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Case Details (Sorted by Age)

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VAERS ID:200856 (history)  Vaccinated:2003-03-30
Age:30.0  Onset:2003-03-31, Days after vaccination: 1
Gender:Male  Submitted:2003-04-03, Days after onset: 3
Location:Unknown  Entered:2003-04-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? 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 BIOSOLUTIONSFAV0721SCRA
Administered by: Military     Purchased by: Unknown
Symptoms: Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Received anthrax and approximately 24 hours later noticed swelling of right upper extremity. This progressed over next 24 hours. No accompanying symptoms such as fever, chills, N/V/D, etc. Denies history of trauma or insect bite. No history of similar sx in past.

VAERS ID:200948 (history)  Vaccinated:2003-04-01
Age:30.0  Onset:2003-04-02, Days after vaccination: 1
Gender:Male  Submitted:2003-04-04, Days after onset: 2
Location:Maryland  Entered:2003-04-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: POS IPPD SINCE 1994
Diagnostic Lab Data: R UPPER ARM 110 X 130 MM EDEMA/ERYTHEMA; NO NODES; AFEBRILE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV 0745SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: PT HAD ANTHRAX #5 24 FEB 2000; FOR ANTHRAX 1-5 HAS HAD SLIGHTLY INCREASING AMOUNTS OF SWELLING AT INJ SITE. THEN HAD ANTHRAX #6 ON 1 APR 03, AND THE FOLLOWING MORNING NOTED VERY RED/SWOLLEN ARM 110MM X 130 MM. NO SYSTEMIC SYMPTOMS. GIVEN NSAIDS AND DIPHENHYDRAMINE.

VAERS ID:201046 (history)  Vaccinated:2003-03-14
Age:30.0  Onset:2003-03-14, Days after vaccination: 0
Gender:Male  Submitted:2003-03-31, Days after onset: 17
Location:Alaska  Entered:2003-04-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NKDA
Diagnostic Lab Data: Cardiac cath
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710SC 
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Headache, Malaise, Pericarditis, Rash, Tonsillitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Systemic lupus erythematosus (broad), Oropharyngeal infections (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Symptoms began on day of vaccination with headache, felt run-down, fatigued. On 3/24, rash developed around vaccine site. Lymph nodes, tonsils were sore. Spread of rash beyond bandage. On 3/27, chest pressure. Sent to hospital. Cath on 3/31/03 normal. Diagnosed with vaccinia related pericarditis.

VAERS ID:201116 (history)  Vaccinated:2003-03-25
Age:30.0  Onset:2003-04-03, Days after vaccination: 9
Gender:Female  Submitted:2003-04-07, Days after onset: 3
Location:Tennessee  Entered:2003-04-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec 10mg tabs, daily multivitamin
Current Illness:
Preexisting Conditions: Seasonal allergies only
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0IDLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Injection site oedema, Lymphadenitis, Lymphangitis, Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: Symptoms include headaches, localized swelling at vaccine site, lymphangitis, lymphadenitis, edema, redness, fever at vaccine and lymphangitis sites. Lymph node involvement includes the axillary, subclavian and submandibular nodes. Time course of symptoms is currently at 5 days. Treatment includes 400-600 mg Naproxen sodium with 50mg Benadryl every 6 hours as needed. Additional events included the appearance of a reddish color maculopapular rash over both arms, neck, face and chest that only lasted a few hours.

VAERS ID:201054 (history)  Vaccinated:2003-01-31
Age:30.0  Onset:2003-01-31, Days after vaccination: 0
Gender:Female  Submitted:2003-03-31, Days after onset: 59
Location:Washington  Entered:2003-04-08, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0711SCRA
Administered by: Other     Purchased by: Military
Symptoms: Erythema, Hypokinesia, Injection site hypersensitivity
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Tx started on presentation to medical 2/3/03. Large are erythema from site on right arm extending below elbow and decreasing ROM of elbow. Measures $g 120 mm. That involved Rx- Prednisone 20 mg PO 2 days x 5 - Hydroceftson (topical) 1% AAA TID - Ice to site. For 3rd Anthrax premedicated NOC at 40 mg prednisone. Received another 40 mg prednisone at time of vax, which was given IM. No adverse response to 3rd Anthrax.

VAERS ID:201060 (history)  Vaccinated:2003-03-10
Age:30.0  Onset:2003-03-12, Days after vaccination: 2
Gender:Female  Submitted:2003-03-18, Days after onset: 6
Location:Oregon  Entered:2003-04-08, Days after submission: 20
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: MD who Dx''d possible post vax RXN of ??? Hep B vax
CDC Split Type: OR200310
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1060M0 RA
Administered by: Other     Purchased by: Unknown
Symptoms: Dizziness, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3/14/03 8:25 - Report of vaccinee via Spanish interpreter, and client reports awoke 3/12 a.m. with dizziness and itchy "rough rash" on belly, arms, back of hands, elbows, knees, can feel it not see it. Also dizzy. Worked 3/13/03 When went to work 3/14 supervisor advised her to call. 3/14/ Tx by Kitinkers Saw Medral PCP as as urticaria (hives)

VAERS ID:201167 (history)  Vaccinated:2003-03-13
Age:30.0  Onset:2003-03-14, Days after vaccination: 1
Gender:Male  Submitted:2003-04-01, Days after onset: 18
Location:Alaska  Entered:2003-04-09, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergy to nuts
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0701SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Injection site reaction, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: PT described redness, swelling and itching at inject site and forearm. Pain related to swelling. PT ibuprofen, Vicodin and applied topical homacaine?. Pain, swelling and redness treated at about 5 days post vax. Today presents 5 adverse Sx''s.

VAERS ID:201169 (history)  Vaccinated:2003-03-25
Age:30.0  Onset:2003-03-26, Days after vaccination: 1
Gender:Male  Submitted:2003-03-27, Days after onset: 1
Location:Unknown  Entered:2003-04-09, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0666SCLA
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Erythema, Injection site hypersensitivity, Injection site oedema, Vasodilation procedure
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Increasing inject site redness, swelling, warmth. Entire left tricep / bicep area involved. Erythema spreading over last 24 hrs. Had entire series in past without prob''s. This was booster dose. Treated by MD for cellulitis $g 12 cm. Area induration (21 x 28 cm)

VAERS ID:201170 (history)  Vaccinated:2003-04-03
Age:30.0  Onset:2003-04-03, Days after vaccination: 0
Gender:Male  Submitted:2003-04-04, Days after onset: 1
Location:Florida  Entered:2003-04-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
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Manufacturer
Lot
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0716 RA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Marked swelling and erythema right arm from shoulder to elbow.

VAERS ID:201232 (history)  Vaccinated:2003-03-26
Age:30.0  Onset:2003-03-28, Days after vaccination: 2
Gender:Female  Submitted:2003-03-31, Days after onset: 3
Location:Mississippi  Entered:2003-04-09, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type: MS03016
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771IDLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Back pain, Dizziness, Dyspepsia, Headache, Myalgia, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific dysfunction (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Onset 3/28/03 HA, backache, muscle aches, joint pain, dizziness, itching, indigestion for 2 days.

VAERS ID:201238 (history)  Vaccinated:2003-03-11
Age:30.0  Onset:2003-03-19, Days after vaccination: 8
Gender:Female  Submitted:2003-03-27, Days after onset: 8
Location:North Carolina  Entered:2003-04-09, 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 at time of vaccination, Ibuprofen for discomfort after vaccination
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: Viral cultures done on blisters on right hand, 4/4/03, not available yet.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IDRA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Headache, Hypoaesthesia, Influenza like illness, Oedema, Pain, Pruritus, Pyrexia, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Day 8 -swelling, left hand, fever 102 (F. Day 9 - rash, fever, itching, headache. Day 10- "flu like" sx - chills, hot. Day 11 - blisters on right hand. Days 14-16 - headache. Day 22 - continues to have headache, right finger numb and aches.

