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Case Details (Sorted by Age)

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VAERS ID:53494 (history)  Vaccinated:1993-04-08
Age:41.3  Onset:1993-04-08, Days after vaccination: 0
Gender:Male  Submitted:1993-04-17, Days after onset: 9
Location:Florida  Entered:1993-06-01, 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:
Current Illness: laceration @ finger
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)PFIZER/WYETH4928278   
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: progressive pain @ inject site;

VAERS ID:53553 (history)  Vaccinated:1992-10-26
Age:41.0  Onset:1992-10-30, Days after vaccination: 4
Gender:Female  Submitted:0000-00-00
Location:Montana  Entered:1993-06-03
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: pt had bell''s palsy attack 12 yrs ago;
Diagnostic Lab Data: n/s
CDC Split Type: 924092060
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Eyelid ptosis, Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)
Write-up: pt recvd fluogen vax & exp bell''s palsy; pt has exp bell''s palsy''s in the past; 1980 & in 1984;

VAERS ID:54600 (history)  Vaccinated:1993-03-12
Age:41.5  Onset:1993-03-12, Days after vaccination: 0
Gender:Female  Submitted:1993-04-29, Days after onset: 47
Location:Washington  Entered:1993-07-12, Days after submission: 74
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: sinus infections; Granes disease
Diagnostic Lab Data:
CDC Split Type: WA93902
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0025W0IM 
Administered by: Public     Purchased by: Private
Symptoms: Ecchymosis, Hypertonia, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: arm bruised @ inject site size of quarter for a month, also muscle spasms & stiffness, very painful 29APR93; arm still spasms; MD advised no #2 or 3 dose of vax; MD told pt it was local rxn;

VAERS ID:54883 (history)  Vaccinated:1993-07-21
Age:41.0  Onset:1993-07-21, Days after vaccination: 0
Gender:Male  Submitted:1993-07-22, Days after onset: 1
Location:Unknown  Entered:1993-07-27, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Throat-nl no diff talking; no neck or facial swelling; heart & lungs nl, no rash;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESEJN0741  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Laryngospasm, Pruritus
SMQs:, Anaphylactic reaction (narrow), Dystonia (broad), Hypersensitivity (narrow)
Write-up: tightness in throat; pt also exp itch;

VAERS ID:54967 (history)  Vaccinated:1993-07-14
Age:41.7  Onset:1993-07-16, Days after vaccination: 2
Gender:Female  Submitted:1993-07-19, Days after onset: 3
Location:Missouri  Entered:1993-08-02, 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: NONE
Diagnostic Lab Data:
CDC Split Type: MO93055
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES334901  LA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Pain, Skin nodule
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 2 days p/vax pt exp pain in the rt deltoid region; area was hard & tender to touch; 19JUL93 is hardly able to left rt arm;

VAERS ID:54996 (history)  Vaccinated:1993-07-14
Age:41.1  Onset:1993-07-14, Days after vaccination: 0
Gender:Female  Submitted:1993-07-20, Days after onset: 6
Location:Wisconsin  Entered:1993-08-02, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: many allergies
Diagnostic Lab Data:
CDC Split Type: WI93055
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES3289006 LA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Myalgia, Oedema, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)
Write-up: 7 days had arm very sore; pain in shoulder & arm; not able to raise arm/shift; no fever sl swelling;

VAERS ID:55025 (history)  Vaccinated:1992-06-15
Age:41.9  Onset:1992-06-17, Days after vaccination: 2
Gender:Female  Submitted:1993-07-29, Days after onset: 407
Location:Massachusetts  Entered:1993-08-03, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: boderline, HTn
Diagnostic Lab Data: audiologic eval;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM881A41IM 
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Ear disorder, Ear pain, Insomnia, Pharyngitis, Tinnitus
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Hearing impairment (narrow)
Write-up: tinnitus-fullness in ears, insomia, fatigue, sore throat, earache;

VAERS ID:55029 (history)  Vaccinated:1992-06-12
Age:41.1  Onset:1992-06-14, Days after vaccination: 2
Gender:Unknown  Submitted:0000-00-00
Location:Massachusetts  Entered:1993-08-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM881A40IM 
Administered by: Private     Purchased by: Private
Symptoms: Malaise, Myalgia, Pharyngitis
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: myalgia, pharyngitis, malaise;

VAERS ID:55261 (history)  Vaccinated:1993-07-13
Age:41.5  Onset:1993-07-15, Days after vaccination: 2
Gender:Female  Submitted:1993-07-29, Days after onset: 14
Location:Missouri  Entered:1993-08-17, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lavirsihe
Current Illness: NONE
Preexisting Conditions: thyroid problems
Diagnostic Lab Data: NA
CDC Split Type: MO93066
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES334902   
Administered by: Other     Purchased by: Public
Symptoms: Headache, Oedema, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: h/a, swollen reddish lump; put ice pack on for several hrs; took a few ASA;

VAERS ID:55281 (history)  Vaccinated:1990-12-03
Age:41.6  Onset:0000-00-00
Gender:Female  Submitted:1993-05-18
Location:Minnesota  Entered:1993-08-17, Days after submission: 91
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM629241 LA
Administered by: Private     Purchased by: Other
Symptoms: Hypotonia, Injection site pain, Myasthenic syndrome, Oedema peripheral, Pain, Paraesthesia
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: arm (swollen), sharp pain from vax site then arm would go limp (very weak), loss of feeling for a time loss of function intermittently; recently had trouble of life side-neck, leg pain; some numbness, vax site pain-pain in arm;

VAERS ID:56089 (history)  Vaccinated:1992-03-02
Age:41.0  Onset:1993-04-01, Days after vaccination: 395
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:1993-09-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Synthroid
Current Illness: NONE
Preexisting Conditions: hashimoto''s chronic thyroiditis/mastectomy breast CA 1987;
Diagnostic Lab Data: r/o addison''s; r/o lupus; lab studies thyroid/cortisol levels; r/o metastatic CA;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.0806T1SCLA
Administered by: Other     Purchased by: Other
Symptoms: Arthritis, Pain
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: sought medical eval to determine source of skeletal pain; Endocrinologist eval thyroid function adrenal, onocologist ordered bone scan; endocrinologist suspected lupus (ruled out); concluded that rapid onset of symetric arthritis in all jo;

VAERS ID:56649 (history)  Vaccinated:1993-10-07
Age:41.6  Onset:1993-10-07, Days after vaccination: 0
Gender:Female  Submitted:1993-10-12, Days after onset: 5
Location:Minnesota  Entered:1993-10-18, 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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00193P0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Conjunctivitis, Eye pain, Face oedema, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow)
Write-up: approx 4 hrs p/inject, eyelids became swollen, eyes were burning, itching, became bloodshot drainage;

VAERS ID:56674 (history)  Vaccinated:1993-10-12
Age:41.8  Onset:1993-10-12, Days after vaccination: 0
Gender:Female  Submitted:1993-10-13, Days after onset: 1
Location:Missouri  Entered:1993-10-19, 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: Bronchodilator recent ATB;
Current Illness:
Preexisting Conditions: allergic to Cephalexin, TCN, Erythromycin;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3J41146 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Tremor, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: ears red, warm face flushed pt described shaky feeling given DPH;

VAERS ID:56735 (history)  Vaccinated:1993-09-02
Age:41.8  Onset:1993-09-08, Days after vaccination: 6
Gender:Male  Submitted:1993-10-11, Days after onset: 33
Location:Colorado  Entered:1993-10-25, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp muscle aches, sweats, dizziness, nausea, dec appetite @ 41 y/o w/Recombi;
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Throat cult-WNL; CBC, HST;
CDC Split Type: CO93069
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0418W2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Anorexia, Dizziness, Hyperhidrosis, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: c/o muscle aches, sweats, dizziness, nausea & dec appetite; seen by MD @ which time stated had the same sx following the 2nd Hep B vax 5APR93; did not report to anyone;

