7 inches below shoulder

VAERS ID:80211 (history)  Vaccinated:1995-11-02
Age:46.5  Onset:1995-11-04, Days after vaccination: 2
Gender:Female  Submitted:1995-12-15, Days after onset: 41
Location:Virginia  Entered:1995-12-21, 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: states rt arm under stress
Preexisting Conditions:
Diagnostic Lab Data: pt states no lab work done
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958115 IMRA
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1725A4 IMLA
Administered by: Other     Purchased by: Public
Symptoms: Hypotonia, Myasthenic syndrome, Pain, Tendon disorder
SMQs:, Peripheral neuropathy (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: no problems @ time of inj;24-48 hrs later pt exp pain in elbow;had trouble gripping & twisting lid off jars;pain went up into shoulder & neck;seeing a RPT for treatments;dx w/tendonitis;denies any pain, numbness, redness or swelling @ inj

VAERS ID:81054 (history)  Vaccinated:1995-07-29
Age:46.0  Onset:1995-08-26, Days after vaccination: 28
Gender:Male  Submitted:1995-10-23, Days after onset: 58
Location:California  Entered:1996-01-03, Days after submission: 72
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: lescol
Current Illness:
Preexisting Conditions: healthy
Diagnostic Lab Data:
CDC 'Split Type': 950107981
Vaccination
Manufacturer
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HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0IM 
Administered by: Private     Purchased by: Private
Symptoms: Deafness, Facial palsy, Neuritis
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (narrow)
Write-up: pt recvd vax; 28 days later exp rt facial palsy;sxs progressed to vestibular neuritis & rt hearing loss; to er; tx steroid & famvir X2;

VAERS ID:80717 (history)  Vaccinated:1995-11-08
Age:46.0  Onset:1995-11-08, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:North Carolina  Entered:1996-01-04
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: sent for eval by personal physician
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F61167 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site mass, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 4x5cm diameter erythemic, warm to touch area; lt upper arm pinpoint center noted to be slightly harder than the outer area;

VAERS ID:81416 (history)  Vaccinated:1996-01-12
Age:46.3  Onset:1996-01-12, Days after vaccination: 0
Gender:Female  Submitted:1996-01-16, Days after onset: 4
Location:Colorado  Entered:1996-01-29, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp fever, n/v, diarrhea w/Recombivax doses 1,2,3
Other Medications: synthroid;Estrace
Current Illness: NONE
Preexisting Conditions: Graves disease
Diagnostic Lab Data: NONE
CDC 'Split Type':
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1949A23IMLA
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Myalgia, Nausea, Pyrexia, Similar reaction on previous exposure to drug, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: 230PM 12JAN96 pt recvd vax 530-6PM diarrhea, nausea, t101.3, vomiting;cont 13JAN96 & seen 14JAN96;15JAN96 nausea & achy;16JAN96 feeling much better;

VAERS ID:81877 (history)  Vaccinated:1995-01-31
Age:46.9  Onset:1995-01-31, Days after vaccination: 0
Gender:Female  Submitted:1995-02-13, Days after onset: 13
Location:Wisconsin  Entered:1996-02-05, Days after submission: 357
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Trinalin, Beconase, immunotherapy, ventolin
Current Illness: NONE
Preexisting Conditions: asthma, resp allergies
Diagnostic Lab Data:
CDC 'Split Type': WI95011
Vaccination
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1397A41 LA
Administered by: Other     Purchased by: Public
Symptoms: Chest pain, Headache, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: red flushed face-4hrs;h/a-4hrs;hives 24hrs;tightness in chest-24hrs

VAERS ID:81910 (history)  Vaccinated:1995-03-09
Age:46.4  Onset:1995-04-17, Days after vaccination: 39
Gender:Male  Submitted:1996-01-18, Days after onset: 276
Location:New York  Entered:1996-02-05, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Mefloguin; Immune Globulin by Michigan dept of pub hlth lot# IG103 given 9MAR95
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESK01160IMRA
Administered by: Private     Purchased by: Private
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: urticarial rash over most of body, treated w/pred on 1JUN95-1DEC95

VAERS ID:82040 (history)  Vaccinated:1996-01-24
Age:46.2  Onset:1996-01-24, Days after vaccination: 0
Gender:Female  Submitted:1996-02-01, Days after onset: 8
Location:Texas  Entered:1996-02-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NoNE
Preexisting Conditions: codeine, PCN, dairy products
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1822A4 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt was beginning the Hep B vax as a new employee;had never had this series before;reported to work p/inj & soon began breaking out in a rash all over;MD dx urticaria & tx w/DPH;

VAERS ID:82326 (history)  Vaccinated:1995-12-07
Age:46.9  Onset:1995-12-08, Days after vaccination: 1
Gender:Female  Submitted:1995-12-28, Days after onset: 20
Location:Wisconsin  Entered:1996-02-12, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vasotec
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WI95075
Vaccination
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Lot
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958100 IMRA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES3949360IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Oedema peripheral, Pain, Paraesthesia
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: lt am edematous x 2 size-w/in 24hrs was cool, numb, lost feeling & pain hurt like the devil;tx DPH w/relief-swelling x 72hrs-dec during that time;

VAERS ID:83045 (history)  Vaccinated:1995-09-21
Age:46.9  Onset:1995-09-22, Days after vaccination: 1
Gender:Female  Submitted:1995-11-20, Days after onset: 59
Location:Mississippi  Entered:1996-02-26, Days after submission: 98
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atarax, cardizem CD, premarin, maxzide
Current Illness:
Preexisting Conditions: HTN
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Conjunctivitis, Headache, Rash, Syncope, Tongue oedema
SMQs:, Torsade de pointes/QT prolongation (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Cardiomyopathy (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax 21SEP & devel rash on groin & stomach;22SEP MD changed meds pt awakened 23SEP w/h/a, swollen tongue, conjunctivitis, pt to ER pt near syncope

VAERS ID:83070 (history)  Vaccinated:1996-01-22
Age:46.7  Onset:1996-01-24, Days after vaccination: 2
Gender:Male  Submitted:1996-02-20, Days after onset: 27
Location:West Virginia  Entered:1996-02-26, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: pt had several x-rays & lab studies
CDC 'Split Type': WV9609
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER710724SCRA
Administered by: Other     Purchased by: Public
Symptoms: Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 2 days p/vax rt arm hand & arm began to swell w/pain-cont to present-swelling & pain subsiding how he has good ROM

VAERS ID:84004 (history)  Vaccinated:1995-10-24
Age:46.3  Onset:1995-10-27, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:Maryland  Entered:1996-02-26
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: labile HTN
Diagnostic Lab Data:
CDC 'Split Type': 895313015L
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49580763IMA
Administered by: Private     Purchased by: Other
Symptoms: Condition aggravated, Face oedema, Hypertension, Paraesthesia oral
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypertension (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 24OCT95 & devel a feeling that lips were swollen (paresthesia w/pins & needles);pt''s blood pressure was also elevated to 160/100;pt does have a hx of labile hypertension;upon exam by MD there was no visible swelling of lips;

VAERS ID:84087 (history)  Vaccinated:1995-10-30
Age:46.3  Onset:1995-10-31, Days after vaccination: 1
Gender:Female  Submitted:1995-11-01, Days after onset: 1
Location:Minnesota  Entered:1996-02-26, Days after submission: 117
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: cold, afeb
Preexisting Conditions: allergies to hismanal;
Diagnostic Lab Data: NONE
CDC 'Split Type': 895318016L
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49580740IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax;following day devel inject site rxn characterized by pain & induration 4-5cm in size;

VAERS ID:84106 (history)  Vaccinated:1995-10-23
Age:46.7  Onset:1995-10-23, Days after vaccination: 0
Gender:Female  Submitted:1995-10-23, Days after onset: 0
Location:Ohio  Entered:1996-02-26, Days after submission: 126
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': 895326001L
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49581501IMLA
Administered by: Public     Purchased by: Other
Symptoms: Dizziness, Paraesthesia, Tongue disorder, Tremor, Vasodilatation
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)
Write-up: pt recv vax;c/o tongue feeling funny,face feeling warm,shaking of rt hand & uncomfortable feeling in rt leg;c/o dizziness;BP was nl;

VAERS ID:84132 (history)  Vaccinated:1995-10-11
Age:46.1  Onset:1995-10-12, Days after vaccination: 1
Gender:Female  Submitted:1995-10-13, Days after onset: 1
Location:Oklahoma  Entered:1996-02-26, Days after submission: 136
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 895332008L
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958119 SCA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 11OCT95 & pt devel an inj site rxn characterized by pain,warmth,swelling & redness;this is one of nine patients from this site who exp above rxn p/vax

VAERS ID:84169 (history)  Vaccinated:1995-10-24
Age:46.1  Onset:1995-10-24, Days after vaccination: 0
Gender:Female  Submitted:1995-10-27, Days after onset: 3
Location:Nebraska  Entered:1996-02-26, Days after submission: 122
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': 895337009L
Vaccination
Manufacturer
Lot
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Route
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958137 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 24OCT95 & w/in 12-24 hrs devel an inj site rxn characterized as red,raised,warm & 3 inches in circumference

VAERS ID:84186 (history)  Vaccinated:1994-12-02
Age:46.2  Onset:1994-12-02, Days after vaccination: 0
Gender:Female  Submitted:1995-11-15, Days after onset: 348
Location:New Hampshire  Entered:1996-02-26, 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: unk
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type': 895340004L
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49481451IMLA
Administered by: Private     Purchased by: Other
Symptoms: Dyspnoea, Injection site oedema, Injection site pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: pt recv vax & devel soreness & swelling @ inj site,as well as diff breathing;no treatment was necessary;

VAERS ID:84362 (history)  Vaccinated:1995-01-25
Age:46.0  Onset:1995-01-28, Days after vaccination: 3
Gender:Male  Submitted:0000-00-00
Location:Oregon  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp similar reaction w/HBIG few years earlier
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: WBC Count 13,700
CDC 'Split Type': WAES95020183
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Chills, Hypokinesia, Leukocytosis, Myasthenic syndrome, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: pt recv vax 25JAN95 & 30JAN95 exp high fever,chills,weakness in legs,such that couldn''t walk;lab eval revealed WBC 13,700,SMAC 22 & liver functional nl;f/u pt exp arthralgia & fever;

VAERS ID:84745 (history)  Vaccinated:1995-06-16
Age:46.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Florida  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: dialysis; renal failure;
Diagnostic Lab Data: HBsAg neg in jul95,aug95;HBsAg pos sep95;
CDC 'Split Type': WAES95090688
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax;tested neg for Hep B surface antigen;in sep95,pt was screened & tested pos or hep B surface antigen;

VAERS ID:84848 (history)  Vaccinated:0000-00-00
Age:46.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: ALT 83 sep93; ALT 77 1jun94; AST 48 1jun94;
CDC 'Split Type': WAES95110578
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased
SMQs:, Liver related investigations, signs and symptoms (narrow)
Write-up: pt recv vax;in sep93 lab eval revealed ALT 83;01jul94 lab revealed ALT 77 and AST 48; pt had no adverse exp;MD not overly concerned w/ lab results;f/u: MD noted that he had very limited information concerning the event;

VAERS ID:83482 (history)  Vaccinated:1996-02-22
Age:46.3  Onset:1996-02-24, Days after vaccination: 2
Gender:Female  Submitted:1996-02-27, Days after onset: 3
Location:New Mexico  Entered:1996-03-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': NM96008
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H71603  RA
Administered by: Public     Purchased by: Public
Symptoms: Injection site mass, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: c/o hardened,warm painful rt deltoid;pt stated it was the size of orange 2 days p/the shot;

VAERS ID:83582 (history)  Vaccinated:1996-01-26
Age:46.2  Onset:1996-01-27, Days after vaccination: 1
Gender:Female  Submitted:1996-02-05, Days after onset: 9
Location:Texas  Entered:1996-03-11, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type': TX96022
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4301093IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Pyrexia, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax;devel edema,tenderness,pain & redness in upper arm;area warm to touch;fever at noc 2 days ago;5 days later sx gone & appeared again;now has area of redness approx 3"x7" on upper arm below inject site;warm to touch;

VAERS ID:84732 (history)  Vaccinated:1996-03-07
Age:46.4  Onset:1996-03-08, Days after vaccination: 1
Gender:Female  Submitted:1996-03-11, Days after onset: 3
Location:Minnesota  Entered:1996-04-09, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': MN96011
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1810A40IMLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Myalgia, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: woke up on friday AM w/some hives;cont to devel hives all day;were pretty much gone by Saturday afternoon;on Saturday Am woke up w/shoulder & joint ache, going up lt side of neck;achiness about the same now;took advil all weekend;

VAERS ID:84946 (history)  Vaccinated:1996-02-28
Age:46.0  Onset:1996-03-15, Days after vaccination: 16
Gender:Female  Submitted:1996-04-03, Days after onset: 19
Location:North Carolina  Entered:1996-04-16, 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: hydrocodone as needed for migraines
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: rheumatoid profile neg 4APR96;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.0749A0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up:

VAERS ID:85029 (history)  Vaccinated:1995-09-21
Age:46.9  Onset:1995-09-22, Days after vaccination: 1
Gender:Female  Submitted:1995-11-20, Days after onset: 59
Location:Unknown  Entered:1996-04-22, Days after submission: 153
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atarax, Premarin, Maxzide, Cardizem Cd, Verelan
Current Illness:
Preexisting Conditions: 25SEP pt w/less erythema, no new lesions, less irritation to eyes,
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Conjunctivitis, Headache, Rash, Syncope, Tongue oedema
SMQs:, Torsade de pointes/QT prolongation (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Cardiomyopathy (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 21SEP95 & devel rash on groin & stomach;22SEP MD changed Verelan to Cardizem pt awakened 23SEP w/h/a,swollen tongue,conjunctivitis,pt to ER -near syncope

VAERS ID:85047 (history)  Vaccinated:1996-04-03
Age:46.5  Onset:1996-04-06, Days after vaccination: 3
Gender:Female  Submitted:1996-04-15, Days after onset: 8
Location:Illinois  Entered:1996-04-22, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Elavil
Current Illness: NONE
Preexisting Conditions: arthritis
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3949030IM 
Administered by: Private     Purchased by: Public
Symptoms: Arthralgia, Arthritis, Condition aggravated, Oedema peripheral, Osteoarthritis
SMQs:, Cardiac failure (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow)
Write-up: devel bilat swelling of knees 6APR96 AM;cont on 7APR96 used ice packs for relief;knees tender no c/o pain;11APR96 has swelling into rt ankle, rt thumb & dorsum of hand;dx arthralgia etiology questionable & has a hx of arthritis knee & wrist

VAERS ID:86048 (history)  Vaccinated:1995-09-01
Age:46.0  Onset:1995-09-01, Days after vaccination: 0
Gender:Female  Submitted:1995-09-18, Days after onset: 17
Location:West Virginia  Entered:1996-05-13, Days after submission: 238
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: unk
CDC 'Split Type': 0010150950206
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00785P IMA
Administered by: Public     Purchased by: Other
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax in SEP95 & devel a hard lump @ inj site;

