MedAlerts Home
  Read the MedAlerts Blog Subscribe to the MedAlerts Blog 

Found 489662 cases in entire database

Case Details (Sorted by Age)

This is page 3993 out of 4897

Result pages: prev   3894 3895 3896 3897 3898 3899 3900 3901 3902 3903 3904 3905 3906 3907 3908 3909 3910 3911 3912 3913 3914 3915 3916 3917 3918 3919 3920 3921 3922 3923 3924 3925 3926 3927 3928 3929 3930 3931 3932 3933 3934 3935 3936 3937 3938 3939 3940 3941 3942 3943 3944 3945 3946 3947 3948 3949 3950 3951 3952 3953 3954 3955 3956 3957 3958 3959 3960 3961 3962 3963 3964 3965 3966 3967 3968 3969 3970 3971 3972 3973 3974 3975 3976 3977 3978 3979 3980 3981 3982 3983 3984 3985 3986 3987 3988 3989 3990 3991 3992 3993 3994 3995 3996 3997 3998 3999 4000 4001 4002 4003 4004 4005 4006 4007 4008 4009 4010 4011 4012 4013 4014 4015 4016 4017 4018 4019 4020 4021 4022 4023 4024 4025 4026 4027 4028 4029 4030 4031 4032 4033 4034 4035 4036 4037 4038 4039 4040 4041 4042 4043 4044 4045 4046 4047 4048 4049 4050 4051 4052 4053 4054 4055 4056 4057 4058 4059 4060 4061 4062 4063 4064 4065 4066 4067 4068 4069 4070 4071 4072 4073 4074 4075 4076 4077 4078 4079 4080 4081 4082 4083 4084 4085 4086 4087 4088 4089 4090 4091 4092   next


VAERS ID:191821 (history)  Vaccinated:2001-11-10
Age:50.0  Onset:2001-11-10, Days after vaccination: 0
Gender:Female  Submitted:2001-12-26, Days after onset: 46
Location:Texas  Entered:2002-10-23, Days after submission: 300
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U200101140
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO685AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site warmth, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad)
Write-up: From phone call received on 11/12/01, it was reported that a patient received Fluzone vaccination on 11/10/01. Patient had a local reaction consisting of red area the size of quarter which was warm to touch. Patient also complained of palpitations for 5 minutes (palpitations began approximately 10 minutes after vaccination. No further information.

VAERS ID:191850 (history)  Vaccinated:2001-10-10
Age:50.0  Onset:2001-10-10, Days after vaccination: 0
Gender:Male  Submitted:2001-12-28, Days after onset: 79
Location:Michigan  Entered:2002-10-23, Days after submission: 298
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: X-rays - negative
CDC Split Type: U200101219
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO713AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: From correspondence received on 12/03/01, it was reported that a 50 year old male patient received a Fluzone SV ''01-''02 vaccination administered on 10/10/01 That same day the patient developed pain at the injection site. X-rays negative - pain unresolved.

VAERS ID:192110 (history)  Vaccinated:2002-10-09
Age:50.0  Onset:2002-10-10, Days after vaccination: 1
Gender:Female  Submitted:2002-10-11, Days after onset: 1
Location:Arizona  Entered:2002-10-29, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zestril, Zocor, Paxil
Current Illness:
Preexisting Conditions: NIDDM W nephropathy, HTN, high chol, depression/MCMA
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0172M   
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU05266AA  RA
Administered by: Private     Purchased by: Private
Symptoms: Injection site oedema, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Fever to 102 degrees. Nausea, vomiting, body aches. RUE swelling/localized. Improved N/V temp-decreasing as left.

VAERS ID:192194 (history)  Vaccinated:2002-10-26
Age:50.0  Onset:2002-10-26, Days after vaccination: 0
Gender:Female  Submitted:2002-10-28, Days after onset: 2
Location:Michigan  Entered:2002-10-30, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: localized reaction;Influenza (unknown mfr);1;45;In Patient
Other Medications: Tenormin
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE31902HA   
Administered by: Other     Purchased by: Other
Symptoms: Feeling hot, Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Localized reaction--bright red, swollen, hot to touch, sore--approximately 4"x2.5". Increase in size for 36 hours after injection.

VAERS ID:192347 (history)  Vaccinated:2002-09-25
Age:50.0  Onset:2002-10-06, Days after vaccination: 11
Gender:Female  Submitted:2002-12-12, Days after onset: 67
Location:Illinois  Entered:2002-11-01, Days after submission: 41
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: IL02057
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1249L0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Lymphadenopathy, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Swollen lymph nodes bilateral neck subsiding. Fever 100.8 orally 10/06/02 lasted 24 hours approximate. Malaise for approximately 2-3 weeks.

VAERS ID:192514 (history)  Vaccinated:1998-09-11
Age:50.0  Onset:1998-09-11, Days after vaccination: 0
Gender:Male  Submitted:2002-10-29, Days after onset: 1509
Location:Virginia  Entered:2002-11-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0170SC 
Administered by: Military     Purchased by: Military
Symptoms: Insomnia
SMQs:
Write-up: Insomnia, local reaction

VAERS ID:192544 (history)  Vaccinated:2002-10-22
Age:50.0  Onset:2002-10-23, Days after vaccination: 1
Gender:Male  Submitted:2002-10-24, Days after onset: 1
Location:Rhode Island  Entered:2002-11-05, 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: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4002340IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Erythema, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives, itching and red rash

VAERS ID:192998 (history)  Vaccinated:2001-01-07
Age:50.0  Onset:2001-03-10, Days after vaccination: 62
Gender:Male  Submitted:2002-11-08, Days after onset: 608
Location:California  Entered:2002-11-08
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor
Current Illness: None
Preexisting Conditions: High cholesterol
Diagnostic Lab Data: Guillain-Barre Syndrome
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURE11941LA9IM 
Administered by: Unknown     Purchased by: Private
Symptoms: Guillain-Barre syndrome, Influenza, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: Got a flu shot in early January 2001. Got the flu about third week in February 2001. Took two weeks to recover from severe flu. Mid-March (about a weeks after symptoms were gone) arms and legs started tingling and going numb with increasing severity. Hospitalized and diagnosed with Guillain-Barre syndrome. Treated blood with immunoglobins. Some nerve damage in arms.

VAERS ID:193199 (history)  Vaccinated:2002-11-06
Age:50.0  Onset:2002-11-08, Days after vaccination: 2
Gender:Male  Submitted:2002-11-13, Days after onset: 5
Location:D.C.  Entered:2002-11-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No fever or acute illness
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0881AA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Cough, Nasal congestion, Pharyngolaryngeal pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Starting Nov 8, experience severe sore throat, low grade fever, terrible cough, and stuffy nose. Very tired and in bed 5 days. Saw physician on Nov 9.

VAERS ID:193229 (history)  Vaccinated:2002-11-01
Age:50.0  Onset:2002-11-01, Days after vaccination: 0
Gender:Female  Submitted:2002-11-04, Days after onset: 3
Location:California  Entered:2002-11-14, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu-like symptoms;Influenza (unknown mfr);;48;In Patient
Other Medications: Toprol XL, Digoxin, Dyazide, Potassium, Coumadin, Triestrogen, Testosterone, Clonazepam, Vitamin D, Magnesium, Multi-vitamin
Current Illness: None
Preexisting Conditions: Congestive heart failure, Artificial Mitral Valve
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0883AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0735M0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Headache, Heart rate increased, Nausea, Pain, Pyrexia, Sleep disorder, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Very high fever, nausea, pounding and rapid heart rate, intense headache, inability to sleep. My arm became swollen, red and sore over an area about the size of my hand. I became very upset when my husband went out to take care of our dogs and didn''t come right back. I imagined he had died, and I cried uncontrollably.

VAERS ID:193235 (history)  Vaccinated:2002-10-23
Age:50.0  Onset:2002-10-23, Days after vaccination: 0
Gender:Female  Submitted:2002-11-04, Days after onset: 12
Location:Wisconsin  Entered:2002-11-14, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO954AA  RA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Chills, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Got the chills very bad, Lasted from about 4:00 PM threw (sic) the night. Couldn''t get warm, Shook all night, My bones hurt and muscles. The next day, I was very tired and slept most of the day. The next day, I was very weak and couldn''t do much without having to lay back down. I was unable to do much for 2 days.

VAERS ID:193365 (history)  Vaccinated:2002-11-05
Age:50.0  Onset:2002-11-06, Days after vaccination: 1
Gender:Male  Submitted:2002-11-15, Days after onset: 9
Location:Minnesota  Entered:2002-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR  IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: I received the vaccine on Nov 5th at 8:30 AM. At 9:15 PM on November 6th, I had an episode of severe dizziness. What I was looking at was percieved to be spinning rapidly as if on a disc. Standing was impossible. This has continued through today, Nov 15, 2002, although slightly letting up in intensity. The percievd motion now is a back and forth rather than a spinning disc. It is most prevalent in the morning and evening when getting up or laying down, although it does occur during the day, but less intensly. Additionally, there is a constant, but low level, sense of dizzyness (although no spinning is associated with this)-- similar to a "light headedness" sensation.

VAERS ID:193398 (history)  Vaccinated:2002-10-19
Age:50.0  Onset:2002-10-21, Days after vaccination: 2
Gender:Female  Submitted:2002-11-04, Days after onset: 14
Location:Wisconsin  Entered:2002-11-18, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CXR with Iordotic view
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0888AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Lymphadenopathy, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient had fluzone on 10/19/02. Presented to urgent care on 10/21/02 with left arm swelling and redness radiating up left side of neck. Swollen glands in neck.

VAERS ID:193528 (history)  Vaccinated:2002-11-06
Age:50.0  Onset:2002-11-07, Days after vaccination: 1
Gender:Male  Submitted:2002-11-08, Days after onset: 1
Location:Wisconsin  Entered:2002-11-19, 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: ASA, Tikosyn, Zocor, Lysine, HCT Z, Indocin, Lisnosix
Current Illness:
Preexisting Conditions: URI
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0931AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0735M IMLA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0818AA IMRA
Administered by: Private     Purchased by: Other
Symptoms: Chills, Fatigue, Pain, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Severe chills, fever, body aches, syncope, sharp pain, intermittent L side of back, fatigue.

VAERS ID:193737 (history)  Vaccinated:2002-10-26
Age:50.0  Onset:2002-10-28, Days after vaccination: 2
Gender:Male  Submitted:2002-11-20, Days after onset: 23
Location:Unknown  Entered:2002-11-21, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Light dizziness and nausea. Reaction to wearing glasses.