VAERS ID:56818 (history)  Vaccinated:1993-09-22
Age:41.0  Onset:1993-09-22, Days after vaccination: 0
Gender:Female  Submitted:1993-10-19, Days after onset: 27
Location:Oklahoma  Entered:1993-10-27, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Ogen
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F410271IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: inject site became red, swollen & itchy;

VAERS ID:57043 (history)  Vaccinated:1992-09-29
Age:41.8  Onset:1992-09-30, Days after vaccination: 1
Gender:Female  Submitted:1993-08-03, Days after onset: 307
Location:Texas  Entered:1993-10-27, Days after submission: 85
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: CO4588
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS2F311431 A
Administered by: Unknown     Purchased by: Unknown
Symptoms: Influenza, Pharyngitis, Pyrexia, Rhinitis
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow)
Write-up: flu like sx occurred on 30SEP w/fever, devel into cold; lasted through following wk;

VAERS ID:56856 (history)  Vaccinated:1993-10-07
Age:41.6  Onset:1993-10-11, Days after vaccination: 4
Gender:Female  Submitted:1993-10-18, Days after onset: 7
Location:Oregon  Entered:1993-10-29, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Premarin; Ventolin
Current Illness: NONE
Preexisting Conditions: food allergies as a child-bronchitis-asthma;
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH4938137  RA
Administered by: Public     Purchased by: Private
Symptoms: Agitation, Constipation, Cough, Myalgia, Pyrexia, Rhinitis, Skin nodule
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: 11OCT93 became irritable, had boyd aches, felt feverish, congested, coughing up bright green mucous; sl constipation; had lump on lt side of neck which became larger;

VAERS ID:70072 (history)  Vaccinated:1993-08-05
Age:41.0  Onset:1993-08-26, Days after vaccination: 21
Gender:Female  Submitted:1993-09-10, Days after onset: 15
Location:Unknown  Entered:1993-10-31, Days after submission: 51
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: 930022431
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: pt recvd vax & 3 wks p/vax exp knee pain & diffuse joint pain;

VAERS ID:56867 (history)  Vaccinated:1993-10-21
Age:41.0  Onset:1993-10-21, Days after vaccination: 0
Gender:Female  Submitted:1993-10-22, Days after onset: 1
Location:Maine  Entered:1993-11-01, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to choc;
Diagnostic Lab Data: NA
CDC Split Type: ME93042
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH43981240IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Syncope, Vasodilatation, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: arm felt hot, vomiting, dizzy, fainted;

VAERS ID:56905 (history)  Vaccinated:1993-10-15
Age:41.5  Onset:1993-10-15, Days after vaccination: 0
Gender:Female  Submitted:1993-10-18, Days after onset: 3
Location:Texas  Entered:1993-11-01, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: TX93181
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F410090 LA
Administered by: Public     Purchased by: Public
Symptoms: Face oedema, Headache, Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt states that w/in 2 hrs of receiving the flu vax had a rash on arm where vax was administered & itched; eyes were swollen & began to have bad h/a;

VAERS ID:56955 (history)  Vaccinated:1993-10-18
Age:41.1  Onset:1993-10-19, Days after vaccination: 1
Gender:Female  Submitted:1993-10-02, Days after onset: 17
Location:Alaska  Entered:1993-11-02, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergic to Deseryl, barbituates;
Diagnostic Lab Data:
CDC Split Type: AK93022
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH4938226 IMLA
Administered by: Private     Purchased by: Public
Symptoms: Asthenia, Headache, Hyperhidrosis, Hypokinesia, Myalgia, Pharyngitis, Visual disturbance, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax lt deltoid 18OCT93 site aching p/vax; 19OCT993 aching, sore throat, lt side neck 730AM by 8PM chills, vomiting, h/a 20OCT93; chills alternating w/sweating; weak couldn''t stand up; unability to focus x 3 days;

VAERS ID:58607 (history)  Vaccinated:1992-08-29
Age:41.8  Onset:1992-08-29, Days after vaccination: 0
Gender:Female  Submitted:1993-02-05, Days after onset: 160
Location:Unknown  Entered:1993-11-03, Days after submission: 271
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: EBU922363
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 2  
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Influenza, Injection site pain, Myalgia, Pharyngitis, Pruritus, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt recvd vax & exp burning during inject w/3rd dose; also exp sore throat, feverish; feeling bodyaches, weakness & was itchy @ the inject site; exp flu like sx; 21AUG92 sx subsided;

VAERS ID:58648 (history)  Vaccinated:1992-07-28
Age:41.0  Onset:1992-07-30, Days after vaccination: 2
Gender:Male  Submitted:1993-02-19, Days after onset: 204
Location:Kentucky  Entered:1993-11-03, Days after submission: 257
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: EBU922446
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1035A4 IMA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Dermatitis exfoliative, Myalgia, Oedema peripheral, Pain, Scleroderma, Serum sickness
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Severe cutaneous adverse reactions (narrow), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt recvd vax 2 days later 30JUL92 exp edema of hands, aching in joints, & soreness in shoulders; 9AUG92 exp tenderness of feet & edema; In late AUG exp sloughing of skin on hands & feet; dx serum sickness; progressive systemic sclerosis;

VAERS ID:58710 (history)  Vaccinated:1992-07-13
Age:41.0  Onset:1992-07-14, Days after vaccination: 1
Gender:Female  Submitted:1992-11-04, Days after onset: 113
Location:New Jersey  Entered:1993-11-03, Days after submission: 364
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Procardia
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: EBU922659
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM893A40IM 
Administered by: Other     Purchased by: Private
Symptoms: Asthma, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Pt recvd vax & w/in 24 hrs devel hives on face, chest, hands & feet; w/in 48 hrs devel wheezing; treated in MD office; took DPH;

VAERS ID:58743 (history)  Vaccinated:1992-07-17
Age:41.0  Onset:1992-07-18, Days after vaccination: 1
Gender:Female  Submitted:1992-11-03, Days after onset: 108
Location:Michigan  Entered:1993-11-03, Days after submission: 365
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Antacids; Reglan; Tavist;
Current Illness:
Preexisting Conditions: hx of hives from nerves;
Diagnostic Lab Data:
CDC Split Type: EBU922736
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM882A41IMRA
Administered by: Other     Purchased by: Private
Symptoms: Face oedema, Laryngospasm, Neck pain, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recvd vax & devel rash, itching, hives, swelling of throat & eyes & neck pain; took DPH;

VAERS ID:59026 (history)  Vaccinated:1992-10-23
Age:41.0  Onset:1992-10-30, Days after vaccination: 7
Gender:Female  Submitted:1992-12-14, Days after onset: 45
Location:New Jersey  Entered:1993-11-03, Days after submission: 324
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:
Diagnostic Lab Data:
CDC Split Type: EBU922895
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Private     Purchased by: Private
Symptoms: Arthropathy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt recvd vax & exp muscle soreness & aches, stiff, joints for 5 wks in ankles,hips, wrists, neck;

VAERS ID:59064 (history)  Vaccinated:1992-11-12
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:1992-12-21
Location:Unknown  Entered:1993-11-03, Days after submission: 317
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp nausea, vomiting, viral infect w/Engerix-B #1 dose;
Other Medications:
Current Illness:
Preexisting Conditions: one lung removed due to carcinoma;
Diagnostic Lab Data:
CDC Split Type: EBU922965
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1  
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt recvd vax 12NOV92 & exp diarrhea, nausea, & vomiting;