VAERS ID:86159 (history)  Vaccinated:1995-10-28
Age:46.0  Onset:1995-10-28, Days after vaccination: 0
Gender:Female  Submitted:1996-01-08, Days after onset: 72
Location:Wisconsin  Entered:1996-05-13, Days after submission: 125
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: unk
Diagnostic Lab Data: none reported
CDC 'Split Type': 0010150950294
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS01185P IMA
Administered by: Public     Purchased by: Other
Symptoms: Headache, Hypoaesthesia, Malaise
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: pt recv vax 28OCT95 & exp h/a, tingling in fingertips & not feeling well;sx gradually lessened throughout the day;pt recovered;

VAERS ID:86231 (history)  Vaccinated:1996-05-10
Age:46.8  Onset:1996-05-12, Days after vaccination: 2
Gender:Male  Submitted:1996-05-14, Days after onset: 2
Location:Pennsylvania  Entered:1996-05-20, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES5K710481IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site mass, Injection site pain, Myasthenic syndrome, Pharyngitis, Pruritus
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Malignancy related conditions (narrow), Oropharyngeal infections (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: devel tender, itchy indurated area 4cm x 8cm @ site of vax;arm felt weak given ibuprofen & cold pack on arm;arm better 14MAY96;devel episode of epiglottis 13MAY95 tx keflex & decadron

VAERS ID:86477 (history)  Vaccinated:1996-05-14
Age:46.4  Onset:1996-05-15, Days after vaccination: 1
Gender:Female  Submitted:1996-05-20, Days after onset: 5
Location:North Carolina  Entered:1996-05-31, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Tinex, synthroid
Current Illness: NONE
Preexisting Conditions: HTN, dec thyroid
Diagnostic Lab Data: NONE
CDC 'Split Type': NC96053
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L710951IMLA
Administered by: Public     Purchased by: Public
Symptoms: Lymphadenopathy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: lymph nodes under arm in neck swelled-saw MD because of unbearable pain & lymph nodes involvement;taking Duricef-sl improvement noted by pt;MD recommended no further;

VAERS ID:86684 (history)  Vaccinated:1995-10-24
Age:46.6  Onset:1995-10-25, Days after vaccination: 1
Gender:Female  Submitted:1996-03-07, Days after onset: 134
Location:Nebraska  Entered:1996-06-03, Days after submission: 87
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 896115006L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49581370IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 24OCT95 & w/in 12-24 hrs devel an inj site rxn characterized as red, swollen, & warm;f/u info was recv 7MAR95;sx lasted 3-4 days & resolved

VAERS ID:86641 (history)  Vaccinated:1996-04-09
Age:46.3  Onset:1996-04-20, Days after vaccination: 11
Gender:Female  Submitted:1996-06-04, Days after onset: 45
Location:Rhode Island  Entered:1996-06-06, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: neuropathy at age 45 w/ dose 3;
Other Medications:
Current Illness: na
Preexisting Conditions: na
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (NO BRAND NAME)UNKNOWN MANUFACTURER 3IMA
Administered by: Private     Purchased by: Unknown
Symptoms: Myalgia, Nausea, Paraesthesia, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax; nausea, muscle aches, numbness in fingers, hives; to ER;

VAERS ID:86875 (history)  Vaccinated:1996-04-08
Age:46.8  Onset:1996-04-09, Days after vaccination: 1
Gender:Female  Submitted:1996-04-11, Days after onset: 2
Location:Arkansas  Entered:1996-06-10, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': AR9642
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES430109 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: 24hr p/vax noted redness below inj site approx 1 1/2in;redness sl larger than half dollar size;inj site red @ puncture site only;appears like an insect bite;area below inj site warm to touch;

VAERS ID:86902 (history)  Vaccinated:1996-05-15
Age:46.3  Onset:1996-05-16, Days after vaccination: 1
Gender:Male  Submitted:1996-05-21, Days after onset: 5
Location:Maine  Entered:1996-06-11, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': ME96012
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L71095 IMRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site reaction, Myalgia, Pyrexia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: heat @ inj site, myalgia, achy;pt had fever (not recorded, took APAP); temp was 98.5 @ 1PM on 16MAY p/APAP

VAERS ID:87167 (history)  Vaccinated:1996-05-30
Age:46.6  Onset:1996-05-31, Days after vaccination: 1
Gender:Male  Submitted:1996-06-12, Days after onset: 12
Location:Pennsylvania  Entered:1996-06-18, 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: deep aching pain in arms & chest & muscle in legs & temp over 101.2;it felt like head was on fire, & was cold @ the same time

VAERS ID:87799 (history)  Vaccinated:1995-06-27
Age:46.8  Onset:1995-06-30, Days after vaccination: 3
Gender:Female  Submitted:1995-08-22, Days after onset: 53
Location:South Carolina  Entered:1996-06-18, Days after submission: 301
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: neck/shoulder excoriation & contusion
Preexisting Conditions:
Diagnostic Lab Data: culture and sensitivity-results-no growth
CDC 'Split Type': 895251004L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES396903 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: approx 3 days p/vax pt had reddened, warm, tender, swollen rxn;@ inj site site tx-symptomatically-referred to MD;

VAERS ID:87414 (history)  Vaccinated:0000-00-00
Age:46.2  Onset:1996-06-05
Gender:Female  Submitted:1996-06-10, Days after onset: 5
Location:California  Entered:1996-06-28, 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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4958061  A
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: pt states had rxn to vax fifty cent size area redness-warmth;pt fine now

VAERS ID:88734 (history)  Vaccinated:1996-07-20
Age:46.0  Onset:1996-07-22, Days after vaccination: 2
Gender:Male  Submitted:1996-08-01, Days after onset: 10
Location:Missouri  Entered:1996-08-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: thumb laceration
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6E81148 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Myalgia, Myasthenic syndrome, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: pt recv ax 20JUL96 & 20 & 21JUL rt shoulder was sore;22JUL pt noted weakness of rt triceps & shoulder & should joint pain;also noted dec sensation i rt long & index finger tips; this persisted & presented for eval 1AUG;

VAERS ID:88882 (history)  Vaccinated:1996-03-15
Age:46.4  Onset:1996-03-15, Days after vaccination: 0
Gender:Female  Submitted:1996-05-31, Days after onset: 76
Location:Tennessee  Entered:1996-08-12, Days after submission: 73
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': TN96061
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1822A40IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site inflammation, Injection site pain, Myasthenic syndrome, Neck pain, Neuropathy, Pain
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: pt recv vax & tenderness up arm into neck;pain got so bad that pt went to ER-pt told inflammation in arm;pt pvt MD states inflammation of nerve ending;pt had diff grasping & lifting anything w/lt hand;

VAERS ID:88916 (history)  Vaccinated:1996-07-23
Age:46.2  Onset:1996-08-02, Days after vaccination: 10
Gender:Male  Submitted:1996-08-06, Days after onset: 4
Location:Texas  Entered:1996-08-12, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: PPD tuberculin skin test given 23JUL96; Papaverine HCL
Current Illness: NONE
Preexisting Conditions: allergic to PCN; 1961 abd hernia, 1985 rt & lt ing hernia, impotence, anxiety, seasonal allergies;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1383B0IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0110D0SCLA
Administered by: Public     Purchased by: Other
Symptoms: Pain, Purpura, Rash, Thrombocytopenia
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow)
Write-up: thrombocytopenia purpura? (large multiple wine spot rashes bilat thighs, legs, 6") was given steroid by mouth, no blood work done, c/o tenderness only;only noticed patches Friday PM 2AUG96, went to MD;

VAERS ID:89529 (history)  Vaccinated:1992-08-28
Age:46.1  Onset:1992-08-29, Days after vaccination: 1
Gender:Female  Submitted:1996-08-13, Days after onset: 1445
Location:New York  Entered:1996-08-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tenormin
Current Illness:
Preexisting Conditions: adjustment disorder w/mixed emotional features, allergic to amoxicillin;allergic to bactrim, allergic to demerol, allergic to morphine, allergic to phenothiazines, anxiety, depression, fibromyalgia, halr loss, hand arthralgias, hysterectomy
Diagnostic Lab Data: 26MAY93 FSH 9;26APR94 FSH 2;26APR94 LH 5.3;12JUL95 LH 32.8;26APR94 IGG 1340;IGA 272;IGM 177;1MAR94 TSH .73;x-ray hand mild osteoarthritic degenerative changes of 1st metatrsal phalangeal joint otherwise unremarkable study;
CDC 'Split Type': 929073471
Vaccination
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM841A41  
Administered by: Other     Purchased by: Other
Symptoms: Alopecia, Arthralgia, Asthenia, Laboratory test abnormal, Myalgia, Myasthenic syndrome, Myopathy, Peripheral vascular disorder, Similar reaction on previous exposure to drug
SMQs:, Rhabdomyolysis/myopathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: pt recv vax 28AUG92 & w/in 24hr exp pain in hand & feet, migratory pain in multiple joints, fatigue, fibromyalgia, polyarthritis, stiffness, alopecia, weakness, arthralgia, swelling of MP & PIP joints, vascular problem, arthropathy;

VAERS ID:89414 (history)  Vaccinated:1995-10-09
Age:46.0  Onset:1995-10-10, Days after vaccination: 1
Gender:Female  Submitted:1996-06-19, Days after onset: 253
Location:Alabama  Entered:1996-08-22, Days after submission: 64
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Premerin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': CO6177
Vaccination
Manufacturer
Lot
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Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5C711221IMLA
Administered by: Private     Purchased by: Other
Symptoms: Hypokinesia, Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: hard indurated knot, w/local tenderness, some swelling & redness & pain w/movement;last prev dose of vax 1989;

VAERS ID:89516 (history)  Vaccinated:1996-02-20
Age:46.0  Onset:1996-02-23, Days after vaccination: 3
Gender:Female  Submitted:1996-06-19, Days after onset: 116
Location:New Jersey  Entered:1996-08-23, Days after submission: 65
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': CO6502
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H71003   
Administered by: Other     Purchased by: Private
Symptoms: Influenza, Myalgia, Oedema, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: 6 in swollen, hot, tender arm w/flu-like sx; From correspondence received at manufacturer on 25-Apr-2000, it was reported that the patient recovered form this experience. This case is closed.

VAERS ID:89385 (history)  Vaccinated:1996-05-08
Age:46.0  Onset:1996-05-17, Days after vaccination: 9
Gender:Female  Submitted:1996-06-24, Days after onset: 38
Location:Oregon  Entered:1996-08-29, Days after submission: 66
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Antihistamines, Beconase, Multivitamin, Melatonin
Current Illness: NONE
Preexisting Conditions: allergies (hayfever);
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1427B0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Drug ineffective, Dyspnoea, Headache, Hypertonia, Infection, Myasthenic syndrome, Pyrexia
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Arthritis (broad)
Write-up: initially eval in ER for jaw pain, fever dx w/clinical case mumps;pt exp t104, weakness, h/a, & diff breathing (x4 wk off work); still exp some residual weakness, jaw muscle spasms;

VAERS ID:89595 (history)  Vaccinated:1996-08-18
Age:46.7  Onset:1996-08-20, Days after vaccination: 2
Gender:Female  Submitted:1996-08-26, Days after onset: 6
Location:California  Entered:1996-09-04, 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: NONE
Current Illness: laceration
Preexisting Conditions: PCN, cranberry juice
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Chills, Hyperhidrosis, Injection site hypersensitivity, Injection site oedema, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: w/in 2 days facial rash, chills, sweats;local swelling involving entire upper arm around inj site, erythema;

VAERS ID:90793 (history)  Vaccinated:1996-10-04
Age:46.9  Onset:1996-10-04, Days after vaccination: 0
Gender:Female  Submitted:1996-10-15, Days after onset: 11
Location:North Dakota  Entered:1996-10-21, 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:
CDC 'Split Type': ND96020
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49681922IMRA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES438594 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: when eating supper, jaw felt swollen et felt swollen inside lt jaw;had discomfort et tenderness still sl sore p/ 11 days;

VAERS ID:91206 (history)  Vaccinated:1996-10-17
Age:46.9  Onset:0000-00-00
Gender:Female  Submitted:1996-10-18
Location:Virginia  Entered:1996-10-24, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Serevent, Beclovent Intal, albuterol, Depro provera, Cardgen;
Current Illness: NONE reported
Preexisting Conditions: HTN, COPD, hypercholesterolemia, allergy PCN, cephalozines
Diagnostic Lab Data: NONE
CDC 'Split Type': VA96070
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00686P0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: local induration & erythema 5x3cm-no resp distress or other systemic complaints;

VAERS ID:91405 (history)  Vaccinated:1996-10-18
Age:46.6  Onset:1996-10-18, Days after vaccination: 0
Gender:Male  Submitted:1996-10-21, Days after onset: 3
Location:Alabama  Entered:1996-10-29, 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: unk
Diagnostic Lab Data: NONE
CDC 'Split Type': AL9624
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E2986FA0 LA
Administered by: Other     Purchased by: Public
Symptoms: Amblyopia, Dizziness
SMQs:, Anticholinergic syndrome (broad), Optic nerve disorders (broad), Vestibular disorders (broad)
Write-up: 1 1/2 hr p/vax pt c/o blurred vision;cont for about 2 1/2hr;nurse advised pt to call pvt MD;did not call MD;nurse called pt next day, doing fine & w/o any sx;reporter states pt also exp dizziness;

VAERS ID:91482 (history)  Vaccinated:1984-12-18
Age:46.0  Onset:1984-12-19, Days after vaccination: 1
Gender:Male  Submitted:1996-10-22, Days after onset: 4324
Location:Pennsylvania  Entered:1996-10-30, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: dog bite
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Neuritis, Oedema peripheral, Paraesthesia, Skin discolouration, Tenosynovitis
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: next day arm swollen & black & blue;pain like tooth ache in arm treated by at least 8 MD, finally MD dx breakline plex 9 years later still pain;

VAERS ID:92956 (history)  Vaccinated:1995-04-21
Age:46.0  Onset:1995-04-22, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1996-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 950091061
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0  
Administered by: Other     Purchased by: Other
Symptoms: Headache, Lymphadenopathy, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: pt recv vax & exp h/a, low grade fever, malaise, & lymph node swelling;pt recovered;

VAERS ID:92994 (history)  Vaccinated:1995-07-10
Age:46.0  Onset:1995-07-17, Days after vaccination: 7
Gender:Male  Submitted:1995-10-10, Days after onset: 85
Location:California  Entered:1996-10-30, Days after submission: 386
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt recv vax & exp dec taste & smell w/dose 1 of HEP A & B
Other Medications: NONE
Current Illness:
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC 'Split Type': 950101771
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1594A40IMA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA435A60IMA
Administered by: Private     Purchased by: Other
Symptoms: Ageusia, Parosmia, Similar reaction on previous exposure to drug
SMQs:, Taste and smell disorders (narrow)
Write-up: pt recv vax 22AUG95 & w/in 1 wk exp dec sense of smell & taste;

