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Case Details (Sorted by Age)

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VAERS ID:121167 (history)  Vaccinated:1996-07-01
Age:53.9  Onset:1997-05-08, Days after vaccination: 311
Gender:Male  Submitted:1999-04-08, Days after onset: 700
Location:Kentucky  Entered:1999-04-13, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: liver problems; sickle cell trait
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F712880 RA
Administered by: Public     Purchased by: Unknown
Symptoms: Dysphagia, Eyelid ptosis, Guillain-Barre syndrome, Hypokinesia, Hypoxia, Influenza, Paralysis, Pneumonia, Respiratory disorder, Sepsis
SMQs:, Agranulocytosis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Demyelination (narrow), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: pt got sick on 8MAY97 w/flu like sx;on 12MAY97 put in ICU for 6wk then sent to hosp for 11months;pt was paralyzed & on a respirator & blood infect & pneumonia & up in a wheel chair & a walker;GBS

VAERS ID:121724 (history)  Vaccinated:1998-06-10
Age:53.2  Onset:1998-06-15, Days after vaccination: 5
Gender:Male  Submitted:1999-04-16, Days after onset: 305
Location:California  Entered:1999-04-26, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 19980159151
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Abdominal pain, Diarrhoea, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 10JUN98 & 15JUN98 pt devel achiness, nausea, diarrhea & cramping;pt was not treated for the event;

VAERS ID:121730 (history)  Vaccinated:1998-06-18
Age:53.0  Onset:1998-06-19, Days after vaccination: 1
Gender:Female  Submitted:1998-08-05, Days after onset: 47
Location:California  Entered:1999-04-26, Days after submission: 264
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control Pills;Calcium;Tricyclin;
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: liver function tests elevated;K decreased;x-ray inflammation & enlargement of the internal organs;sonogram inflammation & enlargement of the internal organs;
CDC 'Split Type': 19980200631
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM657860IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chest pain, Chills, Dyspnoea, Hepatic function abnormal, Jaundice, Laboratory test abnormal, Myalgia, Nuchal rigidity, Photophobia, Pyrexia, Rash, Urine analysis abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 19JUN98 pt had a stiff neck;20JUN98 2 had pain in all joints then in all muscles w/sensitivity to light then chills & fever T102;sore all over legs;inflammation & enlargement of internal organs;rash & pruritus all over;fatigue;urine orange;

VAERS ID:121750 (history)  Vaccinated:1998-06-29
Age:53.0  Onset:0000-00-00
Gender:Male  Submitted:1999-04-11
Location:Alaska  Entered:1999-04-26, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C;Cold liver oil;Calcium;Magnesium;
Current Illness:
Preexisting Conditions: allergic to bee stings, reaction to cholera vaccine;
Diagnostic Lab Data: 1998 thyroid studies nl;WBC nl;HIV nl;
CDC 'Split Type': 19990000931
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM579A41IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Diarrhoea, Lymphadenopathy, Nausea, Oedema, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 29JUN98 & devel abd cramps, nausea, diarrhea, swelling under both axillae & pain running down the inside of the arms to the palms of hands;swelling & pain alternated @ times from one arm to the next;

VAERS ID:121582 (history)  Vaccinated:1999-04-06
Age:53.0  Onset:1999-04-09, Days after vaccination: 3
Gender:Female  Submitted:1999-04-18, Days after onset: 9
Location:Louisiana  Entered:1999-04-27, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aldactone;Lasix;
Current Illness: Routine Check up
Preexisting Conditions:
Diagnostic Lab Data: several CXR-breathing tests & Cat Scan of lungs;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1584H0IM 
Administered by: Private     Purchased by: Unknown
Symptoms: Antinuclear antibody, Cardiovascular disorder, Diabetes mellitus, Drug ineffective, Hypertension, Infection, Pneumonia, Thyroid disorder
SMQs:, Lack of efficacy/effect (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypothyroidism (broad), Hyperthyroidism (broad)
Write-up: pt recv vax 6APR99 & went into ER 9APR99 was dx w/pneumonia;pt hosp until 17APR99;MD swears shot did not give pt pneumonia;pt exp no sx until 9APR99;

VAERS ID:122012 (history)  Vaccinated:1999-04-19
Age:53.7  Onset:1999-04-19, Days after vaccination: 0
Gender:Female  Submitted:1999-04-22, Days after onset: 3
Location:Maine  Entered:1999-05-10, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp localized rxn @ 20yr old w/Td
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': ME99011
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49782431 A
Administered by: Public     Purchased by: Public
Symptoms: Abscess, Diarrhoea, Injection site hypersensitivity, Injection site mass, Pyrexia, Skin discolouration
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: hours later fever, chill, h/a, redness @ site followed by diarrhea;T100 2 days;today is afeb, diarrhea is ending;no chills or h/a;arm is red, hard & hot;area 4" x 6" center area 1 1/2" in diameter red, purple, ready to ooze;

VAERS ID:122055 (history)  Vaccinated:1999-05-05
Age:53.4  Onset:1999-05-05, Days after vaccination: 0
Gender:Male  Submitted:1999-05-06, Days after onset: 1
Location:Massachusetts  Entered:1999-05-11, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: fever, emesis, malaise
Preexisting Conditions: traumatic asplenia
Diagnostic Lab Data: CBC w/d;ESR drawn 6MAY99
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0870H1 LA
Administered by: Private     Purchased by: Private
Symptoms: Malaise, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: fever, chills, malaise, n/v started 2-3hr p/vax 5MAY99 reported to office 8AM 6MAY99;

VAERS ID:122237 (history)  Vaccinated:1999-05-02
Age:53.0  Onset:1999-05-03, Days after vaccination: 1
Gender:Male  Submitted:1999-05-14, Days after onset: 11
Location:Oklahoma  Entered:1999-05-18, Days after submission: 4
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: flu
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0431 RA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Asthenia, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: p/2nd dose of vax pt had mild sinus h/a then progressed next day to aching joints, h/a, chills, fever 101.2, 102.3;fever broke;on 5th woke up tired but feeling better-fever gone;

VAERS ID:122878 (history)  Vaccinated:1998-02-07
Age:53.8  Onset:1998-03-27, Days after vaccination: 48
Gender:Male  Submitted:1999-05-14, Days after onset: 412
Location:New York  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data;
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: 3/27/98 lab test 0.48 IgG ELISA: failed to seroconvert
CDC 'Split Type': WAES98040481
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax & lab eval revealed IgG ELISA of 0.48 which indicated that pt failed to seroconvert;

VAERS ID:123242 (history)  Vaccinated:1999-05-22
Age:53.7  Onset:1999-05-25, Days after vaccination: 3
Gender:Female  Submitted:1999-05-26, Days after onset: 1
Location:Ohio  Entered:1999-06-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none
Other Medications: betrogea, progestacuave
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD01509101A PO 
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Diarrhoea, Dyspepsia, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt exp temp 102, severe vomiting, diarrhea, lack of energy, nausea, severe stomach upset

VAERS ID:123875 (history)  Vaccinated:1999-05-24
Age:53.5  Onset:1999-05-25, Days after vaccination: 1
Gender:Female  Submitted:1999-05-25, Days after onset: 0
Location:Ohio  Entered:1999-06-09, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Feldene, APAP #3;Probrysoline;sporane;amoxicilin
Current Illness: NONE
Preexisting Conditions: rheumatoid arthritis-stage IV
Diagnostic Lab Data: unk
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dizziness, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)
Write-up: rxn from vax very serious weak, dizzy, lightheaded, muscle swelling in legs;

VAERS ID:125500 (history)  Vaccinated:1999-06-30
Age:53.0  Onset:1999-07-04, Days after vaccination: 4
Gender:Female  Submitted:1999-07-06, Days after onset: 2
Location:Kansas  Entered:1999-07-12, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to dust mites, animal hair, bee stings;tick bite;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM596A60IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESPO91020IMLA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES10005700SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: rash onset 7/4/99 arms, torso, neck, back of head;itching;worse @ noc;rash is flat not raised @ all, extremely red;tick bite 3wk ago w/bulls eyes @ that time;to ER 7/5/99;rx cortisone, atarax & unk med;