VAERS ID:193944 (history)  Vaccinated:2002-10-29
Age:50.0  Onset:2002-10-29, Days after vaccination: 0
Gender:Female  Submitted:2002-11-14, Days after onset: 16
Location:Florida  Entered:2002-11-26, 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: Claritin, Monocril, HCTZ, Atenolol
Current Illness:
Preexisting Conditions: Allergic to Penicillin; Hypertension, renal insufficiency, anemia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER4020011   
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0210M0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Chest pain, Erythema, Myalgia, Oedema, Palpitations, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Within 2 hours of injection, soreness right upper arm, then began to feel weak and fever 100-101. Next day palpitation and chest pain worsened by pressure/palpation. Review of systems shows erythema around site and edema to end of mid humerus. Treament H2 blocker. Better by 11/11/02.

VAERS ID:193947 (history)  Vaccinated:2002-11-05
Age:50.0  Onset:2002-11-05, Days after vaccination: 0
Gender:Female  Submitted:2002-11-14, Days after onset: 9
Location:California  Entered:2002-11-26, 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: Wellbutrin SR 75mg
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMLA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dyspnoea, Erythema, Rash macular
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Red blotchy skin around chest/neck area. Difficulty breathing immediately after PPV injection. Flu injection administered at around 8am. Returned same day after 10:30 for pneumonia vaccine

VAERS ID:193968 (history)  Vaccinated:2002-04-09
Age:50.0  Onset:2002-04-10, Days after vaccination: 1
Gender:Male  Submitted:2002-05-13, Days after onset: 33
Location:Washington  Entered:2002-11-26, Days after submission: 197
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WA021848
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5263A40IMLA
Administered by: Public     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: After client received hep B #1 dose of 4/9/02, he proceeded to go tanning and used a tanning accelerant. After tanning, next day client had a itchy palm and foot on L side. Had hives around beltline R and L side and instead of thighs. Eventually went away. After 2nd hep B 5/10/02 he had no rxn.

VAERS ID:194122 (history)  Vaccinated:2002-10-16
Age:50.0  Onset:2002-11-16, Days after vaccination: 31
Gender:Male  Submitted:2002-10-30, Days after onset: 17
Location:Georgia  Entered:2002-11-27, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE34682HA2IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Immediate local reaction, quarter size red swollen area around injection site, heat around read area, patient denies symptoms of systemic reaction, monitored patient in HO for 30 minutes after injection.

VAERS ID:194308 (history)  Vaccinated:2002-11-05
Age:50.0  Onset:2002-11-05, Days after vaccination: 0
Gender:Female  Submitted:2002-11-07, Days after onset: 2
Location:Wyoming  Entered:2002-12-02, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: Asthma, pneumonias
Diagnostic Lab Data: NONE
CDC Split Type: WY0213
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR4020028 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1353L0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Injection site erythema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Large (grapefruit sized) local redness which spread to elbow and chest. Joint soreness. Elbow and shoulder. Fever 101 degrees. did not see phy. Taking Benadryl, Ibuprofen and cold packs (feel better than warm packs).

VAERS ID:194472 (history)  Vaccinated:1999-09-03
Age:50.0  Onset:0000-00-00
Gender:Male  Submitted:2002-11-26
Location:Connecticut  Entered:2002-12-03, 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: Allupruinol, Cozaar
Current Illness: NONE
Preexisting Conditions: Spring time pollen allergies, Crohn''s disease
Diagnostic Lab Data: HLA-dry genetic trait and ANA blood samples
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 2  
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site inflammation, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Increased BP levels; currently on medication. Never had a problem with BP prior to Lymerix vaccinations. Left elbow/tendon area in pain/inflammation.

VAERS ID:194484 (history)  Vaccinated:2002-11-05
Age:50.0  Onset:2002-11-05, Days after vaccination: 0
Gender:Male  Submitted:2002-11-27, Days after onset: 22
Location:Ohio  Entered:2002-12-03, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5312A6 IM 
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU0820AA IM 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURU0705 IM 
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Itchy hives in scalp five hours after vaccines administered. Next 3-4 days hive welts appeared as isolated welts on upper back, rib cage and inner thigh.

VAERS ID:194608 (history)  Vaccinated:2002-11-18
Age:50.0  Onset:2002-12-03, Days after vaccination: 15
Gender:Female  Submitted:2002-12-05, Days after onset: 2
Location:Missouri  Entered:2002-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1536M2IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0529M0SCLA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Fatigue
SMQs:, Arthritis (broad)
Write-up: States developed stiffness and aching of joints with severe fatigue, started around 12/3/02.

VAERS ID:194612 (history)  Vaccinated:2000-11-14
Age:50.0  Onset:2002-11-14, Days after vaccination: 730
Gender:Female  Submitted:2002-12-04, Days after onset: 20
Location:Michigan  Entered:2002-12-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: diovan
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO958AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: At 9:10 AM, after receiving flu vaccine, patient stated that "itching at the site" almost immediately. Shortly thereafter, patient complained of ''itching around nose and mouth'' and subsequent "itchy throat and tongue". 9:25 am administered 0.3mm Epinephrine 1:1000 at site of flu vaccine injection SC. (* times approximate)

VAERS ID:194774 (history)  Vaccinated:2002-11-12
Age:50.0  Onset:2002-11-14, Days after vaccination: 2
Gender:Female  Submitted:2002-12-03, Days after onset: 19
Location:Michigan  Entered:2002-12-10, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0873M0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Oedema, Rash maculo-papular, Vasodilation procedure
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Vaccine administered on 11-12-02 within 48 hours right deltoid became red, swollen with blotchy rash, warm to touch. Shoulder and elbow involved. Medrol dose pack and Cipro 500 bid x 10 que

VAERS ID:194982 (history)  Vaccinated:2002-11-07
Age:50.0  Onset:2002-12-07, Days after vaccination: 30
Gender:Male  Submitted:2002-12-10, Days after onset: 3
Location:New York  Entered:2002-12-16, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Mental Retardation
Diagnostic Lab Data: CT scan/MRI spine/LP Medical records state decreased plateletts, anemia, hyperglycemia. msv
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE32072GA3IMRA
Administered by: Private     Purchased by: Private
Symptoms: Anaemia, Deep vein thrombosis, Hyperglycaemia, Myelitis transverse, Paralysis, Thrombocytopenia, Urinary retention, Urinary tract infection
SMQs:, Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Dx transverse meylitis 12/7/02. Sudden onset. Etiology not known. Received two flu vaccines 10/08/2002, 11/07/2002. 60 day follow up states pt has not recovered. Transverse myelitis- no change in symptoms. The annual follow up received on 1/13/04 states persistent paralysis. Discharge summary states deep vein thrombosis. msv Medical records state anemia, urinary retention, urinary infection. msv

VAERS ID:195395 (history)  Vaccinated:2002-11-27
Age:50.0  Onset:2002-11-28, Days after vaccination: 1
Gender:Female  Submitted:2002-12-10, Days after onset: 12
Location:Alaska  Entered:2002-12-26, Days after submission: 16
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: Asplenia
Diagnostic Lab Data:
CDC Split Type: AK200258
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0885AA3 RA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0735M0 LA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Injection site pain, Injection site reaction, Pneumonia
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Reports red, swollen, very sore local reaction. Redness and swelling extended to elbow. Soreness was very intense. On 12/2/02 reports experiencing asthma attack, was very SOB/difficult breathing. Was seen by NP and prescribed erythromycin. Was bed ridden the entire week and seen again last in ER 12/8/02. Diagnosed with pneumonia. Was doubled in dosage. Local reaction resolved.

VAERS ID:195512 (history)  Vaccinated:2002-12-16
Age:50.0  Onset:2002-12-17, Days after vaccination: 1
Gender:Female  Submitted:2002-12-18, Days after onset: 1
Location:Maryland  Entered:2002-12-26, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU0736AA0IM 
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Erythema 1 1/3"x1 1/3" and raised.

VAERS ID:195715 (history)  Vaccinated:2002-12-04
Age:50.0  Onset:2002-12-05, Days after vaccination: 1
Gender:Female  Submitted:2003-02-21, Days after onset: 78
Location:California  Entered:2003-01-02, Days after submission: 50
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acyclovir
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40200341  
Administered by: Unknown     Purchased by: Other
Symptoms: Asthenia, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: I woke up the next morning with cold sweats, nauseated, very weak feeling. Lasting until the morning of 12/6/02.

VAERS ID:195772 (history)  Vaccinated:2002-11-04
Age:50.0  Onset:2002-11-11, Days after vaccination: 7
Gender:Female  Submitted:2002-12-30, Days after onset: 49
Location:Wisconsin  Entered:2003-01-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, prednisone, Methotryal
Current Illness: Rheumatoid arthritis
Preexisting Conditions: Thyroid removal, Skin Folliculitis
Diagnostic Lab Data: WBC 19.6, no bacteria from site on 11/13/02; WBC increased 150,000.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 5 LA
Administered by: Private     Purchased by: Other
Symptoms: Hypokinesia, Infection, Pain, Pyrexia, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Low grade fever, pain. Shot received on 11/4/02. On 11/11/02 shot boosted immune system. Could not use arm, shoulder shot was given in. MD removed fluid-? of infection. Had arthroscopic surgery on 11/14/02-surgeon MD. Still has pain from shoulder.

VAERS ID:195849 (history)  Vaccinated:2000-08-24
Age:50.0  Onset:2000-09-11, Days after vaccination: 18
Gender:Female  Submitted:2001-01-26, Days after onset: 137
Location:Maryland  Entered:2003-01-07, Days after submission: 711
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Triphasil, Vitamin, Chlorpheniramine Maleate
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: U2000-00813
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)AVENTIS PASTEURR0789 IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: It was reported that a 50-year-old female patient received an Imovax IM Rabies vaccination on 24-Aug-2000 at 12:00pm. Reportedly the patient called Health Dept. late morning 12-Sep-2000 to report that about 8pm the evening before she noticed that her left deltoid "felt like the day I go the shot" and left lateral arm from deltoid distally including back of left hand felt like it was "asleep". This continues today and has not changed in response to Ibuprofen by mouth. From additional information received 9-Jan-201, patient information was updated and reportedly the patient received 9 doses of Rabies vaccine ID in the period of 1982 to 1999. Patient is scheduled to call the reporter in one to 2 days to report status.

VAERS ID:196379 (history)  Vaccinated:2002-04-04
Age:50.0  Onset:2002-04-06, Days after vaccination: 2
Gender:Female  Submitted:2003-01-09, Days after onset: 278
Location:Pennsylvania  Entered:2003-01-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: A0365977A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5272B2 IM 
Administered by: Other     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: On 4/4/02, the vaccinee received a booster dose of Engerix-B (lot ENG5272B2; expiry 8/29/03). The dose number in the series was unspecified. Two days later, she experienced rash on her trunk, but not at the vaccine site. The pt had been taking Benadryl "with no relief". As of 4/15/02, the event was ongoing.