VAERS ID:93012 (history)  Vaccinated:1995-10-13
Age:46.0  Onset:1995-10-14, Days after vaccination: 1
Gender:Female  Submitted:1995-10-24, Days after onset: 10
Location:Florida  Entered:1996-10-30, Days after submission: 372
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-NKA
Diagnostic Lab Data:
CDC 'Split Type': 950110251
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1544A40IMLA
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis exfoliative, Migraine, Mouth ulceration, Stomatitis
SMQs:, Severe cutaneous adverse reactions (narrow), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & w/in 24hr post vax & exp soreness in mouth followed by skin peeling off the sides of cheeks, & appearance of white ulcerated sores on gums;also exp migraine h/a but attributes this to menstrual period during this time;

VAERS ID:93022 (history)  Vaccinated:1995-10-26
Age:46.0  Onset:1995-10-26, Days after vaccination: 0
Gender:Female  Submitted:1995-10-31, Days after onset: 5
Location:Rhode Island  Entered:1996-10-30, Days after submission: 365
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': 950114911
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1665A20IMA
Administered by: Other     Purchased by: Other
Symptoms: Hyperhidrosis, Hypotension, Hypoxia, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & w/in 3-5im exp hypotension (70/40), diaphoresis, & itching on stomach;given Epi;pt was given 02 & taken to ER when recv another inj of epi;BP returned to nl (140/60) in approx 8 min;pt now has hives on stomach;

VAERS ID:93036 (history)  Vaccinated:1995-10-18
Age:46.0  Onset:1995-10-25, Days after vaccination: 7
Gender:Female  Submitted:1995-11-10, Days after onset: 16
Location:New York  Entered:1996-10-30, Days after submission: 355
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vicodin, Naprosyn, Phenobarbital
Current Illness:
Preexisting Conditions: sz disorder;NKA;
Diagnostic Lab Data:
CDC 'Split Type': 950120091
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 2IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax 18OCT95 & 1wk p/vax pt exp pain, tenderness, puffiness @ inj site; sx cont;

VAERS ID:93181 (history)  Vaccinated:1996-03-07
Age:46.0  Onset:1996-03-09, Days after vaccination: 2
Gender:Female  Submitted:1996-03-14, Days after onset: 5
Location:Minnesota  Entered:1996-10-30, 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:
Diagnostic Lab Data:
CDC 'Split Type': 960032571
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1810A40IMLA
Administered by: Other     Purchased by: Other
Symptoms: Myalgia, Nuchal rigidity, Pain, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & awoke w/hives;next day exp shoulder pain, neck stiffness & achiness;tx advil;hives resolved;shoulder pain, neck stiffness, & achiness cont;

VAERS ID:93323 (history)  Vaccinated:1996-03-11
Age:46.0  Onset:1996-03-11, Days after vaccination: 0
Gender:Female  Submitted:1996-04-24, Days after onset: 43
Location:Unknown  Entered:1996-10-30, Days after submission: 189
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 960051601
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 11MAR96 & w/in 1hr post vax pt exp soreness & numbness in vaccinated arm;pt also reported that arm turned sl red around the vax site;pt recovered w/in 48hr;

VAERS ID:93328 (history)  Vaccinated:1996-04-06
Age:46.0  Onset:1996-04-09, Days after vaccination: 3
Gender:Female  Submitted:1996-04-30, Days after onset: 21
Location:Arkansas  Entered:1996-10-30, Days after submission: 183
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp dizziness, flu-like sx, cough, achiness w/dose 1 hep B & dizziness #2
Other Medications: Accupril, HCTZ, Inderal
Current Illness:
Preexisting Conditions: arthritis (19690), HTN, pt had arthritis @ age 19 that responded to therapy
Diagnostic Lab Data:
CDC 'Split Type': 960055301
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 4IMA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Dizziness, Dyspnoea, Hypotension, Photosensitivity reaction, Pulmonary oedema, Rash maculo-papular, Similar reaction on previous exposure to drug, Tachycardia
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recv vax & exp dizziness & profuse sweating, hypotension, tachycardia ($g126bpm);pt exp build-up of clear fluids in lungs;breathing is painful & diff (asthma-like);exp pain in hips, knees, & toes;devel skin rash ;

VAERS ID:91559 (history)  Vaccinated:1996-10-07
Age:46.8  Onset:1996-10-10, Days after vaccination: 3
Gender:Female  Submitted:1996-10-25, Days after onset: 15
Location:California  Entered:1996-11-04, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: hx chronic sinusitis, allergic PCN, tomatoes
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49682652 RA
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Headache, Infection, Leukocytosis, Meningitis, Neck pain
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious meningitis (narrow), Arthritis (broad)
Write-up: pt recv flu vax 7OCT96 & 10OCT96 pt had severe neck, head & back pain w/inc WBC & fever;adm to hosp w/dx viral meningitis;

VAERS ID:91661 (history)  Vaccinated:1996-10-15
Age:46.7  Onset:1996-10-16, Days after vaccination: 1
Gender:Female  Submitted:1996-10-21, Days after onset: 5
Location:Ohio  Entered:1996-11-05, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4968181 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 24hr p/vax pt had local skin rxn (70x45mm) reddened, swelled, & itching;

VAERS ID:91824 (history)  Vaccinated:1996-10-29
Age:46.9  Onset:1996-10-29, Days after vaccination: 0
Gender:Female  Submitted:1996-11-04, Days after onset: 6
Location:Massachusetts  Entered:1996-11-08, 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: verapemil, amiloride w/HCTz;
Current Illness: NONE
Preexisting Conditions: HTN
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F712260 LA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Hyperhidrosis, Nausea, Palpitations
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: felt nauseated immed p/inj;felt weak @ 5" p/inj then said felt heart pounding-perspiring profusely;amb called-felt better by time arrived @ 12:45PM;

VAERS ID:92071 (history)  Vaccinated:1996-10-29
Age:46.6  Onset:1996-10-30, Days after vaccination: 1
Gender:Female  Submitted:1996-11-07, Days after onset: 8
Location:Massachusetts  Entered:1996-11-15, 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:
Current Illness: NONE
Preexisting Conditions: allergy to renographin dye
Diagnostic Lab Data:
CDC 'Split Type': MA9615
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F712260IMLA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Chills, Headache, Malaise, Nuchal rigidity, Pharyngitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Arthritis (broad)
Write-up: h/a, neck stiffness, joint aches, sore throat, chills, malaise;sx lasting more than 7 days;

VAERS ID:92330 (history)  Vaccinated:1996-07-01
Age:46.3  Onset:1996-07-01, Days after vaccination: 0
Gender:Male  Submitted:1996-11-08, Days after onset: 130
Location:Montana  Entered:1996-11-25, 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:
Preexisting Conditions: NKA, no preexisting conditions;
Diagnostic Lab Data: 8NOV96 hepatitis B antibody titer drawn
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1149A1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax 1JUL96 in lt deltoid by 3JUL96 pt had devel 6-7cm circular edematous area circa inj site which has not resolved;swelling is soft, non-red, skin temp nl, w/o pain on palpation;

VAERS ID:92360 (history)  Vaccinated:1996-10-10
Age:46.4  Onset:1996-10-10, Days after vaccination: 0
Gender:Female  Submitted:1996-10-15, Days after onset: 5
Location:Alaska  Entered:1996-11-25, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp fever & swelling @ 40yr old w/tetanus booster;
Other Medications:
Current Illness:
Preexisting Conditions: asthma & environmental allergies, bees
Diagnostic Lab Data: CBC
CDC 'Split Type': AK9632
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E30260B0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0SCA
Administered by: Other     Purchased by: Public
Symptoms: Dyspnoea, Face oedema, Hypertension, Injection site mass, Injection site oedema, Injection site pain, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 10OCT96 530PM site swelling (quarter size);11OCT96 630AM site 4 times larger w/chils, t96.8;11AM t97.2 w/chills, feeling bad; 5 1/2cm wheal;t012, BP elevated, rash, SOB;sent to ER;facial swelling, inj site pain;

VAERS ID:93840 (history)  Vaccinated:1995-11-07
Age:46.2  Onset:1995-11-23, Days after vaccination: 16
Gender:Female  Submitted:0000-00-00
Location:Georga  Entered:1996-12-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES95121342
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.1074B0SC 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Oedema peripheral, Osteoarthritis, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: pt recv vax 7NOV95 & 23NOV95 pt exp pain & swelling of the rt wrist & lt big toe;24NOV95 pt exp pain & swelling of rt hand & fingers;27NOV95 pt exp swelling & pain of rt hand & fingers;30NOV95 pt devel swelling & pain rt knee & ankle

VAERS ID:92884 (history)  Vaccinated:1996-11-26
Age:46.9  Onset:1996-11-27, Days after vaccination: 1
Gender:Female  Submitted:1996-12-02, Days after onset: 5
Location:Wyoming  Entered:1996-12-16, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp induration as a teen w/Td unk dose;
Other Medications: Tenormin, APAP, Motrin
Current Illness: NONE
Preexisting Conditions: telemetry patches;Monistat-local rxn;PCN nausea;cleaning sol
Diagnostic Lab Data: NONE
CDC 'Split Type': WI9616
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6J81325 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Similar reaction on previous exposure to drug, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Wednesday PM exp pain, swelling @ inj site;swelling inc, began using hot wet packs Sunday AM, Monday AM noted redness w/induration;also noted local rxn to the bandaid;this afternoon, redness nearly gone;taking APAP for pain;aching to wrist

VAERS ID:93448 (history)  Vaccinated:1996-10-22
Age:46.8  Onset:1996-10-23, Days after vaccination: 1
Gender:Male  Submitted:1996-11-05, Days after onset: 13
Location:Unknown  Entered:1996-12-31, Days after submission: 56
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: sulfa allergy; hep at age 13;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4968198 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myasthenic syndrome
SMQs:, Malignancy related conditions (narrow)
Write-up: pt recv vax; woke up w/ very weak legs which spread to arms and rest of body, lasted 2 days;

VAERS ID:93619 (history)  Vaccinated:1996-10-11
Age:46.7  Onset:1996-10-13, Days after vaccination: 2
Gender:Male  Submitted:1996-11-05, Days after onset: 23
Location:New York  Entered:1997-01-07, Days after submission: 63
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': BAM029
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F712891 LA
Administered by: Public     Purchased by: Unknown
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: a rash on the rt arm;in the back of the lt side on the elbow, lt side;devel rash 3 days p/vax;

VAERS ID:93749 (history)  Vaccinated:1996-10-16
Age:46.2  Onset:1996-10-30, Days after vaccination: 14
Gender:Female  Submitted:1997-01-02, Days after onset: 64
Location:Massachusetts  Entered:1997-01-13, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F712260IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: extreme muscle & joint pain in both legs, diaphragm, shoulders, hands, h/a, t012 occurred about 2 wk p/vax & lasted about 8-9days;

VAERS ID:93923 (history)  Vaccinated:1996-11-05
Age:46.8  Onset:1996-11-05, Days after vaccination: 0
Gender:Female  Submitted:1996-11-12, Days after onset: 7
Location:Washington  Entered:1997-01-21, Days after submission: 70
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: hayfever;hep A 1976;colitis;arthritis sx x 10yr;ezcema;
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4968265 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Abdominal pain, Arthralgia, Asthenia, Hypokinesia, Injection site hypersensitivity, Injection site mass, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recv vax 8AM that evening 8PM felt induration 33mm @ site, joint pain (especially in hands, no dexterity at all) throughout body;also had extreme fatigue, malaise & nausea w/lower abd pain;had UTI but urine cult negative when saw MD;

VAERS ID:94011 (history)  Vaccinated:1996-10-31
Age:46.0  Onset:1996-10-31, Days after vaccination: 0
Gender:Female  Submitted:1997-01-10, Days after onset: 71
Location:Wisconsin  Entered:1997-01-24, 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:
Current Illness:
Preexisting Conditions: hx of GERD & asthma;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00476P   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dysphonia, Face oedema, Injection site hypersensitivity, Pharyngitis, Pruritus, Tongue oedema
SMQs:, Anaphylactic reaction (narrow), Agranulocytosis (broad), Angioedema (narrow), Parkinson-like events (broad), Oropharyngeal infections (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 31OCT96 & devel local erythema, pruritis, & hives;eyes became puffy & c/o tongue felt swelled;feeling of fullness in throat, had hoarseness;denied SOB & no audible wheezing detected;given epi;adm to ICU for observation;

VAERS ID:94443 (history)  Vaccinated:1997-01-22
Age:46.8  Onset:1997-01-23, Days after vaccination: 1
Gender:Female  Submitted:1997-01-24, Days after onset: 1
Location:Minnesota  Entered:1997-01-28, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': MN97029
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0352D0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 22JAN97 & pt broke out in red, raised areas on hands & feet; c/o of itching;denies problems breathing red, raised areas & itching extended to arms, neck, back on 24JAN97;pt contacted MD;recommended DPH to be taken;

VAERS ID:94585 (history)  Vaccinated:1996-10-09
Age:46.6  Onset:1996-10-09, Days after vaccination: 0
Gender:Female  Submitted:1996-10-15, Days after onset: 6
Location:Texas  Entered:1997-01-30, Days after submission: 107
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Efsexor, Estrogen, Flurazepam
Current Illness: NONE
Preexisting Conditions: depression
Diagnostic Lab Data: NONE
CDC 'Split Type': TX96160
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0332D1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Oedema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: itching & quarter size knot @ site of inj lt arm w/in 30min;as noc progress, swelling devel in axilla & deltoid area;11OCT95 sx improved 14OCT96 sc improved;

VAERS ID:94826 (history)  Vaccinated:1996-10-21
Age:46.5  Onset:1996-10-21, Days after vaccination: 0
Gender:Female  Submitted:1997-01-07, Days after onset: 78
Location:Michigan  Entered:1997-02-05, Days after submission: 29
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) (FLUSHIELD)PFIZER/WYETH49681680IMA
Administered by: Public     Purchased by: Unknown
Symptoms: Asthenia, Injection site hypersensitivity, Injection site mass, Injection site oedema
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: arm heavy feeling & red swollen 2-3 inch diameter @ inj site for 3 days p/vax given;site hot to touch;knot in inj;location still prevalent 3 days p/vax;

VAERS ID:94859 (history)  Vaccinated:1996-10-30
Age:46.1  Onset:1996-10-31, Days after vaccination: 1
Gender:Female  Submitted:1996-11-01, Days after onset: 1
Location:South Carolina  Entered:1997-02-06, Days after submission: 97
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': SC96065
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00986PP0IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & noticed redness & swelling w/warmth to touch;area has enlarged @ this reporting;advised to apply moist heat;called MD should sx persist or worsen;