VAERS ID:201249 (history)  Vaccinated:2003-03-15
Age:30.0  Onset:2003-03-22, Days after vaccination: 7
Gender:Male  Submitted:2003-04-03, Days after onset: 12
Location:Wisconsin  Entered:2003-04-09, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020071   
Administered by: Military     Purchased by: Military
Symptoms: Discomfort, Injection site induration, Pruritus, Rash macular, Rash pustular, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Very faint, small areas of macular eruptions over his upper trunk: injection site appears indurated, but no signs of obvious cellulitis. Benadryl given for itching or discomfort PRN Temp 99.2 degrees

VAERS ID:201318 (history)  Vaccinated:2003-03-21
Age:30.0  Onset:2003-03-29, Days after vaccination: 8
Gender:Male  Submitted:2003-04-04, Days after onset: 6
Location:Missouri  Entered:2003-04-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MO200344
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH10700IDLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Chills, Diarrhoea, Fatigue, Feeling hot, Hyperhidrosis, Nausea, Pain, Rash papular, Skin ulcer
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: vaccination site was left deltoid. On the left shoulder across the back to the right shoulder was a small papular rash. there was a small pustular lesion on the right anterior chest and on the right wrist. Vaccinated on 3-21-03 at HD. Take recorded on 3-27-03(vaccination lesion now scabbed over). He then went to hospital where his father had been hospitalized and a rash was noticed (described as pimple on the back). Called Health Dept. and was referred, who referred him to Dr. Dr. reportedly told him that he had not spread the virus to his back; also told him that he should avoid contact with other persons for a period of time to reduce any possible chance of transmitting vaccinia to tohers; gave him some type od anti-pruritic medication. Approx. 3-4 days ago, developed diarrhea, which lasted 2 days. Yesterday he was tired, aching, sweaty, joint discomfort, felt hot at times (did not take his temp) possibly some nausea. Denied vomiting or diarrhea. Today still not feeling well with simialr symptoms, including apparent chilling. States he has had headache at times during past 2 weeks, which he attributes to sinuses. It does not seem to be particularly bothersome. Says the rash has kind of gone away. It is less noticable than previously. No areas of noticable erythema. Told him it was possible his recent symptoms were due to a viral infection and might not be related to his vaccination. Recommended that he call his private physician''s office, describe what he is experiencing and see if they want to evaluate him and see if they could see him. Gave him my home phone number is case his physician had further questions.

VAERS ID:201414 (history)  Vaccinated:2003-02-19
Age:30.0  Onset:2003-02-19, Days after vaccination: 0
Gender:Female  Submitted:2003-02-19, Days after onset: 0
Location:Michigan  Entered:2003-04-14, Days after submission: 53
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD, Zyrtec, Zoloft, Dyazepan
Current Illness:
Preexisting Conditions: Bee sting, codeine, ASA, PCN, environmental allergies.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5372A21IMRA
Administered by: Other     Purchased by: Private
Symptoms: Asthma, Confusional state, Dysphagia, Hyperhidrosis, Nausea, Pruritus, Rhinitis, Tremor
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 2/19 Engerix-B adult dose given at 8:50 a.m. PT reports approx 10:45 a.m. felt "shaking, nauseated, clammy and disoriented." She said she thought she was having a "hypoglycemic reaction" until about 1/2 hr later, she began itching "intensely", began wheezing, trouble swallowing and nasal congestion.

VAERS ID:201439 (history)  Vaccinated:2003-03-26
Age:30.0  Onset:2003-03-30, Days after vaccination: 4
Gender:Male  Submitted:2003-04-01, Days after onset: 2
Location:Georgia  Entered:2003-04-14, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: CBC, Chem 10, LFT''s, U/A
CDC Split Type:
Vaccination
Manufacturer
Lot
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020071   
Administered by: Military     Purchased by: Unknown
Symptoms: Hypersensitivity, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash x 6 hrs. SP vaccine 1 wk ago. Rash all over body. Rec''d IV Benadryl 50mg. Admitted for 23 hours OBS. Diagnosed as an allergic reaction.

VAERS ID:201452 (history)  Vaccinated:2003-03-14
Age:30.0  Onset:2003-04-11, Days after vaccination: 28
Gender:Female  Submitted:2003-04-14, Days after onset: 3
Location:Louisiana  Entered:2003-04-14
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
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IDLA
Administered by: Public     Purchased by: Public
Symptoms: Face oedema, Hypoaesthesia, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 4/11/03, patient reported to Infection Control/Employee Health Dept. with c/o "whelps and itching" occurring on various parts of body. Digital picture taken and sent to Dr., Rash was not vesicular. Benadryl 25mg PO given for relief. On 4/14/03, Patient reported back to Infection Control with continued c/o itching whelps and left facial swelling and numbness. Dr. notified of situation. Patient referred to E.R. Seen by Dr. Digital pictures forwarded. Patient treated with corticosteroids and sent home.

VAERS ID:201544 (history)  Vaccinated:2003-03-07
Age:30.0  Onset:2003-03-23, Days after vaccination: 16
Gender:Male  Submitted:2003-03-25, Days after onset: 2
Location:Virginia  Entered:2003-04-15, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
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Manufacturer
Lot
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Route
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710IMRA
Administered by: Military     Purchased by: Military
Symptoms: Cow pox, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pruritic diffuse whole body rash

VAERS ID:201552 (history)  Vaccinated:2003-03-24
Age:30.0  Onset:2003-04-01, Days after vaccination: 8
Gender:Female  Submitted:2003-04-04, Days after onset: 3
Location:Puerto Rico  Entered:2003-04-15, 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: NONE
Diagnostic Lab Data: EKG monitor reflected PCV''s - 6-7; Echocardiogram and 24-H, holter.
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710 LA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Laboratory test abnormal, Skin nodule
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Dizziness, SOB, chest tightness, painful left nodule inflammation for 2 days, 7 days after vax. EKG monitor reflected PCV''s - 6-7.

VAERS ID:201575 (history)  Vaccinated:2003-04-01
Age:30.0  Onset:2003-04-02, Days after vaccination: 1
Gender:Female  Submitted:2003-04-03, Days after onset: 1
Location:Unknown  Entered:2003-04-16, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0731SC 
Administered by: Military     Purchased by: Military
Symptoms: Chills, Nasal congestion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Nasal congestion, fever, chills.

VAERS ID:201637 (history)  Vaccinated:2003-02-11
Age:30.0  Onset:2003-02-18, Days after vaccination: 7
Gender:Male  Submitted:2003-04-03, Days after onset: 44
Location:Federated States of Micronesia  Entered:2003-04-16, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200713IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Skin ulcer
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Multiple satellite lesions to left arm. Also had auto-inoculation to left ear. Recovered without complications.

VAERS ID:201648 (history)  Vaccinated:2003-03-24
Age:30.0  Onset:2003-03-25, Days after vaccination: 1
Gender:Female  Submitted:2003-04-16, Days after onset: 21
Location:Arizona  Entered:2003-04-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control (Mircette), Zyrtec
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: fg
CDC Split Type:
Vaccination
Manufacturer
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0823AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Joint range of motion decreased, Nausea, Pain, Shoulder pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: No pain until 24 hours after, then mild soreness. That night the pain woke me several times. In the morning, the 2nd day after injection, there was severe, aching pain and my arm was very sore. It was difficult to use. I took aspirin and used a warm compress throughout the day (I took a sick day at work.) I felt okay to return to work on Thursday, but by noon I began having severe pain,which seemed to spread to the upper shoulder muscle,and nausea. I took aspirin and within an hour I began to feel better. I was able to finish the day at work. The soreness and pain continued through Sunday (the 6th day after injection)but each day was less severe.

VAERS ID:201764 (history)  Vaccinated:2003-02-12
Age:30.0  Onset:2003-02-22, Days after vaccination: 10
Gender:Male  Submitted:2003-04-14, Days after onset: 50
Location:Colorado  Entered:2003-04-18, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mild erythema adjacent to vax site - left deltoid.

VAERS ID:201782 (history)  Vaccinated:2003-01-29
Age:30.0  Onset:2003-02-28, Days after vaccination: 30
Gender:Male  Submitted:2003-04-14, Days after onset: 44
Location:Colorado  Entered:2003-04-18, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Small, itchy lesions, spreading. Vaccine site healing well. Tiny scattered raised lesions on trunk/upper extremities.

VAERS ID:201783 (history)  Vaccinated:2002-12-30
Age:30.0  Onset:2003-02-01, Days after vaccination: 33
Gender:Male  Submitted:2003-04-14, Days after onset: 71
Location:Colorado  Entered:2003-04-18, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site pustule, Lymphadenitis
SMQs:, Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Central pustule with surrounding erythema with enlarged nodes. Diagnosis: lymphadenitis.

VAERS ID:201802 (history)  Vaccinated:2003-04-02
Age:30.0  Onset:2003-04-10, Days after vaccination: 8
Gender:Male  Submitted:2003-04-14, Days after onset: 4
Location:Colorado  Entered:2003-04-18, 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: Allergy meds
Current Illness: NONE
Preexisting Conditions: SAR
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Headache, Malaise, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: + erythema to left deltoid. Tender to left axilla and + supra elavicular nodes fever, malaise, body aches, headache.

VAERS ID:201803 (history)  Vaccinated:2003-04-08
Age:30.0  Onset:2003-04-10, Days after vaccination: 2
Gender:Male  Submitted:2003-04-14, Days after onset: 4
Location:Colorado  Entered:2003-04-18, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Injection site swelling, Skin striae
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling at vaccine site with lymph streaking

VAERS ID:201916 (history)  Vaccinated:2003-03-21
Age:30.0  Onset:2003-03-21, Days after vaccination: 0
Gender:Male  Submitted:2003-04-21, Days after onset: 30
Location:Unknown  Entered:2003-04-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Chronic back pain Depression/Anxiety
Preexisting Conditions: see 18.
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
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Dose
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV 0731SCLA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt reports rapid onset (within 30 to 60 minutes)of nausea, vomiting, fever, chills, myalgias that lasted for approximately 5 days. He reports similar sx with all previous vaccinations although none as severe as with his recent anthrax vaccinations. Following vaccination with AVA and Flu on 5 March he required evaluation in the ER (x2 nights); similar sx of slightly less severity occured following his 2nd AVA on 21 March - no ER visit. He denies any urticaria, angioedema or respiratory symptoms. Treatment was conservative - no medications prescribed.

VAERS ID:202049 (history)  Vaccinated:2003-04-07
Age:30.0  Onset:2003-04-08, Days after vaccination: 1
Gender:Male  Submitted:2003-04-09, Days after onset: 1
Location:Oregon  Entered:2003-04-23, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Common cold
Preexisting Conditions: Nutra sweet
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0733SCLA
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: L arm moderate erythema, moderate swelling all localized-Motrin 500mg 3 x daily, elevation.

VAERS ID:202105 (history)  Vaccinated:2003-02-28
Age:30.0  Onset:2003-03-07, Days after vaccination: 7
Gender:Female  Submitted:2003-04-23, Days after onset: 46
Location:Texas  Entered:2003-04-23
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: None
CDC Split Type: SA0303
Vaccination
Manufacturer
Lot
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IDLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Erythema multiforme, Hypersensitivity, Pruritus, Rash erythematous, Tenderness
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3/7/03 @ 7pm. Red rash began to appear bilaterally on inner aspect of upper arm. Pruritis and tenderness experienced. Rash became raised a short while later. By 3/21 about 15 discrete rash were on each arm and had spread to outer aspect of biceps and several on the back of the trunk. On 3/27 same discrete rash began bilaterally on thigh. Seen by MD on 4/2. Dx: Allergy. Symptoms persisted. Seen by MD on 4/7 & Dx: erythema multiforme. Rx: Allegra & methylprednisone x6D. Within 24 hr pruritis ceased. No further rash developed. Raised rash diminished and skin became flat. Redness decreased. As of 4/11, some red rash still remained, but continued to diminish.

VAERS ID:202212 (history)  Vaccinated:2003-04-24
Age:30.0  Onset:2003-04-25, Days after vaccination: 1
Gender:Female  Submitted:2003-04-25, Days after onset: 0
Location:Maryland  Entered:2003-04-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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RAB: RABIES (RABIE-VAX)SANOFI PASTEUR413882IMRA
Administered by: Military     Purchased by: Military
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Acute Urticarial reaction developed 1 day after receiving her 3rd prophalactic dose of Rabies Vaccine.

VAERS ID:202458 (history)  Vaccinated:2003-04-10
Age:30.0  Onset:2003-04-10, Days after vaccination: 0
Gender:Male  Submitted:2003-05-01, Days after onset: 21
Location:Texas  Entered:2003-05-01
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
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IDLA
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis, Chills, Headache, Injection site reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Began a fever of 103 on 4/10/03 with chills, headache which persisted on 4/11/03 and still 4/12/03. Was seen in ER on 4/12/03 for cellulitis of vaccine site and given IV fluids. Sent home on Keflex po.

VAERS ID:202748 (history)  Vaccinated:2003-04-25
Age:30.0  Onset:2003-05-02, Days after vaccination: 7
Gender:Female  Submitted:2003-05-06, Days after onset: 4
Location:Texas  Entered:2003-05-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IDLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Injection site oedema, Lymphadenopathy, Lymphangitis, Pruritus, Pyrexia, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: Satellite lesions, Lymphangitis from site to regional nodes, Regional lymphadenopathy, Considerable local edema at the site, Intense erythema,running a fever of 101.4 avg., meds- Keflex,Benadryl around site for itching.

VAERS ID:202802 (history)  Vaccinated:2003-04-02
Age:30.0  Onset:2003-04-05, Days after vaccination: 3
Gender:Female  Submitted:2003-05-05, Days after onset: 29
Location:Montana  Entered:2003-05-08, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: States bucked off horse 4 days prior to injections.
Diagnostic Lab Data: No medical care sought- Encourage to see MD
CDC Split Type:
Vaccination
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HEPAB: HEP A + HEP B (TWINRIX)SMITHKLINE BEECHAM235A41IMRA
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUB360AA0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Chills, Myalgia, Paraesthesia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 05/02/2003 TC from pt who received yellow fever vaccine (and Hep B + Hep A- Twinrix) on 04/02/2003. C/O severe muscle and joint soreness. Feverish, chills, tingling in arms and hands for 1 week after injections and lasting 1 month. Better on and off for 1 month. But still sore and achy esp. rib area

VAERS ID:202874 (history)  Vaccinated:2003-04-29
Age:30.0  Onset:2003-04-29, Days after vaccination: 0
Gender:Male  Submitted:2003-05-01, Days after onset: 2
Location:Unknown  Entered:2003-05-12, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0663SCLA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Hypoaesthesia, Injection site inflammation, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Standard inflammatory reaction at site was covering entire triceps area. This lead to compression of elbow and elbow pain, numbness of hand and significant loss of grip strength in the immunized arm.

VAERS ID:202922 (history)  Vaccinated:0000-00-00
Age:30.0  Onset:0000-00-00
Gender:Female  Submitted:2003-04-20
Location:West Virginia  Entered:2003-05-12, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Viral culture for herpes-negative; general vag culture-negative;
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Public     Purchased by: Other
Symptoms: Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Vulvar ulcer right in labia coincided with sx elevated fever, malaise 2-4 weeks after smallpox vaccination and resolved with no tx.

VAERS ID:203092 (history)  Vaccinated:2003-04-30
Age:30.0  Onset:2003-04-30, Days after vaccination: 0
Gender:Female  Submitted:2003-05-07, Days after onset: 7
Location:Michigan  Entered:2003-05-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Had CT scan done in ER on 5/5/03-negative
CDC Split Type:
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0497M1IM 
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)
Write-up: Lt arm became numb in evening of 4/30/03 and stayed numb until present. On 5/4/03 on awakening noted entire Lt side of body was numb and vision was blurred. Was seen in ER on 5/5/03 and began prednisone-if s/s don''t improve to return to Dr. for MRI etc.

VAERS ID:203491 (history)  Vaccinated:2003-04-28
Age:30.0  Onset:2003-04-29, Days after vaccination: 1
Gender:Female  Submitted:2003-04-30, Days after onset: 1
Location:California  Entered:2003-05-21, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0624M0 LA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0830AA3 RA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1148M0 RA
Administered by: Public     Purchased by: Public
Symptoms: Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Topical swelling at the injection site left arm. Treatment hydrocortisone topical cream 1%, Benadryl. (dyphedramine) 25mg 1-2 caps BID

VAERS ID:203517 (history)  Vaccinated:2003-05-02
Age:30.0  Onset:2003-05-10, Days after vaccination: 8
Gender:Female  Submitted:2003-05-21, Days after onset: 11
Location:Nevada  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:
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type: NV0307
Vaccination
Manufacturer
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200770IDLA
Administered by: Public     Purchased by: Unknown
Symptoms: Headache, Malaise, Nausea, Pyrexia, Tenderness, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Severe headache, nausea, vomiting, prolong low grade fever and general malise. Severe tenderness under vaccination arm radiating to lower abdomen.

VAERS ID:203692 (history)  Vaccinated:2003-05-01
Age:30.0  Onset:2003-05-04, Days after vaccination: 3
Gender:Male  Submitted:2003-05-06, Days after onset: 2
Location:Texas  Entered:2003-05-28, Days after submission: 22
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:
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0828AA0 LA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Feeling hot, Injection site swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: DT vaccine administered 05/01/03 in left deltoid. Pt complained of allergic reaction 05/04/03 with fever, body aches and chills. Left arm swollen with heat in it. Tx with Prednisone 40 mg PO x1, Benadryl 50 mg PO x1 and MD appt in AM.

VAERS ID:204072 (history)  Vaccinated:2003-05-06
Age:30.0  Onset:2003-05-07, Days after vaccination: 1
Gender:Male  Submitted:2003-05-21, Days after onset: 14
Location:Utah  Entered:2003-06-03, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0751SC 
Administered by: Military     Purchased by: Other
Symptoms: Headache, Injection site mass, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Headaches about 4 days, sore muscles about 4 days. Took Excedrin 1 time daily (PM use). Lump the size of a quarter at vaccination site. Down to size of a dime by next vaccination (5/20).

VAERS ID:204073 (history)  Vaccinated:2003-04-30
Age:30.0  Onset:2003-05-01, Days after vaccination: 1
Gender:Male  Submitted:2003-05-07, Days after onset: 6
Location:Utah  Entered:2003-06-03, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Other
Symptoms: Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Headaches 3-4 days continuous, sore muscles (upper back). Took Excedrin 1 x daily for headaches, usually in the afternoon.

VAERS ID:204192 (history)  Vaccinated:2003-01-31
Age:30.0  Onset:2003-02-26, Days after vaccination: 26
Gender:Male  Submitted:2003-02-26, Days after onset: 0
Location:Unknown  Entered:2003-06-03, Days after submission: 96
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020071  LA
Administered by: Military     Purchased by: Military
Symptoms: Vaccination complication
SMQs:
Write-up: Reinoculation site 2 cm from initial innoculation along area of derifitis from tape reaction.

VAERS ID:204254 (history)  Vaccinated:2001-09-25
Age:30.0  Onset:2001-09-25, Days after vaccination: 0
Gender:Female  Submitted:2003-05-30, Days after onset: 612
Location:Massachusetts  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: Vitamins
Current Illness:
Preexisting Conditions: Pregnancy NOS (LMP 9/25/01)
Diagnostic Lab Data: Ultrasound-multiple tests normal.
CDC Split Type: WAES01106339
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: Information has been receive from a physician concerning a female in her 30''s with a history of 2 previous prregnancies with 2 live births who on approximately 9/25/01 was vaccinated with a third dose of MMR II. The pt received vaccination at the time of last menstrual period (LMP approximately 9/25/01). It was reported that the pt was vaccinated with a second dose of MMR II. On 10/30/01, the pt found out that she was pregnant. The estimated date of delivery was determined to be 7/2/02. The pt took prenatal vitamins and had no infections or illnesses during her pregnancy. The pt underwent multiple ultrasounds which were normal. It was reported that the pt was placed on bedrest for early cervical dilatation. On 6/27/02, at 39 weeks from LMP, the pt delivered a normal female infant weighing 7lb 0oz. The infant had no complications or congential anomalies. No additional info is expected.

VAERS ID:204319 (history)  Vaccinated:0000-00-00
Age:30.0  Onset:0000-00-00
Gender:Female  Submitted:2003-05-30
Location:Connecticut  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: Serum rubella IgG-negative
CDC Split Type: WAES0207USA00845
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Laboratory test abnormal
SMQs:
Write-up: Information has been received from a registered nurse concerning a 30 year old female who was vaccinated with a dose of MMR II as a child. An unspecified "titer a few years ago was negative" and vaccination with MMR II was repeated, in approximately 2000. In approximately June 2002 the pt had a negative titer for rubella, and vaccination with MMR II was again repeated on 7/9/02. Unspecified medical attention was sought. Additional info has been requested.

VAERS ID:204338 (history)  Vaccinated:2002-07-15
Age:30.0  Onset:2002-07-31, Days after vaccination: 16
Gender:Female  Submitted:2003-05-30, Days after onset: 303
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:
Diagnostic Lab Data: Diagnostic laboratory (08/01/2002): measles
CDC Split Type: 0208USA00638
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Infection
SMQs:
Write-up: Information has been received from a registered nurse concerning a 30 year old female with allergies to penicillin, sulfa, and "myocin" who on 07/15/2002 was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation). On 07/31/2002 the patient developed "a rash on her head, chest, face, arms and legs. She reported having a sore throat, swollen glands, and fever". On 08/01/2002 labs revealed that the patient had measles. Unspecified medical attention was sought. Additional information has been requested.

VAERS ID:204389 (history)  Vaccinated:2002-07-18
Age:30.0  Onset:2002-09-26, Days after vaccination: 70
Gender:Female  Submitted:2003-05-30, Days after onset: 246
Location:New York  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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Serum Measles IgG (09/26/2002): negative
CDC Split Type: 0210USA06014
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0183M SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Initial and follow-up information has been received from a health professional concerning a 30 year old white female with no known drug allergies and no past medical history who on 06/17/2002 was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) subcutaneously (Lot # 639986/1213L). On 07/18/2002 the patient was vaccinated with another dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) subcutaneously (Lot # 642181/0153M). There was no concomitant medication. On 09/26/2002 the patient had a serum measles immunoglobulin G antibody test that was negative. It was reported that no adverse symptoms were noted. The patient sought unspecified medical attention. No additional information is expected.

VAERS ID:204601 (history)  Vaccinated:2003-05-08
Age:30.0  Onset:2003-05-10, Days after vaccination: 2
Gender:Female  Submitted:2003-05-27, Days after onset: 17
Location:Kentucky  Entered:2003-06-06, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: KY2003071
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1119M0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left arm at injection site was swollen with 2 patches of warm, red, welps down my arm. Doctor looked at it and gave me a script for antibotics and Claritin.

VAERS ID:204836 (history)  Vaccinated:2003-05-27
Age:30.0  Onset:2003-05-28, Days after vaccination: 1
Gender:Male  Submitted:2003-05-30, Days after onset: 2
Location:North Carolina  Entered:2003-06-12, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: NC03074
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1066M0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Injection site erythema, Injection site oedema, Stomach discomfort
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt called and reports 5/28 right arm at injection site redness with swelling. Area the diameteer of a baseball. Also had upset stomach and diarrhea. Called PHN on 5/30 and area still red. Did not come in for PHN to see.

VAERS ID:204901 (history)  Vaccinated:2003-04-09
Age:30.0  Onset:2003-04-09, Days after vaccination: 0
Gender:Male  Submitted:2003-06-10, Days after onset: 62
Location:New York  Entered:2003-06-13, Days after submission: 3
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: A0404299A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS 1  
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: A physician reported the occurrence of numbness in a 30-year-old male who was vaccinated with hepatitis A inactivated and hepatitis B recombinant vaccine (Twinrix) for prophylaxis. The pt was described as "healthy". He experienced no adverse events following previous immunizations. Concurrent medications were not reported. On 03/09/2003, the pt received his first injection of Twinrix, without adverse event. On 04/09/2003, the pt received his second injection of Twinrix. Approximately one hour post-immunization, the pt telephoned the physician to report that he was experiencing numbness, tingling and lightheadedness.

VAERS ID:205111 (history)  Vaccinated:2002-11-05
Age:30.0  Onset:2002-11-12, Days after vaccination: 7
Gender:Female  Submitted:2003-04-09, Days after onset: 147
Location:Ohio  Entered:2003-06-18, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5312B61IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site urticaria, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: One week after injection, developed large red, itchy hive at injection site. Hives spread on entire body. Reports hives lasted 3 months. Rx-4 rounds of steroids. Besides seeing family MD, was referred to dermatologist. Both Md''s attribute to hep B vaccine.

VAERS ID:205192 (history)  Vaccinated:2003-06-06
Age:30.0  Onset:2003-06-06, Days after vaccination: 0
Gender:Male  Submitted:2003-06-12, Days after onset: 6
Location:Illinois  Entered:2003-06-20, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu-like symptoms;Td Adsorbed, Adult (no brand name);;19;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0818AA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Shooting pain in shoulder with any mobility. Pinky and ring finger on left arm were numb day of vaccine.

VAERS ID:205493 (history)  Vaccinated:2003-02-24
Age:30.0  Onset:2003-02-24, Days after vaccination: 0
Gender:Male  Submitted:2003-03-31, Days after onset: 35
Location:New Jersey  Entered:2003-06-26, Days after submission: 86
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Penicillin
Diagnostic Lab Data:
CDC Split Type: 20036
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0940M0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dizziness, Dry throat, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Approx 1 1/2 hours after injection, pt became dizzy, weak, had SOB and dry, swollen throat. This volunteer fireman did not report reaction until 3/24/03 when due for 2nd Hep B. To my knowledge he sought no medical care. He has not responded to 2 calls requesting more info.

VAERS ID:205676 (history)  Vaccinated:2003-05-28
Age:30.0  Onset:2003-06-02, Days after vaccination: 5
Gender:Female  Submitted:2003-06-04, Days after onset: 2
Location:Michigan  Entered:2003-07-01, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MI2003032
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0182M1SCLA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0817AA1 LA
Administered by: Public     Purchased by: Unknown
Symptoms: Abdominal pain upper, Haematochezia, Pyrexia
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 1 wk after receiving MMR and Td pt reports that her stomach hurts. Off and on she has had blood in her stools. She is from Okinawa and moved to USA 3 mo ago. Reports her diet is completely differnt. Had a fever one evening and then it subsided. Referred to PMD/assessment.

VAERS ID:205770 (history)  Vaccinated:2003-06-17
Age:30.0  Onset:2003-06-18, Days after vaccination: 1
Gender:Female  Submitted:2003-06-19, Days after onset: 1
Location:California  Entered:2003-07-02, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Seizure;DTP (unknown mfr);;0;In Patient
Other Medications: Albuterol, Singulair, Orthotigyline, Clindamycin cream
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0840AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever, swelling, redness, pain at injection site, body aches.

VAERS ID:206580 (history)  Vaccinated:2003-07-11
Age:30.0  Onset:2003-07-20, Days after vaccination: 9
Gender:Male  Submitted:2003-07-23, Days after onset: 3
Location:Pennsylvania  Entered:2003-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0710SCLA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200740IDRA
Administered by: Military     Purchased by: Military
Symptoms: Malaise, Myalgia, Pyrexia, Rash erythematous, Rash pruritic, Rash pustular, Skin ulcer
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Member received anthrax#1 and smallpox vaccine on 11 July 2003 (first time vaccinee against smallpox). On 20 July member noticed an itchy erythematous pustular rash on trunk and developed worsening myalgias/malaise/subjective fevers. Saw doctor on 21 July 2003 and then presented yesterday to me with a worsening rash involving significant portions of his trunk/upper extremities/neck. He has no facial involvement and has scattered lesions on his lower extremities. There is no oropharyngeal or ocular involvement. Photos were taken and transmitted via email. They were shown to doctor who feels that this rash is consistent with "nonviral pustulosis" which tends to occur in healthy young males in their 20''s. Treatment is supportive and antihistamines are recommended for itching. No bloodwork was recommended at this time. Will continue to observe. Pt is very well appearing and nontoxic.

VAERS ID:206618 (history)  Vaccinated:2003-03-14
Age:30.0  Onset:2003-03-28, Days after vaccination: 14
Gender:Male  Submitted:2003-07-23, Days after onset: 116
Location:New York  Entered:2003-07-23
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: Chest xray, echo, stress test-normal; EKG- abnormal T waves
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200760IDLA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Electrocardiogram abnormal
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Smallpox vaccine was administered on 3/14/2003. Approximately 2 weeks later developed SOB with activity. Seen in employee health, by own PCP, and by cardiologist. Chest xray, echo, and stress test negative. Had abnormal T waves on EKG which resolved on follow up. Pt was found via active surveillance.

VAERS ID:206622 (history)  Vaccinated:2003-05-21
Age:30.0  Onset:2003-05-30, Days after vaccination: 9
Gender:Male  Submitted:2003-07-24, Days after onset: 55
Location:Florida  Entered:2003-07-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data: EKG NSR, CKMB 15.3, Myo 167, Trponin I 1.4
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710 LA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Myocarditis
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 26 y/o male developed sub-sternal chest pain on day 13 following smallpox vaccination. Symptoms were on and off x3 days lasting 20-30 min. and not associated with nausea, diaphoresis, dizziness or SOB. Presented to cardiology office for evaluations and was referred to the emergency room. Elevated cardiac elevations, no significant EKG changes. He was give IV nitroglycerin, Asprin and Lovenox. He was diagnosed with myocarditis secondary to the smallpox vaccine and admitted x 2 days for further observation and treatment.

VAERS ID:206666 (history)  Vaccinated:2003-03-12
Age:30.0  Onset:0000-00-00
Gender:Female  Submitted:2003-07-25
Location:Texas  Entered:2003-07-25
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 known
Diagnostic Lab Data: A biopsy done and sent revealed dermatitis with focal vesicles c/w vaccinia, but PCR was negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Public
Symptoms: Cellulitis, Chest discomfort, Dyspnoea, Erythema, Insomnia, Lymphadenopathy, Myalgia, Oedema peripheral, Pain, Pruritus, Rash, Rash papular, Skin ulcer, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 31 y/o hospital ER nurse first time vaccine (DOV 3/12/2003) had developed nonspecific rash (probably folliculitis) 3/23/2003 resolving over next few weeks. A biopsy done and sent was reported to me by the pt as revealing dermatitis with focal vesicles c/w vaccinia, but PCR was negative for vaccinia. Well until 5/30/2003 when she developed syndrome characterized by acute onset of shortness of breath (woke her up from sleep), chest tightness and sternal tenderness, myalgias, lymphadenopathy, and a "red spot under her L breast.". She was seen by MD and work up was negative (including normal EKG, CXR, and negative troponins). Over the last two months, although her acute syndrome resolved, she has developed recurrent skin lesions and an asymptomatic swollen left ankle without history of injury. She sought care where she has been seen twice. Plane film of the ankle was normal. The skin lesions are painful and rarely if ever pruritic, begin as papules, and then become vesicles.

VAERS ID:206855 (history)  Vaccinated:2003-07-22
Age:30.0  Onset:2003-07-24, Days after vaccination: 2
Gender:Female  Submitted:2003-07-30, Days after onset: 6
Location:Montana  Entered:2003-07-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS750A40IMRA
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURERU0830AA IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURW1366 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient repoted a rash that started on her arms, spread to her hands .Rash started on 7/24/03, and patient called 0n 7/29, still repoting rash and hives now.I advised she been be seen by a health care provided to evaluate and treat

VAERS ID:206865 (history)  Vaccinated:2003-07-29
Age:30.0  Onset:2003-07-29, Days after vaccination: 0
Gender:Female  Submitted:2003-07-30, Days after onset: 1
Location:Alabama  Entered:2003-07-31, 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: Zyrtec
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.1087M1  
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Hyperhidrosis, Nausea, Visual acuity reduced
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Received Hep B at 5 PM 7/29 within 5-10 minutes nausea, sweaty, dizziness all night. One episode of "not seeing very well" 30 minutes after vaccination.

VAERS ID:207534 (history)  Vaccinated:2003-07-29
Age:30.0  Onset:2003-07-29, Days after vaccination: 0
Gender:Male  Submitted:2003-08-05, Days after onset: 7
Location:Connecticut  Entered:2003-08-06, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: CT Scan; Allergy; Splenectomy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0676M1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Disorientation, Erythema, Nausea, Pain, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Severe pain in arm, swelling/redness, fever, nausea, weakness. Disoriented for 1 week. Patient put on Tequin 400mg.

VAERS ID:207542 (history)  Vaccinated:2003-07-15
Age:30.0  Onset:2003-07-15, Days after vaccination: 0
Gender:Male  Submitted:2003-07-16, Days after onset: 1
Location:Oregon  Entered:2003-08-06, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: OR200328
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUB362AA0SC 
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Pruritus, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Shot given 2:15 PM, left office about 3:45 PM. Pt and wife were at travel agency when ears started itching, became red, hives, felt like throat was closing up-went to ER-given oxygen and antihistamines per wife. Discharged at 5:15 PM with Prednisone and Benadryl. 7/17/03-TC-talked with wife-states pt doing fine-has appointment with PMD 1:20 PM.

VAERS ID:207893 (history)  Vaccinated:2003-07-22
Age:30.0  Onset:2003-08-01, Days after vaccination: 10
Gender:Female  Submitted:2003-08-06, Days after onset: 5
Location:Hawaii  Entered:2003-08-15, 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: Allergies to sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0473M0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 08/02/2003 rash at site, 08/03/2003 pain at site, 08/06/2003 fever and vesicles at site- started Keflex 500mg quid x 10 days, 08/08/2003 better

VAERS ID:207959 (history)  Vaccinated:2003-06-03
Age:30.0  Onset:2003-06-05, Days after vaccination: 2
Gender:Female  Submitted:2003-07-17, Days after onset: 42
Location:Washington  Entered:2003-08-18, Days after submission: 32
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: WA031958
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1127M1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Influenza like illness, Nasal congestion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Onset 6/5/03 of generalized dizziness and flu-like symptoms with mild congestion and fever. Pt states symptoms persisted x 3 weeks.

VAERS ID:208139 (history)  Vaccinated:2003-07-16
Age:30.0  Onset:2003-07-18, Days after vaccination: 2
Gender:Female  Submitted:2003-08-20, Days after onset: 33
Location:Arizona  Entered:2003-08-21, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: blisters;Hep B (Engerix-B);1;30;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: Compazine intolerance only
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5301A1  LA
Administered by: Private     Purchased by: Other
Symptoms: Injection site vesicles
SMQs:
Write-up: Pt report small blisters at site of injection with 48 degrees, occurred with 1st and 2nd Hep B.

VAERS ID:208246 (history)  Vaccinated:2003-07-28
Age:30.0  Onset:2003-08-12, Days after vaccination: 15
Gender:Male  Submitted:2003-08-12, Days after onset: 0
Location:New Jersey  Entered:2003-08-25, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 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 PASTEURU0839AA  RA
Administered by: Private     Purchased by: Other
Symptoms: Viral infection
SMQs:
Write-up: Patient developed chicken pox about 2 weeks after vaccine

VAERS ID:208623 (history)  Vaccinated:2003-08-26
Age:30.0  Onset:2003-08-27, Days after vaccination: 1
Gender:Male  Submitted:2003-08-29, Days after onset: 2
Location:Washington  Entered:2003-08-29
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
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0774IMRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710IMLA
Administered by: Military     Purchased by: Military
Symptoms: Feeling hot, Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Erythema, mild tenderness, warm to touch, along posterior aspect of Right Arm from elbow to injection site. Primary Care Provider denied any induration, streaking, vesicles, ulcers, etc. Soldier was treated with Keflex 250mg QID x 10 days.

VAERS ID:208572 (history)  Vaccinated:2003-08-20
Age:30.0  Onset:2003-08-21, Days after vaccination: 1
Gender:Male  Submitted:2003-08-22, Days after onset: 1
Location:Colorado  Entered:2003-09-02, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0776SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left arm swollen, redness - 25cm x 10cm. No induration, fever and otherwise feels well. Notes swelling yesterday.

VAERS ID:208648 (history)  Vaccinated:1998-08-13
Age:30.0  Onset:1998-08-13, Days after vaccination: 0
Gender:Male  Submitted:2003-07-21, Days after onset: 1803
Location:Kentucky  Entered:2003-09-03, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0262 LA
Administered by: Military     Purchased by: Military
Symptoms: Back pain, Dyspnoea, Fatigue, Injection site pain
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad)
Write-up: Extreme pain to site, back pain, breathing problems, fatigue. 60-day follow up on 01/06/04: "Shortness of breath, muscle pain, joint pain, ringing in ears, fatigue, mood changes, sleep apnea, periodic limb movement disorder, limb swelling, memory loss, muscle weakness." The medical records received on 1/12/04 confirms all the previously coded terms.

VAERS ID:208930 (history)  Vaccinated:2003-08-19
Age:30.0  Onset:2003-08-19, Days after vaccination: 0
Gender:Female  Submitted:2003-09-05, Days after onset: 17
Location:South Carolina  Entered:2003-09-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: None known
Preexisting Conditions: Hemoplegic migraines per patient
Diagnostic Lab Data:
CDC Split Type: SC0335
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSENG5373B60IMRA
MER: MEASLES + RUBELLA (MR-VAX II)MERCK & CO. INC.1236 M1SCLA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURUO833AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Migraine
SMQs:
Write-up: Client received MMR, Td, HepB and PPD on 8/19/03. On 8/21/03 returned to Health Department for PPD reading and reported to staff that she had "hemoplegic migraine" shortly after receiving vaccines on 8/19/03. Client reports history of "hemoplegic migraine " after previous MMR approximately 3 years ago. On 8/26/03 client reported that she had not informed nurse of hx of hemplegic migrains on 8/19/03 prior to receiving vaccines and only recalled the episode with the previous MMR when she had the "migraine" on 8/19/03. Client reports does not have family MD. She plans appointment with neurologist and awaiting client to notify Health Department with MD name so consent can be obtained to receive medical information if applicable in regards to vaccination. Client reported signs and symptoms subsided gradually without medical attention on 8/19/03. Follow up on 12/10/03: "No action required for follow up."

VAERS ID:209143 (history)  Vaccinated:2003-08-25
Age:30.0  Onset:2003-08-29, Days after vaccination: 4
Gender:Female  Submitted:2003-09-10, Days after onset: 12
Location:Washington  Entered:2003-09-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS0713SCLA
Administered by: Military     Purchased by: Military
Symptoms: Pain, Palpitations, Rash maculo-papular
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 4 DAYS POST ANTHRAX TO LEFT UPPER ARM, NOTED WALNUT SIZE, PAINFUL TO DEEP PALPATION, SPHERICAL, SMOOTH, LUMP LATERALLY JUST ABOVE LEFT ELBOW, APPROXIMATELY 8 INCHES FROM ORIGINAL INJECTION SITE

VAERS ID:209268 (history)  Vaccinated:2003-08-21
Age:30.0  Onset:2003-08-21, Days after vaccination: 0
Gender:Female  Submitted:2003-08-26, Days after onset: 5
Location:Tennessee  Entered:2003-09-16, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone from previous injury to arm
Current Illness: NONE
Preexisting Conditions: TBD-Maybe referred to neurologist if not better in 10 days.
Diagnostic Lab Data: 08/26/2003: Still painful, less grip
CDC Split Type: TN03052
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.1126M0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Hypoaesthesia, Muscular weakness, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Given MMR injection approximately 16:00 on 08/21/2003. Left arm Lot # 1126M, expiration date 11/14/2004. Arm became painful--less grip noted, numbness; tingling at approximately 18:00. ER visit on 08/23/2003.

VAERS ID:209277 (history)  Vaccinated:2003-06-10
Age:30.0  Onset:2003-06-15, Days after vaccination: 5
Gender:Female  Submitted:2003-09-02, Days after onset: 79
Location:Louisiana  Entered:2003-09-16, 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: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: LA030903
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0529M1SC 
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0828AA0IM 
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Pain, Skin ulcer
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5 days after receiving MMR and Td vaccines, pt broke out on chest with a singular lesion surrounded by swollen, red, hot, painful area. Lesions have appeared one by one on chest, groin area and legs. Pt has not been free of lesions since they began.

VAERS ID:209350 (history)  Vaccinated:2003-09-08
Age:30.0  Onset:2003-09-10, Days after vaccination: 2
Gender:Female  Submitted:2003-09-10, Days after onset: 0
Location:Kansas  Entered:2003-09-17, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5388A20RA 
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0841AA LA 
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Red, warm, indurated area of right deltoid 7cm L x 4cm W.

VAERS ID:209370 (history)  Vaccinated:2000-06-26
Age:30.0  Onset:2001-06-01, Days after vaccination: 340
Gender:Female  Submitted:2003-08-05, Days after onset: 795
Location:New Jersey  Entered:2003-09-17, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALSLY128A2   
Administered by: Private     Purchased by: Other
Symptoms: Rheumatoid arthritis
SMQs:, Arthritis (narrow)
Write-up: Rheumatoid arthritis. I am currently taking Naproxen 500 mg tablet and see a rheumatologist regularly.

VAERS ID:209470 (history)  Vaccinated:2003-09-12
Age:30.0  Onset:2003-09-12, Days after vaccination: 0
Gender:Male  Submitted:2003-09-15, Days after onset: 3
Location:California  Entered:2003-09-22, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NKDA
Diagnostic Lab Data: Cellulitis
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0766 LA
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Heat, redness, swelling at left arm for 3 days.

VAERS ID:209965 (history)  Vaccinated:2002-10-12
Age:30.0  Onset:2002-10-12, Days after vaccination: 0
Gender:Male  Submitted:2003-10-01, Days after onset: 354
Location:Wisconsin  Entered:2003-10-01
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 Medical records state allergy, blurred vision. msv
Diagnostic Lab Data: DOCTORS'' OBSERVATIONS/TESTS, MRI, CT SCAN
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR53692HA1IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Conjunctivitis, Diplopia
SMQs:, Severe cutaneous adverse reactions (broad), Conjunctival disorders (narrow), Ocular infections (broad), Ocular motility disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: I REC''D DURING A HEALTH FAIR AT MY PLACE OF EMPLOYMENT (A YEARLY EVENT) ON 10/12/02. I HAVE HAD FLU SHOTS FOR THE PAST 2 YEARS. APPROX. 4 HOURS AFTER RECEIVING THE FLU SHOT, I DEVELOPED A SEVERE DOUBLE VISION PROBLEM. I VISITED MY EYE DOCTOR SEVERAL TIMES AND HAD A CAT SCAN AND MRI. THE PROBLEM "WENT AWAY" ABOUT 2-3 WEEKS AFTER THE FLU SHOT. RECORDS FOR EXACT VACCINE TYPE WOULD BE AVAILABLE FROM MY EMPLOYER. Medical records state eyes reddened. msv

VAERS ID:209985 (history)  Vaccinated:2003-09-25
Age:30.0  Onset:2003-09-26, Days after vaccination: 1
Gender:Female  Submitted:2003-10-03, Days after onset: 7
Location:California  Entered:2003-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Client with erythema and swelling around injection site.
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUB363AA1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 9/26/03-Erythem, swelling around injection site to elbow area. Approximately 6 inches long by 2 inches wide. 9/27/03 ER-seen by physician. Pt. on Keflex x10 days.

VAERS ID:210005 (history)  Vaccinated:2003-08-28
Age:30.0  Onset:2003-09-07, Days after vaccination: 10
Gender:Male  Submitted:2003-09-26, Days after onset: 19
Location:Illinois  Entered:2003-10-06, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Perforated eardrum 1998, mono 1990, chicken pox as a child
Diagnostic Lab Data: ENT, BLOOD TEST, MRI
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.1083M1SCLA
Administered by: Other     Purchased by: Other
Symptoms: Hearing impaired
SMQs:, Hearing impairment (narrow)
Write-up: Sudden loss of hearing in left ear. Loss occurred over 3 hour period. 09/07/2003-present

VAERS ID:210014 (history)  Vaccinated:2003-09-09
Age:30.0  Onset:2003-09-10, Days after vaccination: 1
Gender:Female  Submitted:2003-09-11, Days after onset: 1
Location:Wisconsin  Entered:2003-10-06, 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: NONE
Current Illness: NONE
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type: WI0307
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5456A40IMLA
Administered by: Public     Purchased by: Public
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Muscle pain in upper legs, shoulder muscle, somewhat in arms.

VAERS ID:210270 (history)  Vaccinated:2003-10-09
Age:30.0  Onset:2003-10-09, Days after vaccination: 0
Gender:Female  Submitted:2003-10-10, Days after onset: 1
Location:Indiana  Entered:2003-10-10
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Many - do not know list
Current Illness: Was well - out of ICU for 3 weeks
Preexisting Conditions: No history of allergies to eggs or antibiotics.
Diagnostic Lab Data: None known to me.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1253AA5IMRA
Administered by: Private     Purchased by: Private
Symptoms: Asthma, Loss of consciousness, Pulse absent
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: Approximately 3 hours after vaccination patient was urinating - arose from the toilet and passed out (was in her daughter''s hospital room - elective admission for IVIG). Had felt well before - no prodromal symptoms. Found pulseless - required CPR and intubation. Extubated and well 2 hours later. Patient had history of multiple ICU admissions for severe asthma, opiate withdrawl and prior syncope attributed to SVT. NO rash, wheezing, angioedema seen during event.

VAERS ID:210340 (history)  Vaccinated:2003-10-13
Age:30.0  Onset:2003-10-13, Days after vaccination: 0
Gender:Male  Submitted:2003-10-13, Days after onset: 0
Location:Indiana  Entered:2003-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Propecia
Current Illness: None
Preexisting Conditions: Allergic to Penecillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Dizziness, Visual disturbance
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Approximately 5-10 minutes following injection I became extremely dizzy and lightheaded and was unable to see clearly. Voices were muffled and seemed distant. My family helped me into our home where I lied down for approximately 20-30 minutes. After that time, I was still stomewhat lightheaded but was beginning to feel somewhat better. I have received flu vaccination for the past 8 years and have never had any experience remotely similar.

VAERS ID:210331 (history)  Vaccinated:2003-10-06
Age:30.0  Onset:2003-10-06, Days after vaccination: 0
Gender:Male  Submitted:2003-10-10, Days after onset: 4
Location:North Carolina  Entered:2003-10-14, 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: NONE
Current Illness: Laceration with knife on hand
Preexisting Conditions: NKDA
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU0829AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypokinesia, Injection site erythema, Injection site pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Erythema, pain and tenderness at injection site (about 5-6 cm circular area of erythema), pain in left shoulder with decreased range of motion and numbness in left upper extremity(s) (decreased sensation left upper extremity).

VAERS ID:210960 (history)  Vaccinated:2003-01-01
Age:30.0  Onset:2003-01-01, Days after vaccination: 0
Gender:Female  Submitted:2003-10-20, Days after onset: 291
Location:Texas  Entered:2003-10-27, 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: NONE
Current Illness:
Preexisting Conditions: Miscarriage; Pregnancy; Endometriosis; Penicillin allergy; Drug Hypersensitivity
Diagnostic Lab Data: Ultrasound 2/11/03-pregnant, 2/18/03-pregnant; serum varicella zoster-negative.
CDC Split Type: WAES0302USA00587
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0866M   
Administered by: Private     Purchased by: Other
Symptoms: Abortion, Unintended pregnancy
SMQs:, Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a registered nurse (RN) and 29 year old white female with endometriosis and allergies to penicillin and aspirin and a history of one previous pregnancy which resulted in a miscarriage at approximately 4 weeks gestation, through a manufacturer pregnancy registry, who in January 2003 was vaccinated with a 0.5ml dose of varicella virus vaccine live (lot # 643822/0866M). There was no concomitant therapy. The patient reported that in January 2003, she received a dose of varicella virus vaccine live (patient was negative for varicella antibodies prior to vaccination). The patient felt that she was vaccinated around the same time of conception. Ultrasounds on 2/11/03 and 2/18/03 confirmed that the patient was pregnant (LMP 12/25/02, EDD 10/01/03). The RN indicated that the patient had no local reaction at the vaccination site, no varciella or herpes zoster symptoms post vaccination. Unspecified medical attention as sought. Follow up information was received from the RN who reported that on 3/12/03, eight week and three days from the LMP, the patient had a spontaneous abortion. The products of conception were examined, but it was unknown if the fetus was normal. Additional information has been requested.

VAERS ID:210964 (history)  Vaccinated:2003-10-12
Age:30.0  Onset:0000-00-00
Gender:Male  Submitted:2003-10-15
Location:North Dakota  Entered:2003-10-27, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130IMLA
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: Cellulitis reaction to left arm 8 days following smallpox vaccination.

VAERS ID:211187 (history)  Vaccinated:2003-10-22
Age:30.0  Onset:2003-10-22, Days after vaccination: 0
Gender:Female  Submitted:2003-10-24, Days after onset: 2
Location:Texas  Entered:2003-10-29, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, Advair, Toprol, Albuterol, Lotril, Singulair
Current Illness: NONE
Preexisting Conditions: Asthma, HTN, depression. Allergic to: PCN, sulfa, steroids, Tricyclen, codeine
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1092AA3IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Hypersensitivity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Immunized at 11:00 AM. About 2:00 PM had local reaction at injection site. About 5:00 PM had difficulty breathing. Took Albuterol nebulizer then and every 4-6 hours. Saw doctor 10/23/03 at noon and was told she had allergic reaction. Told to use nebulizer and Aleve. Had temp 104 degrees.

VAERS ID:211598 (history)  Vaccinated:2003-10-23
Age:30.0  Onset:2003-10-29, Days after vaccination: 6
Gender:Male  Submitted:2003-11-03, Days after onset: 5
Location:Arizona  Entered:2003-11-03
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Chronic Headaches Allergic to Tylox
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Gastrointestinal disorder, Headache, Meningitis, Myocarditis, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 6 days s/p vaccination - developed a severe headache, low grade fever, and nausea without other GI symptoms, as well as chest pain without shortness of breath. The discharge summary and consult reports received on 3/11/04 state myopericarditis and aseptic meningitis. At this point he seems to have recovered. However, we cannot be complete sure until after his 2 yr follow-up.

VAERS ID:211788 (history)  Vaccinated:2003-01-15
Age:30.0  Onset:2003-01-18, Days after vaccination: 3
Gender:Male  Submitted:2003-11-05, Days after onset: 291
Location:Unknown  Entered:2003-11-05
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: Seasonal Allergies
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0644SCLA
Administered by: Military     Purchased by: Military
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient had large local reaction with swelling from shoulder to elbow after last two vaccinations

VAERS ID:212109 (history)  Vaccinated:2003-11-04
Age:30.0  Onset:2003-11-04, Days after vaccination: 0
Gender:Female  Submitted:2003-11-04, Days after onset: 0
Location:New Hampshire  Entered:2003-11-11, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depoprovera
Current Illness: NONE
Preexisting Conditions: One sibling has egg allergy. Pt tolerate eggs.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES7659540IMRA
Administered by: Other     Purchased by: Private
Symptoms: Chest pain, Pain, Pallor, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: Pt presented 45 minutes after vaccination was at her work place. Reports discomfort/pain in chest and right axilla, "throat tightness," and is very pale. Medicated with Benadryl 50mg IM at 1245 by RN. Color improved. throat tightness lessened within 5 mins. Reports first onset of symptoms was within 20 mins of dose. Improved by 1330.

VAERS ID:212123 (history)  Vaccinated:2003-10-27
Age:30.0  Onset:2003-10-29, Days after vaccination: 2
Gender:Female  Submitted:2003-10-31, Days after onset: 2
Location:Colorado  Entered:2003-11-11, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Father had a vaccine reaction some years ago.
Diagnostic Lab Data: Will see allergist.
CDC Split Type: CO030040
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS235A41IMRA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Erythema, Injection site reaction, Oedema, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Began her run at the usual time and route. About 1/3 through, hands began to itch, then ears began to burn and itch. Kept running. Within 30 minutes entire body was red, swollen and itching. Had chills all night. No fever. Shower (cool), Benadryl and rest helped and by morning sxs were improved.

VAERS ID:212379 (history)  Vaccinated:2003-10-15
Age:30.0  Onset:2003-10-15, Days after vaccination: 0
Gender:Male  Submitted:2003-10-16, Days after onset: 1
Location:West Virginia  Entered:2003-11-17, Days after submission: 32
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) (FLUZONE)AVENTIS PASTEURU1074AA  RA
Administered by: Private     Purchased by: Private
Symptoms: Hypoaesthesia, Nausea, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Patient states that he''s developed numbness of right arm and fingers. 12 hours after immunization in same arm Lasted two hours. Later developed shaking, chills, and flu-like symptoms and nausea.

VAERS ID:212427 (history)  Vaccinated:2003-10-29
Age:30.0  Onset:2003-10-29, Days after vaccination: 0
Gender:Female  Submitted:2003-11-17, Days after onset: 19
Location:Ohio  Entered:2003-11-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Ibuprofen
Current Illness:
Preexisting Conditions: Allergy to Amoxicillin, History IBS (irritable bowel syndrome)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES7658763IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypoaesthesia, Injection site pain, Joint range of motion decreased
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Received influenza vaccine in L deltoid (posterior/superior aspect) 10/29/03. Reports that she had immediate pain with numbness/tingling radiating down her L arm to palmar aspects of all digits. Symptoms waned in about 1 hour, but persisted. Presents 11/17/03 with one day of increased tenderness/pain at injection site with decreased range of motion L shoulder (abduction & elevation)and L arm/hand numbness & tingling.

VAERS ID:212561 (history)  Vaccinated:2003-11-12
Age:30.0  Onset:2003-11-12, Days after vaccination: 0
Gender:Female  Submitted:2003-11-12, Days after onset: 0
Location:Utah  Entered:2003-11-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: PCN
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES7657040 RA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient received flu shot for 1st time. Answered no to all screening questions. 10 minutes after vaccine, she was itching on face, legs, arms and chest. Redness on left eyebrow, chin and chest. Stated no respiratory symptoms. She was given 2 tabs (4mg each) of chlorpheniramine.

VAERS ID:212777 (history)  Vaccinated:2003-10-30
Age:30.0  Onset:2003-10-30, Days after vaccination: 0
Gender:Female  Submitted:2003-11-19, Days after onset: 20
Location:New York  Entered:2003-11-21, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Duolin inhaler, Combitide inhaler, Tenoclor, Elina, Singulair, Paxil, Nuvaring
Current Illness:
Preexisting Conditions: Asthma, HTN, severe food allergies to legumes, peas, beans, peanuts, soya bean, aubergine (eggplant). Anaphylactic reaction to legumes and peas.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1137HA  LA
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: C/o SOB. Stated she had similar symptoms when she had anaphylactic reaction to eggplant/legumes. Breath sounds clear, no wheeze, rhonchi. Given Benadryl 25mg PO. Epi-pen administered. 911 called. Ambulance to hospital.

VAERS ID:212821 (history)  Vaccinated:2003-11-20
Age:30.0  Onset:2003-11-20, Days after vaccination: 0
Gender:Female  Submitted:2003-11-21, Days after onset: 1
Location:West Virginia  Entered:2003-11-24, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES766054  LA
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Injection site induration, Injection site oedema, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Tenderness, swelling, induration and increased warmth right injection site increasing over 24 hours post injection.

VAERS ID:213164 (history)  Vaccinated:2003-11-28
Age:30.0  Onset:2003-11-29, Days after vaccination: 1
Gender:Female  Submitted:2003-11-30, Days after onset: 1
Location:California  Entered:2003-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient had just ended a course of antibiotics (amoxicillin capsules)which she had taken on several previous occasions without any reaction. Patient has never had any similar allergic reaction to any medication or substance. ALSO Nasarel
Current Illness: Recent sinus infection, which had been treated with amoxicillin.
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE. Patient was seen at Urgent Care on 11/29/03.
CDC Split Type:
Vaccination
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Eyelid oedema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Within about 18 hours of receiving the shot: Hives on scalp, ears, eyelids, throat/neck, chest, hips, back, legs, wrists. Swollen eyelids. Chills. Treatment: Patient took Benadryl and used Benadryl cream before seeing the doctor (recommended by the advice nurse.) The doctor recommended that the patient take Claritin, and the patient took the generic equivalent (Loratadine). The treatment temporarily eased some of the itching, and the hives appeared to flatten out and spread in diameter. As of 11/30/03: Hives are still present, large, and are even darker pink than before.

VAERS ID:213259 (history)  Vaccinated:2003-11-17
Age:30.0  Onset:2003-11-18, Days after vaccination: 1
Gender:Female  Submitted:2003-11-19, Days after onset: 1
Location:South Carolina  Entered:2003-12-02, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Polycystic Ovarian Disease
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0804SCLA
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES7657541IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Symptoms: 13x20 cm area of redness, swelling, warmth and pruritis over left arm. Occurred approximately 24 hours post vaccination.

VAERS ID:213301 (history)  Vaccinated:2003-11-18
Age:30.0  Onset:2003-11-19, Days after vaccination: 1
Gender:Female  Submitted:2003-11-21, Days after onset: 2
Location:Georgia  Entered:2003-12-02, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Possible cold
Preexisting Conditions: No
Diagnostic Lab Data: CBC - normal
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0793SCRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40300130SCLA
Administered by: Military     Purchased by: Military
Symptoms: Hypoaesthesia, Injection site erythema, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: High fever 101-103 degrees, 2 days. Nausea, redness in local area about 2 inches around. Pain in arm (burning), numbness in fingers. Motrin 600, Benadryl.

VAERS ID:213304 (history)  Vaccinated:2003-01-16
Age:30.0  Onset:2003-01-17, Days after vaccination: 1
Gender:Male  Submitted:2003-01-24, Days after onset: 7
Location:South Carolina  Entered:2003-12-02, Days after submission: 312
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0633 LA
Administered by: Military     Purchased by: Military
Symptoms: Injection site mass, Injection site oedema, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Quarter size notch. Achy joints/pain over whole body and burning rash and swelling from injection site to the elbow.

VAERS ID:213460 (history)  Vaccinated:2003-10-26
Age:30.0  Onset:2003-10-27, Days after vaccination: 1
Gender:Male  Submitted:2003-10-30, Days after onset: 3
Location:Wisconsin  Entered:2003-12-04, Days after submission: 35
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: CBC-normal
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0763SCLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURW13661IDRA
Administered by: Private     Purchased by: Military
Symptoms: Erythema, Feeling hot, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Less than 24 hrs after immunization Lt upper arm became swollen, erythematous and warm compared to other areas of skin. 72 hrs post immunization swelling expanded to forearm and shoulder. Treated with antihistamines.

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