VAERS ID:196473 (history)  Vaccinated:1994-12-05
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2003-01-09
Location:Unknown  Entered:2003-01-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergies to strawberries, allergy to penicillin, allergy to sulfa drugs
Preexisting Conditions: Medical history included "allergic to everything" specifically to penicillin, sulfa drugs, and strawberries. Subject received the smallpox vaccine (unknown mnft''r) in the 70''s which caused "her tear ducts to dry up".
Diagnostic Lab Data: UNK
CDC Split Type: A0383858A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 1 LA
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Eye disorder, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow)
Write-up: This report described the occurrence of hives in a 58 y.o. female who was vaccinated w/the Hep B vaccine recombinant (Engerix-B). This report was received by the subject and has not been verified by a physician or health care professional. The subject''s medical history included allergies specifically to penicillin, sulfa drugs, and strawberries. There were no concurrent medications. The subject stated she received a smallpox vaccine (unknown mnft''r) approximately 30 yrs ago which caused her "tear ducts to dry up". On 12/5/94, the subject received her 2nd injection of Engerix-B. On this same date, the subject also received a tetanus + diphtheria injection (unknown mnft''r). At an unspecified time post vaccination, the subject developed hives and "something to do with her eyes". The events were reported to have resolved. On 8/5/95, the subject received the 3rd injection of Engerix-B and did not experience any adverse reaction.

VAERS ID:196500 (history)  Vaccinated:2002-10-31
Age:50.0  Onset:2002-11-17, Days after vaccination: 17
Gender:Male  Submitted:2003-01-06, Days after onset: 50
Location:Florida  Entered:2003-01-21, 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: Lotensin 10mg q d; Catapres 1mg q d; Lescol 80mg q d
Current Illness: NONE
Preexisting Conditions: Hypertension
Diagnostic Lab Data: X-ray-left hand
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0921EA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Numbness and tingling of left pinky and ring finger and extending to left wrist. TX: Physical Therapy.

VAERS ID:196840 (history)  Vaccinated:2002-10-02
Age:50.0  Onset:2002-10-02, Days after vaccination: 0
Gender:Male  Submitted:2003-01-24, Days after onset: 114
Location:Unknown  Entered:2003-01-28, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Fluzone was last administered in 2001.
Diagnostic Lab Data:
CDC Split Type: U200300054
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0911AA1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1160L0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Injection site oedema, Injection site pain
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: From faxed information received at manufacturer on 1/13/03 it was reported: this is in follow up to a report(s) previously submitted on 8/11/02 and 10/12/02. Information has been received from a registered nurse concerning a 50 year old white male who on 10/02/02 was vaccinated IM in the left deltoid with the first dose of pneumococcal vaccine 23 polyvalent (lot # 641116/1160L). On 10/3/02, the patient was vaccinated IM in the left deltoid with a second dose of concomitant suspect therapy influenza virus vaccine (FLUZONE) (lot #U0911AA), which was last administered in 2001. On 10/3/02, the patient''s arm became extremely swollen and painful. The registered nurse reported that the patient was instructed to seek medical attention. The patient was treated with amoxicillin trihydrate (+) clavulanate potassium (Augmentin), 500mg, acetaminphen (Tylenol) and moist heat. The patient continued to be in pain and became very weak. The patient was admitted to the hospital for three days (dates not reported, and was treated with IV antibiotics. The registered nurse reported that the patient had recovered from the experience. No further information is expected. The case is closed. A 15-day follow up report received 7/16/2003 adds: 06/25/2003: Administrative case closure (no additional info anticipated). 07/07/2003: This version was created to correct the dates that this case was previously submitted by manufacturer to 11/08/2002 and 12/10/2002 (the dates were incorrectly typed as 08/11/2002 and 10/12/2002); and to correct the lot number for PNEUMOVAX 23 in Box 14. The correct lot number is 641116/1160L. From additional info received on 7/14/03, it was reported "this is an amended report. The adverse event onset date and time have been updated and the date and time of administration of secondary suspect vaccination has been updated. The case is closed, no additional info is anticipated."

VAERS ID:196944 (history)  Vaccinated:2002-12-10
Age:50.0  Onset:2002-12-10, Days after vaccination: 0
Gender:Male  Submitted:2003-01-22, Days after onset: 43
Location:Illinois  Entered:2003-01-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5305B61IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM724B61IMLA
Administered by: Other     Purchased by: Public
Symptoms: Drug administration error
SMQs:
Write-up: Havix vaccine was given inappropriate schedule administration, called manufacturer of vaccine. Pt had received one dose of vaccine prior to this one. No ill effects.

VAERS ID:197072 (history)  Vaccinated:2003-01-04
Age:50.0  Onset:2003-01-04, Days after vaccination: 0
Gender:Male  Submitted:2003-01-21, Days after onset: 17
Location:North Dakota  Entered:2003-02-03, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Lab work at ER visit.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0670SCLA
Administered by: Military     Purchased by: Military
Symptoms: Hyperhidrosis, Pharyngolaryngeal pain, Pyrexia, Viral infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Got fever and sweats that evening. Went to ER. Sore throat with a questionable viral infection.

VAERS ID:197235 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2002-02-07
Location:Unknown  Entered:2003-02-04, Days after submission: 362
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U200200046
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0518AA  RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: From telephone contact on 1/30/02 it was reported a 50-year-old woman received TD Adult in right deltoid and next day presented to the doctor with large local reaction at the site with redness and pain. It looked like cellulitis so doctor placed her on antibiotic.

VAERS ID:197410 (history)  Vaccinated:2002-10-21
Age:50.0  Onset:2002-10-21, Days after vaccination: 0
Gender:Female  Submitted:2003-01-28, Days after onset: 99
Location:South Carolina  Entered:2003-02-07, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: HTN, high chol, depression
Diagnostic Lab Data: Vascular ultrasound-neg
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU0908AA5IMLA
Administered by: Military     Purchased by: Other
Symptoms: Injection site pain, Subcutaneous nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: C/O L arm pain post flu shot. Saw family MD D/T "knot" on side of neck L. Ordered Sulfa x 10 days. Refused neurology consult-took Medrol dose pack with relief. Thinks shot was given "too high."

VAERS ID:197740 (history)  Vaccinated:2003-02-04
Age:50.0  Onset:2003-02-06, Days after vaccination: 2
Gender:Male  Submitted:2003-02-12, Days after onset: 6
Location:Unknown  Entered:2003-02-13, Days after submission: 1
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Balance disorder, Dizziness, Headache, Musculoskeletal stiffness, Paraesthesia, Pollakiuria, Vertigo, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Arthritis (broad)
Write-up: Reactions created stiffness in neck, no balance, vertigo, dizziness, tingling/numbness in both left and right hand and both feet. Headaches, blurry vision and extreme increased dizziness when laying down. Extreme no balance, frequent urination. Was given the same shot in March 1991. Same symptoms occurred and continued for a 10 year period.

VAERS ID:198131 (history)  Vaccinated:2003-02-14
Age:50.0  Onset:2003-02-17, Days after vaccination: 3
Gender:Male  Submitted:2003-02-21, Days after onset: 4
Location:New Jersey  Entered:2003-02-22, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020076  LA
Administered by: Public     Purchased by: Public
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Paresthesia (pins & needles) L arm (vaccination arm) and hand (especially) including all five digits.

VAERS ID:198147 (history)  Vaccinated:2003-02-04
Age:50.0  Onset:2003-02-04, Days after vaccination: 0
Gender:Female  Submitted:2003-02-21, Days after onset: 17
Location:New York  Entered:2003-02-24, 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: Advair, Albuterol
Current Illness: NONE
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0955M0 RA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site inflammation, Injection site oedema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling, redness, hot, pain symptoms 2/4/03-2/8/03. 2/8 on swelling down pain subsiding. IV treatments of steroids, antibiotics, and Demoral. I was told it was muscle inflammation.

VAERS ID:198385 (history)  Vaccinated:2002-11-04
Age:50.0  Onset:2002-12-01, Days after vaccination: 27
Gender:Female  Submitted:2003-02-18, Days after onset: 79
Location:California  Entered:2003-02-26, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: See attached
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD880IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Td was given to pt on 11/4/2002. Since then pt complains of persistent arm pain in left arm. Pt was given NSAID.

VAERS ID:198462 (history)  Vaccinated:2003-02-13
Age:50.0  Onset:2003-02-18, Days after vaccination: 5
Gender:Female  Submitted:2003-02-26, Days after onset: 8
Location:New Jersey  Entered:2003-02-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Labetalol Monopril
Current Illness: None
Preexisting Conditions: Hypertension
Diagnostic Lab Data: No laboratory evaluation initiated
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200772IDLA
Administered by: Unknown     Purchased by: Public
Symptoms: Arthralgia, Myalgia, Pyrexia, Rash erythematous, Rash maculo-papular
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Patient developed myalgia, arthralgia, and low-grade fever (100.6 F) 5 days post-vaccination. On the 6th day post-vaccination patient developed erythematous, macular papular confluent pruritic rash over her face and back. The rash worsened in intensity and pruritis (though it did not spread from the initial sites) on day #7. No mucosal involvement was noted. Patient took diphenhydramine x 2 on day # 7 with subsequent improvement in symptoms. Marked improvement in rash noted on day # 8 post-vaccination. This was the patient''s second vaccinia vaccination in the prior 2 weeks (first on 01/31/03 and revaccinated on 02/13/03 when it was determined there was no "take" on the first). Patient had received her primary vaccinia vaccination as a child.

VAERS ID:198484 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:2002-10-25
Gender:Male  Submitted:2003-02-24, Days after onset: 122
Location:Unknown  Entered:2003-02-28, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tendonitis
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Tenderness, Tendonitis
SMQs:
Write-up: PT states: "I received a flu vax in my left arm. I noticed some tenderness in the area of my left deltoid 2 days [post vax] that was especially pronounced when I did push-ups, pull-ups or swimming. This tendonitis is still present after several months, although milder. Otherwise my health is excellent. Is it possible that local inflammation from the fax predisposes people to tendonitis? Or is the timing and location of the tendonitis coincidental?