VAERS ID:94903 (history)  Vaccinated:1996-11-06
Age:46.9  Onset:1996-11-06, Days after vaccination: 0
Gender:Male  Submitted:1996-11-12, Days after onset: 6
Location:Washington  Entered:1997-02-10, Days after submission: 90
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications:
Current Illness:
Preexisting Conditions: states hx of arthritis to neck & hands/arms
Diagnostic Lab Data:
CDC 'Split Type': WA971318
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2013A41IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthritis, Arthropathy, Condition aggravated, Neck pain, Nuchal rigidity
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: pt came to clinic p/vax w/ c/o stiffness & pain @ the back of neck, states even hear cracking sound when turning head to sides;denies pain or swelling of inj site;pt wondering if vax can exacerbate arthritis;

VAERS ID:95006 (history)  Vaccinated:0000-00-00
Age:46.4  Onset:1989-05-16
Gender:Male  Submitted:1997-02-13, Days after onset: 2830
Location:Texas  Entered:1997-02-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Inguinal hernia;lung disorder;
Diagnostic Lab Data: 18NOV88 Anti-HBC positive;anti-HBS positive;Anti-HBE positive;23SEP88 ANA 1:320 positive;11NOV88 ANA 1:40;DEC88 ANA 1:320 positive;11MAY89 1:1280 positive;MAY89 ALT 55:53 elevated;JAN92 ANA 1:1280 positive;
CDC 'Split Type': WAES97011976
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Antinuclear antibody, Cerebrovascular accident, Collagen disorder, Depressed level of consciousness, Immune system disorder, Neuritis, Paraesthesia, Systemic lupus erythematosus
SMQs:, Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Ischaemic cerebrovascular conditions (narrow), Haemorrhagic cerebrovascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: devel a cerebral hemisphere stroke w/diff speech & rt arm weakness;pt concerned w/immune problems w/lupus-type effect have caused a vasculitis & injured peripheral nerves & some CNS;MD felt poss mixed collagen disease;paresthesia

VAERS ID:95326 (history)  Vaccinated:1997-02-21
Age:46.9  Onset:1997-02-22, Days after vaccination: 1
Gender:Female  Submitted:1997-02-27, Days after onset: 5
Location:Montana  Entered:1997-02-28, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp hives, swelling w/earlier doses of Rabies vax;
Other Medications: Premarin;APAP
Current Illness: NONE
Preexisting Conditions: possibly neosporin or triple ATB ointment;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.L06272 LA
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis exfoliative, Face oedema, Pruritus, Similar reaction on previous exposure to drug, Tremor, Urticaria
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & 12hr later eyes swelled shut;gen itch;edema of face;aching;peeling of facial skin;hives on inj arm;

VAERS ID:95486 (history)  Vaccinated:1997-02-26
Age:46.2  Onset:1997-02-26, Days after vaccination: 0
Gender:Female  Submitted:1997-02-27, Days after onset: 1
Location:Louisiana  Entered:1997-03-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp GI bleeding @ 45yr of age w/Hep B dose 1;
Other Medications: NONE
Current Illness:
Preexisting Conditions: allergies demerol & sulfa drugs;hx migraine & neck injury;hx of mastectomy;hx of suspected GI bleedingh;hx of hernia;
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2133A42IMRA
Administered by: Private     Purchased by: Other
Symptoms: Condition aggravated, Headache
SMQs:
Write-up: pt c/o h/a beginning on 26MAR97 about 315Pm;pt recv vax 26MAR97 AM & h/a reported as migraine h/a;pt took migraine protocol @ home;MD recommended returning home & repeating migraine protocol 27FEB97;

VAERS ID:95745 (history)  Vaccinated:1996-11-12
Age:46.6  Onset:1996-11-13, Days after vaccination: 1
Gender:Female  Submitted:1996-11-13, Days after onset: 0
Location:Massachusetts  Entered:1997-03-06, Days after submission: 113
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 896338002L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4968139 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 1 day p/vax pt devel an inj site rxn characterized by a 6cm by 8cm area of redness & swelling;

VAERS ID:95511 (history)  Vaccinated:1997-01-09
Age:46.9  Onset:1997-01-11, Days after vaccination: 2
Gender:Female  Submitted:1997-02-04, Days after onset: 24
Location:Michigan  Entered:1997-03-10, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Bone scan, u/s all negative;
CDC 'Split Type': MI97015
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1819A10 RA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6K813662 LA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site oedema, Injection site pain, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: had some soreness lt deltoid p/inj;awoke from sleep 11JAN w/itching;by PM arm warm to touch, large reddened area;pt to MD 13JAN ATB therapy;15JAN arm swollen from shoulder to elbow painful;adm to hosp IV ATB d/c 17JAN97;dx cellulitis;

VAERS ID:95968 (history)  Vaccinated:0000-00-00
Age:46.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES96040585
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Myasthenic syndrome, Neuropathy, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad)
Write-up: pt recv vax & exp heaviness in arm like muscles are numb;reporter noted that the numbness in the arm was d/t the nurse hitting the nerve during administration of the vax;

VAERS ID:96193 (history)  Vaccinated:1996-07-01
Age:46.3  Onset:1996-07-03, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:Montana  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: 8NOV96 Anti-HBS positive;
CDC 'Split Type': WAES96110801
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1149A1IM 
Administered by: Public     Purchased by: Public
Symptoms: Hepatitis, Infection, Injection site oedema
SMQs:, Hepatitis, non-infectious (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax 1JUL96 & 3JUL96 pt devel edema @ the site of inj that was 6-7cm round;the area was soft & not red or hot & then pt did not exp pain on palpation;pt tested positive for hep b on 8NOV96;

VAERS ID:96203 (history)  Vaccinated:1996-11-07
Age:46.5  Onset:1996-11-07, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Indiana  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES96111707
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0649D3  
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Rash, Rash maculo-papular, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 7NOV96 & 8NOV96 pt presented to ER w/a red inflamed rash on upper trunk & neck;pt was given vax even though had a positive titer;

VAERS ID:96228 (history)  Vaccinated:1996-10-30
Age:46.8  Onset:1996-11-01, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:California  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES96121295
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Anorexia, Cholecystitis, Flatulence, Hepatic function abnormal, Hyperbilirubinaemia, Nausea, Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Infectious biliary disorders (narrow), Biliary system related investigations, signs and symptoms (narrow), Gallbladder related disorders (narrow), Biliary tract disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax & exp nausea, bloating, abd pain w/cramps, loss of appetite, a high fever & had high bilirubin;

VAERS ID:96383 (history)  Vaccinated:1996-10-17
Age:46.2  Onset:1996-10-17, Days after vaccination: 0
Gender:Female  Submitted:1997-02-28, Days after onset: 134
Location:Mississippi  Entered:1997-03-19, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: could not tolerate allergy shots;no brothers or sisters
Other Medications: Ventolin;Vanceril puff;
Current Illness: hx of asthma
Preexisting Conditions: allergies: codeine, fragrances & others;no other drugs;
Diagnostic Lab Data: BP 118/54;P72;R36;t98.5;P84;R20;T98.5;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49681660IMLA
Administered by: Public     Purchased by: Other
Symptoms: Asthma, Condition aggravated, Cough, Dyspnoea, Hyperventilation, Hypoxia, Paraesthesia, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: 935AM pt presented to ER c/o diff breathing, tingling around lips, skin warm & dry;bilat wheezing on expirations;coughing forcefully;10AM breathing better lungs CTA all fiedls;1030AM breathing clearly still;tx w/02, epi, Nebulizer;

VAERS ID:96559 (history)  Vaccinated:1997-01-15
Age:46.0  Onset:1997-01-22, Days after vaccination: 7
Gender:Female  Submitted:1997-02-05, Days after onset: 14
Location:Unknown  Entered:1997-03-24, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Guaifenesin;oral contraceptive;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 22JAN97 SGOT 280;SGPT 612;LDH 267;24JAN97 SGOT 266;SGPT 586;LDH 249;
CDC 'Split Type': 970024031
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Asthenia, Blood lactate dehydrogenase increased, Gamma-glutamyltransferase increased, Hepatic function abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Guillain-Barre syndrome (broad)
Write-up: pt recv vax 15JAn97 & felt tired;22JAN97 pt liver function tests results were SGOT 280, SGPT 612;LDH 267;GGTP 24;& on 24JAN97 they were SGOT 266;SGPT 586;LDH 249;pt is undergoing a work-up;

VAERS ID:96836 (history)  Vaccinated:1997-03-07
Age:46.0  Onset:0000-00-00
Gender:Female  Submitted:1997-04-02
Location:Oregon  Entered:1997-04-08, 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: Ticlid
Current Illness: follow upon a stroke
Preexisting Conditions: Iodine, amitriptyline and demerol
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES436823 IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6J813251IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt devel a total body rash beginning on the rt arm @ the site of the pneumovax;pt came in for the rash 3 days p/vax;pt was given DPH 25-50mg PRN for itching;

VAERS ID:98800 (history)  Vaccinated:1995-10-25
Age:46.0  Onset:1995-10-25, Days after vaccination: 0
Gender:Female  Submitted:1997-02-05, Days after onset: 469
Location:Iowa  Entered:1997-04-18, Days after submission: 71
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: no allergy to foods or medication;contace allergy to eye make-up
Diagnostic Lab Data:
CDC 'Split Type': CO6239
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F61015  A
Administered by: Other     Purchased by: Other
Symptoms: Chest pain, Cough, Lacrimal disorder, Malaise, Rhinitis
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Lacrimal disorders (narrow)
Write-up: chest tightness, watery eyes, congestion, cough, malaise w/in hr of vax 3PM f/u cont coughing since vax recv;will see own MD for addtl f/u;

VAERS ID:97254 (history)  Vaccinated:1997-04-15
Age:46.2  Onset:1997-04-16, Days after vaccination: 1
Gender:Female  Submitted:1997-04-18, Days after onset: 2
Location:Maine  Entered:1997-04-28, 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: Prozac 20mg
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6D81109 IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 4cm x 4cm local rxn-redness, tender, swollen;

VAERS ID:98932 (history)  Vaccinated:1995-08-15
Age:46.3  Onset:1995-08-15, Days after vaccination: 0
Gender:Female  Submitted:1996-02-21, Days after onset: 190
Location:New York  Entered:1997-05-22, Days after submission: 455
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 896138014L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49580131IMRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt devel an inj site rxn characterized by redness & induration p/vax;

VAERS ID:98936 (history)  Vaccinated:1995-08-14
Age:46.1  Onset:1995-08-14, Days after vaccination: 0
Gender:Female  Submitted:1996-02-21, Days after onset: 191
Location:New York  Entered:1997-05-22, Days after submission: 455
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 896138018L
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1414A41 LA
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49580131IMRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt devel an inj site rxn characterized by redness & induration p/vax;

VAERS ID:98937 (history)  Vaccinated:1995-08-16
Age:46.2  Onset:1995-08-16, Days after vaccination: 0
Gender:Female  Submitted:1996-02-21, Days after onset: 189
Location:New York  Entered:1997-05-22, Days after submission: 455
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD
Current Illness: NONE
Preexisting Conditions: hearing impaired;
Diagnostic Lab Data:
CDC 'Split Type': 896138019L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49580262IMRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt devel an inj site rxn characterized by induration & redness p/vax

VAERS ID:98950 (history)  Vaccinated:0000-00-00
Age:46.0  Onset:0000-00-00
Gender:Female  Submitted:1996-07-10
Location:North Carolina  Entered:1997-05-22, Days after submission: 316
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': 896193024L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4958061 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia, Injection site pain, Joint range of motion decreased, Movement disorder, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: pt recv vax & pt exp pain @ the inj site, tingling sensation in the fingers, & limited ROM in the shoulder.

VAERS ID:98968 (history)  Vaccinated:1996-02-12
Age:46.2  Onset:1996-02-12, Days after vaccination: 0
Gender:Female  Submitted:1996-03-12, Days after onset: 29
Location:New York  Entered:1997-05-22, Days after submission: 435
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrogen, Prozac
Current Illness: NONE
Preexisting Conditions: allergic to erythromycin
Diagnostic Lab Data: NONE
CDC 'Split Type': 896221003L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4958010 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Ecchymosis, Injection site mass, Injection site oedema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax & devel inj site rxn characterized by swelling & induration;pt also exp ecchymosis @ the inj site (3 x 5 area);pt was recovered as of the date of this report;

VAERS ID:98414 (history)  Vaccinated:1997-04-21
Age:46.9  Onset:1997-04-22, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Minnesota  Entered:1997-05-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt thinks had a prior problem yr ago but does not know what or when;
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES442452 IMRA
Administered by: Other     Purchased by: Public
Symptoms: Hypotension, Hypothermia, Oedema peripheral, Pain, Pruritus, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Accidents and injuries (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: discomfort noted in upper rt arm on 22APR97 inc s/s on 22APR97;edema, redness 15 x 10cm, warm to touch, itchy, t97.4 oral, BP 162/102;sent to clinic for assessment;tx DPH;

VAERS ID:98549 (history)  Vaccinated:1996-09-26
Age:46.2  Onset:1996-10-10, Days after vaccination: 14
Gender:Female  Submitted:1997-05-28, Days after onset: 230
Location:Montana  Entered:1997-06-02, 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:
Preexisting Conditions: NONE
Diagnostic Lab Data: liver profile performed during & after event;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA488A60IMRA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Hepatic function abnormal, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: elevated liver enzymes, nausea, vomit, upper abd pain w/cramps;

VAERS ID:99958 (history)  Vaccinated:1996-08-01
Age:46.8  Onset:1996-08-06, Days after vaccination: 5
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1997-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES96081092
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0111D0SC 
Administered by: Other     Purchased by: Private
Symptoms: Abdominal pain, Diarrhoea, Flatulence, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 1AUG96 & 6AUG96 pt devel diarrhea w/cramping;9AUG96 pt exp itching all over & devel a rash @ hairline, as well as gassiness;pt recovered from itching all over, rash & diarrhea w/cramping determined not likely r/t vax;

VAERS ID:98611 (history)  Vaccinated:1997-05-19
Age:46.0  Onset:1997-05-21, Days after vaccination: 2
Gender:Male  Submitted:1997-05-28, Days after onset: 7
Location:Washington  Entered:1997-06-03, 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
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM538A60IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Herpes zoster, Infection, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: 2 days p/vax pt noted itching in chest/abd-then devel Herpes Zoster in T11 distribution;

VAERS ID:98703 (history)  Vaccinated:1997-05-20
Age:46.5  Onset:1997-05-29, Days after vaccination: 9
Gender:Female  Submitted:1997-06-03, Days after onset: 5
Location:Maryland  Entered:1997-06-09, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': MD97007
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.L11301 LA
Administered by: Public     Purchased by: Public
Symptoms: Face oedema, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 20MAY97 & 29MAY97 itching @ bedtime;30MAY97 red blotches shoulders scalp, ears, axilla, face, trunk & groin-took DPH 31MAY97: spread to back of knees, legs & top lip became swollen;contacted MD office-advised DPH, cool baths;