VAERS ID:59076 (history)  Vaccinated:1992-12-01
Age:41.0  Onset:1992-12-10, Days after vaccination: 9
Gender:Male  Submitted:1992-12-21, Days after onset: 11
Location:Texas  Entered:1993-11-03, Days after submission: 317
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: ALT 474; AST 203; LDL 180; GGT 86; Glucose 68; SCR 1.0 12DEC92;
CDC Split Type: EBU922981
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM844A4 IMA
Administered by: Private     Purchased by: Private
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Asthenia, Gamma-glutamyltransferase increased, Hepatic function abnormal, Lung disorder, Malaise
SMQs:, Liver related investigations, signs and symptoms (narrow), Guillain-Barre syndrome (broad)
Write-up: Pt recvd vax & 9 days later exp chest congestion, malaise, weakness & elevated liver function tests;

VAERS ID:59484 (history)  Vaccinated:1993-06-04
Age:41.0  Onset:1993-06-05, Days after vaccination: 1
Gender:Female  Submitted:1993-08-05, Days after onset: 61
Location:Oklahoma  Entered:1993-11-03, Days after submission: 90
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 930000661
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1111A20IMA
Administered by: Private     Purchased by: Private
Symptoms: Migraine, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt recvd vax & exp a migraine h/a, nausea & vomiting; migraine h/a lasted 24 hrs;

VAERS ID:59493 (history)  Vaccinated:1993-05-26
Age:41.0  Onset:1993-05-28, Days after vaccination: 2
Gender:Female  Submitted:1993-07-19, Days after onset: 52
Location:Indiana  Entered:1993-11-03, Days after submission: 107
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: hypothyroid
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 930001591
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Coordination abnormal, Insomnia, Myalgia, Neuritis, Paraesthesia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt recvd vax & 2 days p/vax exp paresthesias of the hands & feet, insomnia, lethargy, numbness of the back, face & neck, ataxia, hip pain & myalgia; pt was dx w/polyneuritis; tx Relafen for muscle soreness;

VAERS ID:59534 (history)  Vaccinated:1993-05-13
Age:41.0  Onset:1993-07-07, Days after vaccination: 55
Gender:Male  Submitted:1993-07-27, Days after onset: 20
Location:Alabama  Entered:1993-11-03, Days after submission: 99
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: 930003321
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
Administered by: Other     Purchased by: Other
Symptoms: Facial palsy, Thinking abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: pt recvd vax & approx 8 wks p/dose 2 exp Bell''s palsy; dose 1 administered 13APR93;

VAERS ID:59649 (history)  Vaccinated:1993-08-04
Age:41.0  Onset:1993-08-05, Days after vaccination: 1
Gender:Male  Submitted:1993-08-25, Days after onset: 20
Location:Florida  Entered:1993-11-03, 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: 930015561
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1153A20IMA
Administered by: Private     Purchased by: Private
Symptoms: Influenza, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recvd vax & the next day (5AUG93) exp fever, inject site pain & flu-like sx; pt was seen by MD; pt sx have subsided;

VAERS ID:60136 (history)  Vaccinated:1992-11-11
Age:41.0  Onset:1992-11-11, Days after vaccination: 0
Gender:Female  Submitted:1993-01-18, Days after onset: 68
Location:Massachusetts  Entered:1993-11-03, Days after submission: 289
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: EBU930026
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0SCA
Administered by: Private     Purchased by: Other
Symptoms: Cough, Dyspnoea, Influenza, Malaise, Pharyngitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: pt recvd vax & the same noc felt bad, devel flu like sx & cough; pt got progressively worse w/sore throat & gasping for air; treated w/Erythromycin for sore throat; still has cough & SOB;

VAERS ID:60137 (history)  Vaccinated:1992-12-29
Age:41.0  Onset:1992-12-31, Days after vaccination: 2
Gender:Female  Submitted:1993-01-18, Days after onset: 18
Location:Florida  Entered:1993-11-03, Days after submission: 289
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: TITer drawn 31DEC92 pos for HEP BS Antigen;
CDC Split Type: EBU930027
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1049A42IMA
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recvd 3 dose of of Engerix-B vax; pt reports a pos titer for hep BS antigen; this was determined from blood that was taken from pt 2 days p/3rd vax; not titer, antigenemia;

VAERS ID:60228 (history)  Vaccinated:1992-12-28
Age:41.0  Onset:1992-12-28, Days after vaccination: 0
Gender:Female  Submitted:1993-02-09, Days after onset: 43
Location:Wisconsin  Entered:1993-11-03, Days after submission: 267
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: EBU930258
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1074A22 RA
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Chills, Diarrhoea, Headache, Nausea, Pyrexia, Rhinitis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt recvd vax & 12 hrs p/vax exp chills, abdo cramps, t104, h/a, sneezing, diarrhea, nausea & vomiting;

VAERS ID:60334 (history)  Vaccinated:1992-09-16
Age:41.0  Onset:1992-09-18, Days after vaccination: 2
Gender:Female  Submitted:1993-02-12, Days after onset: 147
Location:Oklahoma  Entered:1993-11-03, Days after submission: 264
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp flu like sx w/Engerix-B dose 1;
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: EBU930293
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1031A41IMA
Administered by: Other     Purchased by: Private
Symptoms: Influenza
SMQs:
Write-up: pt recvd vax & 48 hrs p/vax exp flu-like sx which resolved; 48 hrs p/2nd dose again exp flu-like sx which lasted 5-7 days;

VAERS ID:60340 (history)  Vaccinated:1992-09-29
Age:41.3  Onset:1993-01-15, Days after vaccination: 108
Gender:Female  Submitted:1993-08-13, Days after onset: 209
Location:Maryland  Entered:1993-11-03, Days after submission: 82
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide; Hyfroton; Micronase; Vitamin C; COlace;
Current Illness:
Preexisting Conditions: benign breast biopsy, cesarean section x 2, hypertension, non insulin-dependent diabetes mellitus;
Diagnostic Lab Data: ER exam 2JAN93 BP 150/104, pulse 120 regular, resp 16 unlabored, t37, skin cool & dry, alert, oriented; abdo sonogram 20JAN93 liver measures approx 19 cm; spleen 13.7 cm; suspect for hepatocellular disease; tenderness in liver area;
CDC Split Type: EBU930300
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1  
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Asthenia, Hepatitis, Hepatocellular damage, Hepatosplenomegaly, Leukocytosis, Liver tenderness, Paraesthesia
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt recvd 2nd dose of vax & exp nausea, vomiting & rt upper quad abdominal pain into back; 17JAN93 c/o being weak & shaky; also exp numbness & burning of the toes & dark yellow to orange urine; presented to ER on 20JAN93;

VAERS ID:60343 (history)  Vaccinated:1993-01-20
Age:41.0  Onset:1993-01-20, Days after vaccination: 0
Gender:Female  Submitted:1993-05-04, Days after onset: 103
Location:Connecticut  Entered:1993-11-03, Days after submission: 183
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: MRI degenerative disc disease;
CDC Split Type: EBU930303
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 2IMLA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Neuropathy, Pain
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad)
Write-up: Pt recvd 3rd dose of vax & 4 hrs p/vax exp pain in rt leg & weakness in dorsiflexion of foot; probably unrelated discogenic sciatic nerve irritation indicates responsible MD;