VAERS ID:125966 (history)  Vaccinated:1999-01-22
Age:53.2  Onset:1999-01-22, Days after vaccination: 0
Gender:Male  Submitted:1999-07-12, Days after onset: 170
Location:Colorado  Entered:1999-07-14, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: Pepcid;Claritin;
Current Illness:
Preexisting Conditions: hypercholesterolemia;HTN
Diagnostic Lab Data:
CDC 'Split Type': WAES99011469
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1339H0IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: p/vax pt arm became swollen & tender;pt expressed concern that the swelling spread distally towards in lt elbow;there was no SOB, swelling of throat, or rash;pt reported that has not reacted badly to tetanus or other vax in past;seen by MD

VAERS ID:126161 (history)  Vaccinated:1999-06-09
Age:53.5  Onset:1999-06-10, Days after vaccination: 1
Gender:Male  Submitted:1999-07-15, Days after onset: 35
Location:New York  Entered:1999-07-20, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0430SC 
Administered by: Military     Purchased by: Military
Symptoms: Pain, Pharyngitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow)
Write-up: p/vax pt''s lt shoulder very sore; pt also exp sore throat

VAERS ID:126323 (history)  Vaccinated:1999-05-20
Age:53.5  Onset:1999-06-14, Days after vaccination: 25
Gender:Male  Submitted:1999-07-06, Days after onset: 22
Location:New York  Entered:1999-07-26, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: psoriasis/GERD/BPH
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120691IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Facial palsy, Myasthenic syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: approx 24day p/vax pt devel left sided bells palsy. left sided facial numbness, weakness. rx prednisone. 7/16 facial weakness improving

VAERS ID:126528 (history)  Vaccinated:1999-03-26
Age:53.0  Onset:1999-04-01, Days after vaccination: 6
Gender:Male  Submitted:1999-04-09, Days after onset: 7
Location:New York  Entered:1999-07-30, Days after submission: 112
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: seasonal alergies
Diagnostic Lab Data:
CDC 'Split Type': 1999008154
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IMRA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Gait disturbance, Injection site mass
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: p/vax pt exp bump & knot on arm (inj site); lasted one wk; pain in lt hip when standing; walks w/a limp; pain is intermittent;

VAERS ID:126562 (history)  Vaccinated:1999-04-06
Age:53.0  Onset:1999-04-08, Days after vaccination: 2
Gender:Male  Submitted:1999-04-27, Days after onset: 19
Location:New York  Entered:1999-07-30, Days after submission: 94
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 1999009463
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM12DE90IMRA
Administered by: Public     Purchased by: Other
Symptoms: Face oedema, Headache, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt exp rash rt side face w/swelling; also devel h/a

VAERS ID:126580 (history)  Vaccinated:1999-03-22
Age:53.0  Onset:1999-04-16, Days after vaccination: 25
Gender:Male  Submitted:1999-04-30, Days after onset: 14
Location:New York  Entered:1999-07-30, 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: lyme disease
Diagnostic Lab Data:
CDC 'Split Type': 1999009821
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120D90IMA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Hypertonia, Insomnia
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: p/vax pt exp pain in knees w/prevents pt from sleeping & stiffness in legs;

VAERS ID:126614 (history)  Vaccinated:1999-04-14
Age:53.0  Onset:1999-04-20, Days after vaccination: 6
Gender:Male  Submitted:1999-05-17, Days after onset: 27
Location:New Jersey  Entered:1999-07-30, 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: heart medicine
Current Illness:
Preexisting Conditions: arthritis; hypertension
Diagnostic Lab Data:
CDC 'Split Type': 1999010988
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0 LA
Administered by: Other     Purchased by: Other
Symptoms: Influenza, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: p/vax pt exp flu-like symptoms & tingling in different areas of the body; tx: w/aspirin & resolved in 2-3 days;

VAERS ID:126684 (history)  Vaccinated:1999-04-07
Age:53.0  Onset:1999-04-09, Days after vaccination: 2
Gender:Female  Submitted:1999-06-04, Days after onset: 56
Location:New Jersey  Entered:1999-07-30, Days after submission: 56
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: depression; panic attacks; anxiety, respiratory disease, breast disease (microcalcifications), chronic hand pain secondary to sewing which stopped when patient stopped sewing, thoracic spine scoliosis, arthritis, tubal ligation (1981), possible osteoporosis, left knee skiing injury, bone deformity (thenar eminences), unspecified distal interphalangeals deformity and 36-pound weight change. Patient has been a smoker (one pack per day for 42 years; sometimes did not smoke and used nicotine gum, patch or inhaler instead). The vaccinee had run all her life; reported ran only short distances. PREMARIN, CYORIN, KlLONOPIN, aspirin, PREMPRO, glucosamine/chondroitin and PAMELOR The vaccinee has no drug allergies. Follow up received 7/01. Left breast
Diagnostic Lab Data: 12 April 2000 bilateral mammogram: Impression: There was no evidence of malignant disease or of significant interval change since May 1999. Because of the history of severe left breast pain, the possibility of radiographically occult cysts, for example cannot be excluded due to the dense paronchymal pattern and if symptoms persisted, an ultrasound study might be useful to further evaluate the breast. Continued annual mammographic screening was advised. May 12, 1999 sonohysterogram: There was a focal area of altered echogenicity in the posterior aspect of the fundus measuring roughtly 2.0 x 2.0 x 1.8 cm, most consistent with a leiomyoma. The known posterior leiomyoma did not seem to create a contour deformity of the intrauterine cavity as
CDC 'Split Type': 19990128021
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1UNUN
Administered by: Public     Purchased by: Other
Symptoms: Arthritis, Asthenia, Dyspepsia, Headache, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Arthritis (narrow)
Write-up: p/vax pt c/o weight loss; arthritis symptoms; h/a; tiredness & upset stomach; took ADVIL; it helped a little; Medical record of April 27, 1999 noted that the patient complained of pain in both breasts. The diagnosis was "rule out breast mass". April 3, 2000 medical record noted "lumpy left breast". The vaccinee was diagnosed with "rule out breast mass" and PREMPRO was prescribed. May 2, 2000 physical therapy note: The vaccinee complained of pain in both hands, lumbar spine, both hips, both feet, toes, callus muscles, adn forearm muscles. Patient also had a "constant" headache and weak grip. The vaccinee stated that these symptoms were caused by "medication". The vaccinee had positive myofascial restrictions, normal upper and lower extremity range of motion, and normal ankle strength. May 30, 2000 physical therapy report: the vaccinee received six sessions of physical therapy. Treatment protocol consisted of soft tissue techniques, range of motion, stretching, moist heat, "E-stim", paraffin to bilateral hands, home exercise program, and a comprehensive stretching and strengthening pool program. At discharge, the vaccinee reported good/bad days. Pain complaints fluctuated in intensity and region. Objectively, active range of motion was normal throughout all tested regions. Gross strength was within functional limits. Special testing revealed scoliosis. Myofascial restrictions were significant throughout T/&/L/S (thoracic and lumbar spine) At discharge, the vaccinee was encouraged to manage her condition with stretching and strengthening, including a pool program. It was recommended that patient perform light impact activities, i.e. walking, swimming, for cardiovascular fitness. Recommendation: discharge with home exercises program. June 29, 2000 medical record noted"vaginal lump". The vaccinee was diagnoses with left Bartholin abscess and underwent marsupialization of the left Bartholin abscess on July 1, 2000. The patient tolerated the procedure well. The Bartholin biopsy abscess showed "fragments of fibroconnective tissue with acute and chronic inflammation; no epithelial lining seen." Please note that the events of "lumpy breast mass" and "Bartholin abscess" were not reported as adverse events due to vaccine administration, but were found during the course of review of the patient''s health records. Therefore they are not listed as adverse events. As of June 12, 2001, the outcome of the events is unknown. The adverse events of ''headache'' and ''osteoarthritis'' do not meet ICN serious criteria, but are being submitted as an expedited report by special FDA request per the June 28, 2000 letter. Follow up received 7/2001.