VAERS ID:99032 (history)  Vaccinated:1997-06-05
Age:46.0  Onset:0000-00-00
Gender:Female  Submitted:1997-06-11
Location:South Carolina  Entered:1997-06-16, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49681290 LA
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Lymphadenopathy
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: pt seen by MD works w/MD who reported pt had severe local rxn w/swelling, pain, redness, & tenderness @ site & under axilla;also exp limited ORM w/arm vax given in;

VAERS ID:99196 (history)  Vaccinated:1996-10-18
Age:46.6  Onset:1996-10-25, Days after vaccination: 7
Gender:Female  Submitted:1996-11-05, Days after onset: 11
Location:Washington  Entered:1997-06-20, Days after submission: 226
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': WA971321
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH6249006   
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: sx started 25OCT96 7 days p/vax rt side of face started not to work;droopy side of face;couldn''t chew, dx bell''s palsy;relapsed 31OCT96 put back on pred;weak & tired;facial paralysis improved but still present to a sl degree;

VAERS ID:99328 (history)  Vaccinated:1997-06-10
Age:46.6  Onset:1997-06-10, Days after vaccination: 0
Gender:Female  Submitted:1997-06-19, Days after onset: 9
Location:West Virginia  Entered:1997-06-26, 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: CBC;EKG, pulse oximetry
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.08890  RA
Administered by: Public     Purchased by: Other
Symptoms: Chest pain, Injection site hypersensitivity, Pruritus, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt had measles inj 10JUN97 & started getting sick that afternoon w/chest pain, itching & vomiting;went to MD 14JUN & ER on 15JUN97;in ER w/rash around inj site, itching, vomiting, chest discomfort;

VAERS ID:100142 (history)  Vaccinated:1997-04-03
Age:46.1  Onset:1997-04-03, Days after vaccination: 0
Gender:Female  Submitted:1997-04-15, Days after onset: 11
Location:South Dakota  Entered:1997-07-10, Days after submission: 86
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': SD97012
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7B91518 IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Oedema, Pruritus, Rash, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: itch 9APR;rash, itch, swollen, warm told to call clinic & instructed to take DPH;15APR97 problem resolving w/DPH;

VAERS ID:100185 (history)  Vaccinated:1997-04-16
Age:46.7  Onset:1997-04-16, Days after vaccination: 0
Gender:Female  Submitted:1997-04-21, Days after onset: 5
Location:New Mexico  Entered:1997-07-14, Days after submission: 84
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Rexeven (Mexico)
Current Illness: NONE
Preexisting Conditions: allergy PCN
Diagnostic Lab Data: BP 170/102;t101.5;
CDC 'Split Type': NM97013
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6B810360IMRA
Administered by: Public     Purchased by: Public
Symptoms: Hypertension, Injection site hypersensitivity, Injection site oedema, Injection site pain, Oedema peripheral, Pyrexia, Tachycardia, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Hypersensitivity (narrow)
Write-up: 3hr p/vax pt noticed progressive redness, tenderness, swelling & hot to the touch area on rt upper anterior arm;to MD on 18APR97 w/arm measuring 22cm x 22cm;red, tender, hot to touch & swollen 2cm in depth;t101.5, BP 170/102;P96;R20;to ER

VAERS ID:100512 (history)  Vaccinated:1996-11-04
Age:46.4  Onset:1996-11-04, Days after vaccination: 0
Gender:Female  Submitted:1996-11-19, Days after onset: 15
Location:Kentucky  Entered:1997-07-18, Days after submission: 240
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: UNK
Diagnostic Lab Data:
CDC 'Split Type': 896337004L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH    
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Hypokinesia, Myasthenic syndrome, Osteoarthritis
SMQs:, Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: flu vax was inadvertently injected into pt shoulder joint;following day joint became swollen;the swelling was worsening @ the date of this report;f/u info recv 7JAN97 indicated pt also exp arthralgia w/loss of motion, strength & grip ;

VAERS ID:100402 (history)  Vaccinated:1997-06-25
Age:46.0  Onset:1997-06-26, Days after vaccination: 1
Gender:Female  Submitted:1997-06-27, Days after onset: 1
Location:Texas  Entered:1997-07-21, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0329D0SCL
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6K81366 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Chills, Oedema peripheral, Pain, Pyrexia, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt devel lt arm swelling w/erythema & tenderness on the same evening;fever 102 w/chills;cellulitis-Keflex;

VAERS ID:101407 (history)  Vaccinated:1996-06-12
Age:46.3  Onset:1996-06-14, Days after vaccination: 2
Gender:Male  Submitted:1997-04-11, Days after onset: 301
Location:Texas  Entered:1997-07-22, Days after submission: 102
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': CO6653
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L71095 IMA
Administered by: Public     Purchased by: Other
Symptoms: Face oedema, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: red rash on back, face, back of upper arms & buttocks;over the course of the past few days covered entire body;eyes were also swollen sl;no problems breathing;No serious enough to go to ER;tx w/DPH;

VAERS ID:100714 (history)  Vaccinated:1996-12-24
Age:46.0  Onset:1997-04-01, Days after vaccination: 98
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: APR97 titer negative;
CDC 'Split Type': WAES97041726
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax 24DEC96 & APR97 pt exp failure to seroconvert confirmed by serological testing;

VAERS ID:100847 (history)  Vaccinated:1997-04-07
Age:46.9  Onset:1997-04-08, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:South Carolina  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES97050309
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1479D0SC 
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 7APR97 & that same day pt exp a red area & itching @ inj site;

VAERS ID:100986 (history)  Vaccinated:0000-00-00
Age:46.5  Onset:1997-05-22
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES97052287
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Conjunctivitis, Eye pain
SMQs:, Severe cutaneous adverse reactions (broad), Glaucoma (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: 22MAY97 while preparing the vax nurse splashed some of it in eye;nurse reported initially it did not burn;eye flushed w/water & it started to burn;@ time of report eye was red;

VAERS ID:101966 (history)  Vaccinated:1996-06-21
Age:46.6  Onset:1996-06-22, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1997-07-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES96070168
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)
Write-up: pt recv vax 21JUN96 & 22JUN96 pt exp pain @ inj site & soreness of lt arm;pt recovered;

VAERS ID:102107 (history)  Vaccinated:1997-07-31
Age:46.2  Onset:1997-07-31, Days after vaccination: 0
Gender:Female  Submitted:1997-08-07, Days after onset: 7
Location:Michigan  Entered:1997-09-02, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': MI97088
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1819A12 RA
Administered by: Public     Purchased by: Unknown
Symptoms: Arthralgia, Insomnia, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: pt states on the evening of 31JUL97 could not sleep well d/t achy joints, especially hips;also c/o itchy skin; pt stated both are starting to diminish 6AUG97;pt later added thought had a temp that noc;

VAERS ID:102295 (history)  Vaccinated:1997-08-08
Age:46.1  Onset:1997-08-21, Days after vaccination: 13
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1997-09-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Ferrous sulfed;Elavil
Current Illness: NONE
Preexisting Conditions: totracyclin-rash;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4978061 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Pyrexia, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 18AUG97 & had 1010cm erythema, induration, warmth rt deltoid;21AUG97 had fever to 101-102;rx motrin chlortrimeton, medrol dosage, keflex 25AUG;

VAERS ID:102398 (history)  Vaccinated:1996-10-14
Age:46.0  Onset:1996-10-14, Days after vaccination: 0
Gender:Female  Submitted:1996-10-25, Days after onset: 11
Location:Iowa  Entered:1997-09-10, Days after submission: 320
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lotensin;Glucotrol XC;Prempro;Glucophage;
Current Illness: UNK
Preexisting Conditions: diabetes mellitus, type II
Diagnostic Lab Data:
CDC 'Split Type': 896323011L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS    
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4334020IM 
Administered by: Private     Purchased by: Private
Symptoms: Hypertonia, Hypokinesia, Injection site hypersensitivity, Injection site oedema, Oedema peripheral, Vomiting
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: 1hr p/vax pt devel redness @ the inj site, swelling @ the inj site which extended to the elbow, stiffness w/an inability to lift arm, & vomiting;

VAERS ID:102721 (history)  Vaccinated:1997-09-12
Age:46.2  Onset:0000-00-00
Gender:Female  Submitted:1997-09-20
Location:Georga  Entered:1997-09-26, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recv MMR lot# 14440 31JUL97
Current Illness: NONE
Preexisting Conditions: unk
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0108E1SC 
Administered by: Private     Purchased by: Other
Symptoms: Cough, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad)
Write-up: body aches, cough, arm soreness 48hr later;

VAERS ID:102782 (history)  Vaccinated:0000-00-00
Age:46.0  Onset:0000-00-00
Gender:Female  Submitted:1997-02-03
Location:Arizona  Entered:1997-09-29, 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:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4968177  LA
Administered by: Public     Purchased by: Unknown
Symptoms: Bronchitis, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: felt achy for 2wk became worse w/muscle aches, denied a fever, denied SOB;viral synd devel secondary;bronchitis;

VAERS ID:102847 (history)  Vaccinated:1997-07-22
Age:46.4  Onset:1997-07-29, Days after vaccination: 7
Gender:Female  Submitted:1997-08-01, Days after onset: 3
Location:Texas  Entered:1997-09-30, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: unk
Preexisting Conditions: unk
Diagnostic Lab Data: NONE
CDC 'Split Type': TX97106
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6F81202 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Hypersensitivity, Infection, Injection site hypersensitivity, Injection site mass, Injection site oedema, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 29JUL97 pt c/o swelling & knot around inj site;white around inj site w/redness to surrounding area;site itches;no pain;MD visit 29JUL97 dx allerg rxn/infect;rx ATB, DPH for itch;rash around inj site;

VAERS ID:103096 (history)  Vaccinated:0000-00-00
Age:46.0  Onset:1997-10-10
Gender:Male  Submitted:1997-10-13, Days after onset: 3
Location:Missouri  Entered:1997-10-14, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest pain, Dizziness, Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: fever, aches, tightness in chest, dizziness, over all bad feeling, heaviness in head;

VAERS ID:103149 (history)  Vaccinated:1997-04-21
Age:46.9  Onset:1997-04-30, Days after vaccination: 9
Gender:Female  Submitted:1997-10-09, Days after onset: 162
Location:Idaho  Entered:1997-10-15, Days after submission: 6
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Synthroid, Multivitamin
Current Illness: NONE
Preexisting Conditions: prior breast cancer & endometrial CA
Diagnostic Lab Data: 23MAY97 dx w/adeno carcinoma on the liver;
CDC 'Split Type': ID97044
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.053101IMA
Administered by: Public     Purchased by: Public
Symptoms: Neoplasm malignant
SMQs:, Malignant tumours (narrow)
Write-up: vaccine apparently triggered metastatic breast or endometrial cancer to appear in the liver;prior to vax, cancer had been totally treated w/surgery & had assurance that was 95% cured;

VAERS ID:103273 (history)  Vaccinated:1997-10-03
Age:46.1  Onset:1997-10-03, Days after vaccination: 0
Gender:Female  Submitted:1997-10-06, Days after onset: 3
Location:California  Entered:1997-10-20, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F818620IMRA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Chills, Headache, Injection site hypersensitivity, Injection site oedema, Lymphadenopathy, Malaise, Skin ulcer
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: blister @ inj site;fatigue noted in evening when @ home noted blister in evening;reddened area w/bandaid covering an open blister area;did not feel well;redness, swelling & induration;h/a;chills, swollen gland;

VAERS ID:103616 (history)  Vaccinated:1997-06-13
Age:46.0  Onset:1997-06-13, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Arkansas  Entered:1997-10-20
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: No relevant data;
CDC 'Split Type': WAES97071341
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0349E0SC 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Malaise
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 13JUN97 & 13JUN97 pt felt sick;devel 2 or 3 small vesicles on leg & arms;Er physician assessed pox;pt recovered;

VAERS ID:104082 (history)  Vaccinated:1997-09-25
Age:46.0  Onset:1997-09-26, Days after vaccination: 1
Gender:Female  Submitted:1997-10-29, Days after onset: 33
Location:Hawaii  Entered:1997-10-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NIL
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F81819 IMA
Administered by: Public     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 3" diameter, redness, swelling, lumpy, painful @ inj site;

VAERS ID:104084 (history)  Vaccinated:1997-10-27
Age:46.5  Onset:1997-10-28, Days after vaccination: 1
Gender:Male  Submitted:1997-10-30, Days after onset: 2
Location:Ohio  Entered:1997-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE, vitamin supplements
Current Illness: NONE-athlete
Preexisting Conditions: sulfa drugs
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
Administered by: Other     Purchased by: Private
Symptoms: Chills, Hyperhidrosis, Injection site pain, Myalgia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)
Write-up: on second day p/vax severe chills, sweating & uncontrollable shivering for several hr;regular blankets, electric blanket, & hot showers required to stop chills;muscle pain @ point of vax;other muscle pain also;

VAERS ID:105494 (history)  Vaccinated:1996-10-30
Age:46.0  Onset:1996-11-06, Days after vaccination: 7
Gender:Male  Submitted:1996-12-18, Days after onset: 42
Location:Unknown  Entered:1997-10-30, Days after submission: 316
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: 6NOV96 SGPT 82;BILTOT 2.4;NOV96 ultrasound nl;
CDC 'Split Type': 960180641
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Anorexia, Gastrointestinal disorder, Hepatic function abnormal, Nausea, Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax & 1wk post vax pt exp nausea, diff digesting, no appetite, & elevated liver enzymes;1mo post vax pt exp fever;as of 16DEC96 sx are ongoing;no tx was given;the vax series was discontinued;

VAERS ID:105981 (history)  Vaccinated:1996-05-20
Age:46.0  Onset:1996-05-20, Days after vaccination: 0
Gender:Female  Submitted:1997-05-22, Days after onset: 367
Location:Kansas  Entered:1997-10-30, Days after submission: 161
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp mild rash @ 40yr old w/engerix-B dose 1;
Other Medications: Pred;DPH;Tagamet;
Current Illness: NONE
Preexisting Conditions: allergy to ampicillin;
Diagnostic Lab Data:
CDC 'Split Type': 970023241
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1  
Administered by: Other     Purchased by: Other
Symptoms: Face oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 20MAY96 & exp lip swelling w/in 30min of vax;there were no sx of anaphylaxis, no SOB, & the swelling resolved spontaneously;

VAERS ID:104109 (history)  Vaccinated:1997-08-13
Age:46.7  Onset:1997-08-15, Days after vaccination: 2
Gender:Female  Submitted:1997-09-16, Days after onset: 32
Location:Massachusetts  Entered:1997-10-31, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin;Klonipin PRN
Current Illness: NONE
Preexisting Conditions: allerby-compazineDVP dye;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD66  LA
Administered by: Private     Purchased by: Public
Symptoms: Pain
SMQs:
Write-up: approx 48hr p/vax pt begin to have throbbing pain in upper arm;