VAERS ID:198516 (history)  Vaccinated:1999-06-04
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2005-01-25
Location:Unknown  Entered:2003-02-28, Days after submission: 697
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin, ibuprofen, Actifed, Celebrex, Zoloft, Diflucan, Prilosec, Actifed, thyroid, baby aspirin, and nutritional supplements Conjugated estrogene;(Codeine phosphate + Paracetamol + Triprolidine HCl + Guaiphenesin Dextromethorphan HBr +
Current Illness: UNK
Preexisting Conditions: The medical history included Lyme disease, restless leg syndrome, migratory arthralgias, back pain, heart surgery NOS, tearfulness, moodiness, anxiety, degenerative disc changes lumbosacral spine, hysterectomy, chronic pain, memory problems, "nerve twitching," and difficulty sleeping. From 1996 to 3/2/99, the pt was treated by a chiropractor for the following:constant low backache
Diagnostic Lab Data: Lyme total antibodies, 2 August 2000: Negative. Lyme IgG Western blot, 15 January 2001: Negative: 41 and 31 kb bands present. Lyme IgM Western blot, 15 January 2001: Negative: zero bands present. X-rays left knee, 23 January 2001: "Impressi
CDC Split Type: A0359658A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 1  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Cognitive disorder, Influenza like illness, Insomnia, Joint swelling, Memory impairment, Migraine, Myalgia, Restless legs syndrome
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad)
Write-up: Report A0359658A describes restless leg syndrome in a 49 year old female who received Lyme disease vaccine recombinant OspA LYMErix. This report was received as part of litigation proceedings, with forwarding of medical records. The medical history included Lyme disease, restless leg syndrome, migratory arthralgias, back pain, heart surgery NOS, tearfulness, moodiness, anxiety, degenerative disc changes lumbosacral spine, hysterectomy, chronic pain, memory problems, "nerve twitching," and difficulty sleeping. From 1996 to 3/2/99, the pt was treated by a chiropractor for the following:constant low backache (lumbar pain/tenderness) with intermittent posterior right leg pain, lumbar/lumbosacal area subluxation-radicular syndrome of the lower limb, lumbar strain, lumbalgia, lumbar related paresthesia, low back tight and achy, lower back pain into left/right buttock region and intermittent left/right proximal posterior leg ache with cramping, low back muscle spasms, muscle spasms, muscle ache and tenderness across the low back and lumbar spine, increased pain with movement at the waist, pain in lumbar spine over the left S1 joint, pain and ache over right S1 joint, pain radiates across the belt line, pain with quick movement, pain that radiates down to the lumbosacral, muscle spasms, aches and mild cramping in the left/right legs, muscle ache and ache that radiates into proximal left/right posterior legs, pain across the left upper "trapes" and shoulder, subluxations at cervical/thoracic area, cervical/thoracic area with muscle tenderness, cervicalgia, cervical strain, cervical stiffness, cervical pain cervical/thoracic spine pain, "felt pop in her neck," pain and "felt a pop in her mid thoracic spine," increased pain with head movement in cervical area, headache, migraine type headache, increased stress, sinus headache, stiffness in the upper spine, stiff neck, lumbar related paresthesia, pain in cervical area, activities of daily living and movement were decreased, increased stress, left shoulder pain, migraine type

VAERS ID:198527 (history)  Vaccinated:2000-05-30
Age:50.0  Onset:2000-09-28, Days after vaccination: 121
Gender:Male  Submitted:2003-02-14, Days after onset: 869
Location:New Jersey  Entered:2003-02-28, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Abdominal pain, allergic rhinitis, arthritis, back pain, cellulitis, chest pain, chronic pancreatitis, colon polyp, colonoscopy, coronary artery disease, diverticulitis, fall, fascicular block, fatty liver, heart catheterization, HBP, hyperlipidemia, hyperplastic polyps, joint pain, left ventricular hypertrophy, lyme disease, marijuana use, myocardial infarction, neuritis, nevus, non-specific ST abnormality, palpitations, sinus arrhythmia, sinus bradycardia, tiredness, tobacco use, trace mitral insufficiency
Diagnostic Lab Data: Antinuclear antibody negative; Babesi IgG 1:64; Babesia IgM <1:64; Babesia by PCR negative; Bartonella henselae by PCR negative; Borrelia burgdorferi by PCR negative; Ehrlichiosis IgG <1:80; Ehrlichiosis IgM <1:20; Erythrocyte Sedimentation Rate 5mm/hr; HLA-B27 typing not detected; HLA-DR typing complete DR4; HLA-DR typing loci DR11; Lyme disease serology non-reactive; Lyme urine negative, 74ng/mL, 70ng/mL; Non-reactive Lyme disease IgM 0.43; Rheumatoid factor <20.0IU/mL; Lyme total antibodies 0.120 O.D.; Lyme IgG Western Blot; MRI left knee: non-specific mild joint effusion and about a 2cm sized septated Baker''s cyst in the posteromedial aspect. No discernible meniscal tear
CDC Split Type: A0362649A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS144B91IMRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Back pain, Bursitis, Eczema, Eye pain, Fatigue, Headache, Influenza like illness, Lymphadenopathy, Muscle twitching, Musculoskeletal stiffness, Myalgia, Nausea, Oedema peripheral, Paraesthesia, Rheumatoid arthritis, Sexual dysfunction
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: Report A0362649A describes rheumatoid arthritis in a 50 year old male who received Lyme disease vaccine recombinant OspA (LYMErix) for prophylaxis. This report was received as part of litigation proceedings, with forwarding of medical records. Medical history included Lyme disease (with tiredness, arthritis, and neuritis 1986), joint pain (hand), high blood pressure, chest pain, myocardial infarction (1999) managed with Beta blocker (metoprolol tartrate) and aspirin, trace mitral insufficiency, concentric left ventricular hypertrophy, sinus arrhythmia, sinus bradycardia, palpitations, coronary artery disease, left posterior fascicular block, non specific ST abnormality, hyperlipidemia, fatty liver, chronic pancreatitis, sigmoid polyp, abdominal pain, diverticulitis, back pain, fall, plantar spur, cellulitis, allergic rhinitis, multiple nevi, and occasional marijuana usage. Surgical history included colonoscopy with biopsies and heart catheterization. The subject smoked two packs of cigarettes per day. The subject had no known drug allergies. There was a family history of osteoarthritis and Alzheimer''s. Concurrent medications included metoprolol tartrate (Lopressor), aspirin, amoxicillin/clavulanate potassium, simvastatin, cortic ear drops, amoxicillin, loratadine, cluticasone propionate, and ammonium lactate. The subject received injection of LYMErix 3/2/00 (lot LY130N4) and 5/30/00 (lot LY144B9). on 2/12/02, in a statement of injuries, the subject''s attorney alleged that the subject suffers from joint pain, especially, his knees and hands swell and ache. He experiences pain in his back, hips, groin, and feet. He also experiences muscle aches and twitching. In addition he has eye problems and buzzing in his ears. He experiences flu-like symptoms and fatigue and his glands have swollen. He also suffers from fatigue, a stiff neck and he has decreased sex drive. The following information was obtained from medical records. The subject presented to his vaccine provider on 8/15/00 with complaints of knee pain. The physician''s impression was illegible. Lab analysys performed on 8/15/00 demonstrated normal results. Please see lab data section. The subject remained under the care of this physician until at least 12/4/01. During this time, the subject reported foot swelling. The physician made a diagnosis of Lyme disease with rheumatoid arthritis. The physician prescribed meloxicam. Per pharmacy records, the physician also prescribed amoxicillin/clavulanate potassium, amoxicillin, and nabumetone. The subject as evaluated by another physician on 9/28/00. The subject reported that following the second injection of LYMErix, he developed knee, ankle and hand swelling; neck pain; muscle pain as if exercising; hip pains; left ear aches; eye twitching; muscle twitching and cramping; profound fatigue; paresthesias of the fingers and feet; and intermittent nausea. The physician noted he had no fevers, sweats or cognitive changes. The subject had a family history of osteoarthritis and Alzheimer''s. On physical examination, the physician noted bilateral knee effusions and Heberden''s nodes. Lyme serology was equivocal. Pleas see lab data section. The physician prescribed weekly IM injections of benzathine penicillin G, magnesium, and vitamin B12; discontinuation of cigarettes; physical therapy; diet; and meloxicam. The subject remained under the care of this physician until at least 1/7/02. During this time, the physician noted noticeable improvement on shots on 11/16/00; increased symptoms day 10-14 and in exactly 21 days after that flare, multiple joint pain and new neuropathic pain right leg. She noted he also had increased gas and bloating on 12/21/00; progressive improvement of all symptoms with 24 day cyclical fares; left knee with slight prepatellar bursitis; definite improvement with last flare lasting only 2 days and less intense and knee better on 3/25/01. He had increased headache, constant back pain, and increased knee pain. His MRI sho

VAERS ID:198782 (history)  Vaccinated:2003-01-12
Age:50.0  Onset:2003-01-15, Days after vaccination: 3
Gender:Male  Submitted:2003-01-31, Days after onset: 16
Location:New Jersey  Entered:2003-03-04, Days after submission: 32
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: High blood pressure
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0662SCLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURU0315  RA
Administered by: Military     Purchased by: Military
Symptoms: Feeling hot, Muscular weakness, Pain, Tendon disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Three day post shot L arm-tenderness in arm. Whole length of arm-warm sensation, pins and needles, feels very weak.

VAERS ID:198787 (history)  Vaccinated:2003-02-18
Age:50.0  Onset:2003-02-19, Days after vaccination: 1
Gender:Male  Submitted:2003-02-27, Days after onset: 8
Location:North Carolina  Entered:2003-03-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0645 LA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200712 RA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Fatigue, Myalgia, Nausea, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Chills, nausea, fatigue, body aches, "itchy" sensation. Symptoms resolved after 4 days w/out intersection except symptomatic treatment (Motrin, anti-emetic)

VAERS ID:198898 (history)  Vaccinated:2003-02-25
Age:50.0  Onset:2003-03-02, Days after vaccination: 5
Gender:Female  Submitted:2003-03-04, Days after onset: 2
Location:Florida  Entered:2003-03-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Eye irritation
SMQs:, Corneal disorders (broad)
Write-up: Pt chief complaint: eyes itching since yesterday. client assessed. No swelling, no redness, vision not affected. Client referred to ophthalmalogist.

VAERS ID:198918 (history)  Vaccinated:2000-08-03
Age:50.0  Onset:2000-08-17, Days after vaccination: 14
Gender:Male  Submitted:2003-02-20, Days after onset: 917
Location:Texas  Entered:2003-03-06, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? Yes
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
TTOX: TETANUS TOXOID (NO BRAND NAME)PFIZER/WYETH49983261 LA
Administered by: Public     Purchased by: Private
Symptoms: Herpes zoster, Infection, Nerve injury
SMQs:, Accidents and injuries (narrow)
Write-up: Exactly two weeks after innoculation, a severe shingles infection which after treatment left nerve (1) from solar plexis around rib-cage to the spinal column dead. Doctors suspects distinct pathology (neurological reaction).

VAERS ID:198953 (history)  Vaccinated:2003-01-28
Age:50.0  Onset:2003-02-01, Days after vaccination: 4
Gender:Female  Submitted:0000-00-00
Location:Virginia  Entered:2003-03-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Pt F/U at ID Dept
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020071   
Administered by: Military     Purchased by: Military
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: Macular, papular rash starting on trunk and moving outwards. Pt seen by Infectious Disease Dept.

VAERS ID:199142 (history)  Vaccinated:2003-03-01
Age:50.0  Onset:2003-03-09, Days after vaccination: 8
Gender:Female  Submitted:2003-03-01, Days after onset: 8
Location:West Virginia  Entered:2003-03-10, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771 LA
Administered by: Public     Purchased by: Unknown
Symptoms: Ocular hyperaemia, Pruritus
SMQs:, Anaphylactic reaction (broad), Glaucoma (broad), Hypersensitivity (broad)
Write-up: Redness and itching of lt eye. Seen in ER.

VAERS ID:199250 (history)  Vaccinated:2003-02-22
Age:50.0  Onset:2003-03-01, Days after vaccination: 7
Gender:Female  Submitted:2003-03-11, Days after onset: 10
Location:Puerto Rico  Entered:2003-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper respiratory tract infection
Preexisting Conditions: None
Diagnostic Lab Data: Samples obtained from 2 lesions (vesicle top, smear of the base, and a swab)
CDC Split Type: PR001
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Other     Purchased by: Unknown
Symptoms: Headache, Pyrexia, Rash macular, Skin ulcer
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: On March 1, 7 days after accidentally touching her son''s smallpox vaccination site pustule, started running high fever (101), and headache. One day later macular rash in trunk and arms lasting 24 hours. Fever and headache continued for 4-5 days. She observed 2 round red lesions on the third day of fever, located in the chest right under the breast (one left and one right) painful initially but then very itchy, 2x2 cm, with what looked a pustule in the middle. When we actually explored the patient, the lesions where 1x1 cm with a tiny pustule (4mm) in teh middle and had no fever anymore.

VAERS ID:199459 (history)  Vaccinated:2003-02-19
Age:50.0  Onset:2003-03-03, Days after vaccination: 12
Gender:Female  Submitted:2003-03-12, Days after onset: 9
Location:Pennsylvania  Entered:2003-03-12
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chronic hepatitis (I do not know type as I am not her usual provider)
Diagnostic Lab Data: Lab testing done at Medical Center, I am not aware of her test results.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200711IDLA
Administered by: Military     Purchased by: Military
Symptoms: Hepatitis, Jaundice
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow)
Write-up: Patient with prior history of Hepatitis (I do not know type). Recieved smallpox vaccination and noted to be progressively jaundiced. Currently diagnosed as possibly having autoimmune hepatitis and/or chronic hepatitis. Patient has been an inpatient at hosptial since 03/03/03.

VAERS ID:199835 (history)  Vaccinated:2003-03-07
Age:50.0  Onset:2003-03-11, Days after vaccination: 4
Gender:Male  Submitted:2003-03-12, Days after onset: 1
Location:Utah  Entered:2003-03-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prevacid, HCTZ
Current Illness: NONE
Preexisting Conditions: High blood pressure, esophageal spasms every 3-5 yrs.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Anxiety, Chest discomfort, Confusional state, Dizziness, Headache, Hyperhidrosis, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (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 (narrow), Vestibular disorders (broad)
Write-up: On day 4 post-vaccine, sudden onset of anxiety, chest heaviness, dizziness, confusion, headache, nausea, sweats. Evaluated in ER. No treatment.

VAERS ID:199836 (history)  Vaccinated:2003-03-03
Age:50.0  Onset:2003-03-09, Days after vaccination: 6
Gender:Female  Submitted:2003-03-12, Days after onset: 3
Location:Utah  Entered:2003-03-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771 LA
Administered by: Public     Purchased by: Private
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: Cellulitis at injection site. Treated with Rocephin 500 mg IM and Keflex 500mg a 4 times a day for 10 days.

VAERS ID:199890 (history)  Vaccinated:2003-01-15
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2003-03-07
Location:California  Entered:2003-03-19, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)SMITHKLINE BEECHAM235AA0 LA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0823AA0 RA
Administered by: Private     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: Pt states after 2 months arm continues to feel painful and weak in left arm. One full month of documented pain.

VAERS ID:200213 (history)  Vaccinated:2003-02-21
Age:50.0  Onset:2003-02-21, Days after vaccination: 0
Gender:Female  Submitted:2003-03-25, Days after onset: 32
Location:Maryland  Entered:2003-03-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Morphine for pain control at hospital
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data: Lumbar puncture showed unremarkable spinal fluid cytology and glucose levels; spinal fluid protein of 49 is slightly above that laboratory''s upper limit of normal (45); ESR of 18 within lab''s normal limits; CBC showed a slight anemia with s
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH1531IDUN
Administered by: Public     Purchased by: Public
Symptoms: Headache, Laboratory test abnormal
SMQs:
Write-up: Headache, developing on day of vaccination ("2/22/03")after being vaccinated; H/A continuous and escalated to 3/20, when described as 10 on a scale where 10 indicates worst pain ever experienced; hospitalized through Emergency Department of a local hospital on 3/21 for diagnostic studies and pain management.

VAERS ID:200237 (history)  Vaccinated:2002-06-28
Age:50.0  Onset:2002-07-29, Days after vaccination: 31
Gender:Female  Submitted:2003-01-08, Days after onset: 163
Location:Mississippi  Entered:2003-03-26, Days after submission: 77
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: Possibly Penicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV063 SCRA
Administered by: Public     Purchased by: Other
Symptoms: Hypokinesia, Injection site erythema, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pain in right shoulder and upper arm - Began after 3rd vaccine 7/29/2002. Have limited arm mobility. (Visited Chiropractor) Severe local redness at site of injection 1/8/2003.

VAERS ID:200270 (history)  Vaccinated:2003-01-17
Age:50.0  Onset:2003-01-30, Days after vaccination: 13
Gender:Female  Submitted:2003-02-07, Days after onset: 8
Location:Indiana  Entered:2003-03-26, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HRT
Current Illness: NONE
Preexisting Conditions: Cephalexin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0530M0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Gait disturbance, Oedema peripheral, Osteoarthritis, Pain, Pyrexia, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Onset 1/30/03 "Lumps" posterior neck, above ear - "top of head hurt" - 2/1/03 Onset rash back, buttocks, anterior chest - little on arms & legs w/low grade fever. 2/2/03 - swelling of joints (wrist, knees, ankles) - "couldn''t hardly walk" - Took Ibuprofen 499 mg Q 4-6 x 5 days - developed migraine - took Amerga(?). 2/7/03 - Onset discomfort in hands esp. left middle finger with swelling. Discomfort in ankles, knees - resolved.

VAERS ID:200523 (history)  Vaccinated:2003-03-18
Age:50.0  Onset:2003-03-19, Days after vaccination: 1
Gender:Female  Submitted:2003-03-27, Days after onset: 8
Location:California  Entered:2003-03-31, 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:
Current Illness:
Preexisting Conditions: DM; Asthma
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1119M IMRA
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0816AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Presented to ED complaining of headache, myalgias and pain most intense at right shoulder/axilla. No fever, rash, focal neuro symptoms, chest pain or SOB. No erythema, warmth or induration. No joint swelling.

VAERS ID:200658 (history)  Vaccinated:2003-03-17
Age:50.0  Onset:2003-03-24, Days after vaccination: 7
Gender:Female  Submitted:2003-04-01, Days after onset: 8
Location:Florida  Entered:2003-04-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Rhinocort nasal spray
Current Illness: NONE
Preexisting Conditions: Mitral valve prolapse
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200772 LA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Injection site warmth, Lymphadenopathy, Skin striae
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: On the evening on 3/24/03 the vaccinee noted an area of streaking from reddened area surrounding the vaccination site extending downward forward the inner elbow. By the AM of 3/25/03 the area was 3 1/2" long x 1 1/2" wide with redness, edema and hot to touch with pain. Pt also had swollen lymph nodes in same arm. Saw physician on 3/28 and was treated by anti inflam? and cold compresses. Involved area lymph nodes had resolved within 3 days.

VAERS ID:200803 (history)  Vaccinated:2003-02-24
Age:50.0  Onset:2003-02-25, Days after vaccination: 1
Gender:Female  Submitted:2003-02-26, Days after onset: 1
Location:Kansas  Entered:2003-04-02, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: KS200312
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0815AA0 LA
Administered by: Public     Purchased by: Other
Symptoms: Feeling hot, Injection site mass, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)
Write-up: Received TD at 05:30pm on 02/24/2003. On 02/25/2003 noticed knot the size of a golf ball, warmth, tenderness, sore muscle.

VAERS ID:200821 (history)  Vaccinated:2003-02-21
Age:50.0  Onset:2003-03-13, Days after vaccination: 20
Gender:Female  Submitted:2003-04-01, Days after onset: 19
Location:Mississippi  Entered:2003-04-02, 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: HCTZ
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: MS03015
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771IDLA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Dyspnoea, Headache, Heart rate increased, Hypertension, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad)
Write-up: 3/13/03 PATIENT DEVELOPED NAUSEA, SOB, CP, HA, BP 196/96, PULSE 110. STATES NO PREVIOUS HX OF CARDIA PROBLEMS. CONTINUES TO HAVE SOB 4/01/03.

VAERS ID:200834 (history)  Vaccinated:2003-02-17
Age:50.0  Onset:2003-03-21, Days after vaccination: 32
Gender:Female  Submitted:2003-04-02, Days after onset: 12
Location:Florida  Entered:2003-04-03, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lithoid and Premarin
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: CXR: nml heart size, COPD 3/31/2003; WBC 21,000, 82 percent Neudrophils, ESR 7, CHem 7 wnl, LFTs wnl, EKG NSR, heart rate 67, Non-specific T wave changes, O2 sat (room air) 88 percent
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771 LA
Administered by: Public     Purchased by: Public
Symptoms: Cough, Hypoxia, Nasal congestion, Pneumonia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad)
Write-up: 3/21/2003 Pt seen in ER for cough, green nasal discharge and congestion. Started on Z pack and Allegra with no improvement. CXR showed L upper lobe infiltrate. On 3/26/2003 seen by PMD and given po Tequin amd Medrol dose pack. Seen in ER on 3/30/2003 with worsening sx and temp 101. Admitted to hospital with diagnosis of pneumonia and hypoxia. Had no cardiac sx. EKG nml except for non specific T wavw abnormalities. WBC=21,000, CXR showed COPD. Treated with IV antibiotics and steroids. VQ scan ruled out PE. Patient remains hospitalized.

VAERS ID:201118 (history)  Vaccinated:2003-03-11
Age:50.0  Onset:2003-03-29, Days after vaccination: 18
Gender:Unknown  Submitted:2003-04-07, Days after onset: 8
Location:Illinois  Entered:2003-04-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: no
Diagnostic Lab Data: EKG, CBC, CPK
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771IDLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypokinesia, Joint stiffness, Joint swelling
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: Vaccinated with Smallpox vaccine (Lot#40200770 and Diluent Lot # 802236A) on 03/11/2003 @ Health Department on left upper arm. Take check varied on 3/18/2003 as major by R.N. Started with C/o shortness of breath while performing routine gardening activites on 3/38-29-2003. Within the next 2-3 days developed stiffness and swelling in all joints both of upper and lower extremities. Impaired mobility and dexterity of both hands. Incapacitating for normal work activities in practice for Monday 3/31/03, 04/01 and 04/02/2003. After information regarding cardiac recommendation, seen by M.D. and EKG, CBC, and CPK obtained. All testing reported as normal. Resumed office duties on 04/03/03 with residual stiffness of joints. Denies chest pain or other cardiac symptoms.

VAERS ID:201224 (history)  Vaccinated:2003-03-28
Age:50.0  Onset:2003-03-30, Days after vaccination: 2
Gender:Female  Submitted:2003-04-08, Days after onset: 8
Location:North Dakota  Entered:2003-04-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: EKG - Normal Heart monitor - normal Troponin T - normal at 0.01 CBC - Normal PT, PTT - Normal Echocardiogram - Normal
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IDRA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Dyspnoea, Heart rate increased, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Onset 03/30/2003 Chest discomfort, short of breath, slight fever - Seen in ER Rx with tylenol 04/03 Complained of heavy chest, Apprehension, Temp 101.9, Increased heart rate on exertion

VAERS ID:201356 (history)  Vaccinated:2003-03-25
Age:50.0  Onset:2003-04-01, Days after vaccination: 7
Gender:Female  Submitted:2003-04-10, Days after onset: 8
Location:California  Entered:2003-04-11, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EKG, CXR nl CPK, Tuiporin nl
CDC Split Type: CA030016
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020077  LA
Administered by: Public     Purchased by: Public
Symptoms: Chest discomfort, Dizziness, Malaise
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: 04/01/2003 pt c/o of dizziness on and off since SP vaccine Also reports "tightening of chest area" 2-3 times. Evaluated. Referred to UCI ED for evaluation. c/o dizzy and 4 days worse today. This is a 51 year old female who was sent from the health dept because she had diizziness and malaise for the past 4 days. Five days ago the pt reports that she had an episode of chest tightness that lasted 10 minutes. the pt has had no pain or discomfort in her chest since. The pt received a SP vaccine 1 week ago. The pt has no headache, change in mental status, change in vision, weakness, numbness, trouble thinking, talking or walking: no fever, no rash. Th health dept. doctor referred the pt here saying that her vaccine site appeared consistent with a normal reaction. The pt also has a history of having has SP as a child.

VAERS ID:201388 (history)  Vaccinated:2003-03-19
Age:50.0  Onset:2003-04-10, Days after vaccination: 22
Gender:Female  Submitted:2003-04-12, Days after onset: 2
Location:Ohio  Entered:2003-04-12
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: none except for osteoarthritis and depression and has not been on any meds for $g4 months
Diagnostic Lab Data: none at this time..she is to see the dermatologist on april 15 at 0815
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 1IDLA
Administered by: Public     Purchased by: Unknown
Symptoms: Headache, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: On day 22 post vaccinia administration, she developed headache at 0400 that woke her from sleep. later that day around 1600 she developed a truncal rash that spread peripherally. rash was very pruritic and spread to palms / soles/ arms/legs. she saw ER doc (employed as an RN there) and was prescribed 20 mg of prednisone. she took benadryl 50 mg and called me on april 12 in the am..took photos and contacted Dept of Health and CDC.

VAERS ID:201527 (history)  Vaccinated:2003-04-02
Age:50.0  Onset:2003-04-10, Days after vaccination: 8
Gender:Female  Submitted:2003-04-11, Days after onset: 1
Location:Oregon  Entered:2003-04-14, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: or200313
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200761IDLA
Administered by: Public     Purchased by: Unknown
Symptoms: Cellulitis, Feeling hot, Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt vaccinated on 4/2/2003. On 4/10/03 noted to have erythema surrounding vaccine site, approx 3" Site warm to touch, tender. No fever. Nodes palpable. Diagnosis: cellulitis. prescribed dicloxicillin 500 mg po qid x 10 days.

VAERS ID:201506 (history)  Vaccinated:2003-04-08
Age:50.0  Onset:2003-04-08, Days after vaccination: 0
Gender:Female  Submitted:2003-04-10, Days after onset: 2
Location:New York  Entered:2003-04-15, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Flu vaccine, CT contrast, MSG allergy
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5312C60IMRA
Administered by: Other     Purchased by: Other
Symptoms: Anxiety, Flushing, Pruritus, Tongue disorder
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: C/O severe itching, increase anxiety. C/O tongue itching, remained a & o x 3 no SOB lungs clear. Given Benadryl 50mg po x 1 with resolution of symptoms. 10:10 given vaccine. 10:20 c/o severe itching, anxious, no hives, lungs clear bilaterally BP 158/100 P 80 R 18 unlabored. Approx 10:22 contacted PCP. 10:28 50mg Benadryl po x 1. 10:35 itching severe, c/o tongue itching. No c/o SOB, midly anxious. No c/o tongue thickness a & o x 3. BP 140/86 P 76 RR 22. 10:50 c/o generalized itching tongue itching resolved. 10:55 lung sounds clear bilaterally no stridor noted 140/85 P 76 R 20 anxiety minimal, itching sensation partially relieved. 11:05 BP 140/90 R 20 P 72 lungs clear. Skin not as pink/ flushed, itching much less. 11:40 BP 132/78 P 78 R 16 breath sounds clear bilaterally calm no anxiety, states itching almost resolved. 12:15 allowed to leave clinic site.

VAERS ID:201832 (history)  Vaccinated:2003-04-13
Age:50.0  Onset:2003-04-13, Days after vaccination: 0
Gender:Female  Submitted:2003-04-18, Days after onset: 5
Location:Washington  Entered:2003-04-18
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: Acne
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0714SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site hypersensitivity, Injection site oedema, Injection site pain, Injection site reaction, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Moderate to severe localized reaction right arm anterior half armpit to two inches below elbow- Red, hot, swollen itchy, tender

VAERS ID:202353 (history)  Vaccinated:1999-06-23
Age:50.0  Onset:1999-09-01, Days after vaccination: 70
Gender:Female  Submitted:2003-04-23, Days after onset: 1330
Location:New York  Entered:2003-04-30, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Penicillin, sulfa (antibiotics).
Diagnostic Lab Data: Positive western blot for Lyme-May 2002
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 0  
Administered by: Private     Purchased by: Private
Symptoms: Balance disorder, Chest pain, Dizziness, Ear pain, Fatigue, Headache, Hypoaesthesia, Infection parasitic, Influenza like illness, Insomnia, Nausea, Neurological symptom, Pain, Pharyngeal oedema, Pyrexia, Toothache, Vertigo
SMQs:, Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypersensitivity (narrow)
Write-up: I began to have flu-like symptoms, slight fever, achiness, nausea and I thought I had flu. I also developed headaches, vertigo, numbness in my arms and legs, and neurological symptoms-pain in teeth, tongue throat, chest. I have extreme fatigue, bladder symptoms, and problems sleeping. I have been treated for Lyme disease, after testing positive, which was after LYMErix vaccine. I have been on various courses of antibiotics which have included: Doxycycline 200mg per day-2 months, Zithromax 500mg per day-3 months, Primaxin 1500mg per day IV-6 weeks; Zithromax 750mg per day-6 weeks to present and continuing. I began having symptoms after the Lymerix vaccine, but did not realize that my illness could have been a result of the vaccine. I was sick for 3 out of 6 months after the first 2 doses of the vaccine, which was the last month of 1999. I was sick on and off in 2000, with a bad episode in the fall of 2000 beginning in September. In 2001, my symptoms seemed to worsen and included severe headaches, toothaches, earaches, a feeling of swelling in my throat, pressure and pain in the chest, faintness, dizziness, weakness, severe fatigue, and muscle aches. At the end of 2001, I became so ill that I could not work. I was sick for months and never really recuperated-all of the same symptoms grew worse. I began to experience crushing pressure in my head and tingling and prickling sensations in my arms, hands, legs and all over-even the face and spine. I had severe neurological symptoms in my bladder. I returned to the doctor several times with various symptoms, but was never diagnosed with Lyme until May of 2002. I began treatment at the very end of May 2002 and am still being treated. I am also still sick every day and have dramatically curtailed my usual activities. 60 day follow up states: pt has headaches, earaches, vertigo, tingling in arms and hands, legs and feet, fatigue (extreme), a feeling of fullness and pressure in head, chest, stomach. This particularly effects the face, ears, jaw, and throat. Pt has not felt h

VAERS ID:202410 (history)  Vaccinated:2003-03-25
Age:50.0  Onset:2003-04-13, Days after vaccination: 19
Gender:Female  Submitted:2003-04-28, Days after onset: 15
Location:Virginia  Entered:2003-04-30, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: NA
CDC Split Type: VA03-S007
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200761IDUN
Administered by: Public     Purchased by: Public
Symptoms: Erythema multiforme, Rash macular
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: upper arms, trunk and upper thighs - 1-1.5 cm sl. elevated "macules", well scattered, asymptomatic. erythema multiforme minor according to a local physician. Rx: watchful waiting

VAERS ID:202658 (history)  Vaccinated:2003-04-04
Age:50.0  Onset:2003-04-19, Days after vaccination: 15
Gender:Female  Submitted:2003-05-05, Days after onset: 16
Location:Maryland  Entered:2003-05-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771SCLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Musculoskeletal stiffness, Neck pain
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: 50 yo WF day 16-17 onset of "dull headache/neck pain" described as dull ache at the occiput/nape of neck. Pt described neck as "stiff/sore" but has FROM, no N/V/F/change in vision although states "my eyes feel strange" but when she looked in the mirror, stated that her eyes "looked normal". Vaccine site clean and dry. No paresthesias/neuropathies. Pt went home from work w/instructions to seek assistance if sx worsened. 4/22/03: pt still at home - no change in sx, unrelieved with ibuprofen but states more comfortable resting at home. 4/23/03: improved sx but still at home. 4/24/03: pt states sx resolved - back at work.

VAERS ID:202858 (history)  Vaccinated:2003-03-24
Age:50.0  Onset:2003-04-04, Days after vaccination: 11
Gender:Male  Submitted:2003-05-09, Days after onset: 34
Location:California  Entered:2003-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Blood Pressure
Current Illness: None.
Preexisting Conditions: Diabetes; hypertension
Diagnostic Lab Data: Cardiac Treadmill
CDC Split Type: CA030035
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020077   
Administered by: Public     Purchased by: Unknown
Symptoms: Arthralgia, Chest pain, Lethargy, Nausea
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad)
Write-up: Lethargy; sore, achy joints; chest pain; nausea

VAERS ID:202860 (history)  Vaccinated:2003-04-29
Age:50.0  Onset:2003-04-29, Days after vaccination: 0
Gender:Female  Submitted:2003-05-09, Days after onset: 10
Location:New York  Entered:2003-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Blood Pressure initially 120/90 Five minutes later was 118/75
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200761IDRA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient developed hives on her face approximately 10 minutes after inoculation. Patient was monitored and no other symptoms were noted.

VAERS ID:202890 (history)  Vaccinated:1999-02-18
Age:50.0  Onset:1999-02-18, Days after vaccination: 0
Gender:Male  Submitted:2003-05-04, Days after onset: 1535
Location:Florida  Entered:2003-05-12, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone, Relafen, Premarin
Current Illness: Systemic Lupus Eryth.
Preexisting Conditions: Penicillin, Clinoril, Septra
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Influenza like illness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad)
Write-up: Low grade temperature of 101 degrees F. Flu like symptoms. In bed all weekend. Very weak. (It''s been so long-all the details are not clear.) The follow up received on 5/23/03 states "the doctor''s office told me that they did not have the manufacturer or lot #. If you need need that info, you will have to call Dr."

VAERS ID:202927 (history)  Vaccinated:2003-01-30
Age:50.0  Onset:2003-02-28, Days after vaccination: 29
Gender:Female  Submitted:2003-05-12, Days after onset: 72
Location:South Dakota  Entered:2003-05-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucotrol, Glucophage, Tenuate, Prozac, Lipitor
Current Illness: None
Preexisting Conditions: Allergy to Ceclor. Medical conditions of hypertension (controlled) and Type 2 Diabetes.
Diagnostic Lab Data: xray
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IDRA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Arthritis, Nail discolouration, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (narrow)
Write-up: Patient called the CDC Clinician Information Line on 5-9-03 to ask about some symptoms since receiving the Smallpox vaccination. They told her to fill out a VAERS report. Patient states that she has been recently diagnosed with degenerative arthritis. It has been affecting her first digit of her little finger on her right hand. She began having some minor discomfort in it about a month after getting the smallpox vaccination. States she has very little cartilage left. A couple of weeks ago she noticed that the nail bed was white. States she has good circulation to the finger but that the joint is swollen and painful with movement. Patient states that this is the only joint affected at this time. Patient is a diabetic but has no history of cardiac problems. Patient states that her arm still aches at times where her vaccination was given.

VAERS ID:203150 (history)  Vaccinated:2003-03-11
Age:50.0  Onset:2003-03-22, Days after vaccination: 11
Gender:Female  Submitted:2003-05-14, Days after onset: 52
Location:Texas  Entered:2003-05-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771IDLA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: C/O Chest pain on 3/22 and 3/23, pain went through chest area and then went away. Did this Approx. 3 times in 30 minute time period. No other c/o voiced at that time.

VAERS ID:203167 (history)  Vaccinated:2003-05-07
Age:50.0  Onset:2003-05-07, Days after vaccination: 0
Gender:Female  Submitted:2003-05-09, Days after onset: 2
Location:Unknown  Entered:2003-05-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEUR  SC 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Pt was given Diphtheria/Tetanus Adult intradermally instead of the tuberculin Mantoux intended. The area became reddened up to 8 cm with 1 cm area dark red and hard. Pt complains of stinging and itching.

VAERS ID:203188 (history)  Vaccinated:2003-03-18
Age:50.0  Onset:2003-03-20, Days after vaccination: 2
Gender:Male  Submitted:2003-05-15, Days after onset: 55
Location:Ohio  Entered:2003-05-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771IDRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: pt recieved his smallpox vaccination in the right arm and it was covered with an occlusive dressing. Approx. 48 hours later he noticed a vaccinia lesion on his left arm that then progressed through the same stages as the vaccination site. He stated he had never removed the originally applied dressing at the time he discovered the lesion on the left arm

VAERS ID:203426 (history)  Vaccinated:2003-02-19
Age:50.0  Onset:2003-04-27, Days after vaccination: 67
Gender:Female  Submitted:2003-05-20, Days after onset: 23
Location:Minnesota  Entered:2003-05-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: PCR for vaccinia was negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Public     Purchased by: Public
Symptoms: Blister, Erythema, Injection site induration, Lymphadenopathy, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Smallpox vaccination and subsequent major reaction, scab took over four weeks to detach. Following detachment, site was still erythematous and pruritic and there was persistent axillary lymphadenopathy. 4/27/03 site became indurated and was raised, however no lymphadenopathy. Evaluated by an Infectious Disease physician on 4/29/2003: 0.8 cm area of erythema on scar, indurated, raised non-tender, large flat vesicles in the area. Specimens were collected from the site and tested for vaccinia.

VAERS ID:203553 (history)  Vaccinated:2003-01-23
Age:50.0  Onset:2003-02-05, Days after vaccination: 13
Gender:Male  Submitted:2003-05-21, Days after onset: 104
Location:Texas  Entered:2003-05-21
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: 8 weeks after symptoms, resting stress echo showed no myocarditis or ischemia and cardiac enzymes and troponin normal
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200711  
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Cough, Dysphagia, Fatigue, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Chest pain,dysphagia, dry cough, tachycardia with mild exertion, and profound fatigue 12 days after smallpox vaccination

VAERS ID:203531 (history)  Vaccinated:2003-05-14
Age:50.0  Onset:2003-05-17, Days after vaccination: 3
Gender:Male  Submitted:2003-05-20, Days after onset: 3
Location:Texas  Entered:2003-05-22, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)AVENTIS PASTEURU13881IMLA
Administered by: Other     Purchased by: Private
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pt received rabies vaccine 5/14/03 - began itching on arms on 5/17/03 without visible rash. Arm itching subsided by 5/19/03 when began itching on palms and anterior surface of feet for 1-2 hours. This also subsided. Tx Benadryl 25 mg PO x 1.

VAERS ID:204053 (history)  Vaccinated:2003-02-20
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2003-06-02
Location:Florida  Entered:2003-06-02
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: Asthma
Diagnostic Lab Data: Abnormal MRI; Hearing loss
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Demyelination, Dizziness, Ear pain, Hypoacusis, Otitis media, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Demyelination (narrow), Hearing impairment (narrow), Vestibular disorders (broad)
Write-up: 5 days after I had the vaccine, I developed an earache and fever. I went to my doctor, he said I had otitis media in my left ear. He treated me with an antibiotic. I returned two more times to him due to the pain. I have no other hx of ear infection. He referred me to an ENT as I was losing my hearing, felt dizzy. The other doctor said I no longer had an infection and tested my hearing and I had some deafness in my left ear (I had no trouble hearing prior to vaccination). In a couple of weeks, I return to the specialist and I told him that the pain and deafness was gone. He wanted a MRI to r/o a brain tumor. I had the MRI and it suggests demyeinating disease. I will see a neurologist in about 1 week. I wonder if the ear infection, deafness, and lesions of white matter on MRI could be related to the vaccine. Did this happen to anyone else? Thank you.

VAERS ID:204364 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2003-05-30
Location:Alaska  Entered:2003-06-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES0208USA04071
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Information has been received from a physician concerning a 50 year old female who was vaccinated with MMR II prior to medical school. Subsequently the pt experienced arthralgias and myalgia. Unspecified medical attention was sought. Additional info has been requested.

VAERS ID:204438 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Male  Submitted:2003-05-30
Location:Unknown  Entered:2003-06-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: Diagnostic laboratory: 0.00, measles titer; Diagnostic laboratory: 0.39, measles titer after MMRII booster
CDC Split Type: 0212USA02251
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a registered nurse concerning a 50 year old male patient who was vaccinated with measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation). Subsequently the patient had a measles titer of 0.00. He was given a booster of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) and the level went to 0.39. Unspecified medical attention was sought. Additional information has been requested.

VAERS ID:204520 (history)  Vaccinated:2003-05-21
Age:50.0  Onset:2003-05-21, Days after vaccination: 0
Gender:Female  Submitted:2003-05-27, Days after onset: 6
Location:Nevada  Entered:2003-06-05, 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: Iodine, sulfur, flu shot, Scullys anemia, hypothyroidism
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU0820AA IMRA
Administered by: Military     Purchased by: Military
Symptoms: Dry mouth, Injection site induration, Injection site oedema, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Body rash, aches, fever, localized swelling, cotton mouth, swelling up to right side of neck. 3cm x 4cm area of induration on right upper deltoid area. Pain in area of vaccine.

VAERS ID:204655 (history)  Vaccinated:2003-04-11
Age:50.0  Onset:2003-04-21, Days after vaccination: 10
Gender:Female  Submitted:2003-05-02, Days after onset: 11
Location:Ohio  Entered:2003-06-09, Days after submission: 38
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: Dr. wrote note stating he had impression that the rash and arthralgia was adverse reaction to MMR on 4/11/03.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0542M1IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0631M0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Asthenia, Difficulty in walking, Lymphadenopathy, Ocular hyperaemia, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 4/23 - Achy, could not walk up and down stares. Pink prickly rash - 4/25 (trunk and extremities) no resp. symptoms. Arthralgia, joint pain , weak, tired. No fever, wrists and hands painful and weak. Neck felt funny, lymph nodes felt "weird". Redness in eyes, looked like conjunctivitis (per patient).

VAERS ID:204658 (history)  Vaccinated:2003-03-03
Age:50.0  Onset:2003-05-30, Days after vaccination: 88
Gender:Female  Submitted:2003-06-09, Days after onset: 10
Location:Wyoming  Entered:2003-06-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HCTZ, Zocor
Current Illness:
Preexisting Conditions: Hypertension Elevated Cholesterol
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH   LA
Administered by: Unknown     Purchased by: Public
Symptoms: Injection site vesicles, Skin ulcer
SMQs:
Write-up: Patient had normal take with 1 satellite lesion at 2 cm from main site. No complications. On 5/30/03, noted vesicle (~2 mm diam) at vaccination site and 4-6 red papules near site. No induration or fluctuance. No systemic symptoms.

VAERS ID:204809 (history)  Vaccinated:2003-02-28
Age:50.0  Onset:2003-03-17, Days after vaccination: 17
Gender:Female  Submitted:2003-06-11, Days after onset: 85
Location:Texas  Entered:2003-06-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: High B/P, hypercholesterolemia, and Thyroid Storm
Diagnostic Lab Data: Echocardiogram, ultra-sound, stress test, Holter monitor, and labwork.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771 LA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: 3/17/03 Started having palpitations and chest pain. Client is taking B/P meds. Needed echocardiogram on 3/19 the ultrasound during week of the 24th. 4/3 and 4/5 had another episode of palpitations and chest pain. Stress test done 4/7. Changed meds., wore Holter monitor for 1 week. 5/27 had thyroid storm.

VAERS ID:204832 (history)  Vaccinated:2002-10-16
Age:50.0  Onset:2002-11-01, Days after vaccination: 16
Gender:Female  Submitted:2003-06-11, Days after onset: 221
Location:North Carolina  Entered:2003-06-12, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluticasone+salmeterol; Triamcinolone acetonide; Sertraline hydrochloride; Beclomethasone dipropion
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: A0403185A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS 1  
Administered by: Private     Purchased by: Private
Symptoms: Bronchitis, Upper respiratory tract infection
SMQs:
Write-up: This report describes the occurrence of bronchitis in a 50 year old female who was vaccinated with hepatitis A inactivated and hepatitis B recombinant vaccine (Twinrix) for prophylaxis. This report was received from the subject and has been verified by a physician. The subject reported that she had no relevant medical history or allergies. However, she reported that concurrent medications included fluticasone proprionate+salmeterol xinafoate and triamcinolone acetonide nasal spray. Her physician reported that the concurrent medications were sertraline hydrochloride and beclomethasone dipropionate nasal spray. The subject received her first injection of Twinrix on 9/17/02; no adverse experiences were reported following this injection. The subject received her second injection of Twinrix on 10/16/02. In November 2002, she developed a severe upper respiratory infection. She was seen by a physician, who made a diagnosis of bronchitis and prescribed two courses of amixicillin clavulanate. The bronchitis resolved. The subject received her third injection of Twinrix on 3/18/03. In April 2003, she again became very ill with bronchitis. As of 4/3/03, she was being treated with levofloxacin. The subject stated that she mentioned this respiratory infection as a possible reaction and he (her primary physician) said it was not likely the cause. I think it was since I reacted after two shots--same symptoms exactly ten days after each shot. The most recent information received was from the treating physician on 6/2/03. The bronchitis resolved. The reporting physician stated, Although I cannot exclude a cause-effect relationship, I am not suspicious of it. The reporting physician considered the two episodes of bronchitis to be serious because they required intervention (the administration of antibiotics) to prevent serious outcome. Therefore, this report has been reclassified as serious.

VAERS ID:204907 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:2002-11-15
Gender:Male  Submitted:2003-05-08, Days after onset: 173
Location:California  Entered:2003-06-13, 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:
Current Illness: NONE
Preexisting Conditions: Previous initial episode of brachial neuritis 1994.
Diagnostic Lab Data: MRI
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Muscle atrophy, Muscular weakness, Neuritis, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Brachial neuritis 2-3 weeks post vaccine onset. Tx: Analgesics, steroids, MRI, upper plexus distribution. Severe pain, muscle atrophy (c 5-6 distribution), weakness 3 month duration. 70-80% recovery of muscle strength.

VAERS ID:205159 (history)  Vaccinated:2003-01-14
Age:50.0  Onset:2003-01-19, Days after vaccination: 5
Gender:Female  Submitted:2003-06-18, Days after onset: 149
Location:Georgia  Entered:2003-06-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None, Graves disease in 1997-1999 in remission, advised staff of this
Diagnostic Lab Data: ana, crp, sed rate, ct scans, broncoscophy, cbc, xrays
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Other     Purchased by: Other
Symptoms: Alopecia, Arthralgia, Atelectasis, Bacterial infection, Candidiasis, Chills, Cough, Dyspnoea, Joint range of motion decreased, Laboratory test abnormal, Lung disorder, Lymphadenopathy, Malaise, Neck pain, Pain, Pharyngolaryngeal pain, Pleurisy, Pneumonia, Pyrexia, Systemic lupus erythematosus, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Vaccine on 1-14-03; Adverse events: 1-19-03,01-20-03 sore throat, swollen lymph nodes, malaise, 01-27-03 viral throat ulcers; 01-27-03 malaise and fever, took Tylenol and prescribed lido/vsc; 02-03-03 sore throat, 02-5-03 left vaccine arm very sore unable to raise arm over head, node between left thumb & index finger sore; 02-07-03 scab fell off, temp of 100.2, malaise took Tylenol; 0208/ 02-09-03 joint pain, malaise, diagnosed w/ bacterial throat infection, 02-10-03 sore throat, neck, joints, chills dry cough, and temp 101.02 prescribed endocet. 02-11-03 thru 2-13-03 fevers between 102.7 to 103.01, cough joint pain, chills vomiting; on 02-13-03 addmitted to Hospital for bi-pneumonia, antibiotics and steroids administerd; had steroid induced diabetes which went away after stopped steroids; discharged 02-18-03; 02-21-03 sore throat and thrush; fevers 02-24-03, sore throat 02-25-03, fever and left knee, and hip swollen 02-26-03 thru 02-26-03; relapse 03-07-03 readmitted to hosp w/bi-pneumonia; discharged 03-19-03 no fever; but fevers resumed 04-07-03 thru 04-10-03; referred to Lung Specialist, put on Prednisone 10mg to control fevers, ana up, sed rate up, crp up, fluid on lungs; fevers again 05-22-03 thru 05-24-03 Prednisone upped to 20mg, developed shortness of breath upon exertion; fluid cleared 05-22-03; bottom part of lungs have stopped expanding; Referred to rheumatologist, ana negative but other tests positive, vaccine seems to have triggered lupus; will need lung biopsy to verify; (WILL BE scheduled in late June) Unable to work Prednisone increased to 40mg then 60mg daily, lower bases of lungs hurt; have had 2 lung infections in 5-03, re-occurring Pleurisy, shortness of breath increasing, hair shedding, aches, malaise.

VAERS ID:205636 (history)  Vaccinated:2003-06-20
Age:50.0  Onset:2003-06-20, Days after vaccination: 0
Gender:Female  Submitted:2003-06-23, Days after onset: 3
Location:Unknown  Entered:2003-07-01, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEUR  IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Chest pain, Injection site erythema, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Pt had dt booster left deltoid - experienced slight fever, malaise, localized reaction with erythema and cellulitis. Had chest pain with negative EKG. Pt had had (she thinks) 3 dt''s in about 5 years? No SOB or anaphlactic reaction.

VAERS ID:205754 (history)  Vaccinated:2003-06-24
Age:50.0  Onset:2003-06-25, Days after vaccination: 1
Gender:Male  Submitted:2003-06-26, Days after onset: 1
Location:New York  Entered:2003-07-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0840AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pain, tenderness, swelling at injection site (left deltoid)

VAERS ID:205827 (history)  Vaccinated:2003-01-31
Age:50.0  Onset:2003-05-10, Days after vaccination: 99
Gender:Female  Submitted:2003-07-03, Days after onset: 54
Location:New Jersey  Entered:2003-07-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Public     Purchased by: Public
Symptoms: Diplopia, Dysphagia, Eyelid ptosis, Multiple sclerosis, Neurological symptom, Paresis, Speech disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Optic nerve disorders (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)
Write-up: On post vaccination day 99, patient began to complain of neurologic symptoms: diplopia, ptosis, leg paresis, dysphagia, and blurred speech. Saw a neurologist 3 days later who gave a diagnosis of multiple sclerosis. Clinical team in process of obtaining documentation.

VAERS ID:205930 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Male  Submitted:2003-07-07
Location:Unknown  Entered:2003-07-09, Days after submission: 2
Life Threatening? Yes
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: Rabies exposure
Diagnostic Lab Data:
CDC Split Type: MA20030347
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABIPUR)CHIRON CORPORATION    
Administered by: Other     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: We received from our license partner the information that in a local newspaper the following case was reported: A 50 year old male patient was admitted to a hospital in October 2002 and was administered Rabipur following exposure. Afterwards he was discharged from hospital. Following rabies symptoms he was readmitted to the same hospital. Following deterioration of his condition, he was moved to another hospital on 12/4/02, where he died on 12/8/02. We are awaiting further information.

Result pages: prev   3894 3895 3896 3897 3898 3899 3900 3901 3902 3903 3904 3905 3906 3907 3908 3909 3910 3911 3912 3913 3914 3915 3916 3917 3918 3919 3920 3921 3922 3923 3924 3925 3926 3927 3928 3929 3930 3931 3932 3933 3934 3935 3936 3937 3938 3939 3940 3941 3942 3943 3944 3945 3946 3947 3948 3949 3950 3951 3952 3953 3954 3955 3956 3957 3958 3959 3960 3961 3962 3963 3964 3965 3966 3967 3968 3969 3970 3971 3972 3973 3974 3975 3976 3977 3978 3979 3980 3981 3982 3983 3984 3985 3986 3987 3988 3989 3990 3991 3992 3993 3994 3995 3996 3997 3998 3999 4000 4001 4002 4003 4004 4005 4006 4007 4008 4009 4010 4011 4012 4013 4014 4015 4016 4017 4018 4019 4020 4021 4022 4023 4024 4025 4026 4027 4028 4029 4030 4031 4032 4033 4034 4035 4036 4037 4038 4039 4040 4041 4042 4043 4044 4045 4046 4047 4048 4049 4050 4051 4052 4053 4054 4055 4056 4057 4058 4059 4060 4061 4062 4063 4064 4065 4066 4067 4068 4069 4070 4071 4072 4073 4074 4075 4076 4077 4078 4079 4080 4081 4082 4083 4084 4085 4086 4087 4088 4089 4090 4091 4092   next

New Search

Link To This Search Result:
http://www.medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=3993&PERPAGE=100&ESORT=A
GE


Copyright © 2015 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166