VAERS ID:60367 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:1992-12-18
Gender:Female  Submitted:1993-02-25, Days after onset: 69
Location:Florida  Entered:1993-11-03, Days after submission: 251
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Depakote
Current Illness:
Preexisting Conditions: sz disorder;
Diagnostic Lab Data:
CDC Split Type: EBU930360
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM  IMA
Administered by: Private     Purchased by: Private
Symptoms: Gamma-glutamyltransferase increased
SMQs:, Liver related investigations, signs and symptoms (narrow)
Write-up: Pt recvd vax & exp elevated gamma GT;

VAERS ID:60495 (history)  Vaccinated:1991-09-12
Age:41.0  Onset:1991-09-12, Days after vaccination: 0
Gender:Female  Submitted:1993-07-20, Days after onset: 677
Location:Indiana  Entered:1993-11-03, Days after submission: 106
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aplisol Tuberculosis Test;
Current Illness:
Preexisting Conditions: Allergic to sulfa;
Diagnostic Lab Data:
CDC Split Type: EBU930871
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IM 
Administered by: Public     Purchased by: Other
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pt recvd vax & exp generalized itching immed afterwards which was treated w/DPH; itching has lasted for months; refused 3rd dose;

VAERS ID:60553 (history)  Vaccinated:1993-01-22
Age:41.0  Onset:1993-01-27, Days after vaccination: 5
Gender:Female  Submitted:1993-03-15, Days after onset: 47
Location:Louisiana  Entered:1993-11-03, Days after submission: 233
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rash & not feeling good @ 41 w/Engerix B dose 1;
Other Medications: APAP
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: EBU930434
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM4050A42IMRA
Administered by: Other     Purchased by: Other
Symptoms: Influenza, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt recvd vax & exp rash & flu-like sx;

VAERS ID:61151 (history)  Vaccinated:1993-01-16
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:1993-03-30
Location:Alabama  Entered:1993-11-03, Days after submission: 218
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp inject hurt going in, felt flu-like w/Engerix #1 dose; vaginal yeast, inf
Other Medications: Beconase nasal inhaler, Premarin, Thyroid;
Current Illness:
Preexisting Conditions: Thyroid condition;
Diagnostic Lab Data:
CDC Split Type: EBU930534
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 2IMA
Administered by: Private     Purchased by: Private
Symptoms: Adverse drug reaction, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax & arm muscles felt sore;

VAERS ID:61179 (history)  Vaccinated:1993-04-06
Age:41.0  Onset:1993-04-06, Days after vaccination: 0
Gender:Female  Submitted:1993-04-13, Days after onset: 7
Location:Alaska  Entered:1993-11-03, Days after submission: 204
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: neg TB test;
Diagnostic Lab Data:
CDC Split Type: EBU930637
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM  IM 
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Headache, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Pt recvd vax & devel severe h/a, muscle aches, nausea, vomiting & diarrhea; sx treated w/bed rest, fluids & Motrin as needed;

VAERS ID:61216 (history)  Vaccinated:1992-03-10
Age:41.0  Onset:1992-03-12, Days after vaccination: 2
Gender:Female  Submitted:1993-06-04, Days after onset: 448
Location:Virginia  Entered:1993-11-03, Days after submission: 152
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp prolonged menses, bruises on chest, occurrence of breast lumps @ 41 yrs;
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: EBU930729
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1062A41 A
Administered by: Other     Purchased by: Private
Symptoms: Ecchymosis, Menstrual disorder, Skin nodule
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recvd vax & w/in 2 days devel prolonged menses, bruises on chest & there was an occurence of breast lumps;

VAERS ID:61225 (history)  Vaccinated:1993-02-23
Age:41.4  Onset:1993-03-16, Days after vaccination: 21
Gender:Female  Submitted:1993-08-18, Days after onset: 154
Location:Maryland  Entered:1993-11-03, Days after submission: 77
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Halcion
Current Illness:
Preexisting Conditions: dysuria, hemorrhagic cystitis, low back discomfort, snapping hips, strep throat; father died recently of MI; mom dies from renal failure & lung CA; both parents were smokers;
Diagnostic Lab Data: PE 17NOV92; BP 112/76, pulse 68, resp 12; sinuses neg; conjunctivae pink & anicteric; neck supple no jugular venous distention;
CDC Split Type: EBU930740
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Back pain, Chest pain, Influenza, Leukocytosis, Red blood cell sedimentation rate increased, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)
Write-up: pt recvd vax & w/in minutes p/inject had lightheadedness; reporting MD indicated that shortly p/inject pt had what sound like vasovagal episode; 24 hrs p/vax pt had flu-like sx & was lethargic; pt recvd APAP & Motrin; also back pain;

VAERS ID:61310 (history)  Vaccinated:1993-05-26
Age:41.4  Onset:0000-00-00
Gender:Female  Submitted:1993-07-26
Location:Wisconsin  Entered:1993-11-03, Days after submission: 100
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rash @ 41 y/o w/Engerix-B dose #1;
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: EBU930977
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1051A41IMA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & exp a rash which leaves demarcation when subsides;

VAERS ID:61331 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:1993-07-02
Location:California  Entered:1993-11-03, Days after submission: 124
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Voltaren;
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: EBU930984
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: pt recvd vax & following 2nd inject pt had allergic react to alcohol & p/ingesting alcohol developed hives that lasted 3 days; pt was seen by MD;

VAERS ID:61334 (history)  Vaccinated:1993-06-17
Age:41.0  Onset:1993-06-20, Days after vaccination: 3
Gender:Male  Submitted:1993-08-23, Days after onset: 64
Location:New York  Entered:1993-11-03, 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: Prednisone
Current Illness:
Preexisting Conditions: sarcoidosis
Diagnostic Lab Data:
CDC Split Type: EBU930989
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Asthenia, Diabetes mellitus, Diarrhoea, Headache, Hyperhidrosis, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Pt recvd vax & 3-4 days later exp severe constant nausea, abdo pain, diarrhea, h/a, joint soreness, fever, noc sweats & extreme weakness & fatigue;

VAERS ID:61349 (history)  Vaccinated:1993-01-07
Age:41.0  Onset:1993-01-08, Days after vaccination: 1
Gender:Female  Submitted:1993-09-07, Days after onset: 241
Location:Texas  Entered:1993-11-03, Days after submission: 57
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: EBU930949
Vaccination
Manufacturer
Lot
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 2IMA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Pain, Rash, Systemic lupus erythematosus
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recvd vax & 24 hrs p/3rd dose of vax pt exp rash on arm, pain in arm & joint pain; pt took Pred & was seen by regular MD; evaluated for poss lupus;

VAERS ID:61351 (history)  Vaccinated:1993-05-19
Age:41.0  Onset:1993-06-09, Days after vaccination: 21
Gender:Female  Submitted:1993-07-02, Days after onset: 23
Location:Georgia  Entered:1993-11-03, Days after submission: 124
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp aching in legs, muscle pain, premature ventricular contractions;
Other Medications: Oral contraceptives
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: EBU930956
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 2IM 
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Chest pain, Condition aggravated, Guillain-Barre syndrome, Leukopenia, Thinking abnormal, Ventricular extrasystoles
SMQs:, Haematopoietic leukopenia (narrow), Peripheral neuropathy (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Ventricular tachyarrhythmias (narrow), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Demyelination (narrow)
Write-up: Pt recvd vax & exp premature ventricular contractions & chest pain; 4 days later was found to have a mitral valve heart murmur; condition of pt is currently being labeled as GBS synd;