VAERS ID:104410 (history)  Vaccinated:1997-10-15
Age:46.3  Onset:1997-10-21, Days after vaccination: 6
Gender:Female  Submitted:1997-10-28, Days after onset: 7
Location:New York  Entered:1997-11-05, 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: SUlfamethtrim DS for sinus infect;
Current Illness: told nurse was on sulfa;
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4978169   
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Hyperhidrosis, Hypokinesia, Hypothermia, Pain, Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: sl fever 100.5, noc sweats, joint pain-knees, elbow, severe pain both legs;temp swings 98.1-99.8 over couple days;had trouble sitting, standing-leg pain severe 21OCT-24OCT97;pt states had allerg rxn w/aleve-rash, itching;

VAERS ID:104546 (history)  Vaccinated:1997-10-09
Age:46.6  Onset:1997-10-11, Days after vaccination: 2
Gender:Male  Submitted:1997-11-04, Days after onset: 24
Location:D.C.  Entered:1997-11-07, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: unk
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: ragweed, grass, cat & dogs hair/dander
Diagnostic Lab Data: IgG/IgM
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0474E SCLA
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Infection, Lymphadenopathy, Pharyngitis, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: devel confirmed case of measles 2 days post vax;sx rash, fever, sore throat, lymphadenopathy;

VAERS ID:104975 (history)  Vaccinated:1997-11-03
Age:46.7  Onset:1997-11-03, Days after vaccination: 0
Gender:Female  Submitted:1997-11-12, Days after onset: 9
Location:Wisconsin  Entered:1997-11-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Relafen
Current Illness: NONE
Preexisting Conditions: arthritis
Diagnostic Lab Data: referred to DM
CDC 'Split Type':
Vaccination
Manufacturer
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2370A40 LA
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Dizziness, Headache, Hypersensitivity, Hypertension, Injection site oedema, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: pt MD suspected an allerg rxn to the mercury in vax;adverse rxn included local swelling, fever, h/a, dizziness, pain locally as well as back pain, nausea, HTN, swelling of entire arm;tx inc BP meds temp/rest;

VAERS ID:105096 (history)  Vaccinated:1997-10-31
Age:46.1  Onset:1997-10-31, Days after vaccination: 0
Gender:Female  Submitted:1997-11-04, Days after onset: 4
Location:California  Entered:1997-11-24, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Ziac
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49782003IMA
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow)
Write-up: red rash noted under both arms 31OCT97 in early AM;symmetrical in design;over next 24hr rash spread to chest & abd;DPH taken w/hydrocortisone;cream applied;rash spread w/in 48hr to upper thighs;itching;dx systemic allerg rxn;

VAERS ID:105157 (history)  Vaccinated:1997-10-09
Age:46.5  Onset:1997-10-09, Days after vaccination: 0
Gender:Male  Submitted:1997-10-23, Days after onset: 14
Location:New Hampshire  Entered:1997-11-25, Days after submission: 33
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: CBC done WNL; sed rate WNL
CDC 'Split Type': NH97025
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F81854 IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Facial palsy, Nuchal rigidity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: pt recv vax p/noon of 9OCT97 later that PM pt noticed stiff neck-progressed over weekend to lt side of face, head, neck and lt arm numbness;no paralysis, no vision change;seen in office 14OCT97;

VAERS ID:105165 (history)  Vaccinated:1997-10-29
Age:46.2  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Ohio  Entered:1997-11-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F81742 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Cough, Headache, Myalgia, Pharyngitis, Pyrexia, Rhinitis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad)
Write-up: h/a-sore throat, aching body-fever;coughing-congested;

VAERS ID:105215 (history)  Vaccinated:1997-11-17
Age:46.1  Onset:1997-11-18, Days after vaccination: 1
Gender:Female  Submitted:1997-11-21, Days after onset: 3
Location:California  Entered:1997-11-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp swelling @ 44yr old w/flu vax;
Other Medications:
Current Illness:
Preexisting Conditions: pt says had some radation 2yr ago but not last yr
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F81841  A
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Similar reaction on previous exposure to drug, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt has swelling @ the site of the flu inj about 1 1/4" on 18NOV97 & 2" x 3" on 19NOV97;swelling was red & hot;advised that pt could use DPH;

VAERS ID:105241 (history)  Vaccinated:1997-11-13
Age:46.0  Onset:1997-11-15, Days after vaccination: 2
Gender:Female  Submitted:1997-11-21, Days after onset: 6
Location:Tennessee  Entered:1997-11-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications: Depo provero;Niferex;Glynose
Current Illness: NONE
Preexisting Conditions: erythromycin, diabetes (type II), iron def anemia
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4425210IM 
Administered by: Private     Purchased by: Private
Symptoms: Chills, Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: $gnausea, vomiting, h/a, chills

VAERS ID:105248 (history)  Vaccinated:1997-10-27
Age:46.4  Onset:1997-11-07, Days after vaccination: 11
Gender:Female  Submitted:1997-11-10, Days after onset: 3
Location:Ohio  Entered:1997-11-28, 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: codeine, Ritalin
Diagnostic Lab Data:
CDC 'Split Type': OH97086
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2296A43IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0625E0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Lymphadenopathy, Malaise, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: red rash on face & trunk 7NOV97, pruritus, malaise, afeb, swollen postauricular nodes;

VAERS ID:105250 (history)  Vaccinated:1997-10-15
Age:46.8  Onset:1997-10-16, Days after vaccination: 1
Gender:Female  Submitted:1997-11-17, Days after onset: 32
Location:Ohio  Entered:1997-11-28, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: hx of TMJ
Diagnostic Lab Data: NONE
CDC 'Split Type': OH97089
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F817880 RA
Administered by: Public     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: awoke next day following flu vax w/severe h/a;no other sx;recv partial relief w/advil;slept most of day;

VAERS ID:105556 (history)  Vaccinated:1997-12-03
Age:46.7  Onset:1997-12-03, Days after vaccination: 0
Gender:Female  Submitted:1997-12-03, Days after onset: 0
Location:New Hampshire  Entered:1997-12-09, 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: Dephot;clonapin, sancerf
Current Illness: NONE
Preexisting Conditions: allergy to PCN, sz disorder;
Diagnostic Lab Data:
CDC 'Split Type': NH97026
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2506A41IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Asthma, Chest pain, Hypoxia, Tremor
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: 1015AM weakness, gen tremors;1025AM chest tightness, wheeze bilat upon auscultation, AR 100, irregular, R20;1030AM epi given 02;1030AM EMT called;1040AM lungs clear chest tightness gone to ER via amb;

VAERS ID:105809 (history)  Vaccinated:1997-09-26
Age:46.3  Onset:1997-09-29, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1997-12-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness:
Preexisting Conditions: allergy to sulfa; daughter had reyes synd;
Diagnostic Lab Data: ESR 30, WBC 13,900, PCV 40.5, PLT 232,000;evidence leads towards TYPE III hypersensitivity rxn w/immune complex deposits skin, joints;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthropathy, Chills, Confusional state, Leukocytosis, Oedema peripheral, Red blood cell sedimentation rate increased, Serum sickness, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recv vax 26SEP97 & devel pruritic whelps over both thighs then swelling of extremities;tx w/medrol dose pack;devel acute febrile rx w/T104, chills, rigor, confusion-adm to ICU;dx is serum sickness according to rheumatology consult;

VAERS ID:105921 (history)  Vaccinated:1997-11-12
Age:46.0  Onset:1997-11-12, Days after vaccination: 0
Gender:Female  Submitted:1997-12-18, Days after onset: 36
Location:Hawaii  Entered:1997-12-26, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: PCN/vibramycin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F818190 LA
Administered by: Military     Purchased by: Unknown
Symptoms: Hypokinesia, Myalgia, Myasthenic syndrome, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 15min post vax pt lt deltoid pain down lt arm to hand x 1 1/2 day the aching intermittently diff lt arm until present;weakness lt arm;unable to raise lt arm above head w/o discomfort;seen by MD x2;

VAERS ID:107305 (history)  Vaccinated:1996-06-13
Age:46.6  Onset:1996-06-13, Days after vaccination: 0
Gender:Male  Submitted:1997-10-21, Days after onset: 495
Location:New Hampshire  Entered:1998-01-08, Days after submission: 79
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp local rxn & flu-like events p/2nd dose in series;
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': CO6649
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.K11202IMA
Administered by: Other     Purchased by: Other
Symptoms: Influenza, Injection site hypersensitivity, Injection site mass, Malaise, Similar reaction on previous exposure to drug, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 13JUN96 & w/in 24hr of vax pt exp a local rxn of 3x3 that was red, indurated & warm, flu-like sx & malaise;

VAERS ID:107337 (history)  Vaccinated:0000-00-00
Age:46.0  Onset:0000-00-00
Gender:Female  Submitted:1997-10-24
Location:Oklahoma  Entered:1998-01-08, Days after submission: 76
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': CO7084
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hyperhidrosis, Hypertonia, Similar reaction on previous exposure to drug, Tinnitus, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow)
Write-up: pt recv vax SEP96 & exp sweating & muscle tremors;sweating to the point of where hair is wet everyday;also reported ringing in ears;tightened diaphragm & sweating over whole body;

VAERS ID:106277 (history)  Vaccinated:1997-12-10
Age:46.7  Onset:1997-12-10, Days after vaccination: 0
Gender:Female  Submitted:1997-12-17, Days after onset: 7
Location:Texas  Entered:1998-01-09, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: depression, chemical allergies
Preexisting Conditions: other allergies, allergy to sulfa;
Diagnostic Lab Data: NA
CDC 'Split Type': TX97169
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F818034 LA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES448191  LA
Administered by: Private     Purchased by: Private
Symptoms: Hypokinesia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: aching body, could not get out of bed for a day & half;could not raise arm;

VAERS ID:106363 (history)  Vaccinated:1997-11-24
Age:46.8  Onset:1997-11-25, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:1998-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: injury to rt hand 1mo prior had swelling nox-ray done
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WA971414
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49781741 LA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Oedema, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & about 2:30 next day pt noted white circle around the inj site that morning;pt had swelling of hands neck & arms;advised to get DPH & use q 4hr;describes chills & ?fever;

VAERS ID:107537 (history)  Vaccinated:1996-10-22
Age:46.2  Onset:1996-10-22, Days after vaccination: 0
Gender:Female  Submitted:1997-12-30, Days after onset: 434
Location:South Carolina  Entered:1998-01-15, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': CO6944
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F71289   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Dizziness, Headache, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: pt recv vax 22OCT96 & pt felt dizzy for 30min immed p/vax;pt exp malaise for the next 3 days;on the 4th day 26OCT96 pt exp fever, chills, h/a & nausea;27OCT96 pt felt better;

VAERS ID:107609 (history)  Vaccinated:1996-10-15
Age:46.4  Onset:1996-10-15, Days after vaccination: 0
Gender:Male  Submitted:1997-11-28, Days after onset: 409
Location:Connecticut  Entered:1998-01-15, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': CO6882
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F71308   
Administered by: Other     Purchased by: Unknown
Symptoms: Diarrhoea, Gastrointestinal disorder, Headache, Nausea, Pruritus, Urticaria
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: pt recv vax 15CT96 pt devel GI sx, nausea & diarrhea later that evening;the next had h/a & itching around the collar & neck;2 days later had hive devel on forearm in morning (less than 48hr p/dose given);

VAERS ID:107620 (history)  Vaccinated:1996-10-14
Age:46.0  Onset:1996-10-15, Days after vaccination: 1
Gender:Female  Submitted:1997-11-28, Days after onset: 409
Location:Washington  Entered:1998-01-15, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': CO6895
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F71320   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Ecchymosis, Injection site hypersensitivity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 14OCT96 & the next day pt exp an erythema rxn @ the inj site;rxn lasted 1wk now 22OCT96 looks bruised;can see where the med had spread in that area but doesn''t feel bruised;

VAERS ID:106427 (history)  Vaccinated:1997-10-03
Age:46.9  Onset:0000-00-00
Gender:Male  Submitted:1997-11-21
Location:Tennessee  Entered:1998-01-16, Days after submission: 56
Life Threatening? No
Died? Yes
   Date died: 1997-10-07
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: diabetes
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2300861IMLA
Administered by: Other     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up:

VAERS ID:107385 (history)  Vaccinated:1997-10-30
Age:46.5  Onset:1997-10-31, Days after vaccination: 1
Gender:Female  Submitted:1998-01-16, Days after onset: 77
Location:Illinois  Entered:1998-02-09, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Premarin;HCTZ;Aerobid;Vancenase
Current Illness: NONE
Preexisting Conditions: olives, celery, Thimerosol, PCN, Cephalosporins, sulfa, Darvon, grass, shagbark, cabbage;
Diagnostic Lab Data: quantitative ANA !:160;1:80;DS-DNA 5;pattern speckled, homogenous;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4978210   
Administered by: Private     Purchased by: Private
Symptoms: Antinuclear antibody, Arthralgia
SMQs:, Arthritis (broad)
Write-up: diffuse arthralgias;

VAERS ID:107727 (history)  Vaccinated:1997-10-22
Age:46.3  Onset:1997-10-23, Days after vaccination: 1
Gender:Female  Submitted:1997-10-24, Days after onset: 1
Location:Louisiana  Entered:1998-02-13, Days after submission: 112
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': LA980203
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E3257FA IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6L87392 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site reaction, Oedema peripheral, Pain, Pharyngitis, Vasodilatation
SMQs:, Cardiac failure (broad), Agranulocytosis (broad), Angioedema (broad), Oropharyngeal infections (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: reports severe local rxn lt arm swelling of arm & fingers, red & very painful;seen @ local ER & was told to take APAP;later returned to ER & recv cortisone shot;

VAERS ID:107788 (history)  Vaccinated:1997-10-15
Age:46.4  Onset:1997-10-22, Days after vaccination: 7
Gender:Female  Submitted:1997-10-23, Days after onset: 1
Location:Colorado  Entered:1998-02-23, Days after submission: 123
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49781840IMRA
Administered by: Public     Purchased by: Private
Symptoms: Deafness
SMQs:, Hearing impairment (narrow)
Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

VAERS ID:108245 (history)  Vaccinated:1995-10-01
Age:46.1  Onset:1995-10-01, Days after vaccination: 0
Gender:Female  Submitted:1997-11-07, Days after onset: 768
Location:Illinois  Entered:1998-03-05, Days after submission: 118
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pred;Methotrexate;Folic acid
Current Illness: unk
Preexisting Conditions: Rheumatoid arthritis
Diagnostic Lab Data:
CDC 'Split Type': 897344038L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH 0IMA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Oedema peripheral, Rash, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: several hr p/vax pt devel an inj site rxn characterized by swelling, redness, warmth & a rash which extended to elbow;pt was treated w/ice & APAP & recovered w/in 3-4 days;

VAERS ID:108390 (history)  Vaccinated:1996-10-29
Age:46.6  Onset:1996-10-29, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES97052626A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad)
Write-up: pt recv vax 29OCT96 & 29OCT96 pt exp lightheadedness w/in hr of vax;pt finished work day, but could not wait to ge home & get into bed;pt stayed in bed the following day;