VAERS ID:126693 (history)  Vaccinated:1999-04-30
Age:53.0  Onset:1999-05-25, Days after vaccination: 25
Gender:Female  Submitted:1999-06-08, Days after onset: 14
Location:Iowa  Entered:1999-07-30, Days after submission: 52
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp arm pain inj site @ age 53yr w/dose 1 lymerix;
Other Medications: Vitamins
Current Illness:
Preexisting Conditions: uterine fibroids
Diagnostic Lab Data:
CDC 'Split Type': 1999013206
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1 A
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Injection site pain, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: p/vax pt exp extreme fatigue;approx 25 days later pt exp heavy vaginal bleeding;LoOvral given as tx;vaginal bleeding lasted 4 days & fatigue resolved;

VAERS ID:126694 (history)  Vaccinated:1999-04-30
Age:53.0  Onset:1999-04-30, Days after vaccination: 0
Gender:Male  Submitted:1999-06-08, Days after onset: 39
Location:Iowa  Entered:1999-07-30, Days after submission: 52
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp sore arm @ injsite w/#1 Lymerix;
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 1999013220
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1 A
Administered by: Other     Purchased by: Other
Symptoms: Asthenia
SMQs:, Guillain-Barre syndrome (broad)
Write-up: p/vax pt exp extreme fatigue;no tx given;

VAERS ID:126708 (history)  Vaccinated:1999-05-24
Age:53.0  Onset:1999-05-26, Days after vaccination: 2
Gender:Male  Submitted:1999-06-10, Days after onset: 15
Location:New York  Entered:1999-07-30, Days after submission: 50
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C;Multivitamin;Calcium;
Current Illness:
Preexisting Conditions: environmental allergies such as grass;
Diagnostic Lab Data:
CDC 'Split Type': 1999013459
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0 LA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Diarrhoea, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: p/vax pt devel a fever which reached 102.2 5/27/99;6/26/99 exp severe chills & diarrhea;tx w/APAP;lymerix was discontinued;pt condition is ongoing;

VAERS ID:126712 (history)  Vaccinated:0000-00-00
Age:53.0  Onset:0000-00-00
Gender:Unknown  Submitted:1999-06-11
Location:Wisconsin  Entered:1999-07-30, Days after submission: 49
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: Crohn''s Disease
Diagnostic Lab Data:
CDC 'Split Type': 1999013560
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0  
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia, Pain, Vasodilatation
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: p/vax pt exp inflammation of soles of the feet w/burning & redness;pt had great distress walking & could not wear shoes;

VAERS ID:126719 (history)  Vaccinated:1999-04-26
Age:53.2  Onset:1999-05-17, Days after vaccination: 21
Gender:Female  Submitted:1999-06-15, Days after onset: 29
Location:New York  Entered:1999-07-30, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp pain site arm, chills, fever w/lymerix #1 @ age 53
Other Medications: Synthroid;Calcium;
Current Illness:
Preexisting Conditions: Hypothyroid, Lyme Disease, Migraines, Osteopenia;
Diagnostic Lab Data: 6/7/99 urine cult negative;5/19/99 HGB 11;HCT 31;NEUTB 7;LYMPH 2;MONO 20;6/7/99 HGB 11.6;WBC 4.7;
CDC 'Split Type': 1999013698
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1  
Administered by: Other     Purchased by: Other
Symptoms: Adverse drug reaction, Anaemia, Asthenia, Dehydration, Haematuria, Infection, Injection site pain, Laboratory test abnormal, Myalgia, Pyrexia, Similar reaction on previous exposure to drug, Urine analysis abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)
Write-up: p/vax pt exp fever, chills & severe pain in inj site arm;pt w/fever & intermittent chills;T100 tympanic;also cough, body aches, fatigue & feeling dry;blood & leucocytes in urine & urine cult showed E-coli $g100,000;tx w/cipro & keflex;

VAERS ID:126967 (history)  Vaccinated:1999-07-23
Age:53.8  Onset:1999-07-23, Days after vaccination: 0
Gender:Female  Submitted:1999-07-28, Days after onset: 5
Location:Maryland  Entered:1999-08-06, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: ASA, premaria, fosomax, cycria
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: n/a
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM596C61IMA
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Face oedema, Oedema peripheral, Pruritus, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: p/vax pt took ASA; pt ate black cherry ice cream cone;had dinner salad w/strawberries, wlanuts, blue cheese, poppy seed dressing, merlot;pt devel itching, swelling hands, lips; vomiting; diarrhea

VAERS ID:127079 (history)  Vaccinated:1999-06-06
Age:53.1  Onset:1999-06-06, Days after vaccination: 0
Gender:Male  Submitted:1999-07-27, Days after onset: 51
Location:Ohio  Entered:1999-08-10, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to sulfa drugs
Diagnostic Lab Data: eval @ allergy/immunology clinic w/skin test;advised to take H1& H2 antihistamine prior, during & p/vax;
CDC 'Split Type':
Vaccination
Manufacturer
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Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0412SC 
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: hives over neck & upper chest w/gen pruritus less than 2hr p/vax;

VAERS ID:127406 (history)  Vaccinated:1999-06-18
Age:53.4  Onset:1999-07-18, Days after vaccination: 30
Gender:Female  Submitted:1999-08-16, Days after onset: 29
Location:Massachusetts  Entered:1999-08-19, Days after submission: 3
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt, flu; age 43; almost same sx
Other Medications: premarin; provera; clonozapaim; vitamins; calcium
Current Illness: none
Preexisting Conditions: food allergies (fish, cottonseed oil), soy extractin
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM   RA
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES 1 LA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: p/vax pt devel large area on arm 12'''' long x 4" wide, raised bumpy, red, hot, itchy; tx: prednisone; lasting 5 to 8 weeks;

VAERS ID:127650 (history)  Vaccinated:1999-05-04
Age:53.0  Onset:1999-05-06, Days after vaccination: 2
Gender:Female  Submitted:1999-06-17, Days after onset: 42
Location:Idaho  Entered:1999-08-26, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin;Provera;Synthroid;Prilosec
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': ID99010
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2720C60IMLA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM572A60IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0960580 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Influenza, Lymphadenopathy, Myalgia, Myasthenic syndrome, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Malignancy related conditions (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: weakness in lt arm which was still sore 1-2 days later;aching joints & muscles over entire body (felt like flu);by 4th day it was still sore under lt arm & axillary lymph nodes were still sore;6/17/99 still sore when lifts arm;

VAERS ID:128293 (history)  Vaccinated:1999-08-25
Age:53.0  Onset:1999-08-25, Days after vaccination: 0
Gender:Male  Submitted:1999-08-25, Days after onset: 0
Location:California  Entered:1999-09-15, 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM598A6  RA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.P03022 SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7258BA  LA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESP14263  LA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES7372AA0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site oedema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: p/vax p/removing needle site began to swell, noted bleeding @ inj site - pressure applied then ice to site, swelling decreased p/10min;

VAERS ID:128490 (history)  Vaccinated:1999-08-08
Age:53.0  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:Oregon  Entered:1999-09-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none~~ ~~In patient
Other Medications: anthrax, 1st & 2nd, 7/10/99 & 7/22/99
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER 2  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Injection site pain, Paraesthesia, Thinking abnormal, Vasodilatation
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: p/vax pt exp burning at inj point; hands alternately numb & tingling; felt hot; all joints x/knees & ankles;pt knees & fingers sore; felt spacey; all symptoms went away w/in 36 hr

VAERS ID:128507 (history)  Vaccinated:1999-08-26
Age:53.8  Onset:1999-08-26, Days after vaccination: 0
Gender:Male  Submitted:1999-09-15, Days after onset: 20
Location:California  Entered:1999-09-27, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: n/a
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Diagnostic Lab Data: n/a
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0433SC 
Administered by: Military     Purchased by: Military
Symptoms: Pain, Skin nodule, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: p/vax pt devel knot approx size of ping pong ball; extremely sore; some redness; lasted 4 days

VAERS ID:128508 (history)  Vaccinated:1999-04-05
Age:53.1  Onset:1999-04-15, Days after vaccination: 10
Gender:Male  Submitted:1999-09-17, Days after onset: 155
Location:Connecticut  Entered:1999-09-27, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: RA , ANA & LYME-neg;C1Q binding assay; C reactive proten; ehrlichiosis-neg; Hemagram, differential, absolute differential, morphology-nl; manual hematology-sed rate; electrolytes;chemistry;serology-neg
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120B90IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Headache, Hypokinesia
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: pt exp h/a of inc severity; knee pain of inc severity; now limiting ability to walk;

VAERS ID:128515 (history)  Vaccinated:1999-08-19
Age:53.5  Onset:1999-08-19, Days after vaccination: 0
Gender:Female  Submitted:1999-08-25, Days after onset: 6
Location:New York  Entered:1999-09-27, Days after submission: 33
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: Meniere''s Disease, allergic to PCN & Demerol
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.PMP09993IMLA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Ecchymosis, Influenza, Injection site hypersensitivity, Injection site mass, Myalgia, Pruritus, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: p/vax pt devel some flu-like sx, body aches & chills which started about 7:30PM on 8/19/99 lasted all noc;8/20/99 in AM felt fine;a small bruise noted on lt arm below site of infect;also states arm @ inj site very itchy & redness also hot;

VAERS ID:128522 (history)  Vaccinated:1999-07-30
Age:53.6  Onset:1999-08-08, Days after vaccination: 9
Gender:Female  Submitted:1999-08-27, Days after onset: 19
Location:Florida  Entered:1999-09-27, 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: PPD by PMC lot# 251011 given 6/14/99;
Current Illness: NONE
Preexisting Conditions: codeine, ampicillin, Ibuporfen, compazine;
Diagnostic Lab Data: ANA, CBC
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1170H SCLA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: p/vax pt devel lt thumb pain which was warm & tender;sx progressed to pain in lt wrist on 8/15/99 & then on 8/16 to rt wrist & lt knee;generally feels achy & sore;tx celebrex & pred;referred to MD;

VAERS ID:128569 (history)  Vaccinated:1999-06-30
Age:53.7  Onset:1999-07-01, Days after vaccination: 1
Gender:Female  Submitted:1999-09-18, Days after onset: 79
Location:New York  Entered:1999-09-27, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi Vitamin, estra tab, Acyclovir, Vit E, Citrical
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: elevated sed rate (42);auto-immuen tests negative (RA, anti DNa, etc);CBC, Chem nl;negative for GBS;
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Myalgia, Neuropathy, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: p/vax arthralgia & myalgia starting in spine, migrating large upper legs muscles, knees, shoulders, wrists & hands;?nerve connection;pain has been somewhat managed by Ibuprofen, now Celebrex currently in shoulders-hands;

VAERS ID:128788 (history)  Vaccinated:1999-09-08
Age:53.0  Onset:1999-09-08, Days after vaccination: 0
Gender:Female  Submitted:1999-09-10, Days after onset: 2
Location:Virginia  Entered:1999-09-30, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': VA99047
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7301BA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: p/vax next morning entire upper arm firm, warm to touch, red & swollen;remains itchy;hot & swollen 2 days later;

VAERS ID:128856 (history)  Vaccinated:0000-00-00
Age:53.0  Onset:1999-09-26
Gender:Male  Submitted:1999-09-30, Days after onset: 4
Location:Utah  Entered:1999-10-04, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prilosec
Current Illness: NONE
Preexisting Conditions: GERD, ulcerative colitis
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Injection site oedema, Injection site pain, Myalgia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: systemic weak, shaky, myalgias, local tender, marked swelling;

VAERS ID:128907 (history)  Vaccinated:1999-07-16
Age:53.7  Onset:1999-07-16, Days after vaccination: 0
Gender:Male  Submitted:1999-10-01, Days after onset: 77
Location:Arizona  Entered:1999-10-05, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER453800 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis
SMQs:
Write-up: p/vax pt devel cellulitis (arm) required oral ATB intervention & ER visit;

VAERS ID:128973 (history)  Vaccinated:1999-07-16
Age:53.7  Onset:1999-07-16, Days after vaccination: 0
Gender:Male  Submitted:1999-10-01, Days after onset: 77
Location:Arizona  Entered:1999-10-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER453800 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis
SMQs:
Write-up: pt devel cellulitis/arm;required oral ATB intervention & ER visits;

VAERS ID:129362 (history)  Vaccinated:1999-09-28
Age:53.4  Onset:1999-09-28, Days after vaccination: 0
Gender:Male  Submitted:1999-09-29, Days after onset: 1
Location:Florida  Entered:1999-10-14, Days after submission: 15
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: semi achey, tired
Preexisting Conditions: NKA, NONE
Diagnostic Lab Data: NA
CDC 'Split Type': FL99033
Vaccination
Manufacturer
Lot
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Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.914504IMRA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: c/o fever 103.4, chills, sweating, weakness, sl dizziness, nausea w/o vomiting, pain in hands & legs p/vax;denies stiff neck;

VAERS ID:129442 (history)  Vaccinated:1999-07-11
Age:53.0  Onset:1999-07-11, Days after vaccination: 0
Gender:Male  Submitted:1999-09-24, Days after onset: 75
Location:Massachusetts  Entered:1999-10-18, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0410 RA
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES0939440090 LA
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Headache, Injection site hypersensitivity, Injection site mass, Injection site oedema, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: immed area of inj site was hot & swollen;the next day;7/12/99 feverish, stomach-cramped & became very fatigued;knot in arm is still there;

VAERS ID:129443 (history)  Vaccinated:1999-07-25
Age:53.0  Onset:1999-07-25, Days after vaccination: 0
Gender:Male  Submitted:1999-09-28, Days after onset: 65
Location:Massachusetts  Entered:1999-10-18, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0411 LA
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Asthenia, Headache, Injection site hypersensitivity, Injection site oedema, Skin discolouration, Skin nodule, Vasodilatation
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (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), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Immediate injection site became feverish and swollen. Arm doubled in diameter and was very red and hot. Feverish, stomach cramping, fatigue accompanied with severe headaches for seven days. The knot in my arm is still blue after over 2 months. Fatigue was severe and I needed 9 hours sleep to overcome.

VAERS ID:129478 (history)  Vaccinated:1999-10-15
Age:53.5  Onset:1999-10-15, Days after vaccination: 0
Gender:Female  Submitted:1999-10-15, Days after onset: 0
Location:Texas  Entered:1999-10-18, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: nasal spray;
Current Illness: sinus congestion
Preexisting Conditions: pt mom allergic to eggs;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982801IMLA
Administered by: Other     Purchased by: Private
Symptoms: Hyperventilation, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: onset of rashes noted on both cheeks & neck;feels hot;no resp problems;no itching;given DPH;P80;RR 22;

VAERS ID:129549 (history)  Vaccinated:1999-09-22
Age:53.1  Onset:1999-09-23, Days after vaccination: 1
Gender:Female  Submitted:1999-10-15, Days after onset: 22
Location:Illinois  Entered:1999-10-19, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Public     Purchased by: Private
Symptoms: Dermatitis bullous, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: red bumpy dots, ovals w/yellow centers that itchy back, chest, arms, legs & buttocks since 9/23/99;pt still has rash;

VAERS ID:129622 (history)  Vaccinated:1999-10-15
Age:53.9  Onset:1999-10-18, Days after vaccination: 3
Gender:Female  Submitted:1999-10-20, Days after onset: 2
Location:Minnesota  Entered:1999-10-21, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NA
Preexisting Conditions: hayfer
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0128AA0IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: p/vax pt had T100.6 & c/o bodyaches;on 10/19/99 pt felt worsened & sent to see family MD;MD advised pt was having adverse rxn to shot;

VAERS ID:129713 (history)  Vaccinated:1999-09-30
Age:53.8  Onset:1999-10-01, Days after vaccination: 1
Gender:Female  Submitted:1999-10-15, Days after onset: 14
Location:Iowa  Entered:1999-10-22, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: denies
Current Illness: sinus infect
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': IA99026
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3132A60IMLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Arthritis (broad)
Write-up: 10/1 less than 24hr later red raised rash bilat, wrists, spreading up arms & now on entire body as of 10/15/99;also c/o severe aching bilat knee joints;referred to MD;

VAERS ID:129723 (history)  Vaccinated:1999-10-12
Age:53.6  Onset:1999-10-12, Days after vaccination: 0
Gender:Female  Submitted:1999-10-20, Days after onset: 8
Location:California  Entered:1999-10-22, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: PCN, sodiumBenzoate, Food preservative;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Amblyopia, Asthenia, Dizziness, Headache, Influenza, Injection site hypersensitivity, Injection site oedema, Injection site pain, Laryngospasm, Pain, Paraesthesia, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Optic nerve disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: extreme pain in arm where shot given red, swelling, pain across entire arm-back-other arm;h/a, crawly skin, legs felt semi paralyzed;T102 & fatigue, dizzy, flu sx, congestion, swollen throat, blurred vision;

VAERS ID:129757 (history)  Vaccinated:1999-10-02
Age:53.2  Onset:1999-10-10, Days after vaccination: 8
Gender:Male  Submitted:1999-10-14, Days after onset: 4
Location:Oregon  Entered:1999-10-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0411SCLA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Headache, Nausea, Pyrexia, Rhinitis
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: nausea x 72hr;aching joints;stated temp x 24hr;congestion;moderate to severe h/a;

VAERS ID:129851 (history)  Vaccinated:1999-10-02
Age:53.3  Onset:1999-10-03, Days after vaccination: 1
Gender:Male  Submitted:1999-10-13, Days after onset: 10
Location:Tennessee  Entered:1999-10-26, 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: Claritin D quit Flonase 2wk prior to shot
Current Illness: NONE
Preexisting Conditions: cyst in lt sinus & seasonal allergies;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0430SCRA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Myalgia, Rash, Skin nodule
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Nodule p/1st shot lasted 2-3 days & resurfaced 7 days later w/rash around pt neck;muscle & joint pain that lasted approx 36hr;

VAERS ID:129939 (history)  Vaccinated:1999-10-12
Age:53.5  Onset:1999-10-12, Days after vaccination: 0
Gender:Female  Submitted:1999-10-14, Days after onset: 2
Location:Virginia  Entered:1999-10-26, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: mitral value prolapse, allergy shots0bordust, molds, trees, grasses;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02089P7 RA
Administered by: Public     Purchased by: Private
Symptoms: Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad)
Write-up: rapid heartbeat-6hrs;12midnight 12/12/99 to 6AM 12/13/99;

VAERS ID:129969 (history)  Vaccinated:1999-10-21
Age:53.9  Onset:1999-10-21, Days after vaccination: 0
Gender:Female  Submitted:1999-10-21, Days after onset: 0
Location:Ohio  Entered:1999-10-26, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: dust
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0150AA0 RA
Administered by: Other     Purchased by: Public
Symptoms: Chills, Hyperhidrosis, Malaise
SMQs:, Neuroleptic malignant syndrome (broad)
Write-up: cold, clammy, felt faint;wanted to lie down;unable to get BP;epi given;rescue called;palpated BP 88/-;refused transfer;pt stated always feels like will pass out w/any shot;

VAERS ID:130267 (history)  Vaccinated:1999-10-07
Age:53.5  Onset:1999-10-08, Days after vaccination: 1
Gender:Female  Submitted:1999-11-02, Days after onset: 25
Location:Ohio  Entered:1999-11-03, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0136AA1IMRA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Conjunctivitis, Cough, Injection site hypersensitivity, Injection site oedema, Lacrimal disorder, Rhinitis, Vasodilatation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow)
Write-up: p/vax draining clear & redness in both eyes;chills, cough, congestion w/yellow;heat @ inj site;redness, swelling @ inj site;

VAERS ID:130784 (history)  Vaccinated:1999-11-01
Age:53.5  Onset:1999-11-02, Days after vaccination: 1
Gender:Female  Submitted:1999-11-10, Days after onset: 8
Location:California  Entered:1999-11-15, 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: multiple sclerosis;
Preexisting Conditions: multiple sclerosis;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0046AA2 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1692H SCLA
Administered by: Public     Purchased by: Public
Symptoms: Oedema, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: redness, edematous;

VAERS ID:130785 (history)  Vaccinated:1999-10-29
Age:53.7  Onset:1999-11-08, Days after vaccination: 10
Gender:Female  Submitted:1999-11-11, Days after onset: 3
Location:South Carolina  Entered:1999-11-15, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0928J0SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Arthralgia, Face oedema, Lymphadenopathy, Pharyngitis, Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: started w/achy joints, swollen gland especially behind lt ear;rash started on face down neck, chest, arms-fever, sore throat;rash spread, itchy, eyes swollen;saw MD;

VAERS ID:130824 (history)  Vaccinated:1999-09-20
Age:53.2  Onset:1999-09-22, Days after vaccination: 2
Gender:Male  Submitted:1999-11-02, Days after onset: 41
Location:Minnesota  Entered:1999-11-15, Days after submission: 13
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: GERD, migraine h/a;
Diagnostic Lab Data: NONE
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU001DAA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypertonia, Injection site hypersensitivity, Injection site oedema, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), 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), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: p/vax whole body very sore & stiff day 2-3 p/vax;day 5 pt 1st noticed a sl swollen 2" red area;stated did not have redness prior to this day;sore & stiff body gone p/2 days;

VAERS ID:130965 (history)  Vaccinated:1999-10-06
Age:53.2  Onset:1999-10-06, Days after vaccination: 0
Gender:Female  Submitted:1999-10-13, Days after onset: 7
Location:Ohio  Entered:1999-11-22, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: unk
Diagnostic Lab Data: unk
CDC 'Split Type': FLU1081099
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02779P0 LA
Administered by: Other     Purchased by: Other
Symptoms: Oedema, Pain, Rash, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt devel redness, edema, warmth & pain shooting up shoulder & down arm, erythema from 15025mm reported by school nurse;

VAERS ID:130968 (history)  Vaccinated:1999-10-06
Age:53.2  Onset:1999-10-06, Days after vaccination: 0
Gender:Male  Submitted:1999-11-05, Days after onset: 30
Location:Ohio  Entered:1999-11-22, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: unk
CDC 'Split Type': FLU1111199
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS0277P0 LA
Administered by: Other     Purchased by: Unknown
Symptoms: Oedema, Pain, Rash, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt devel redness, edema, warmth & pain shooting up shoulder & down arm;erythema from 15-25mm;

VAERS ID:131022 (history)  Vaccinated:1999-11-04
Age:53.2  Onset:1999-11-05, Days after vaccination: 1
Gender:Female  Submitted:1999-11-09, Days after onset: 4
Location:Washington  Entered:1999-11-22, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: APAP;Zyrtex;Pempro
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3066A41IMRA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash, Skin discolouration, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: p/vax woke up w/itching all over body;itching cont through 11/6/99;on 11/7/99 itching improved but noticed a sl reddened rash on upper chest & mottled appearing skin on both arms;11/8//99 s/s almost gone;11/9/99 s/s gone;took DPH;

VAERS ID:132035 (history)  Vaccinated:1999-11-12
Age:53.0  Onset:1999-11-12, Days after vaccination: 0
Gender:Female  Submitted:1999-11-30, Days after onset: 18
Location:Unknown  Entered:1999-12-03, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC 'Split Type': 19990311721
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2935A40  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypertension, Malaise
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow)
Write-up: Hypertensive Crisis, (BP not provided) pt. sent to ER room. Pt recv. unspecified medical intervention and was released after six hours. It was reported that sx resolved but pt. felt "lousy" during the following week.

VAERS ID:132543 (history)  Vaccinated:1999-10-06
Age:53.0  Onset:1999-10-06, Days after vaccination: 0
Gender:Female  Submitted:1999-12-09, Days after onset: 64
Location:Oklahoma  Entered:1999-12-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide Hyzaar
Current Illness: NONE
Preexisting Conditions: Multiple allergies:smoke, grass, cat hair, and yeast
Diagnostic Lab Data: chest x-ray:negative and Oxy. Sat. was 100%
CDC 'Split Type': 2046111OCT
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982300IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: A pharmacist reported that an employee received an injection of Flu Shield(1999-2000 Formula)on 10/6/99 and subsquently developed resp distress 4.5 hrs after immunization. Pt. received oxy.,IV Benadryl, IV SoluMedrol, and SC epinephrine.

VAERS ID:132571 (history)  Vaccinated:1999-07-11
Age:53.7  Onset:1999-07-11, Days after vaccination: 0
Gender:Male  Submitted:1999-11-27, Days after onset: 139
Location:New York  Entered:1999-12-15, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0432SCRA
Administered by: Military     Purchased by: Unknown
Symptoms: Adverse drug reaction, Asthenia, Headache, Injection site hypersensitivity, Injection site mass, Myalgia, Pharyngitis, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: 6/11/99 was fatigued, weak, headach, lump on arm, nausea; 6/24/99 weak, fatigued, all bones ached, lump on arm; 7/11/99 headache, sore throat, large rash on neck w/in 1 hr of shot, lasted 2 weeks, raspberry type rash still persists.

VAERS ID:132059 (history)  Vaccinated:1999-11-24
Age:53.7  Onset:1999-11-26, Days after vaccination: 2
Gender:Female  Submitted:1999-11-29, Days after onset: 3
Location:New Jersey  Entered:1999-12-28, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bactrim, prednisone
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CBC - (WBC 5.8), Blood Culture
CDC 'Split Type':
Vaccination
Manufacturer
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.148350IMLA
Administered by: Public     Purchased by: Other
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site pain, Injection site reaction, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Check out 17 x 9 cm of reddness, erythema, warm to touch, tender in LUD. Dx - Cellulitis

VAERS ID:132071 (history)  Vaccinated:1999-11-26
Age:53.2  Onset:1999-11-26, Days after vaccination: 0
Gender:Male  Submitted:1999-12-01, Days after onset: 5
Location:Massachusetts  Entered:1999-12-28, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Dyspnoea, Palpitations, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Heart palpitations, dizziness, heavy breathing, fell off of chair, unconscious for about 5 seconds.

VAERS ID:132100 (history)  Vaccinated:1999-10-19
Age:53.6  Onset:1999-10-19, Days after vaccination: 0
Gender:Female  Submitted:1999-11-01, Days after onset: 13
Location:Vermont  Entered:1999-12-28, Days after submission: 57
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor,albuterol,Xanax,prednisone,Ambien
Current Illness: NONE
Preexisting Conditions: asthma,hypertension,elevated cholestrol,MVP,osteoarthritis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS03179P0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Back pain, Chills, Injection site hypersensitivity, Injection site mass, Neck pain, Vasodilatation
SMQs:, Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: By 4p on 10/19/99, pt had a raised,bright red welt approx 2" x 3" in diam;hot to the touch at inj. site,neck,shoulder, & lower back pain w/ accompying chills.The next day,sx worsened.Tx w/ Benadryl & cephalexin.

VAERS ID:132795 (history)  Vaccinated:1999-12-17
Age:53.1  Onset:1999-12-17, Days after vaccination: 0
Gender:Female  Submitted:1999-12-21, Days after onset: 4
Location:Puerto Rico  Entered:1999-12-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pt dvlped a rash following a flu shot when he was 52.
Other Medications: Prim-Pro, Flexeril
Current Illness: NONE
Preexisting Conditions: cervical back pain
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998238 IMRA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES459041 IMLA
Administered by: Private     Purchased by: Public
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Itching all over trunk,arms, & hands w/ red sunburn like rash,onset 9p on 12/17/99.Tx on 12/18 w/ oral Benadryl w/ no relief.Cont''d Benadryl thru 12/20 w/ no abatement of symptoms.Seen by MD who plans Decadron therapy.

VAERS ID:131780 (history)  Vaccinated:1999-11-12
Age:53.7  Onset:1999-11-13, Days after vaccination: 1
Gender:Female  Submitted:1999-11-15, Days after onset: 2
Location:New York  Entered:1999-12-29, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Anibiotics, Zocor, Premarin, Cardizem, Asmacort, PPD Provventil inh
Current Illness: NONE
Preexisting Conditions: PCN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Public     Purchased by: Other
Symptoms: Pain, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Arm was sore initially. Around 4:00 on 11/13/99, redness, warmth and itching began, progressively worsening until pt came to ER to seek treatment.

VAERS ID:131920 (history)  Vaccinated:1999-11-12
Age:53.2  Onset:1999-11-15, Days after vaccination: 3
Gender:Female  Submitted:1999-11-23, Days after onset: 8
Location:Maryland  Entered:1999-12-29, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02289P0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Asthenia, Eye pain, Pain
SMQs:, Guillain-Barre syndrome (broad), Glaucoma (broad), Arthritis (broad)
Write-up: 11/12, sore arm. 11/15, aching joints, tiredness & eyes hurt. No knowledge of temp. 11/16, felt better during the am, but sx''s reoccurred in the evening, to a lesser degree. Aching joints, hips, wrist, knees-more at night. 11/21,felt normal

VAERS ID:132883 (history)  Vaccinated:1999-11-15
Age:53.0  Onset:1999-11-15, Days after vaccination: 0
Gender:Female  Submitted:1999-12-20, Days after onset: 35
Location:Unknown  Entered:1999-12-29, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0432 LA
Administered by: Military     Purchased by: Public
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt has lump at injection site.

VAERS ID:133033 (history)  Vaccinated:1999-11-05
Age:53.3  Onset:1999-11-12, Days after vaccination: 7
Gender:Male  Submitted:1999-11-23, Days after onset: 11
Location:Oklahoma  Entered:2000-01-05, Days after submission: 43
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': OK9960
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02089P0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pain in arm & R/hand 1 wk after injection to date reported 11/23/99. Injection given 11/5/99. Also, noticed a knot at injection site, 7x7mm hard knot on R/upper arm, warm to touch.

VAERS ID:132496 (history)  Vaccinated:0000-00-00
Age:53.0  Onset:1999-10-26
Gender:Female  Submitted:1999-12-01, Days after onset: 36
Location:California  Entered:2000-01-06, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tagamet
Current Illness: N/A
Preexisting Conditions: Hay fever in spring
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Approx 24 hrs post vax, inject site had 3" raised circle red, hot to touch, itched. Lasted about 5 days with gradual to normal.

VAERS ID:133142 (history)  Vaccinated:1999-10-13
Age:53.2  Onset:1999-10-14, Days after vaccination: 1
Gender:Female  Submitted:1999-11-22, Days after onset: 39
Location:Georga  Entered:2000-01-07, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: EKG-normal sinus rhythm,WBC-12.1,hemoglobin-13.3,platlets-288,000
CDC 'Split Type': GA99181
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER03179P0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0042J IMLA
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Chest pain, Hypertension, Leukocytosis, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad)
Write-up: Immunized 10/13/99, pt developed swelling of l/arm that evening. 10/14/99, pt had l/arm swelling, fever & chest pain. Went to clinic, BP 200/168, called ambulance, pt hospitalized in ICU. BP under control, swelling in arm decreased.

VAERS ID:133421 (history)  Vaccinated:1999-11-03
Age:53.0  Onset:1999-11-15, Days after vaccination: 12
Gender:Female  Submitted:2000-01-11, Days after onset: 57
Location:California  Entered:2000-01-24, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Ct scan - normal, scope in larynx - normal
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998252 IM 
Administered by: Private     Purchased by: Private
Symptoms: Guillain-Barre syndrome, Vocal cord paralysis
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Demyelination (narrow)
Write-up: paralized vocal cord (Guillain Barre Syndrome)

VAERS ID:133554 (history)  Vaccinated:1999-10-18
Age:53.0  Onset:1999-10-21, Days after vaccination: 3
Gender:Female  Submitted:2000-01-23, Days after onset: 94
Location:Mississippi  Entered:2000-02-01, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Provera, Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Oedema, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Light-headed, few seconds. Red & swollen arm, three wks. No treatment by Dr.

VAERS ID:133590 (history)  Vaccinated:0000-00-00
Age:53.0  Onset:2000-01-19
Gender:Male  Submitted:2000-01-25, Days after onset: 6
Location:Unknown  Entered:2000-02-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergic: Toradol, Has Diabetes Type II
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1575H   
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER1692H IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction
SMQs:
Write-up: Local reaction to Pneumonia vaccine. Began 24 hrs after injection.

VAERS ID:133598 (history)  Vaccinated:1999-05-01
Age:53.0  Onset:1999-05-04, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:2000-02-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: Hepatitis C+
Preexisting Conditions: Allergic to Penicillin, Sulfa
Diagnostic Lab Data: 10/19/99, pain mgmt ctr consult, tentative dx of FM, recommendation of Psych.
CDC 'Split Type':
Vaccination
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Chills, Diarrhoea, Dyspnoea, Headache, Influenza, Myalgia, Nausea, Pain, Pyrexia, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Noninfectious diarrhoea (narrow)
Write-up: Within 3 days of vax, had "flu-like" illness, temp 102, diarrhea, nausea, ringing in ears, bodyaches everywhere; exacerbation of FM beyond bearing-extreme pain in hip, knees impeding walking. Had headache, 5/2, chills, aches.

VAERS ID:133545 (history)  Vaccinated:2000-01-20
Age:53.0  Onset:2000-01-20, Days after vaccination: 0
Gender:Male  Submitted:2000-01-20, Days after onset: 0
Location:Louisiana  Entered:2000-02-03, 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: Glyburide
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0310SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anxiety, Asthenia, Vasodilatation
SMQs:, Guillain-Barre syndrome (broad)
Write-up: Weakness, flushed for 20 minutes after injection, suspected anxiety.

VAERS ID:133684 (history)  Vaccinated:1999-10-26
Age:53.0  Onset:1999-10-26, Days after vaccination: 0
Gender:Female  Submitted:1999-10-28, Days after onset: 2
Location:Washington  Entered:2000-02-03, Days after submission: 98
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HRT
Current Illness: NONE
Preexisting Conditions: Allergy to Sulfa/hives
Diagnostic Lab Data: NONE
CDC 'Split Type': WA991608
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3066A40IMLA
Administered by: Private     Purchased by: Public
Symptoms: Oedema, Respiratory disorder, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Acute central respiratory depression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Subjective swelling of l/side of throat and sinus pressure. Later, 2 hives on l/shoulder. Rx Benadryl

VAERS ID:133739 (history)  Vaccinated:2000-01-18
Age:53.0  Onset:2000-01-19, Days after vaccination: 1
Gender:Male  Submitted:2000-01-25, Days after onset: 6
Location:Unknown  Entered:2000-02-03, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1585H   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site reaction
SMQs:
Write-up: Local reaction to Pneumonia vaccine. Began 24 hours post vaccine.

VAERS ID:133836 (history)  Vaccinated:1999-11-29
Age:53.0  Onset:1999-12-24, Days after vaccination: 25
Gender:Female  Submitted:2000-01-28, Days after onset: 35
Location:New York  Entered:2000-02-09, Days after submission: 12
Life Threatening? Yes
Died? Yes
   Date died: 2000-05-22
   Days after onset: 149
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Norvase, Dilantin
Current Illness: NONE
Preexisting Conditions: Seizure disorder, HTP
Diagnostic Lab Data: + CP and FMG
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0104AA IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0043J IMRA
Administered by: Private     Purchased by: Private
Symptoms: Cardiac arrest, Guillain-Barre syndrome
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (narrow), Cardiomyopathy (broad), Demyelination (narrow)
Write-up: Pt was dx w/ Guillian-Barre. Cause of death given as cardiac arrest.

VAERS ID:133917 (history)  Vaccinated:1999-09-22
Age:53.0  Onset:0000-00-00
Gender:Male  Submitted:2000-01-25
Location:Texas  Entered:2000-02-14, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lanoxin, Albuterol, Flovent
Current Illness: NONE
Preexisting Conditions: Supraventricular Tachycardia (past Hx) & Asthma
Diagnostic Lab Data: Nml ESR, CBC, Lytes. MRI of L/Spine & EMG both mildly abnormal but abnormalties not relevant to current illness.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998259 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Hypokinesia, Myalgia, Myasthenic syndrome, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Developed fever, myalgias & asthenia, 1 wk after Flu shot. This progressed to proximal muscle weakness & severe lwr extremity weakness. Extensive w/u "autoimmune myalgias". Pt has limited exercise & walking; still have sx''s after 3 mos.

VAERS ID:134057 (history)  Vaccinated:1999-10-02
Age:53.0  Onset:1999-10-02, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Michigan  Entered:2000-02-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LOPID
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0384UNUN
Administered by: Military     Purchased by: Military
Symptoms: Injection site inflammation, Injection site mass, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Large lump, redness/inflammation 3" across at injection site. Soreness, fever. Have been taking EXCEDRIN for fever & inflammation. Still experiencing as of 10/5/99.

VAERS ID:134397 (history)  Vaccinated:2000-02-14
Age:53.0  Onset:2000-02-14, Days after vaccination: 0
Gender:Female  Submitted:2000-02-18, Days after onset: 4
Location:Pennsylvania  Entered:2000-02-28, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Possible Allergy to PCN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0011AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: At site: reddened, itchy, hard and raised, covered entire upper arm.

VAERS ID:134385 (history)  Vaccinated:2000-02-04
Age:53.7  Onset:2000-02-06, Days after vaccination: 2
Gender:Female  Submitted:2000-02-15, Days after onset: 9
Location:Pennsylvania  Entered:2000-02-29, 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: Synthroid, Folic Acid, Calcium
Current Illness:
Preexisting Conditions: Hypothyroid, headaches
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4653124IMLA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: Pt developed a cellulitis at site of injection.

VAERS ID:134439 (history)  Vaccinated:1999-11-10
Age:53.0  Onset:1999-11-11, Days after vaccination: 1
Gender:Female  Submitted:2000-01-18, Days after onset: 68
Location:Indiana  Entered:2000-02-29, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ7688307DEC1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998260 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dyspepsia, Vasodilatation
SMQs:, Gastrointestinal nonspecific dysfunction (narrow)
Write-up: A nurse reported that a 53 year old female vaccinated on 11/10/1999, post vax, on 11/11/1999, she felt "sick to stomacn" and developed an injection site reaction characterized by a 3.5" circle of redness and warmth. The pt recovered.

VAERS ID:134553 (history)  Vaccinated:2000-02-22
Age:53.0  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:California  Entered:2000-03-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Not IU
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV043 SC 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Cough, Headache, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: Fever, sore joints, headache, runny nose, throat and cough. Follow up 06/05/2000: "Patient recovered from adverse event."

VAERS ID:134667 (history)  Vaccinated:1999-11-26
Age:53.0  Onset:1999-11-26, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:2000-03-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergic to Penicillin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0159AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis exfoliative, Oedema peripheral, Pruritus
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Swelling of feet and hands with itching skin. Desquamation of plantar area.

VAERS ID:150192 (history)  Vaccinated:0000-00-00
Age:53.0  Onset:0000-00-00
Gender:Male  Submitted:2000-02-29
Location:Oregon  Entered:2000-03-17, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  SC 
Administered by: Military     Purchased by: Military
Symptoms: Anorexia, Dizziness, Fatigue, Hypertension, Night sweats, Pain, Pyrexia, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (broad)
Write-up: Fever, night sweats, fatigue, aching, weight loss, dizziness, loss appetite, high blood pressure.

VAERS ID:150340 (history)  Vaccinated:1999-10-20
Age:53.0  Onset:1999-10-21, Days after vaccination: 1
Gender:Female  Submitted:1999-12-13, Days after onset: 53
Location:California  Entered:2000-03-23, Days after submission: 101
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac
Current Illness:
Preexisting Conditions: hx shoulder bursitis and calcifications
Diagnostic Lab Data: neck x-ray-disc space narrowing, posterior osteoprytic spurring.
CDC 'Split Type': U1999010160
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0130AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Bone disorder, Injection site pain, Joint range of motion decreased, Neck pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: It was reported that a female pt received a Fluzone vax on 10/20/99. Reportedly on 10/21/99, the pt developed pain at the injections site that radiated to the neck and arm. The pt also had a decreased range of motion. 1

VAERS ID:150401 (history)  Vaccinated:1999-10-11
Age:53.0  Onset:1999-10-12, Days after vaccination: 1
Gender:Male  Submitted:2000-03-15, Days after onset: 155
Location:Illinois  Entered:2000-03-24, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: cirrhosis of liver, benign hypertension, hx of injury
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES458744  RA
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt experienced redness with very slight heat at site of injection on right arm. It was apparently worse yesterday.

VAERS ID:150566 (history)  Vaccinated:1999-06-01
Age:53.0  Onset:1999-06-01, Days after vaccination: 0
Gender:Female  Submitted:2000-01-19, Days after onset: 232
Location:Massachusetts  Entered:2000-03-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Lab test for Lyme disease was positive in September, 1999.
CDC 'Split Type': 19990268361
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Headache, Laboratory test abnormal, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Three hours post vax, the pt experienced intense joint pain, headache, fever, occasional nausea and weakness. She continued to have joint pain on and off. Fever and nausea resolved. She took aspirin for the pain.

VAERS ID:150568 (history)  Vaccinated:1999-07-19
Age:53.0  Onset:1999-07-19, Days after vaccination: 0
Gender:Female  Submitted:2000-01-19, Days after onset: 184
Location:Massachusetts  Entered:2000-03-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa, Zantac
Current Illness:
Preexisting Conditions: chronic pain in neck and chest, depression, tinnitus
Diagnostic Lab Data: Lyme-neg, electrolytes-nml, TSH-nml, CBC-nml, ESR-nml, ANA-neg
CDC 'Split Type': 19990270541
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM16A21IMRA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Arthritis, Difficulty in walking, Muscle spasms, Musculoskeletal stiffness, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (narrow)
Write-up: Immediately following second dose of Lymerix, she experienced arthritis. On 8/17/99, at physician visit, she complained of a one month history of muscle aches, joint aches, etc. She also had a superimposed viral infection with some nausea and upset stomach, starting 8/16/99. Assessment: arthralgia (multiple sites). Dr stated it was possible the pt could have some sort of serum sickness response to the Lyme titer and a rheumatologic exam will be pursued. 9/2/99 Rheumatology consult: She has been treated by a chiropractor for many years due to pain in neck and chest caused by an automobile accident, with improvement. However, more recently, she has developed increasing symptoms of pain and stiffness in her neck, difficulty moving her neck and she awakens with pain and also has paresthesias in both arms. She has a lot of spasms in her neck and also her low back. In the mornings upon waking, she has a difficulty walking down stairs. Dx: arthralgia multiple sites, low back pain, neck pain. Rheumatologist stated that complaints of arthralgias appeared to be temporarily related to Lymerix. Another Dr visit assessment is that she is improving and treated her with Elavil and Doxycycline. The most recent information, received on 11/18/99, reports the condition of the pt is improving.

VAERS ID:150572 (history)  Vaccinated:1999-09-17
Age:53.0  Onset:1999-10-03, Days after vaccination: 16
Gender:Male  Submitted:2000-01-19, Days after onset: 108
Location:Pennsylvania  Entered:2000-03-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BP medications (nos)
Current Illness:
Preexisting Conditions: Hypertension
Diagnostic Lab Data:
CDC 'Split Type': 1999027511B
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthropathy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Joints do not bend well (joint disorder nos). Muscle soreness. Sixteen days post vax, pt experienced muscle soreness in legs. Additionally he found it difficult to bend his ankles, shoulders, and finger joints. He was treated with aspirin. He reported that symptoms were gone within the next week and he was back to normal again. Most recent information received on 11/30/99 reports the condition is resolved.

VAERS ID:150624 (history)  Vaccinated:2000-03-27
Age:53.0  Onset:2000-03-27, Days after vaccination: 0
Gender:Male  Submitted:2000-03-28, Days after onset: 1
Location:Texas  Entered:2000-03-31, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0411SCLA
Administered by: Military     Purchased by: Military
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Onset of facial numbness developed approximately immediately after the vaccine lasting for 1 day. Pt still feels residual tingling.

VAERS ID:150870 (history)  Vaccinated:1999-12-16
Age:53.0  Onset:1999-12-17, Days after vaccination: 1
Gender:Female  Submitted:2000-03-21, Days after onset: 95
Location:Michigan  Entered:2000-04-07, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergy to PCN, Sulfur, low blood sugar
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0881J1IM 
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (narrow)
Write-up: Pt complained of vertigo, light-headedness and spinning.

VAERS ID:151197 (history)  Vaccinated:2000-01-20
Age:53.0  Onset:2000-01-27, Days after vaccination: 7
Gender:Male  Submitted:0000-00-00
Location:Michigan  Entered:2000-05-03
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: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0319SCLA
Administered by: Other     Purchased by: Private
Symptoms: Hypoaesthesia, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Within 1 week, noted numbness and tingling in armpit and middle and ring finger left arm. Within 6 weeks, noted increase of weakness of lower left arm and weak left hand grasp. Occasional dropping of objects placed in left hand. Today, he feels some return of strength. Occaionally notices numbness and tingling of left armpit and fingers. Follow up 06/05/2000: "Patient partially recovered from adverse event. Numbness underarm in armpit area and numbness of ring finger some improvement in strength and grip."

VAERS ID:151774 (history)  Vaccinated:1999-04-28
Age:53.0  Onset:0000-00-00
Gender:Male  Submitted:2000-05-04
Location:New York  Entered:2000-05-09, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120F91IM 
Administered by: Private     Purchased by: Other
Symptoms: Joint stiffness, Pain
SMQs:, Arthritis (broad)
Write-up: Developed increased pain and stiffness in hands, approximately 2 months, post vax. No treatment for symptoms to this time.

VAERS ID:151797 (history)  Vaccinated:1999-11-19
Age:53.0  Onset:1999-12-01, Days after vaccination: 12
Gender:Female  Submitted:2002-04-10, Days after onset: 860
Location:Florida  Entered:2000-05-10, Days after submission: 700
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vasoretic
Current Illness: NONE
Preexisting Conditions: T-cell lymphoma (NOS)
Diagnostic Lab Data: Biopsy NOS - non-malignant nodules, however, follow-up information from physician indicated the biopsy revealed T-cell lymphoma.
CDC 'Split Type': HQ1061214FEB2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH    
Administered by: Private     Purchased by: Other
Symptoms: Lymphoma, Subcutaneous nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad), Malignant tumours (narrow), Malignant lymphomas (narrow)
Write-up: A husband reported that his wife received vax on 11/19/99. Two days post vax, she developed nodules in her fatty tissue over her entire body. A biopsy of the nodules reportedly revealed that they were benign. Follow-up information received from the physician provided that the biopsy revealed T-cell lymphoma. The physician does not feel that the lymphoma was caused or aggravated by the vax administration. He stated that ''it was just a coincidence'' and ''not at all related'' to the vax. Additional info received on follow-up from the physician on 04/08/2002 indicated thatt he pt partially recovered. She was treated for T-cell lymphoma and that the number of nodules was decreased from 20 to 2. The pt did not have follow-up with the physician since 05/19/2000.

VAERS ID:151885 (history)  Vaccinated:1999-09-01
Age:53.0  Onset:2000-01-01, Days after vaccination: 122
Gender:Male  Submitted:2000-04-21, Days after onset: 110
Location:Pennsylvania  Entered:2000-05-12, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pt had a prior history of Lyme disease about 4 years ago but had been asymptomatic for about 2 years prior to vaccination.
Diagnostic Lab Data:
CDC 'Split Type': 20000055181
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Pain
SMQs:, Arthritis (broad)
Write-up: In September, October and November, 1999, the pt received Lymerix vaccines. Immediately, after each injection (exact date not provided), he had pain which resolved. Then in January, 2000, he experienced a severe flare-up of pain in his knees and his thighs. The most recent information received on 2/17/2000, indicates the outcome of the symptoms as unknown. Additional information has been requested. 1

VAERS ID:151894 (history)  Vaccinated:1999-11-11
Age:53.0  Onset:1999-12-01, Days after vaccination: 20
Gender:Female  Submitted:2000-04-21, Days after onset: 141
Location:Massachusetts  Entered:2000-05-12, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt had no history of Lyme disease or arthritis.
Diagnostic Lab Data: Relevant lab test results include a Western Blot that has tested positive for serveral strains as well as Erlichia.
CDC 'Split Type': 20000056821
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Infection parasitic
SMQs:, Arthritis (broad)
Write-up: On 11/11/99, the pt received her 1st injection of Lymerix and in early December, 1999, the pt experienced a severe burning in her knees, shoulders and elbows. Relevant lab test results include a Western Blot that has tested positive for several strains as well as Erlichia. Treatment was not specified. The pt has never received the 2nd injection of Lymerix vaccine. The most recent information received on 2/17/200 reports the outcome of the adverse events as unknown. Additional information has been requested.

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