VAERS ID:57083 (history)  Vaccinated:1993-09-23
Age:41.4  Onset:1993-09-24, Days after vaccination: 1
Gender:Female  Submitted:1993-09-28, Days after onset: 4
Location:Pennsylvania  Entered:1993-11-05, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Motrin
Current Illness: unk
Preexisting Conditions: none specified;
Diagnostic Lab Data: MRI Brain-nl; MRI spine-demyelinating lesion @ c-2; LP-results unk;
CDC Split Type: 894045001J
Vaccination
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Lot
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH4938143 IMA
Administered by: Private     Purchased by: Other
Symptoms: Myelitis, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt recvd vax 23SEP93 & 24 hrs later devel numbness & painful paresthesias of the trunk which then extended to the upper extremities down to calves; adm to hosp, underwent MRI of brain & spinal cord, LP & unspecified blood work;

VAERS ID:57174 (history)  Vaccinated:1993-10-13
Age:41.5  Onset:1993-10-14, Days after vaccination: 1
Gender:Male  Submitted:1993-10-18, Days after onset: 4
Location:New Hampshire  Entered:1993-11-08, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NH93024
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH49380860 LA
Administered by: Public     Purchased by: Private
Symptoms: Malaise, Myasthenic syndrome, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow)
Write-up: febrile, gen malaise, muscle weakness x 24 hrs; no tx x/APAP;

VAERS ID:57213 (history)  Vaccinated:1993-08-16
Age:41.5  Onset:1993-08-17, Days after vaccination: 1
Gender:Female  Submitted:1993-08-27, Days after onset: 10
Location:Washington  Entered:1993-11-09, Days after submission: 74
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: WA93944
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES346911  LA
Administered by: Private     Purchased by: Public
Symptoms: Hyperhidrosis, Injection site hypersensitivity, Injection site mass, Myalgia, Pyrexia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt called office & 8AM on 18AUg93 c/o poss lt deltoid tetanus inject react on 17AUg93; hard lump, red, warm & inc temp, body aches, sweats;

VAERS ID:57257 (history)  Vaccinated:1993-01-05
Age:41.4  Onset:1993-01-06, Days after vaccination: 1
Gender:Male  Submitted:1993-11-01, Days after onset: 299
Location:New York  Entered:1993-11-09, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp pain in shoulders & neck (arthritic type pain) w/Hep B vax;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: herniated disc in neck;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Arthritis, Neck pain, Pain
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: pain in shoulders & neck (arthritic type pain) a day or 2 p/vax cont w/o relief to date;

VAERS ID:57536 (history)  Vaccinated:1993-11-11
Age:41.2  Onset:0000-00-00
Gender:Female  Submitted:1993-11-15
Location:New York  Entered:1993-11-19, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Choledyl, Librax, Alupent, Cartate;
Current Illness: NONE
Preexisting Conditions: allergies NONE/asthma;
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
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Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F41008 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: redness @ inject site, burning, swelling of extremities from site to fingers;

VAERS ID:57589 (history)  Vaccinated:1993-10-25
Age:41.3  Onset:1993-10-26, Days after vaccination: 1
Gender:Female  Submitted:1993-11-01, Days after onset: 6
Location:Missouri  Entered:1993-11-22, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MO93101
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F41033  L
Administered by: Other     Purchased by: Unknown
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: red itchy rash appeared the next day on lower extremities, arms, necks, back;

VAERS ID:57782 (history)  Vaccinated:1993-09-28
Age:41.7  Onset:1993-09-29, Days after vaccination: 1
Gender:Female  Submitted:1993-10-01, Days after onset: 2
Location:Oregon  Entered:1993-11-29, Days after submission: 59
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER00763P  RA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER1042V  LA
Administered by: Public     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site inflammation, Injection site oedema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: fever, sore lt arm from shoulder to elbow, swelling of arm specifically medial side above elbow w/erythema; ATB prescribed by MD 30SPE93 unsure if inflammation related to inject;

VAERS ID:57898 (history)  Vaccinated:1993-08-02
Age:41.0  Onset:1993-08-02, Days after vaccination: 0
Gender:Female  Submitted:1993-08-04, Days after onset: 2
Location:Michigan  Entered:1993-12-06, Days after submission: 124
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DPH
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MI93123
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)MICHIGAN DEPT PUB HLTH6130A  RA
Administered by: Public     Purchased by: Public
Symptoms: Infection, Injection site inflammation, Injection site mass, Injection site pain, Pyrexia, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: 2AUG93 pt given vax large-hard-lump @ site approx 2 1/2-3" in circumference; very sore, but can move; low grade fever also; seen by MD; area inflammed & hot to touch; MD felt infected @ site;

VAERS ID:57945 (history)  Vaccinated:1993-10-16
Age:41.1  Onset:1993-10-16, Days after vaccination: 0
Gender:Female  Submitted:1993-10-16, Days after onset: 0
Location:Minnesota  Entered:1993-12-06, Days after submission: 51
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp dizzy w/swine flu;
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: previous react to swine flu vax;
Diagnostic Lab Data:
CDC Split Type: MN93058
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F411140IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Hyperhidrosis, Hypotension, Nausea, Pallor, Tachycardia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: c/o dizziness, became pale, diaphoretic, nauseated: p=12--no discernable BP 15 mins p/shot administered; givenEpi & BP & pulse returned to nl p/45 mins;

VAERS ID:57981 (history)  Vaccinated:1993-10-27
Age:41.5  Onset:1993-11-02, Days after vaccination: 6
Gender:Female  Submitted:1993-11-30, Days after onset: 28
Location:Tennessee  Entered:1993-12-06, 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: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type: TN93124
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH49381640 A
Administered by: Private     Purchased by: Private
Symptoms: Pharyngitis, Pyrexia
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow)
Write-up: sore throat 6 days p/shot x 2 days; fever 101.3 x 3 days; URI x 2 days;

VAERS ID:58036 (history)  Vaccinated:1993-11-05
Age:41.1  Onset:1993-11-06, Days after vaccination: 1
Gender:Female  Submitted:1993-11-09, Days after onset: 3
Location:North Carolina  Entered:1993-12-08, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fedhist, Amoxicillin;
Current Illness: sinusitis
Preexisting Conditions: NKA''s
Diagnostic Lab Data: NONE
CDC Split Type: NC9396
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES348910 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site oedema, Injection site pain, Lymphadenopathy, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 9NOV93 c/o soreness, swelling & heat to lt arm; markedly swollen lt detloid region; tender & painful to touch & painful on abduct/adduct fullness & swelling supra clavicular area-node 1x2 cm; ?cellulitis react to Td vax;

VAERS ID:61463 (history)  Vaccinated:1993-05-26
Age:41.0  Onset:1993-05-27, Days after vaccination: 1
Gender:Female  Submitted:1993-05-28, Days after onset: 1
Location:Texas  Entered:1993-12-08, Days after submission: 194
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: pt allergic to ASA, ATB x/Ceclor, codeine;
Diagnostic Lab Data:
CDC Split Type: 893158001K
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)PFIZER/WYETH49281980IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax & devel painful swelling of the lymph nodes; pt also had inject site swelling & redness; The react resolved w/in 3 to 4 days;

VAERS ID:58197 (history)  Vaccinated:1993-10-18
Age:41.7  Onset:1993-10-18, Days after vaccination: 0
Gender:Female  Submitted:1993-12-08, Days after onset: 51
Location:California  Entered:1993-12-13, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unk
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH4938158  LA
Administered by: Other     Purchased by: Private
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: pt stated is subject to anxiety attacks felt tingling in fingertips; pt took medication for anxiety attacks;

VAERS ID:58809 (history)  Vaccinated:1993-10-15
Age:41.0  Onset:1993-10-15, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Minnesota  Entered:1994-01-04
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: x-ray; ultrasound;
CDC Split Type: MN93067
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH49381210IMLA
Administered by: Public     Purchased by: Private
Symptoms: Hypokinesia, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)
Write-up: aching pain in lt arm, lt shoulder & lt jaw following shot; pain got worse @ noc & p/1 month has gotten better but not gone & lt shoulder ROM limited due to pain;

VAERS ID:61491 (history)  Vaccinated:1993-06-09
Age:41.8  Onset:1993-06-10, Days after vaccination: 1
Gender:Female  Submitted:1993-07-07, Days after onset: 27
Location:California  Entered:1994-01-06, Days after submission: 183
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD given same day as vax;
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 893196002K
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)PFIZER/WYETH4928299 SCA
Administered by: Military     Purchased by: Military
Symptoms: Hyperhidrosis, Injection site oedema, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt recvd vax & devel swelling @ inject site & sweating; 2 days later devel worsening of prev sx accompanied by nausea & vomiting;

VAERS ID:58883 (history)  Vaccinated:1993-12-15
Age:41.0  Onset:1993-12-15, Days after vaccination: 0
Gender:Male  Submitted:1993-12-21, Days after onset: 6
Location:Alaska  Entered:1994-01-10, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergic to fabric softener, allergic to PCN;
Diagnostic Lab Data:
CDC Split Type: 930055431
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1017A40IMA
Administered by: Private     Purchased by: Private
Symptoms: Bradycardia, Convulsion, Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Pt recvd vax & became hypotensive & exp bradycardia, sz & 1 episode of syncope; treated w/Epi; hospitalized overnoc for observation; dx syncopal episode; events resolved & pt discharged the next morning; The vax series has been discontinued

VAERS ID:59796 (history)  Vaccinated:1993-11-01
Age:41.4  Onset:1993-11-01, Days after vaccination: 0
Gender:Female  Submitted:1993-11-02, Days after onset: 1
Location:Minnesota  Entered:1994-01-10, Days after submission: 69
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: allergies: dust, mold, strawberries, seafood;
Diagnostic Lab Data: NONE
CDC Split Type: MN93073
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1195B42IMLA
Administered by: Public     Purchased by: Private
Symptoms: Amblyopia, Dizziness, Pain, Tongue oedema, Tremor, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Noninfectious encephalopathy/delirium (broad), Optic nerve disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: 145PM arms on fire, hives erupted on arms, face, back & soles of feet; 2PM took 415PM DPH syrup called clinic rested & then vision became blurred & became lightheaded & shaky 245PM tongue thickened;

VAERS ID:58965 (history)  Vaccinated:1993-10-23
Age:41.1  Onset:1993-10-25, Days after vaccination: 2
Gender:Male  Submitted:1994-01-08, Days after onset: 75
Location:Michigan  Entered:1994-01-13, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Motrin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EEG neg; all labs neg;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3O411480 A
Administered by: Military     Purchased by: Military
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: 2 days following vax pt exp sz like activity x 3 episodes; pt was in ICU x 3 days; hospitalized x 4 days;

VAERS ID:59299 (history)  Vaccinated:1994-01-07
Age:41.2  Onset:1994-01-08, Days after vaccination: 1
Gender:Female  Submitted:1994-01-14, Days after onset: 6
Location:Alabama  Entered:1994-01-27, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: DPH
Diagnostic Lab Data: NA
CDC Split Type: AL9402
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES346949  LA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 24 hrs p/vax pt noticed localized redness & swelling; pt says had a h/o local rxn to injects; pt was advised to take APAP;

VAERS ID:61517 (history)  Vaccinated:1992-11-05
Age:41.2  Onset:1992-11-19, Days after vaccination: 14
Gender:Female  Submitted:1993-10-15, Days after onset: 329
Location:Pennsylvania  Entered:1994-02-02, Days after submission: 110
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: pre-existing Lyme disease;
Diagnostic Lab Data:
CDC Split Type: 893300003C
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH4928130 IMA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Condition aggravated, Headache, Neck pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: Pt recvd vax & exp accentuation of Lyme''s sx; w/in 2 wks of vax pt c/o fatigue, fever, joint aches & head & neck pain; sx lasted for more than 2 wks;

VAERS ID:59780 (history)  Vaccinated:1994-01-19
Age:41.1  Onset:1994-01-19, Days after vaccination: 0
Gender:Male  Submitted:1994-01-26, Days after onset: 7
Location:North Carolina  Entered:1994-02-09, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pravacol
Current Illness: denied
Preexisting Conditions: denied
Diagnostic Lab Data:
CDC Split Type: NC94012
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1243W0IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.J0312 SCLA
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESEJN0760SCRA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES348910 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site pain, Rash maculo-papular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax 230PM; 6PM devel red, sl raised rash on head, neck & face which lasted 1 1/2 hrs; also @ same time noticed burning rt arm; inject site of vax;

VAERS ID:59974 (history)  Vaccinated:1994-01-28
Age:41.6  Onset:1994-01-29, Days after vaccination: 1
Gender:Female  Submitted:1994-02-01, Days after onset: 3
Location:Illinois  Entered:1994-02-22, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: PCN & Sulfa
Diagnostic Lab Data:
CDC Split Type: IL94006
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0634W2 LA
Administered by: Public     Purchased by: Public
Symptoms: Laryngospasm, Myalgia, Oedema peripheral, Rash maculo-papular, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: 31JAN94 PC from client; states had hep vax 28JAN94; 29JAN94 lt arm started swelling & became sore from elbow up to neck; 30JAN94 broke out w/hives on lt arm which spread to chest & abdo; face was blotchy & had a few hives on back & leg;

VAERS ID:59986 (history)  Vaccinated:1993-05-26
Age:41.5  Onset:1993-05-29, Days after vaccination: 3
Gender:Female  Submitted:1993-08-18, Days after onset: 81
Location:Indiana  Entered:1994-02-22, Days after submission: 188
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: synthroid;
Current Illness: NONE
Preexisting Conditions: hypthyroidism
Diagnostic Lab Data: EMG & nerve conduction extremities results showed marked slowing of distal latencies for sensory & motor fxn;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Deafness, Laboratory test abnormal, Myalgia, Paraesthesia, Somnolence, Thinking abnormal, Visual disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hearing impairment (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: myalgia started on 29MAY93 followed by neck et shoulder girdle pain et pelvic girdle pain; also back pain w/spasms then arthralgia et paresthesia of hands et feet; low grade fever; rash et itching across abdo then paresthesia; nose et lips;

VAERS ID:60021 (history)  Vaccinated:1993-12-01
Age:41.0  Onset:1994-01-01, Days after vaccination: 31
Gender:Male  Submitted:1994-02-17, Days after onset: 47
Location:Virginia  Entered:1994-02-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Anti-HBs 26;
CDC Split Type: WAES94020092
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Jaundice
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recvd vax in DEC93 & 4 wks later pt was hospitalized for 4 days for severe abdo cramps; pt was jaundiced & lab eval revealed neg hepatitis antigen & anti-Hbs of 26;

VAERS ID:61657 (history)  Vaccinated:1993-06-08
Age:41.8  Onset:1993-06-10, Days after vaccination: 2
Gender:Female  Submitted:1994-02-25, Days after onset: 260
Location:Texas  Entered:1994-03-01, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: medical hx: D & C; renal calculus;
Diagnostic Lab Data: ANA 1:80; ESR 60; ESR 112; ANA 1:640, rheumatoid factor positive;
CDC Split Type: WAES93080506
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1651V0  
Administered by: Private     Purchased by: Private
Symptoms: Anaemia, Antinuclear antibody, Arthralgia, Oedema peripheral, Osteoarthritis, Red blood cell sedimentation rate increased, Rheumatoid arthritis, Serum sickness
SMQs:, Cardiac failure (broad), Angioedema (broad), Haematopoietic erythropenia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: pt recvd vax & exp allergic react causing painful sx of rhematoid arthritis w/swelling in hands followed by joint pain & swelling of fingers, knees, shoulders, wrist, feet, rt knee; lab eval revealed ANA of 1:80; inc ESR of 60.

VAERS ID:60259 (history)  Vaccinated:1994-01-27
Age:41.9  Onset:1994-02-10, Days after vaccination: 14
Gender:Female  Submitted:1994-02-17, Days after onset: 7
Location:Tennessee  Entered:1994-03-04, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: TN94030
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1136A2 IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1026W  LA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES356906   
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Arthropathy, Osteoarthritis
SMQs:, Arthritis (narrow)
Write-up: rt knee swollen to size of grapefruit, stiff & painful water had to be drawn from knee on 11FEB93; swelliing has now gone to lt wrist, stiff & painful;

VAERS ID:60373 (history)  Vaccinated:1994-02-26
Age:41.0  Onset:1994-02-26, Days after vaccination: 0
Gender:Male  Submitted:1994-03-01, Days after onset: 3
Location:Colorado  Entered:1994-03-08, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO5287
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.J05075IM 
Administered by: Military     Purchased by: Military
Symptoms: Face oedema, Pruritus, Rash, Tongue oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: facial rash, swelling of lips & tongue, generalized itching 10 mins post vax; no resp distress, BP nl; treated w/Epi & DPH, steroids; hospitalized 24 hrs;

VAERS ID:62551 (history)  Vaccinated:1992-09-01
Age:41.3  Onset:1992-11-05, Days after vaccination: 65
Gender:Male  Submitted:0000-00-00
Location:Michigan  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergy sulfa; allergy ASA; allergy Indocin;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES93010796
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Pain
SMQs:
Write-up: pt recvd vax SEP92 & on 5NOV92 devel pain in lt arm; No further details were provided;

VAERS ID:62589 (history)  Vaccinated:1993-01-25
Age:41.6  Onset:1993-01-25, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Kentucky  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: hayfever
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES93011437
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1468V0IM 
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dizziness
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: pt recvd vax & exp weakness, lightheadedness, dizziness & felt like was going to pass out; later that day pt had completely recovered; No further details were provided;

VAERS ID:62597 (history)  Vaccinated:1993-01-28
Age:41.4  Onset:1993-01-28, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Massachusetts  Entered:1994-03-14
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: septum, deviated;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES93011577
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Haemorrhage, Hyperhidrosis, Injection site haemorrhage, Injection site mass, Pallor
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt recvd 3rd dose of vax & devel bleeding @ inject site, also devel hematoma, a feeling of faintness & was very pale; ice was applied to the inject site & pt''s face; pt also devel an induration under the hematoma; pt felt flushed & sweaty;

VAERS ID:62691 (history)  Vaccinated:1992-08-21
Age:41.4  Onset:1992-11-21, Days after vaccination: 92
Gender:Female  Submitted:0000-00-00
Location:Louisiana  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 21Nov92 anti Hbs- neg;
CDC Split Type: WAES93021051
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1310V2IM 
Administered by: Public     Purchased by: Public
Symptoms: Drug ineffective, Injection site pain
SMQs:, Lack of efficacy/effect (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recvd vax 21AUG92 & c/o soreness @ inject site; 21NOV92 lab eval showed anti-HBs neg; No further details provided;

VAERS ID:62707 (history)  Vaccinated:1993-01-21
Age:41.6  Onset:1993-01-21, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins
Current Illness:
Preexisting Conditions: allergy, yeast;
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES93030054
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0681V0  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Ecchymosis, Face oedema, Injection site hypersensitivity, Personality disorder, Petechiae, Tachycardia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recvd vax;pt devel urticaria;tenderness,inject site;vertigo;dizziness;confus;behavior disturbance;erythema,inject site;flushing;arthritis;myalgia;tachycardia;insomnia;edema;angioneurotic;vaginitis;palpitation;petechiae;asthenia;irritabil

VAERS ID:63706 (history)  Vaccinated:0000-00-00
Age:41.0  Onset:1993-05-13
Gender:Male  Submitted:0000-00-00
Location:Illinois  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Micronase
Current Illness:
Preexisting Conditions: allergy, Lopid; Diabetes mellitus, non-insulin;
Diagnostic Lab Data: 13MAY93 Serum alk phos 466; SGOT 35; SGPT 83; GGT 737;
CDC Split Type: WAES93060956
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Blood alkaline phosphatase increased, Gamma-glutamyltransferase increased, Hepatic function abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Biliary system related investigations, signs and symptoms (broad)
Write-up: pt recvd vax & 13MAY lab eval revealed elevated liver enzymes; alkaline phosphatase was 466, SGOT was 35, SGPT 83, GGT 737; diagnostic tests revealed nl CBC neg Eptstein-Barr antibody & neg CMV;

VAERS ID:63994 (history)  Vaccinated:1992-11-19
Age:41.6  Onset:1993-05-31, Days after vaccination: 193
Gender:Female  Submitted:0000-00-00
Location:Maryland  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ativan;
Current Illness:
Preexisting Conditions: gastritis; hay fever; panic attacks;
Diagnostic Lab Data: X-ray arthritis;
CDC Split Type: WAES93061110
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthritis, Hypokinesia, Neuritis
SMQs:, Peripheral neuropathy (narrow), Systemic lupus erythematosus (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow)
Write-up: pt rcvd vax; pt dx w/ arthritis & brachial; plexitis of unknown etiology; some decreased mobility;

VAERS ID:64014 (history)  Vaccinated:1992-11-01
Age:41.7  Onset:1992-12-01, Days after vaccination: 30
Gender:Male  Submitted:0000-00-00
Location:Ohio  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp malaise @ 42 y/o w/Recombivax 1st dose
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: ESR elevated; blood tests abnorm; liver func tests abnorm; latex agglutination pos;
CDC Split Type: WAES93061411
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Hepatic function abnormal, Laboratory test abnormal, Pneumonia, Red blood cell sedimentation rate increased, Rheumatoid arthritis, Systemic lupus erythematosus
SMQs:, Liver related investigations, signs and symptoms (narrow), Systemic lupus erythematosus (narrow), Eosinophilic pneumonia (broad), Arthritis (narrow)
Write-up: pt recvd vax; pt devel pneumonia; pt dx w/ rheumatoid arthritis & devel inc liver function tests; blood value abnorm; ESR elevated & latex agglutination test pos; MD trying to rule out lupus;

VAERS ID:64037 (history)  Vaccinated:1992-09-21
Age:41.9  Onset:1992-10-05, Days after vaccination: 14
Gender:Female  Submitted:0000-00-00
Location:Maryland  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt had irritability, weight gain,inc constipat, frequent period w/ 1st dose vax;
Other Medications:
Current Illness:
Preexisting Conditions: psoriasis; asthma; allergy, darvon; allergy, anesthesia;
Diagnostic Lab Data: TSH 66.67; T4 5.4; TSH 1.8; T4 7.0; TSH .139; T4 13.5; TSH 8.7; T4 3.22; serum bilirubin 1.4; serum bilirubin 1.7; serum creatine 1.4; tot protein 8.4; serum albumin 5.6; BUN 21; tot co2 19; plasma sodium 150; dx test: urinalysis 1+blood/2+
CDC Split Type: WAES93070547
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0842V1  
Administered by: Other     Purchased by: Other
Symptoms: Condition aggravated, Dizziness, Hormone level abnormal, Palpitations, Thinking abnormal
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: pt recvd vax; pt devel ketosis; irritability; constipation; weight gain; menstruation disorder; dizziness; palpitation; mental acuity dec; TSH inc; asthenia/fatigue; nausea; pain abdominal; anorexia; weight loss; pain chest; hematuria;

VAERS ID:64063 (history)  Vaccinated:1993-07-20
Age:41.1  Onset:1993-07-22, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:Oklahoma  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: capoten; procardia; lozol; zintar;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES93071122
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0298W1IM 
Administered by: Other     Purchased by: Public
Symptoms: Chills, Diarrhoea, Headache, Myalgia, Nausea, Pyrexia, Vasodilatation, 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), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax; pt exp''d nausea, fever, vomiting, diarrhea, a headache, a feeling of hot & cold, & aching muscles;

VAERS ID:64203 (history)  Vaccinated:1993-08-31
Age:41.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Colorado  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES93090803
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Headache, Hypoaesthesia, Injection site reaction, Myalgia, Nausea, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax & devel deep aching in rt shoulder & elbow, & numbness & tingling; pt also devel headache & queasy stomach; pt has a dec sensation on a dorsum of hand in the absence of hand weakness; MD felt was having a local rxn to the vax;

VAERS ID:64231 (history)  Vaccinated:1988-07-01
Age:41.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt had rxn w/ tetanus vax; also pt devel rash & swollen arm w/ recombivax;
Other Medications: none;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES93091045
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Hypersensitivity, Oedema, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & devel rash & a swollen arm; pt devel also multiple allergies & sensitivity to many things; pt devel hives & swelling;

VAERS ID:64307 (history)  Vaccinated:1993-10-21
Age:41.0  Onset:1993-10-22, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Connecticut  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hydrodiuril, vasotec;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES93101502
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax & devel muscle pain & back ;

VAERS ID:64316 (history)  Vaccinated:1993-10-29
Age:41.1  Onset:1993-10-29, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: chinese herbs;
Current Illness:
Preexisting Conditions: tendinitis
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES93110106
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Oedema peripheral, Pruritus, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax & noted left arm was swollen & pruritic; rash appeared following day;

VAERS ID:67288 (history)  Vaccinated:1993-05-27
Age:41.8  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:1994-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: in pt dizziness; hep B vax 1st dose;
Other Medications: apap;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: anti hbs neg on 10mar93 & 17may93; 19jul93 eval showed anti hbsag pos;
CDC Split Type: WAES93040842
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 4IM 
Administered by: Other     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: pt recvd vax & felt dizzy & lightheaded for 20 sec;lab tests showed: anti-HBsag neg; pt was vax w/ a booster dose of hepatitis; next anti HBsag neg; pt had another booster & showed anti HBsag pos;

VAERS ID:60707 (history)  Vaccinated:1994-03-07
Age:41.6  Onset:1994-03-07, Days after vaccination: 0
Gender:Male  Submitted:1994-03-09, Days after onset: 2
Location:Missouri  Entered:1994-03-15, 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: ?cold
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESEJN**0931SCLA
Administered by: Other     Purchased by: Private
Symptoms: Bone pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax & p/2nd dose c/o bones hurting, achey feeling;

VAERS ID:60810 (history)  Vaccinated:1993-11-10
Age:41.7  Onset:1993-11-11, Days after vaccination: 1
Gender:Female  Submitted:1993-11-30, Days after onset: 19
Location:Georgia  Entered:1994-03-16, Days after submission: 106
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: 893343015J
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH  IMLA
Administered by: Public     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax 10NOV93 & the next day devel a rash (urticaria); pt is treating self w/Calamine lotion & DPH cream;

VAERS ID:60851 (history)  Vaccinated:1993-11-16
Age:41.7  Onset:1993-11-17, Days after vaccination: 1
Gender:Female  Submitted:1993-11-18, Days after onset: 1
Location:Maryland  Entered:1994-03-21, Days after submission: 123
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: NKA
Diagnostic Lab Data:
CDC Split Type: MD93055
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES3F410351IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, 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: c/o soreness @ site immed p/vax & w/in 24 hrs c/o site was sorer, red, hot to touch, swollen & hard approx 4"x2" oval area; Is able to move arm but it hurts when raises it only;

VAERS ID:60910 (history)  Vaccinated:1994-02-14
Age:41.8  Onset:0000-00-00
Gender:Female  Submitted:1994-02-22
Location:Washington  Entered:1994-03-21, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: sinusitis infect on ATB last dose 12FEB
Preexisting Conditions:
Diagnostic Lab Data: No problem w/dose #1, #2 pt states;
CDC Split Type: WA941009
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1688W2IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Hypokinesia, Injection site oedema, Myasthenic syndrome, Nausea, Oedema, Pain, Peripheral vascular disorder, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt states lt arm swollen of inject site then to lt neck & shoulder couldn''t use arm, no strength in arm, painful burning in arm; hand turned blue; t101-102 for 2 days; 14FEB94 nauseated; off work 4 days;

VAERS ID:61132 (history)  Vaccinated:1994-03-03
Age:41.1  Onset:1994-03-03, Days after vaccination: 0
Gender:Female  Submitted:1994-03-03, Days after onset: 0
Location:Texas  Entered:1994-03-30, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: TX9451
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES356906  LA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Dry mouth, Myalgia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt exp light headedness, drowsiness, dry mouth & achy arm; layed down @ place of employment & slept; sx better now but still lingering drowsiness & dry mouth;

VAERS ID:64519 (history)  Vaccinated:1993-10-04
Age:41.2  Onset:1993-10-04, Days after vaccination: 0
Gender:Female  Submitted:1993-10-06, Days after onset: 2
Location:New Jersey  Entered:1994-04-04, Days after submission: 180
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: 893284002J
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH  IMA
Administered by: Private     Purchased by: Private
Symptoms: Chest pain, Cough, Dyspnoea, Hypersensitivity, Injection site hypersensitivity, Pain, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & exp local rxn consisting of redness & pruritus at inject site; pt had an allergic rxn w/ cough & mucous,chest tightness,lightheadness, labored breathing,burning sensation & itching & numbness feeling; burning in the throat;

VAERS ID:64561 (history)  Vaccinated:1993-10-12
Age:41.7  Onset:1993-10-12, Days after vaccination: 0
Gender:Female  Submitted:1993-10-12, Days after onset: 0
Location:Florida  Entered:1994-04-04, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: 12OCT93 01710 BP 119/69 pulse 94; 0713 89/58 pulse 78; 0732 111/68, 97; 0830 121/70, 81;
CDC Split Type: 893286003J
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)PFIZER/WYETH49381430IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Dry mouth, Hypotension, Nausea, Tachycardia, Tongue oedema, Tremor
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & c/o dry mouth, nausea, & feeling lightheaded, began to shake, BP dec (89/58) & tongue thickened; pt seen in ER & placed on a cardiac monitor & treated w/DPH, SoluMedrol, Tagamet & IV fluids, then discharged

VAERS ID:61788 (history)  Vaccinated:1994-03-14
Age:41.7  Onset:1994-03-14, Days after vaccination: 0
Gender:Female  Submitted:1994-03-14, Days after onset: 0
Location:Florida  Entered:1994-04-13, Days after submission: 29
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: hay fever & pollen allergies;
Diagnostic Lab Data: NONE:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1314A42IMLA
Administered by: Public     Purchased by: Private
Symptoms: Agitation, Anorexia, Chills, Headache, Lacrimal disorder, Laryngospasm, Nausea, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow)
Write-up: Pt recvd vax & had feeling of nausea nothing given that time; eyes watery; unable to eat stomach turning; trembling, cold, crying; head hurting; throat felt tight;

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