VAERS ID:108391 (history)  Vaccinated:1997-01-21
Age:46.9  Onset:1997-01-21, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp lightheadedness & stayed in bed w/dose 1 hep b vax;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES97052626B
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Hypokinesia, Similar reaction on previous exposure to drug, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax 21JAN97 & exp lightheadedness;pt finished work but could not wait to get home & get into bed;pt stayed in bed the following day;

VAERS ID:108516 (history)  Vaccinated:1997-05-01
Age:46.9  Onset:1997-08-16, Days after vaccination: 107
Gender:Male  Submitted:0000-00-00
Location:Texas  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: glucophage
Current Illness:
Preexisting Conditions: diabetes mellitus
Diagnostic Lab Data: 1MAR97 serum hepatitis B surface negative;16AUG97 serum hepatitis B surface negative;
CDC 'Split Type': WAES97081533A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 3IM 
Administered by: Other     Purchased by: Public
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 3 doses of vax & lab eval revealed a lack of response;

VAERS ID:108520 (history)  Vaccinated:0000-00-00
Age:46.1  Onset:1997-07-08
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: Cardizem;Klonopin;dicyclomine hydrochloride;
Current Illness:
Preexisting Conditions: allergy PCN, allergy;diarrhea;fatty liver;fibrosis;hep B;hep C
Diagnostic Lab Data: hepatitis C antibody C positive;polymerase chain reactive negative x 2;serum hepatitis B surface core antibody positive;serum hepatitis B surface surface antibody negative;serum hepatitis B surface 8JUL97 negative;
CDC 'Split Type': WAES97080336A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Unknown
Symptoms: Diarrhoea, Drug ineffective
SMQs:, Lack of efficacy/effect (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 1987 & approx 1mo later blood tests showed that hep b was gone;2JUN97 exp chronic diarrhea & was seen by MD;

VAERS ID:108521 (history)  Vaccinated:1997-07-14
Age:46.1  Onset:1997-07-17, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp diarrhea & no drug effect w/dose 1 hep b;
Other Medications: Cardizem;Klonopin;dicyclomine hydrochloride
Current Illness:
Preexisting Conditions: allergy PCN; allergy;diarrhea;fatty liver;fibrosis;hep B;hep C
Diagnostic Lab Data:
CDC 'Split Type': WAES97080336B
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.2146A40  
Administered by: Private     Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Chest pain, Diarrhoea, Headache, Similar reaction on previous exposure to drug, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 14JUL97 & 17JUL97 pt exp h/a, joint pain, vomiting & worsening diarrhea;also exp rt upper quadrant pain in & around the liver area @ the base of the rib cage, that worsened when eating or drinking;24JUL97 chest pain;

VAERS ID:108522 (history)  Vaccinated:1990-03-07
Age:46.0  Onset:1990-04-01, Days after vaccination: 25
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES97090801
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: pt recv vax 7MAR90 pt recv vax & exp GBS & was seen by MD:the reporter felt that the GBS was not r/t the vax;pt exp were felt to be disabling;

VAERS ID:108617 (history)  Vaccinated:1997-11-24
Age:46.1  Onset:1997-11-24, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES97120707
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0876E1IM 
Administered by: Other     Purchased by: Private
Symptoms: Myasthenic syndrome, Nausea, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax 24NOV97 & w/in 10min of vax pt exp numbness in hands, tingling in fingers & nausea;

VAERS ID:108628 (history)  Vaccinated:1997-12-19
Age:46.1  Onset:1997-12-19, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES97121365
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0780E0IM 
Administered by: Other     Purchased by: Other
Symptoms: Paraesthesia, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad)
Write-up: pt recv vax 19DEC97 & immed p/vax pt head felt very hot, & feet felt very tingly;sx lasted for a few min then recovered;later that same noc pt exp itching on both arms;

VAERS ID:108158 (history)  Vaccinated:1997-11-13
Age:46.1  Onset:0000-00-00
Gender:Unknown  Submitted:1998-02-25
Location:Connecticut  Entered:1998-03-11, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': CT9719
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4978195  RA
Administered by: Other     Purchased by: Unknown
Symptoms: Malaise
SMQs:
Write-up: pt claims to be sick since two days p/vax;

VAERS ID:109105 (history)  Vaccinated:1997-10-01
Age:46.3  Onset:1998-01-22, Days after vaccination: 113
Gender:Male  Submitted:1998-03-13, Days after onset: 50
Location:Unknown  Entered:1998-03-23, 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: Multivitamins,NOS
Current Illness:
Preexisting Conditions: allergy to sulfa
Diagnostic Lab Data: 22JAN98 hepatitis B test negative;SGPT 38;SGOT 60;
CDC 'Split Type': 19980031321
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow)
Write-up: pt recv vax OCT97 & 22JAN98 concurrent blood testing revealed elevated LFTs (ALT 38 & AST 60);blood test result for hep B was negative & for hep C was not yet available;

VAERS ID:108858 (history)  Vaccinated:1998-03-12
Age:46.4  Onset:1998-03-13, Days after vaccination: 1
Gender:Female  Submitted:1998-03-18, Days after onset: 5
Location:Minnesota  Entered:1998-03-24, 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: unk
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': MN98003
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2388A42IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Dizziness, Headache, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: h/a, nausea, dizzy, malaise, chills which cont 6 days post vax;denies vomiting;denies fever;no rxn to prev two doses 4SEP97 & 6OCT97;

VAERS ID:109117 (history)  Vaccinated:1997-09-24
Age:46.0  Onset:1997-09-26, Days after vaccination: 2
Gender:Male  Submitted:1997-10-03, Days after onset: 7
Location:Illinois  Entered:1998-03-26, Days after submission: 174
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: hypertension, sleep apnea and seizure activity
Diagnostic Lab Data:
CDC 'Split Type': 897289017L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49782960IMLA
PPV: PNEUMO (PNU-IMUNE)PFIZER/WYETH4436600IMLA
Administered by: Military     Purchased by: Unknown
Symptoms: Influenza, Injection site hypersensitivity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Pt received Flu Shield(97-98 formula) & Pnu-Imune23 mixed & injected into 1 site. Devel fever, flu-like symptoms, inject site rxn of redness, raised bumps. Reporter recommends vax''s not be mixed, but injected separately.

VAERS ID:109124 (history)  Vaccinated:1997-10-06
Age:46.4  Onset:1997-10-06, Days after vaccination: 0
Gender:Female  Submitted:1997-10-06, Days after onset: 0
Location:Montana  Entered:1998-03-26, Days after submission: 171
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unk
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 897293011L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4978143 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: Immed following vax, pt exp arm pain from shoulder to hand. Pain resolved within 30 min.This is 1of 3 employees to exp arm pain following vax with lot #4978143. Reporter notes: 25 gauge, 1 in. needle used to administer vax.

VAERS ID:109257 (history)  Vaccinated:1997-10-27
Age:46.9  Onset:1997-10-27, Days after vaccination: 0
Gender:Unknown  Submitted:1997-10-27, Days after onset: 0
Location:North Carolina  Entered:1998-03-26, Days after submission: 150
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 897329021L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4978142 IM 
Administered by: Public     Purchased by: Other
Symptoms: Dry mouth, Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 45min p/vax pt exp n/v, h/a & dry mouth;pt was taken to ER;

VAERS ID:108953 (history)  Vaccinated:1998-02-18
Age:46.9  Onset:1998-03-02, Days after vaccination: 12
Gender:Female  Submitted:1998-03-03, Days after onset: 1
Location:Michigan  Entered:1998-03-30, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Estrogen patch
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': MI98019
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.0656E0 LA
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES7C915561 RA
Administered by: Private     Purchased by: Other
Symptoms: Lymphadenopathy, Pruritus, Rash maculo-papular, Skin nodule
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: itching rash, some raised, possible;lymphadenopathy began 2MAR98 (has lump @ back of neck on hair line)

VAERS ID:109020 (history)  Vaccinated:1998-03-13
Age:46.7  Onset:1998-03-13, Days after vaccination: 0
Gender:Female  Submitted:1998-03-25, Days after onset: 12
Location:Wisconsin  Entered:1998-03-31, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09239101 LA
Administered by: Private     Purchased by: Private
Symptoms: Myalgia, Nausea, Oedema peripheral, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: nausea, very achy all over, swelling in arm, large red spot @ least 4 inches;

VAERS ID:109721 (history)  Vaccinated:1997-10-27
Age:46.9  Onset:1997-10-27, Days after vaccination: 0
Gender:Female  Submitted:1998-01-08, Days after onset: 73
Location:Colorado  Entered:1998-04-13, Days after submission: 94
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: allergy PCN
Diagnostic Lab Data:
CDC 'Split Type': CO98003
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F817400 LA
Administered by: Private     Purchased by: Private
Symptoms: Asthma, Chest pain, Cough, Dysphonia, Pharyngitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Asthma/bronchospasm (narrow), Parkinson-like events (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: 3-4hr p/vax noted hoarse cough;1hr later painful cough, very tight chest/wheezing;lasted all evening-3-4hr ent to bed-better in AM;

VAERS ID:110385 (history)  Vaccinated:1998-03-18
Age:46.0  Onset:1998-03-18, Days after vaccination: 0
Gender:Female  Submitted:1998-03-20, Days after onset: 2
Location:Florida  Entered:1998-04-27, 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: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2589A1IMLA
Administered by: Public     Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: 45min p/vax c/o chills, fever, h/a on 18MAR98;c/o pain lt upper extremities;reports still c/o chills, h/a today;reports T100 on 18MAR98 p/vax;

VAERS ID:110395 (history)  Vaccinated:1998-04-03
Age:46.8  Onset:1998-04-03, Days after vaccination: 0
Gender:Female  Submitted:1998-04-08, Days after onset: 4
Location:Missouri  Entered:1998-04-27, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivit;herbs for memory
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': MO98015
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7J919131IMLA
Administered by: Public     Purchased by: Public
Symptoms: Back pain, Injection site pain, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: 3APR98 immed pain @ inj site-heart pounding & racing all noc;4APR98 evening severe backache;6APR98 w/report of poss rxn to Td-backache relieved by AM of 8APR98 sl tenderness @ inj site;

VAERS ID:110477 (history)  Vaccinated:1998-04-10
Age:46.3  Onset:0000-00-00
Gender:Female  Submitted:1998-04-17
Location:Oregon  Entered:1998-04-28, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7A91471 IMRA
Administered by: Unknown     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt returned to clinic 7 days later w/c/o itching & redness @ inj site;area 7.5 x 8.5cm macular inflammation, sl edema;no induration;

VAERS ID:110483 (history)  Vaccinated:1997-12-29
Age:46.8  Onset:1997-12-29, Days after vaccination: 0
Gender:Female  Submitted:1998-04-21, Days after onset: 112
Location:Arizona  Entered:1998-04-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: hayfever
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7C91583   
Administered by: Public     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: a deep & aching pain in upper lt arm;pt states has had this pain since recv vax;

VAERS ID:110694 (history)  Vaccinated:1998-04-24
Age:46.0  Onset:1998-04-25, Days after vaccination: 1
Gender:Female  Submitted:1998-04-30, Days after onset: 5
Location:Wisconsin  Entered:1998-05-07, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: no allergies, sinusitis, depression
Diagnostic Lab Data: 30APR98 ESR 19;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES09157100 RA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Diarrhoea, Dyspepsia, Hypertonia, Influenza, Nausea, Osteoarthritis, Pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 24APR98 & 25APR98 flu-like sx, stomach upset;nausea/diarrhea;26APR98 back of rt knee tight & very swollen lasted through 24APR98;29APR98 bath feet & ankles swollen painful to step on;30APR98 feet & ankles sore;wrists painful;

VAERS ID:110774 (history)  Vaccinated:1998-04-03
Age:46.3  Onset:1998-04-04, Days after vaccination: 1
Gender:Female  Submitted:1998-05-11, Days after onset: 36
Location:Michigan  Entered:1998-05-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: fibromyalgia
Preexisting Conditions: sulfa, dramamine allergies, hx fibromyalgia;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES448168 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: very painful day of inj then began w/welts over deltoid area which lasted 2 days;cont to have bruised muscle sensation over upper arm;

VAERS ID:111061 (history)  Vaccinated:1997-06-16
Age:46.6  Onset:1997-06-19, Days after vaccination: 3
Gender:Female  Submitted:1998-04-16, Days after onset: 301
Location:New York  Entered:1998-05-19, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type': CO 7383
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7C91583 IMA
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction
SMQs:
Write-up: 19June97 pt exp a large local rxn.

VAERS ID:111173 (history)  Vaccinated:1997-12-30
Age:46.4  Onset:1998-01-15, Days after vaccination: 16
Gender:Female  Submitted:1998-05-18, Days after onset: 122
Location:Oklahoma  Entered:1998-05-26, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Lymphadenopathy, Myalgia, Osteoarthritis, Pain, Paraesthesia, Rash maculo-papular, Rheumatoid arthritis, Skin nodule
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: 2nd/3rd wk JAN broke out like having measles;last week JAN lt side of neck was swollen-acts like mumps;rt thumb swollen-can''t write easily;lt foot swollen;lt hip uncomfortable;bad stomach cramps;swollen wrist;numb;rheumatoid arthritis;vomit

VAERS ID:111730 (history)  Vaccinated:1998-01-09
Age:46.5  Onset:1998-01-19, Days after vaccination: 10
Gender:Female  Submitted:1998-05-29, Days after onset: 129
Location:Unknown  Entered:1998-06-02, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC 'Split Type': WAES98011870
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Influenza, Myalgia, Pyrexia, Rash maculo-papular
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recv vax 9JAN98 & 19JAN98 pt presented to ER w/achiness & a sl fever;pt thought had the flu;tx w/biaxin;21JAN98 pt devel rash described as little red-like pimples on face, hair line,back & trunk;also c/o joint tenderness;

VAERS ID:111409 (history)  Vaccinated:1998-05-11
Age:46.1  Onset:1998-05-13, Days after vaccination: 2
Gender:Female  Submitted:1998-05-21, Days after onset: 8
Location:Illinois  Entered:1998-06-04, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: seravent inhaler;aerobid inhaler
Current Illness: sarcoidosis
Preexisting Conditions: sarcoidosis x 5yr;amoxil, floxin, lamask, shrimp, seafood
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2521B62 LA
Administered by: Private     Purchased by: Private
Symptoms: Ecchymosis, Injection site reaction, Oedema peripheral, Paraesthesia
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax 11MAY98 & reports local rxn of lt arm @ inj site w/ 1/2" ecchymosis resolved p/1wk on 13MAY98;pt reports edema of lt leg from knee & foot;tingling & dec of touch;edema;

VAERS ID:111815 (history)  Vaccinated:1998-03-24
Age:46.7  Onset:1998-03-27, Days after vaccination: 3
Gender:Female  Submitted:1998-06-05, Days after onset: 69
Location:Michigan  Entered:1998-06-12, 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: THyroid;Vitamins
Current Illness: NONE
Preexisting Conditions: allergy do codeine;hypothyroidism;family hx of MS
Diagnostic Lab Data: 13MAR98 rubella AB IgG 0.0
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.0948E2SC 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Arthropathy, Dry eye, Infection, Injection site pain, Insomnia, Nuchal rigidity, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Corneal disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: itching/burning around eyes (2 days p/vax);rash on back & both forearms (4 days p/vax);paresth4sia in lower extremities & hands (7wk p/vax);soreness/pain around inj site;joint pain discomfort (8wk p/vax);infectious disease;

VAERS ID:111923 (history)  Vaccinated:1998-05-19
Age:46.0  Onset:1998-05-19, Days after vaccination: 0
Gender:Female  Submitted:1998-06-09, Days after onset: 21
Location:South Dakota  Entered:1998-06-16, 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: no
Preexisting Conditions: PCN, cephalosporins, codeine;
Diagnostic Lab Data: Xray to r/o vertebrae problem - neg.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1 A
Administered by: Other     Purchased by: Public
Symptoms: Hypertonia, Injection site hypersensitivity, Injection site pain, Myasthenic syndrome, Neck pain, Nuchal rigidity, Oedema peripheral, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Pt exp inj site pain & warmth.Pain traveled down arm & up right side of neck.Right side was stiff. Right thumb had spasms.Arm weak & tight. Right shoulder hard & swollen. 2 Physical Therapists felt spasms due to shot nicking a nerve

VAERS ID:112013 (history)  Vaccinated:1998-06-10
Age:46.0  Onset:1998-06-10, Days after vaccination: 0
Gender:Male  Submitted:1998-06-12, Days after onset: 2
Location:Missouri  Entered:1998-06-23, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NO
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM594C60IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Headache, Nausea, Pyrexia, Vasodilatation
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: 06/10/98 pt exp nausea;06/11/98 h/a, hot,sweaty & dizzy. 06/12/98 pt called MD. Weak & dizzy when up, h/a cont. Temp to 100 night of 06/11/98.06/13 cont fever 99.5, weak. 06/14 sx gone.

VAERS ID:112109 (history)  Vaccinated:1997-05-22
Age:46.2  Onset:1997-05-22, Days after vaccination: 0
Gender:Female  Submitted:1997-06-17, Days after onset: 26
Location:Ohio  Entered:1998-06-23, Days after submission: 371
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prempro
Current Illness: NONE
Preexisting Conditions: DJD, osteoarthritis, hemorrhoids
Diagnostic Lab Data:
CDC 'Split Type': 897184010L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES441185 IMA
Administered by: Private     Purchased by: Other
Symptoms: Headache, Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & devel a severe h/a & an inj site rxn characterized by redness, swelling & discomfort;

VAERS ID:112757 (history)  Vaccinated:1996-07-09
Age:46.2  Onset:0000-00-00
Gender:Male  Submitted:1998-07-10
Location:Missouri  Entered:1998-07-20, 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: pt recv oral typhoid by Vivotif Berna given 29OCT96 lot# 142791A & hep A by SKB given 2APR97 lot# VHA503B6;also Menomune
Current Illness: NONE
Preexisting Conditions: asthma
Diagnostic Lab Data: MRI, EEG, CT scan of shoulder
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA485B6 IMLA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES6B71045 SCA
Administered by: Public     Purchased by: Private
Symptoms: Arthropathy, Myasthenic syndrome, Neck pain, Pain
SMQs:, Malignancy related conditions (narrow), Arthritis (broad)
Write-up: sx began end of DEC96 was returning from a trip to africa;began to have pain in rt shoulder, neck then stated lost all muscle control in rt shoulder;tx w/physical therapy;still has weakness & pin in rt shoulder;

VAERS ID:113081 (history)  Vaccinated:0000-00-00
Age:46.7  Onset:1997-10-30
Gender:Male  Submitted:1998-07-30, Days after onset: 272
Location:Unknown  Entered:1998-08-03, 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: Percocet;Lipitor;Duragesic;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES97110278
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: pt recv vax & 30OCT97 pt exp arm soreness;

VAERS ID:113330 (history)  Vaccinated:1998-07-08
Age:46.9  Onset:1998-07-14, Days after vaccination: 6
Gender:Female  Submitted:1998-07-19, Days after onset: 5
Location:Oregon  Entered:1998-08-10, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications:
Current Illness: NONE
Preexisting Conditions: codeine/tagamet
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0934600 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 3"x4" red, swollen area on rt deltoid @ inj site;started 14JUL98;pt took Ibuprofen;

VAERS ID:113409 (history)  Vaccinated:1998-05-22
Age:46.2  Onset:1998-05-23, Days after vaccination: 1
Gender:Female  Submitted:1998-06-29, Days after onset: 37
Location:Washington  Entered:1998-08-13, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Transidone;Paxil
Current Illness: NONE
Preexisting Conditions: PCN allergy
Diagnostic Lab Data: rheumatoid factor 31;CBC & sed rate 10;lymphocytes 15.4;
CDC 'Split Type': WA981475
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.102021 LA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Arthritis, Lymphocytosis, Osteoarthritis, Rash, Rash maculo-papular, Serum sickness, Tendon disorder
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: sore ankles & wrists the day p/vax;rash on ankles & wrists;saw PMD;severe tendonitis & arthritis poss a serum sickness like illness;indurated patchy rash on hands, wrists, ankles-joints very tender & swollen;tx w/pred;

VAERS ID:113563 (history)  Vaccinated:1998-07-31
Age:46.1  Onset:1998-08-01, Days after vaccination: 1
Gender:Female  Submitted:1998-08-18, Days after onset: 17
Location:Wisconsin  Entered:1998-08-21, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2492A22IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: devel severe h/a 12hr p/vax which lasted 36hr;pt had vomiting;tried taking advil & excedrin but could not keep it down;

VAERS ID:113581 (history)  Vaccinated:1998-06-16
Age:46.9  Onset:1998-06-17, Days after vaccination: 1
Gender:Female  Submitted:1998-06-25, Days after onset: 8
Location:Pennsylvania  Entered:1998-08-24, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09233800IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt began to have swelling, red, warm area rt deltoid where Td given;given ATB, heat;

VAERS ID:114408 (history)  Vaccinated:1998-09-03
Age:46.1  Onset:1998-09-04, Days after vaccination: 1
Gender:Female  Submitted:1998-09-16, Days after onset: 12
Location:Louisiana  Entered:1998-09-28, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': LA980903
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09295902IMRA
Administered by: Public     Purchased by: Other
Symptoms: Muscle atrophy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad)
Write-up: pt reports by phone 8SEP98 severe aching pain & muscle wasting;advised to see MD;pt to ER;

VAERS ID:114445 (history)  Vaccinated:1998-09-16
Age:46.5  Onset:1998-09-18, Days after vaccination: 2
Gender:Unknown  Submitted:1998-09-23, Days after onset: 5
Location:Florida  Entered:1998-09-29, 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: Hep B by SKB lot# 2586A6 given 19AUG98
Current Illness: had sniffles
Preexisting Conditions: type II diabetes
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2586A61IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Back pain, Chills, Hepatomegaly, Hyperhidrosis, Malaise, Pain, Vasodilatation, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: began feeling sick 19SEP, 10PM & was ill 19SEP & 20SEp still not feeling well, c/o chills, n/v, hurting across back, pain in rt side, feeling pressure under ribs on rt side;states believes liver may be enlarged;c/o feeling clammy & warm

VAERS ID:115106 (history)  Vaccinated:1998-10-06
Age:46.5  Onset:1998-10-06, Days after vaccination: 0
Gender:Male  Submitted:1998-10-07, Days after onset: 1
Location:Washington  Entered:1998-10-19, 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: allegra D;
Current Illness: NONE
Preexisting Conditions: hayfever
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES097721020IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1542E0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Hyperhidrosis, Injection site hypersensitivity, Injection site oedema, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 6hr p/vax pt devel fever, chills & sweats episode followed by noc axillary adenopathy;the next morning 20hr later erythema & edema 5mm below inj site;

VAERS ID:115146 (history)  Vaccinated:1998-10-10
Age:46.9  Onset:1998-10-10, Days after vaccination: 0
Gender:Female  Submitted:1998-10-14, Days after onset: 4
Location:Missouri  Entered:1998-10-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: PCN;Codeine
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E20208HA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chest pain, Chills, Dyspnoea, Hyperhidrosis, Hypersensitivity, Hypertension, Tremor, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 10min p/vax c/o funny feeling that started in chest 7 went to my stomach;was clammy, warm, shaky, SOB, BP 140/90;assessed in systemic allergic rxn & Epi given;hosp for cardiac eval;

VAERS ID:115280 (history)  Vaccinated:1998-10-14
Age:46.3  Onset:1998-10-14, Days after vaccination: 0
Gender:Female  Submitted:1998-10-14, Days after onset: 0
Location:North Carolina  Entered:1998-10-26, 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: NONE
Current Illness:
Preexisting Conditions: allergic to ocntrast dye, codeine, pain relievers
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09786601 LA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Dyspnoea, Hypertension, Hyperventilation, Injection site hypersensitivity, Nervousness, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 1230PM 14OCT98 & pt reported itching & redness in a hive formation below site;reported feeling light headed & nervous w/a very sl feeling of SOB;given epi;vs BP 146/86, R22, P88;pt reported sx improved but still c/o lightheaded

VAERS ID:115294 (history)  Vaccinated:1998-10-16
Age:46.8  Onset:1998-10-17, Days after vaccination: 1
Gender:Male  Submitted:1998-10-19, Days after onset: 2
Location:Pennsylvania  Entered:1998-10-26, 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: Zocor;Pepcid;Flonase;ASA
Current Illness: NONe
Preexisting Conditions: CAD, GERD
Diagnostic Lab Data: UA abnormal;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Unknown
Symptoms: Arthralgia, Dysuria, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: dysuria, generalized myalgia, arthralgias, fever, chills & nausea;

VAERS ID:115428 (history)  Vaccinated:1998-10-22
Age:46.1  Onset:1998-10-23, Days after vaccination: 1
Gender:Female  Submitted:1998-10-23, Days after onset: 0
Location:Missouri  Entered:1998-10-28, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp chills @ 44yr w/flu vax;
Other Medications:
Current Illness: NONE
Preexisting Conditions: PCN, seclor, hx mitral valve prolapse
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Private     Purchased by: Other
Symptoms: Anxiety, Chills, Dizziness, Similar reaction on previous exposure to drug, Tachycardia, Tongue oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: severe chills, almost passed out, anxiety, dizzy, rapid heart rate, thick tongue x 10-20min;

VAERS ID:115509 (history)  Vaccinated:1998-10-28
Age:46.7  Onset:1998-10-28, Days after vaccination: 0
Gender:Female  Submitted:1998-10-29, Days after onset: 1
Location:California  Entered:1998-10-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Face oedema, Headache, Myalgia, Nausea, Pruritus, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 10/28/98; on same day pt exp itching at vax site, nausea,sinus swelling, hard to breath,eyes swelling, red rash on upper torso,achy,headache, fever &chills.

VAERS ID:115688 (history)  Vaccinated:1997-10-14
Age:46.0  Onset:1997-10-14, Days after vaccination: 0
Gender:Male  Submitted:1998-10-26, Days after onset: 377
Location:Texas  Entered:1998-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': 19970246391
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2399A42  
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Hypertension, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (narrow)
Write-up: Pt recv vax on 10/14/97; 30 min later pt exp vertigo, dizziness & increased blood pressure.

VAERS ID:115958 (history)  Vaccinated:1998-05-11
Age:46.0  Onset:1998-05-13, Days after vaccination: 2
Gender:Female  Submitted:1998-10-26, Days after onset: 166
Location:Illinois  Entered:1998-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: inhaler
Current Illness:
Preexisting Conditions: allergic to amoxil, allergic to bananas, allergic to eggs, allergic to floxin, allergic to lomisol, allergic to seafood, sarcoidosis;
Diagnostic Lab Data:
CDC 'Split Type': 19980133941
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2521B62IMLA
Administered by: Other     Purchased by: Other
Symptoms: Oedema peripheral, Paraesthesia
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax 11MAY98 & 13MAY98 pt devel swelling & tingling of lower lt leg;s/s worse, progressed up leg

VAERS ID:115964 (history)  Vaccinated:1998-05-18
Age:46.0  Onset:1998-05-18, Days after vaccination: 0
Gender:Male  Submitted:1998-10-26, Days after onset: 161
Location:Indiana  Entered:1998-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 19980144821
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMRA
Administered by: Other     Purchased by: Other
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: pt recv vax 18MAY98 & 4-5hr later devel numbness on skin on back of rt hand below the wrist up to the knuckles;

VAERS ID:116027 (history)  Vaccinated:1998-08-05
Age:46.8  Onset:1998-08-05, Days after vaccination: 0
Gender:Female  Submitted:1998-10-26, Days after onset: 82
Location:Pennsylvania  Entered:1998-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Maxzide;monopril;Premarin
Current Illness:
Preexisting Conditions: allergic to bees, allergic to erythromycin, allergic to tetanus vaccine, HTN phlebitis;
Diagnostic Lab Data:
CDC 'Split Type': 19980207251
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2589A42IMA
Administered by: Private     Purchased by: Private
Symptoms: Ecchymosis, Pruritus
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (broad)
Write-up: pt recv vax 5AUG98 exp itching;3 days later 8AUG98 pt devel purple spots on torso;

VAERS ID:115623 (history)  Vaccinated:1998-10-05
Age:46.6  Onset:1998-10-06, Days after vaccination: 1
Gender:Female  Submitted:1998-10-27, Days after onset: 21
Location:Illinois  Entered:1998-11-03, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09757901IMLA
Administered by: Public     Purchased by: Private
Symptoms: Headache, Hypokinesia, Immune system disorder, Myasthenic syndrome, Oedema peripheral, Rash maculo-papular, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 5OCT98 & 16OCT98 hands & feet turned red, legs turning red, lt leg hives & splotching 7OCT98;all joints painful, difficult to walk, no strength in joints, h/a;immune rxn;

VAERS ID:115724 (history)  Vaccinated:1998-10-22
Age:46.3  Onset:1998-10-22, Days after vaccination: 0
Gender:Female  Submitted:1998-10-30, Days after onset: 8
Location:North Carolina  Entered:1998-11-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Wellbutran,Synthroid
Current Illness: NONE
Preexisting Conditions: Clinical depression,Hypothyroidism,right club foot, S/P, cortisone injection 10/21/98
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882040IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Hypotension, Hypothermia, Nausea, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Pt recv vax on 10/22/98; on same day pt exp wooziness, hot face, dizziness, nausea

VAERS ID:116150 (history)  Vaccinated:1998-10-07
Age:46.2  Onset:1998-10-15, Days after vaccination: 8
Gender:Female  Submitted:1998-11-04, Days after onset: 20
Location:Oregon  Entered:1998-11-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Deperdal,Paxil,Atenolal,Premarin,Gogentin,Reglin,Moxitain
Current Illness: NONE
Preexisting Conditions: Amoxicillin, Hypertension
Diagnostic Lab Data: M.R.I.-negative
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0969610 IMLA
Administered by: Private     Purchased by: Public
Symptoms: