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Found 583703 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:116911 (history)  Vaccinated:1998-11-03
Age:34.9  Onset:0000-00-00
Gender:Female  Submitted:1998-11-23
Location:Minnesota  Entered:1998-11-27, 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: Cimetidine
Current Illness: NONE
Preexisting Conditions: allergic to compazine, codeine, cephalosporin, PCN, & sulfa;
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882200IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: alleges rt lymph (axillary) tenderness;

VAERS ID:116983 (history)  Vaccinated:1998-10-16
Age:34.5  Onset:1998-10-17, Days after vaccination: 1
Gender:Female  Submitted:1998-10-18, Days after onset: 1
Location:Virginia  Entered:1998-12-01, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Flutamide,birth control, prilecek
Current Illness: NA
Preexisting Conditions: seasonal, environmental
Diagnostic Lab Data: CBC-nl
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09701700IMRA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Chills, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)
Write-up: feeling very tired & weak;switching back & forth from sweating spells, then chills;

VAERS ID:117115 (history)  Vaccinated:1998-11-22
Age:34.5  Onset:1998-11-24, Days after vaccination: 2
Gender:Male  Submitted:1998-12-02, Days after onset: 8
Location:Maryland  Entered:1998-12-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp rash over chest wall w/itchy & raised edema w/dose 1 anthrax;
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0341  
Administered by: Military     Purchased by: Military
Symptoms: Adverse drug reaction, Pruritus, Rash, Similar reaction on previous exposure to drug
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 22NOV98 & 24NOV98 noticed rash over chest;area large & itched ;physical exam WNL;

VAERS ID:117145 (history)  Vaccinated:1998-10-07
Age:34.0  Onset:1998-10-07, Days after vaccination: 0
Gender:Female  Submitted:1998-10-09, Days after onset: 2
Location:Georgia  Entered:1998-12-07, Days after submission: 59
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma
Diagnostic Lab Data: NONE
CDC Split Type: GA98108
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1541E0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 7OCT98 & that evening area began to throb, swell & turn red & hot;APAP taken every 4hr;seen @ clinic 9OCT98 for eval;area indurated 6cm x 7cm w/satellite redness & induration located lt & distal inj site 1 1/2cm x 3cm;

VAERS ID:117182 (history)  Vaccinated:1998-10-28
Age:34.7  Onset:1998-10-29, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1998-12-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0981850 IMA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)
Write-up: w/in 24hr of vax devel partial facial paralysis;dx bell''s palsy;

VAERS ID:117217 (history)  Vaccinated:1998-10-15
Age:34.3  Onset:1998-10-17, Days after vaccination: 2
Gender:Female  Submitted:1998-10-19, Days after onset: 2
Location:Nebraska  Entered:1998-12-08, Days after submission: 50
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49781413IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt arm became itchy, red, & swollen, area swollen & sore was approx egg size & warm to touch, went to ER 12:00;tx was taken DPH;pt refused because of large dose @ 745PM;DPH taken & heat applied to area for 3hr;

VAERS ID:117238 (history)  Vaccinated:1998-10-02
Age:34.8  Onset:1998-10-02, Days after vaccination: 0
Gender:Female  Submitted:1998-11-17, Days after onset: 46
Location:North Carolina  Entered:1998-12-09, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to beestings, seasonal allergies
Diagnostic Lab Data:
CDC Split Type: NC98068
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0929590 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Lung disorder, Oedema, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt recv vax 930AM & by 1PM had significant swelling & pain which pt felt was nl expectation;swelling cont & by the afternoon 3OCT98 had swelling from elbow to wrist w/inability to flex elbow;also had mild resp sx;seen in ER:

VAERS ID:117399 (history)  Vaccinated:1998-12-04
Age:34.0  Onset:1998-12-05, Days after vaccination: 1
Gender:Female  Submitted:1998-12-07, Days after onset: 2
Location:California  Entered:1998-12-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Heart murmur
Diagnostic Lab Data: UNK
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM584A40IMRA
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES0709M3PO 
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD0150510PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Headache, Hyperhidrosis, Myalgia, Rhinitis, Sinusitis
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Pt recv vax on 12/4/98; on 12/5/98 pt exp headache, body aches, chills, night sweats, runny nose

VAERS ID:117641 (history)  Vaccinated:1998-12-09
Age:34.1  Onset:1998-12-10, Days after vaccination: 1
Gender:Female  Submitted:1998-12-14, Days after onset: 4
Location:Texas  Entered:1998-12-22, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: PPD by Connaught lot# 249911 given 9DEC98
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: TX98184
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)CONNAUGHT LTD.M001821SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES093944B  LA
Administered by: Public     Purchased by: Public
Symptoms: Malaise, Myalgia, Pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: 14DEC98 lt arm/hand achiness, tingling, numbness, malaise, worse in AM;APAP since 10DEC;warm compresses suggested;17DEC no more numbness, sl pain w/pressure, still hot compresses as needed esp stiff & sore in morning;

VAERS ID:117658 (history)  Vaccinated:1998-11-08
Age:34.0  Onset:1998-11-22, Days after vaccination: 14
Gender:Male  Submitted:1998-12-16, Days after onset: 24
Location:Georgia  Entered:1998-12-28, Days after submission: 12
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: NONE
Diagnostic Lab Data: Neurological tests to dx GBS
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, Paralysis
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Pt recv vax on 11/8/98; on 11/22/98 pt exp muscular weakness to hands, then general weakness; progressed to paralysis; dx= Guillain Barre syndrome; pt hosp/ ICU; tx=plasmapheresis, intubated for ventilation

VAERS ID:117783 (history)  Vaccinated:1998-12-01
Age:34.4  Onset:1998-12-03, Days after vaccination: 2
Gender:Female  Submitted:1998-12-15, Days after onset: 12
Location:Missouri  Entered:1998-12-29, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: NONE
Preexisting Conditions: Allergic to Keflex, Percodon; Hypothyroid
Diagnostic Lab Data: Unable to to allergy testing because of meds pt is taking
CDC Split Type: MO98086
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2802A40IMRA
Administered by: Other     Purchased by: Other
Symptoms: Chest pain, Face oedema, Laryngospasm, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt recv vax on 12/1/98; on 12/3/98 pt exp hives, tight chest, face & throat swollen; tx=Epinephrine, Benadryl, Hydrocortisone injections; pt to allergist

VAERS ID:117793 (history)  Vaccinated:1998-12-14
Age:34.2  Onset:1998-12-14, Days after vaccination: 0
Gender:Female  Submitted:1998-12-15, Days after onset: 1
Location:Missouri  Entered:1998-12-29, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp extreme soreness & swelling @ 24yr old w/Td ?1st or 2nd;
Other Medications: NONE
Current Illness: injury @ work prior to inj but cut hand on greasy blade-pizza kit
Preexisting Conditions: IVP dye;cut hand @ work;
Diagnostic Lab Data:
CDC Split Type: MO98085
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4514631IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, 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: extreme pain-burning sensation approx 2-3inches below inj site;unable to raise arm w/o assistance;extreme pain started approx 10hr later;used ibuprofen, ice & heat;

VAERS ID:118035 (history)  Vaccinated:1998-10-06
Age:34.6  Onset:1998-10-06, Days after vaccination: 0
Gender:Male  Submitted:1998-10-06, Days after onset: 0
Location:Minnesota  Entered:1999-01-12, Days after submission: 98
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: BP 140/92, P64, R16;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0975800 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Chest pain, Chills, Condition aggravated, Hypertension, Hypothermia, Hypoventilation, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (narrow), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Respiratory failure (narrow)
Write-up: pt recv vax 745AM came back to nurse 9:45;stated vomited, felt chilled;pt is asthmatic;uses inhaler for wheezing;pt stated had stomach flu/bronchitis 1mo earlier;pt vomited x1, chills, T97.2;

VAERS ID:118039 (history)  Vaccinated:1998-10-05
Age:34.9  Onset:1998-10-05, Days after vaccination: 0
Gender:Female  Submitted:1998-10-05, Days after onset: 0
Location:Minnesota  Entered:1999-01-12, Days after submission: 99
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09758000 LA
Administered by: Other     Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Headache, Hyperhidrosis, Hypertension, Hypotension, Hypoventilation
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Respiratory failure (narrow), Hypoglycaemia (broad)
Write-up: pt recv vax 130PM & 10min p/ c/o diaphoresis & severe abd cramping VS BP 118/70, HR 70 & RR16;lungs clear;EMS notified given epi;VS 155PM BP 120/72, HR 64, RR18;pt exp high BP, h/a;weak seen by MD;

VAERS ID:118356 (history)  Vaccinated:1997-10-16
Age:34.0  Onset:1997-10-17, Days after vaccination: 1
Gender:Female  Submitted:1998-10-09, Days after onset: 357
Location:Virginia  Entered:1999-01-26, Days after submission: 109
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp SOB,n,chills, sweat, h/a, dizziness,stiff neck,myalgia,malaise w/rabies~ ()~~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: Iodine; Morphine; Suffers from paranoid and schizophrenia
Diagnostic Lab Data:
CDC Split Type: 7649
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.M069033UNUN
Administered by: Private     Purchased by: Private
Symptoms: Chills, Dizziness, Dyspnoea, Headache, Hyperhidrosis, Malaise, Myalgia, Nausea, Nuchal rigidity
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Pt recv vax 16OCT97 & the next day pt exp SOB, nausea, chills, sweats, h/a, dizziness, stiff neck, general myalgia & malaise;sx have occurred w/increasing severity p/each vax; It was reported that a 34-year-old female was vaccinated with RAB-IMOVAX Rabies on October 16, 1997 as the fourth dose of a post exposure treatment series. The next day the patient experienced shortness of breath, nausea, chills, sweats, headache, dizziness, stiff neck, general nyalgia and malaise. The patient has been in contact with her physician regarding these symptoms. The patient reports that the symptoms have occurred with increasing severity following each vaccine dose of the treatment series. From follow-up #1, November 7, 1997, the recovery status of the patient was not reported and remains unknown. From Follow-up correspondence received at Manufacturer on 18-Apr-2000, it was reported that the patient recovered from this experience. The patient had paranoid schizophrenia and this impairs comunication at times, she had recovered from bite and reaction.

VAERS ID:118543 (history)  Vaccinated:1998-10-28
Age:34.6  Onset:1998-11-19, Days after vaccination: 22
Gender:Male  Submitted:1999-01-22, Days after onset: 64
Location:New York  Entered:1999-02-04, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: Proventil inhaler, Lidex cream/ Lachydro
Current Illness: UNK
Preexisting Conditions: Allergic to Penicillin
Diagnostic Lab Data: WBC - 12/15/98: 3.4
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882120 LA
Administered by: Other     Purchased by: Public
Symptoms: Leukopenia, Nervousness, Tremor
SMQs:, Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt recv vax on 10/28/98; on 11/19/98 pt exp nervousness & shakes

VAERS ID:118676 (history)  Vaccinated:1998-10-27
Age:34.9  Onset:1998-10-28, Days after vaccination: 1
Gender:Female  Submitted:1998-10-28, Days after onset: 0
Location:California  Entered:1999-02-09, Days after submission: 104
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
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09846200 RA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site pain, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: site of flu vax red & warm;redness measures 4.6cm x 6cm;mild soreness @ site;noticed it all the next morning @ 715AM;c/o itchy inside also;29OCT98 no redness & no warmth;

VAERS ID:118714 (history)  Vaccinated:1999-01-23
Age:34.0  Onset:1999-01-26, Days after vaccination: 3
Gender:Male  Submitted:1999-01-29, Days after onset: 3
Location:California  Entered:1999-02-09, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA~~ ~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURERFAV0341SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, 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 states approx 2 days p/vax noted the upper area of lt arm was swollen & was itchy;no n/v/d/h/a, dizziness;pt states was also sore;

VAERS ID:118860 (history)  Vaccinated:1998-10-21
Age:34.8  Onset:1998-10-21, Days after vaccination: 0
Gender:Female  Submitted:1999-01-19, Days after onset: 90
Location:Nebraska  Entered:1999-02-09, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09818000IM 
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Chest pain, Cough, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt recv vax on 10/21/98; 4 hr post vax pt exp tight chest, cough, fatigue & body aches

VAERS ID:118983 (history)  Vaccinated:1998-11-30
Age:34.1  Onset:1998-11-30, Days after vaccination: 0
Gender:Female  Submitted:1998-12-01, Days after onset: 1
Location:California  Entered:1999-02-11, Days after submission: 72
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions: influenza 2 weeks prior to receiving immunization;
Diagnostic Lab Data:
CDC Split Type: 898341012A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH 0 RA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES   LA
Administered by: Private     Purchased by: Other
Symptoms: Headache, Influenza, Myalgia, Pharyngitis
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 30NOV98 & w/in 12hr exp flu like sx including sore throat, h/a & myalgia;

VAERS ID:119025 (history)  Vaccinated:1999-01-12
Age:34.7  Onset:1999-01-14, Days after vaccination: 2
Gender:Female  Submitted:1999-01-15, Days after onset: 1
Location:Georgia  Entered:1999-02-16, Days after submission: 32
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: GA99003
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0430H0 LA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09447800 RA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site pain, Pyrexia, Vasodilatation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt recv vax on 1/12/99; on 1/14/99 pt exp rt arm sore/red/warm, fever; tx=cold & warm compress, Tylenol

VAERS ID:119158 (history)  Vaccinated:1998-08-18
Age:34.0  Onset:0000-00-00
Gender:Female  Submitted:1998-09-03
Location:Tennessee  Entered:1999-02-18, Days after submission: 168
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:
CDC Split Type: 898252026A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)PFIZER/WYETH4978105   
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax & devel an inj site rxn characterized by redness, warmth, swelling, itching & induration;pt was seen by MD & treated w/applications of ice;

VAERS ID:119224 (history)  Vaccinated:1995-05-25
Age:34.0  Onset:1995-06-02, Days after vaccination: 8
Gender:Female  Submitted:1999-02-16, Days after onset: 1355
Location:Michigan  Entered:1999-02-22, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: NONE
Diagnostic Lab Data: Immuno 1, Blood print IGG, food sensitivity, Assay results-allergy to yeast
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt recv vax on 5/25/95; on 6/2/95 pt exp swollen lymph glands throughout body

VAERS ID:119382 (history)  Vaccinated:1999-01-25
Age:34.0  Onset:0000-00-00
Gender:Female  Submitted:1999-02-15
Location:South Carolina  Entered:1999-02-25, 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: allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0301  
Administered by: Other     Purchased by: Other
Symptoms: Chills, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax 25JAN99 & had nausea w/in minutes lasting approx 12;when pt recv second series was initially fine but w/in a couple of hr exp n,v & extreme chills lasting 4-5hr;

VAERS ID:119383 (history)  Vaccinated:1999-01-25
Age:34.6  Onset:1999-01-25, Days after vaccination: 0
Gender:Male  Submitted:1999-02-15, Days after onset: 21
Location:South Carolina  Entered:1999-02-25, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp itching w/dose 1 arnthrax vax
Other Medications: Premarin;Allegra
Current Illness: NONE
Preexisting Conditions: asthma;allergy: Iodine, sulfa, PCn, chocolate, Corn
Diagnostic Lab Data:
CDC Split Type: WA991531
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0301  
Administered by: Public     Purchased by: Military
Symptoms: Adverse drug reaction, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax & 12hr later began to itch all over body;pt had no rash @ the inj site or anywhere else on body;pt had no acute distress, moist mucous membranes;no audible wheezing, no visible resp distress;no facial swelling;

VAERS ID:119632 (history)  Vaccinated:1997-11-20
Age:34.3  Onset:1997-11-21, Days after vaccination: 1
Gender:Female  Submitted:1998-08-04, Days after onset: 255
Location:North Carolina  Entered:1999-02-26, Days after submission: 206
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: Pred was prescribed as a taper;
Current Illness: NONE
Preexisting Conditions: allergies to: trees, dust, plantin, ragweed, feathers, dogs & cats;
Diagnostic Lab Data: C4 drawn @ later date 10DEC, RASt test 10DEC;
CDC Split Type: 7787
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F81754 IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Asthma, Chest pain, Cough, Dyspnoea, Face oedema, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 20NOV97 & 2hr p/vax pt exp pain in the shoulder;8hr p/vax pt awoke w/lips, nose & eyes very swollen;exp diff annunciating words, chest felt very heavy d/t swelling, asthma type feeling-coughing, sl SOB, tightness;

VAERS ID:119676 (history)  Vaccinated:1993-04-19
Age:34.5  Onset:1994-04-19, Days after vaccination: 365
Gender:Female  Submitted:1999-02-24, Days after onset: 1772
Location:Illinois  Entered:1999-03-03, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: erythromycin allergy;hypothyroidism;rheumatoid arthritis;
Diagnostic Lab Data: serum ANA positive 1-40;serum rheumatoid factor 160 positive;
CDC Split Type: WAES99011474
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia, Myalgia, Oedema, Rheumatoid arthritis
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 19APR93 & 19APR94 pt exp rheumatoid arthritis & fibromyalgia;pt could not move or get out of bed & felt achy & sore;pt also exp swelling;arthritis was in all joints;pt thought was dying;dx rheumatoid arthritis w/fibromyalgia;Annual follow-up dated 11/27/00 provided no additional data.

VAERS ID:119854 (history)  Vaccinated:1998-02-11
Age:34.6  Onset:1998-02-27, Days after vaccination: 16
Gender:Female  Submitted:1999-03-01, Days after onset: 367
Location:Pennsylvania  Entered:1999-03-03, 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: Desogen, Synthroid
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES98030391
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Eye disorder, Headache, Hypokinesia, Neck pain, Oedema peripheral, Osteoarthritis, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Corneal disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow)
Write-up: Pt recv vax on 2/11/98; on 2/27/98 pt exp neck pain, pain when turning head, eye capillary burst, headache; tx=Compazine w/out resolve, Demerol; 3/4/98 pt exp swollen knee w/ fluid on the knee & swollen wrists

VAERS ID:119905 (history)  Vaccinated:1998-04-20
Age:34.5  Onset:1998-04-22, Days after vaccination: 2
Gender:Male  Submitted:1999-03-01, Days after onset: 313
Location:Connecticut  Entered:1999-03-03, 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: UNK
Current Illness:
Preexisting Conditions: Hepatitis C
Diagnostic Lab Data: 5/6/98 Serum direct bilirubin 1.4, Serum alanine aminotrans 1720, Serum aspartate aminotra 920, Serum LDH 994;5/8/99 WBC 3.4; 5/11/98 Total serum bilirubin 2.0
CDC Split Type: WAES98050729
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IM 
Administered by: Private     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Asthenia, Blood lactate dehydrogenase increased, Flatulence, Hepatic function abnormal, Hyperbilirubinaemia, Laboratory test abnormal, Leukopenia, Nausea
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (narrow), Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt recv vax on 4/20/98; on 4/22/98 pt exp fatigue, nausea, bloating, hepatic function abnormality

VAERS ID:119986 (history)  Vaccinated:1998-08-26
Age:34.1  Onset:1998-08-26, Days after vaccination: 0
Gender:Female  Submitted:1999-03-01, Days after onset: 187
Location:Arizona  Entered:1999-03-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: NSAID allergy;Codeine allergy
Diagnostic Lab Data:
CDC Split Type: WAES98081907
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Chills, Dizziness, Pyrexia, Syncope, Vasodilatation
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax 26AUG98 & same day pt devel feverish sx, chills, fatigue, heat sensations, dizziness & a feeling of passing out;

VAERS ID:120147 (history)  Vaccinated:1999-01-26
Age:34.7  Onset:1999-01-26, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Virginia  Entered:1999-03-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: VA99010
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2724A41IMRA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Dizziness, Infection, Myasthenic syndrome, Oedema, Paraesthesia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: c/o numbness or heavy feeling in arm, lightheaded, joint pain, swelling;(immed following infect) daycare ctr director took pt to see pvt MD;

VAERS ID:120284 (history)  Vaccinated:1999-01-27
Age:34.0  Onset:1999-01-27, Days after vaccination: 0
Gender:Male  Submitted:1999-02-02, Days after onset: 6
Location:Tennessee  Entered:1999-03-15, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flovent, Lavoxyl, Proventil
Current Illness: NONE
Preexisting Conditions: Hypothyroid, Chronic asthma
Diagnostic Lab Data: UNK
CDC Split Type: TN99001
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2930A20IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM547A10IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Hypokinesia, Myalgia, Nausea, Somnolence, Thinking abnormal, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Pt recv vax on 1/27/99; on same day pt exp weak feeling, shaky, sore legs, lethargy, cold sweats, nausea, unclear thinking, dizzy, barely able to walk

VAERS ID:120308 (history)  Vaccinated:1998-10-14
Age:34.2  Onset:1998-10-15, Days after vaccination: 1
Gender:Male  Submitted:1998-10-21, Days after onset: 6
Location:South Dakota  Entered:1999-03-15, Days after submission: 145
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: SD99025
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7B9158 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre 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 recv vax on 10/14/98; on 10/15/98 pt exp fever (103), weak, headache, achy, nausea

VAERS ID:120311 (history)  Vaccinated:1998-08-17
Age:34.2  Onset:0000-00-00
Gender:Female  Submitted:1998-08-20
Location:South Dakota  Entered:1999-03-15, Days after submission: 207
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: SD99022
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR I)MERCK & CO. INC.0029H1SCLA
Administered by: Other     Purchased by: Public
Symptoms: Hypersensitivity, Injection site hypersensitivity, Injection site oedema, Injection site pain, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt recv vax on 8/17/98; post vax pt exp abdominal rash, nausea, vomiting, vax site sore/red/swollen, fever; dx=allergic response to vax; tx=Benadryl

VAERS ID:120535 (history)  Vaccinated:1999-02-11
Age:34.9  Onset:1999-02-16, Days after vaccination: 5
Gender:Female  Submitted:1999-03-17, Days after onset: 29
Location:Virginia  Entered:1999-03-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: cult of abscess fluid
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0950740 IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site abscess, Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv vax 11FEB99 & saw GYN d/t rash & erythema @ site a few days later;2 courses of Keflex;saw MD 12MAR99 w/abscess @ site-drained-sterile;

VAERS ID:120551 (history)  Vaccinated:1999-03-16
Age:34.8  Onset:1999-03-16, Days after vaccination: 0
Gender:Female  Submitted:1999-03-17, Days after onset: 1
Location:Ohio  Entered:1999-03-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
RAB: RABIES (NO BRAND NAME)UNKNOWN MANUFACTURER    
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax & 30min post vax pt noted 4cm diameter red, hot, itchy area 24hr p/vax;pt still reports very warm, itchy raised reddened area described as approx 2 inches in diameter;

VAERS ID:120682 (history)  Vaccinated:1998-06-04
Age:34.9  Onset:1998-06-08, Days after vaccination: 4
Gender:Female  Submitted:1998-07-10, Days after onset: 32
Location:Colorado  Entered:1999-03-29, Days after submission: 262
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Orthro-novum 777, Feldene PRn
Current Illness: cut web between 4 & 5 fingers lt hand sutured;
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: U199800299
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0934600   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Oedema, Skin nodule, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: pt recv vax 4JUN98 & 8JUN98 pt c/o redness, swelling & warmth;last booster 11 years ago;s/sx have not subsided;from f/u 23JUN98 pt cont to have divided lump-warm to touch, non tender;

VAERS ID:120684 (history)  Vaccinated:1998-06-08
Age:34.2  Onset:1998-06-12, Days after vaccination: 4
Gender:Unknown  Submitted:1998-06-17, Days after onset: 5
Location:New York  Entered:1999-03-29, Days after submission: 285
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: A&A positive w/low titer; 1:160 homogenous;
CDC Split Type: U199800303
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0929590   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv 6JUN98 & 12JUN98 pt c/o of muscle aches, joint aches & upper arm sore;

VAERS ID:120870 (history)  Vaccinated:1999-03-10
Age:34.7  Onset:1999-03-12, Days after vaccination: 2
Gender:Female  Submitted:1999-03-26, Days after onset: 14
Location:California  Entered:1999-04-02, 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: Metal foreign body in thumb
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC- mild eosinophil incr
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0997390 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Erythema nodosum, Injection site hypersensitivity, Injection site pain, Laboratory test abnormal
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 3/10/99; on 3/12/99 pt exp vax site pain x8-10 days, erythema nodosum at vax site x 1 wk, chills

VAERS ID:120903 (history)  Vaccinated:1998-10-15
Age:34.2  Onset:1998-10-15, Days after vaccination: 0
Gender:Female  Submitted:1999-03-30, Days after onset: 166
Location:Minnesota  Entered:1999-04-05, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: possible latex allergy, seasonal allergies, depression
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES098459010IMLA
Administered by: Military     Purchased by: Other
Symptoms: Hypoxia, Injection site oedema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: w/in 20min p/vax pt began to exp itching, hives & swelling to inj site;applied ice pack & took DPH;scalp & arms began to itch;seen in ER given epi & 02;

VAERS ID:120917 (history)  Vaccinated:1999-03-30
Age:34.8  Onset:1999-04-01, Days after vaccination: 2
Gender:Female  Submitted:1999-04-01, Days after onset: 0
Location:Michigan  Entered:1999-04-05, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: rt rib area tenderness
Preexisting Conditions: NKMA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0994610 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 2 days post vax pt devel 4cm x 5cm red, sl elevated, warm to touch area over rt deltoid;pt given med;warm moist packs, elevate arm no lifting;if itching develops may taken DPH;

VAERS ID:120923 (history)  Vaccinated:1998-10-15
Age:34.8  Onset:1998-10-16, Days after vaccination: 1
Gender:Female  Submitted:1998-10-19, Days after onset: 3
Location:Wisconsin  Entered:1999-04-05, Days after submission: 168
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WI98072
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882040IMLA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1605E0IMRA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4481740SCLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Injection site hypersensitivity, Injection site oedema, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre 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 (broad)
Write-up: lt arm swelling, redness @ site of inj & entire upper noted on 16OCT98 per pt;fever 102 48hr, weakness, malaise noted on 16OCT98 12noon per pt;advised to take Ibuprofen

VAERS ID:121014 (history)  Vaccinated:1999-03-14
Age:34.3  Onset:0000-00-00
Gender:Male  Submitted:1999-04-06
Location:Michigan  Entered:1999-04-07, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0303  
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Chest pain, Chills, Cough, Diarrhoea, Haemoptysis, Headache, Hyperhidrosis, Influenza, Mouth ulceration, Myalgia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt recv vax on 4/14/99; post vax pt exp body aches, joint pain, headaches, chest pains, diarrhea, stomach cramps, blisters in mouth, sweating/chills, coughing up blood/phlegm, tremors

VAERS ID:121197 (history)  Vaccinated:1999-04-09
Age:34.5  Onset:1999-04-10, Days after vaccination: 1
Gender:Male  Submitted:1999-04-12, Days after onset: 2
Location:Pennsylvania  Entered:1999-04-14, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0382  
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dyspnoea, Headache, Hyperhidrosis, Hypotonia, Malaise, Pallor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Pt recv vax on 4/9/99; on 4/10/99 pt exp cold sweat, pale, short of breath, weak, headache, limp body; tx=Benadryl, Prednisone

VAERS ID:121307 (history)  Vaccinated:1999-04-08
Age:34.8  Onset:1999-04-10, Days after vaccination: 2
Gender:Female  Submitted:1999-04-13, Days after onset: 3
Location:Tennessee  Entered:1999-04-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4546151 RA
Administered by: Other     Purchased by: Other
Symptoms: Injection site inflammation, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax 8APR99 & started having inflamed site & swelling on 10APR99;upper arm became painful & swollen;saw PMD on 12APR99 given hydroxyzine HCL 25mg q 6hr sx are improving;

VAERS ID:121400 (history)  Vaccinated:1999-03-03
Age:34.2  Onset:1999-03-03, Days after vaccination: 0
Gender:Female  Submitted:1999-03-03, Days after onset: 0
Location:Maryland  Entered:1999-04-22, Days after submission: 49
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Asthma history
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2795A21 RA
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (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: Pt recv vax on 3/3/99; on same day pt exp swelling/ red/ itching at vax site, swollen face, periorbital edema

VAERS ID:121753 (history)  Vaccinated:1999-02-05
Age:34.0  Onset:1999-02-06, Days after vaccination: 1
Gender:Male  Submitted:1999-02-10, Days after onset: 4
Location:New York  Entered:1999-04-26, Days after submission: 74
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Recombivir;Wellbutrin;Bactrim;Ambien;Experimental drugs;
Current Illness:
Preexisting Conditions: human immunodeficiency virus;
Diagnostic Lab Data:
CDC Split Type: 19990032761
Vaccination
Manufacturer
Lot
Dose
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Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM605A40IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 5FEB99 & 6FEB99 pt devel a rash;

VAERS ID:121650 (history)  Vaccinated:1998-11-15
Age:34.9  Onset:1999-02-24, Days after vaccination: 101
Gender:Unknown  Submitted:0000-00-00
Location:Texas  Entered:1999-04-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: TX99083
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0973930   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Influenza
SMQs:
Write-up: flu like sx;

VAERS ID:122002 (history)  Vaccinated:1999-04-22
Age:34.7  Onset:0000-00-00
Gender:Female  Submitted:1999-05-04
Location:Massachusetts  Entered:1999-05-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49782450 LA
Administered by: Private     Purchased by: Unknown
Symptoms: Abscess, Pain
SMQs:
Write-up: lt shoulder pain-redness abscess draining-pus-no temp;abscess drain & clear;

VAERS ID:122146 (history)  Vaccinated:1999-04-21
Age:34.0  Onset:1999-04-26, Days after vaccination: 5
Gender:Female  Submitted:1999-05-06, Days after onset: 10
Location:California  Entered:1999-05-14, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: C&S of abscess-no growth
CDC Split Type:
Vaccination
Manufacturer
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Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site abscess
SMQs:
Write-up: lt deltoid area sterile abscess which required I&D, gauze packing & several subsequent visits to doctor;

VAERS ID:122255 (history)  Vaccinated:0000-00-00
Age:34.5  Onset:1999-02-18
Gender:Female  Submitted:1999-05-11, Days after onset: 81
Location:California  Entered:1999-05-20, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp nausea, dizzy, twitch w/hep b dose 1;
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Dizziness, Muscle twitching, Nausea, Similar reaction on previous exposure to drug
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: nausea, dizzy, twitching of hand past taking vaccine (same happened 1st dose)

VAERS ID:122300 (history)  Vaccinated:1999-04-29
Age:34.2  Onset:1999-05-04, Days after vaccination: 5
Gender:Female  Submitted:1999-05-07, Days after onset: 3
Location:Connecticut  Entered:1999-05-21, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt dizziness, Lymerix, dose 1
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergies: sulfa, PCN
Diagnostic Lab Data: BP 100/68;T98/7, pulse 80;resp 16;pharynx clear;adenopathy inc ervicalarea or axilla;lungs are clear to auscultation & percussion;skin reveals no rashes;cranial nerves II-XII are intact;Calcium 8.3;WBCC 3.85;RBC 3.81;HGB 11.4;HCT 34.0;Tim
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM104A21IMLA
Administered by: Private     Purchased by: Private
Symptoms: Anaemia, Asthenia, Chills, Dizziness, Eye pain, Headache, Hyperaesthesia, Hyperhidrosis, Hypocalcaemia, Hypotension, Hypoventilation, Laboratory test abnormal, Leukopenia, Pain, Similar reaction on previous exposure to drug, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Vestibular disorders (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: pt recv vax 29APR99 & 4MAY99 began to exp severe bifrontal & vertex h/a associated w/pain in eyes;skin sensitivity describe as a pain;sweats & chills;dizziness;movement or rotation;fatigue;BP 100/68;resp 16;

VAERS ID:122734 (history)  Vaccinated:1997-06-02
Age:34.2  Onset:0000-00-00
Gender:Female  Submitted:1999-05-14
Location:Texas  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES97070688
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Abnormal labour
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: pt recv vax & became pregnant LMP 5/30/97;the estimated date of delivery is 3/5/98;routine sonograms were performed 5/97;pt exp preterm lab;

VAERS ID:122751 (history)  Vaccinated:1998-01-27
Age:34.0  Onset:0000-00-00
Gender:Female  Submitted:1999-05-14
Location:Colorado  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant data;
Other Medications: Vitamins
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: ultrasound 6/4/98 nl;ultrasound 9/30/98 r/o abnormalities;
CDC Split Type: WAES98030555
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Infection, Pharyngitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax 1/27/98 & 3/5/98 pt was found to be preg & urine preg test;pt exp streptococcal pharyngitis & was treated w/PCN;this report is part of preg registry;

VAERS ID:122946 (history)  Vaccinated:1998-04-20
Age:34.0  Onset:1998-04-20, Days after vaccination: 0
Gender:Female  Submitted:1999-05-14, Days after onset: 389
Location:Texas  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data~ ()~ ~~In patient
Other Medications: unknown
Current Illness:
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC Split Type: WAES98041453
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site hypersensitivity, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: immed p/ pt recv vax pt ``complained of stinging pain w/hematoma & redness of one inch in diameter'''' lasting 24 hr & by 4/21 pt recovered

VAERS ID:122963 (history)  Vaccinated:1996-05-20
Age:34.0  Onset:1998-04-22, Days after vaccination: 702
Gender:Female  Submitted:1999-05-14, Days after onset: 387
Location:North Carolina  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: drug allergy: iodine allergy; penicillin alergy; sulfa allergy
Diagnostic Lab Data:
CDC Split Type: WAES98041665
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 1st & 2nd doses varivax 4/3& 5/20/96 then 4/22/98 pt devel chickenpox

VAERS ID:123493 (history)  Vaccinated:1998-04-24
Age:34.7  Onset:1998-05-10, Days after vaccination: 16
Gender:Male  Submitted:1999-05-14, Days after onset: 369
Location:Illinois  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98060862
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt devel five lesions on stomach, chest & back;pt sought unspecified medical attention;

VAERS ID:123615 (history)  Vaccinated:0000-00-00
Age:34.0  Onset:0000-00-00
Gender:Female  Submitted:1999-05-14
Location:New York  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98070544
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: it was rpt a pt who was vax w/2nd dose of varivax & lab tests revealed negative varicella antibody titers.

VAERS ID:123658 (history)  Vaccinated:1998-07-07
Age:34.0  Onset:1998-07-12, Days after vaccination: 5
Gender:Male  Submitted:1999-05-14, Days after onset: 306
Location:Michigan  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: unk
Current Illness:
Preexisting Conditions: varicella exposure;
Diagnostic Lab Data:
CDC Split Type: WAES98071100
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Encephalitis, Headache
SMQs:, Noninfectious encephalitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt exp severe cephalgia & was hosp for poss encephalitis; Annual follow-up received on 11/27/00 provided no additional data.

VAERS ID:124328 (history)  Vaccinated:1998-12-10
Age:34.0  Onset:1998-12-10, Days after vaccination: 0
Gender:Male  Submitted:1999-05-14, Days after onset: 154
Location:New York  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98120893
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1419E0SC 
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Paraesthesia, Thinking abnormal
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)
Write-up: p/vax pt exp lightheadedness, an inability to concentrate, & numbness & tingling in fingers and extremities;

VAERS ID:124368 (history)  Vaccinated:1998-12-01
Age:34.9  Onset:1998-12-17, Days after vaccination: 16
Gender:Male  Submitted:1999-05-14, Days after onset: 147
Location:Georgia  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98121614
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis bullous, Infection
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: it was rpt fr RN concerning a pt who was vax & approx 17 days later exp chickenpox w/lesions

VAERS ID:124377 (history)  Vaccinated:0000-00-00
Age:34.0  Onset:1998-12-19
Gender:Female  Submitted:1999-05-14, Days after onset: 145
Location:Colorado  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: pregnancy
Diagnostic Lab Data: serum varicella zoster, neg varicella titers
CDC Split Type: WAES98121690
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: it was rpt fr MD concerning pt who was vax when 1wk preg. on 19dec98 pt delivered. healthy baby.at that time lab tests revealed pt was negative for varicella titers. no complications w/delivered

VAERS ID:124392 (history)  Vaccinated:1998-09-01
Age:34.8  Onset:0000-00-00
Gender:Female  Submitted:1999-05-14
Location:New York  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: 1998, neg varicella antibody titer
CDC Split Type: WAES98121966
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: it was rpt fr HCP concerning pt who was vax & in 1998 pt exp a lack of seroconversion. addl info requested

VAERS ID:124461 (history)  Vaccinated:1998-12-21
Age:34.4  Onset:1999-01-10, Days after vaccination: 20
Gender:Female  Submitted:1999-05-14, Days after onset: 123
Location:Wisconsin  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no relevant data
Other Medications: colistin, flonase, pancrease, prednisone, tremetoprim-sulfa, vitamin e, vitamins
Current Illness:
Preexisting Conditions: cystic fibrosis
Diagnostic Lab Data:
CDC Split Type: WAES99011257
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0665H0SCRA
Administered by: Private     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: approx 13mos p/vax pt exp chickenpox lesions

VAERS ID:124527 (history)  Vaccinated:1996-09-20
Age:34.5  Onset:1997-09-09, Days after vaccination: 354
Gender:Male  Submitted:1999-05-14, Days after onset: 612
Location:Connecticut  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES99020806
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Dermatitis bullous, Drug ineffective, Infection, Pruritus, Pyrexia, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt sought medical treatment for a varicella like rash;pt presented w/ pruritic rash & a low grade temp lasting a few days;rash was noted as erythematous papules w/blistering;exp breakthrough case of chickenpox;

VAERS ID:124534 (history)  Vaccinated:1999-01-27
Age:34.6  Onset:1999-02-03, Days after vaccination: 7
Gender:Male  Submitted:1999-05-14, Days after onset: 99
Location:Massachusetts  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: 2/24/99 BP;echocardiography nl;lab test nl lipid profile;serum cholesterol 173;
CDC Split Type: WAES99020961
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1101E0SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cardiovascular disorder, Hypercholesterolaemia, Injection site pain, Malaise, Rash maculo-papular
SMQs:, Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Lipodystrophy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt exp soreness @ the inj site which subsided;pt started to devel a rash w/approx 10 bumps that resembled insect bites w/surround red area that have been coming & going;malaise;scattered papules;dx Ehlers-Danlos synd;

VAERS ID:124624 (history)  Vaccinated:1998-12-28
Age:34.6  Onset:1999-02-28, Days after vaccination: 62
Gender:Female  Submitted:1999-05-14, Days after onset: 74
Location:Alabama  Entered:1999-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: 2/28/99 serum varicella zoster virsu negative;
CDC Split Type: WAES99030551
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1155H1  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: p/vax pt lab eval revealed a lack of response;

VAERS ID:122685 (history)  Vaccinated:1999-04-16
Age:34.1  Onset:1999-04-29, Days after vaccination: 13
Gender:Female  Submitted:1999-05-18, Days after onset: 19
Location:Wisconsin  Entered:1999-05-25, 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
Dose
Route
Site
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.0768H SCRA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: measles titer non-immune;measles immun started 16APR99;no documentation of measles immunization or disease prior;rash on chest 30APR99 reported saw Md;felt was rxn to immunization;

VAERS ID:123245 (history)  Vaccinated:1999-05-19
Age:34.4  Onset:1999-05-19, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1999-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES49782520IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt seen on 5/26/99 stated lt swollen arm was red & very hot, & arm was slightly red. pt not seen by provider;pt stated arm was ok

VAERS ID:123266 (history)  Vaccinated:1999-01-30
Age:34.2  Onset:1999-01-30, Days after vaccination: 0
Gender:Female  Submitted:1999-02-04, Days after onset: 5
Location:Alaska  Entered:1999-06-02, Days after submission: 117
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Ecchymosis, Injection site oedema, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt rpt sore/swollen @ rt arm since vax, seen @clinic w/bruising, slight swelling @ rt arm, full rom rt shoulder/arm.

VAERS ID:124833 (history)  Vaccinated:1998-07-14
Age:34.9  Onset:1998-07-14, Days after vaccination: 0
Gender:Female  Submitted:1998-07-30, Days after onset: 16
Location:New Mexico  Entered:1999-06-10, Days after submission: 315
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: rash (sulfa allergy)
Diagnostic Lab Data:
CDC Split Type: 98AEAV02
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0301SCRA
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Headache
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt returned on 15jul98 complaining of headache that began immed p/inject. an hour p/inject pt had diarrhea lasting all night

VAERS ID:124123 (history)  Vaccinated:1999-05-27
Age:34.0  Onset:1999-05-27, Days after vaccination: 0
Gender:Male  Submitted:1999-06-02, Days after onset: 6
Location:Virginia  Entered:1999-06-11, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0433SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site reaction, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 2x3 area of localized erythema;no tenderness to palpation no sx of cellulitis;no sensory deficit noted;DTR 2+ in extremities;STR 5/5 in extremities;

VAERS ID:124957 (history)  Vaccinated:1999-05-20
Age:34.0  Onset:1999-05-21, Days after vaccination: 1
Gender:Male  Submitted:1999-06-04, Days after onset: 14
Location:North Carolina  Entered:1999-06-17, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.455755 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest pain, Pyrexia, Skin disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt recv vax & reported to clinic next day w/fever 103-104, generalized total body skin discomfort & chest tightness;tx w/pred & DPH;

VAERS ID:123630 (history)  Vaccinated:1998-06-26
Age:34.4  Onset:1998-07-11, Days after vaccination: 15
Gender:Female  Submitted:1999-05-14, Days after onset: 307
Location:Massachusetts  Entered:1999-06-21, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No Relevant Data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98070673
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt devel approx 50-100 lesions on face, arms, & more numerous on trunk;no fever was present;pt never had chickenpox & has not had any known exposure to wild type chickenpox;MD felt skin lesions was not r/t vax;

VAERS ID:125198 (history)  Vaccinated:1999-02-05
Age:34.8  Onset:1999-02-23, Days after vaccination: 18
Gender:Female  Submitted:1999-06-17, Days after onset: 113
Location:Delaware  Entered:1999-06-28, 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:
Preexisting Conditions:
Diagnostic Lab Data: ultrasounds 1st one showed five & half week gestational sac & 2nd showed no gestational sac (miscarried);
CDC Split Type:
Vaccination
Manufacturer
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Dose
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0303 A
Administered by: Military     Purchased by: Military
Symptoms: Abortion
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: On 2/23/99, pt found out was preg;pt started spotting therefore seen by OB/GYN & they did a 48hr comparison & blood & results were not progressing as it should for preg;had two ultrasounds;MD confirmed spontaneous abortion;

VAERS ID:125321 (history)  Vaccinated:1999-06-21
Age:34.7  Onset:0000-00-00
Gender:Female  Submitted:1999-06-28
Location:Minnesota  Entered:1999-07-02, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4978121 IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: local reaction, redness, & itching;

VAERS ID:125388 (history)  Vaccinated:1999-06-26
Age:34.4  Onset:1999-06-27, Days after vaccination: 1
Gender:Male  Submitted:1999-06-29, Days after onset: 2
Location:Nevada  Entered:1999-07-07, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0410SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: fever 102 for 2 days;swelling/redness @ inj site for 2 days;civilian MD prescribed ATB;

VAERS ID:125390 (history)  Vaccinated:1999-06-23
Age:34.2  Onset:1999-06-24, Days after vaccination: 1
Gender:Male  Submitted:1999-06-25, Days after onset: 1
Location:Louisiana  Entered:1999-07-07, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0410SCLA
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: multiple pruritic wheals on entire skin surface;

VAERS ID:125759 (history)  Vaccinated:1999-04-09
Age:34.5  Onset:1999-04-09, Days after vaccination: 0
Gender:Female  Submitted:1999-04-09, Days after onset: 0
Location:Indiana  Entered:1999-07-13, Days after submission: 95
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Diagnostic Lab Data: unk
CDC Split Type: 899103133A
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV: ROTAVIRUS (ROTASHIELD)PFIZER/WYETH 0  
Administered by: Private     Purchased by: Other
Symptoms: Eye pain
SMQs:, Glaucoma (broad)
Write-up: it was rpt by nurse concerning pt who was administered w/vax on 4/9 & a small amount of vax splashed into nurse''s eye, causing a burning sensation; she flushed eye w/water;

VAERS ID:126032 (history)  Vaccinated:1999-04-22
Age:34.0  Onset:1999-04-22, Days after vaccination: 0
Gender:Female  Submitted:1999-07-07, Days after onset: 76
Location:Delaware  Entered:1999-07-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: ANA, RF, CPK, LDH, CBC, Sed rate (pending)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0430SCLA
Administered by: Military     Purchased by: Military
Symptoms: Ear disorder, Paraesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow)
Write-up: p/vax pt devel tingling entire lt side of body to include head;12-24hr pt went on flying trip; lt ear problems began p/trip;feeling of closing, stuffiness & eventually loud ringing in lt ear x 48hr;

VAERS ID:126117 (history)  Vaccinated:1999-06-22
Age:34.6  Onset:1999-06-22, Days after vaccination: 0
Gender:Male  Submitted:1999-06-22, Days after onset: 0
Location:North Carolina  Entered:1999-07-19, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: none
Current Illness: na
Preexisting Conditions: na
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0136J0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Dizziness, Hyperventilation, Pyrexia, Vasodilatation, Visual disturbance
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: day of vax pt sudden onset of slight dizziness, cold chills (transient) difficulty reading, flushed feeling, deep breathing. temp 99.3

VAERS ID:126144 (history)  Vaccinated:1999-02-16
Age:34.6  Onset:1999-02-17, Days after vaccination: 1
Gender:Female  Submitted:1999-03-18, Days after onset: 29
Location:Washington  Entered:1999-07-19, Days after submission: 122
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: sulfa drugs
Diagnostic Lab Data: n/a
CDC Split Type: WA991558
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2724A40 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1183H SCLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Face oedema, Myalgia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: day following vax pt exp very tired, felt warm, face was swollen. upper body soreness, next day just fine

VAERS ID:126413 (history)  Vaccinated:1999-06-29
Age:34.5  Onset:1999-06-30, Days after vaccination: 1
Gender:Female  Submitted:1999-07-12, Days after onset: 12
Location:Pennsylvania  Entered:1999-07-28, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type: PA9951
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09605801IMLA
Administered by: Public     Purchased by: Public
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/recv vax pt on 6/30 devel hives on legs & feet. treated w/benadryl but rash continued until 7/4/99

VAERS ID:126443 (history)  Vaccinated:1998-04-06
Age:34.9  Onset:1998-10-09, Days after vaccination: 186
Gender:Male  Submitted:1999-06-01, Days after onset: 235
Location:Idaho  Entered:1999-07-29, Days after submission: 58
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt-2"x2" rash on arm-ANTH #2
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: skin biopsy revealed lichen planis/lichenoid
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0173  
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Asthenia, Colitis, Diarrhoea, Dyspnoea, Eye pain, Headache, Laboratory test abnormal, Lichenoid keratosis, Myalgia, Rash, Similar reaction on previous exposure to drug
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Glaucoma (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/ 3rd vax rash on arm spread over entire body below the neck;since then have had daily h/a, joint pain, muscle aches, fatigue chronic, SOB, eye sockets ache, diarrhea;tx w/pred & Elavil

VAERS ID:126507 (history)  Vaccinated:1999-03-23
Age:34.2  Onset:1999-03-23, Days after vaccination: 0
Gender:Male  Submitted:1999-05-07, Days after onset: 44
Location:Connecticut  Entered:1999-07-30, Days after submission: 84
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: alergic to dust
Diagnostic Lab Data:
CDC Split Type: 1999007439
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120E90  
Administered by: Public     Purchased by: Other
Symptoms: Cough, Diarrhoea, Influenza, Injection site hypersensitivity, Injection site oedema, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax devel severe flu-like symptoms;diarrhea;cough;fever;body achiness; & local inj site soreness; lasted approx 2wk;site soreness lasted 4day, however redness & swelling for 2 1/2 wk; treating MD felt probably had combo flu & react to vax

VAERS ID:126517 (history)  Vaccinated:1999-03-03
Age:34.8  Onset:1999-03-03, Days after vaccination: 0
Gender:Male  Submitted:1999-04-07, Days after onset: 34
Location:New Jersey  Entered:1999-07-30, Days after submission: 114
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 1999007935
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120B90IMRA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Myalgia, Pain, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: p/vax became shaky, feverish; had rigors; lasted 3hr; next day muscle aches; pain over entire body; low grade fever;MD decided not to give 2nd dose of vax due to react

VAERS ID:126530 (history)  Vaccinated:1999-04-06
Age:34.0  Onset:1999-04-06, Days after vaccination: 0
Gender:Male  Submitted:1999-04-12, Days after onset: 6
Location:New Jersey  Entered:1999-07-30, Days after submission: 109
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 1999008255
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IMRA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Dyspnoea, Hyperhidrosis, Oedema peripheral, Tremor
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Hypoglycaemia (broad)
Write-up: p/vax pt exp shaking uncontrollably; heavy breathing; sweating; aching joints; rt arm swelling; tx tylenol 2

VAERS ID:126707 (history)  Vaccinated:1999-05-03
Age:34.0  Onset:1999-05-03, Days after vaccination: 0
Gender:Male  Submitted:1999-06-10, Days after onset: 38
Location:New York  Entered:1999-07-30, Days after submission: 50
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 1999013458
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120F90IMLA
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Myalgia, Neck pain, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: p/vax pt exp pain, achiness & stiffness (no swelling) in the inj arm, which radiated up to neck & down the lt side of back;pt said could not lift arm above shoulder height;pt took some ASA & pain resolved;

VAERS ID:126881 (history)  Vaccinated:1999-07-20
Age:34.7  Onset:1999-07-22, Days after vaccination: 2
Gender:Male  Submitted:1999-07-27, Days after onset: 5
Location:Massachusetts  Entered:1999-08-03, 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: ippd, conngt, #1250311, given 4/21/99
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0411SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: local swelling & redness w/subcutaneous nodule subsiding gradually; 7/26/99 both sites itching 31/2x21/4 raised papular rash on lt arm- rt arm site redness w/inc size of nodule from nickle to quarter w/slight red rash

VAERS ID:127004 (history)  Vaccinated:1999-02-08
Age:34.3  Onset:1999-02-12, Days after vaccination: 4
Gender:Male  Submitted:1999-07-29, Days after onset: 166
Location:South Carolina  Entered:1999-08-09, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: same rxn Anthrax#2 1/8/99
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: blood work & urine tests, neg
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0302  
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Asthenia, Chills, Hyperhidrosis, Malaise, Pyrexia, Similar reaction on previous exposure to drug
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: high fever (100-102); chills; severe fatigue; sweats; joint pain; malaise; lassitude

VAERS ID:127005 (history)  Vaccinated:1999-01-08
Age:34.2  Onset:1999-01-12, Days after vaccination: 4
Gender:Male  Submitted:1999-07-29, Days after onset: 197
Location:South Carolina  Entered:1999-08-09, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: same rxn w/ Anthrax#1 12/18/98
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0361  
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Asthenia, Chills, Hyperhidrosis, Malaise, Pyrexia, Similar reaction on previous exposure to drug
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: high fever (100-102); chills; severe fatigue; sweats; joint pain; malaise; lassitude;

VAERS ID:127006 (history)  Vaccinated:1998-12-18
Age:34.2  Onset:1998-12-21, Days after vaccination: 3
Gender:Male  Submitted:1999-07-29, Days after onset: 219
Location:South Carolina  Entered:1999-08-09, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0360  
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Asthenia, Chills, Hyperhidrosis, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: high fever (100-102); severe fatigue; chills; sweats; joint pain; malaise; lassitude

VAERS ID:127083 (history)  Vaccinated:1999-07-27
Age:34.5  Onset:1999-07-28, Days after vaccination: 1
Gender:Male  Submitted:1999-08-02, Days after onset: 5
Location:Colorado  Entered:1999-08-10, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0413SCLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESP032320IMRA
Administered by: Military     Purchased by: Military
Symptoms: Influenza, Injection site mass, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: p/vax pt exp mild flu sx initially;also w/pain in lt thigh after shots;no injury known;also w/induration @ site of anthrax;

VAERS ID:127371 (history)  Vaccinated:1999-05-12
Age:34.0  Onset:1999-05-12, Days after vaccination: 0
Gender:Male  Submitted:1999-08-02, Days after onset: 82
Location:South Dakota  Entered:1999-08-11, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rxn to rabies vax prev;
Other Medications: NONE
Current Illness:
Preexisting Conditions: saliva exposure to a calf which tested positive ofr rabies;prev immunized w/rabies vax;had past rxn to a rabies vac;
Diagnostic Lab Data:
CDC Split Type: 4049
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION2080110IM 
Administered by: Public     Purchased by: Private
Symptoms: Chills, Malaise, Myalgia, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: p/vax pt exp chills, muscle pain, general malaise,T102r, & shakiness;pt began shaking violently;pt recv APAP & sx subsided;sx resolved p/taking Ibuprofen;

VAERS ID:127374 (history)  Vaccinated:1999-06-05
Age:34.5  Onset:1999-06-05, Days after vaccination: 0
Gender:Female  Submitted:1999-08-02, Days after onset: 58
Location:New York  Entered:1999-08-11, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Rabies exposure, allergic to tetracycline;
Diagnostic Lab Data:
CDC Split Type: 4141
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION2080112IM 
Administered by: Other     Purchased by: Public
Symptoms: Malaise, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: p/vax pt exp paresthesia of extremities;pt stated not able to feel body & tingling, general bad feeling upon waking from nap;

VAERS ID:127415 (history)  Vaccinated:1999-07-29
Age:34.4  Onset:1999-07-31, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:New Jersey  Entered:1999-08-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0441 LA
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt devel itch; rash size 6''''x5''''; pt states had rash; itching;

VAERS ID:127420 (history)  Vaccinated:1999-05-01
Age:34.0  Onset:1999-06-01, Days after vaccination: 31
Gender:Male  Submitted:1999-08-10, Days after onset: 70
Location:Connecticut  Entered:1999-08-17, Days after submission: 7
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:
Preexisting Conditions: bicuspid aortic valve
Diagnostic Lab Data: holter monitor, neg
CDC Split Type: 1999019812
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2  
Administered by: Public     Purchased by: Other
Symptoms: Arrhythmia, Back pain, Coordination abnormal, Dizziness, Pharyngitis, Somnolence
SMQs:, Agranulocytosis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: p/vax pt exp lyme-like symptoms of lethargy & loss of balance; ER w/acute faintness; in ER had possible episode of arrhythmia; persistent sore throats & variable back pain; pt currently seeing ENT; as of 8/9 pt condition unk;

VAERS ID:127344 (history)  Vaccinated:1999-04-08
Age:34.8  Onset:1999-04-08, Days after vaccination: 0
Gender:Male  Submitted:1999-08-13, Days after onset: 127
Location:Delaware  Entered:1999-08-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt anthrax, joint pain; stress; fatigue; forgetfullness; nausea, 1,2,3 doeses
Other Medications: none
Current Illness: knee injuries, phys therapy
Preexisting Conditions:
Diagnostic Lab Data: care panel; ESR/WEST; ANA; RF/RA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0433  
Administered by: Military     Purchased by: Military
Symptoms: Adverse drug reaction, Amnesia, Anxiety, Arthralgia, Asthenia, Nausea, Similar reaction on previous exposure to drug
SMQs:, Acute pancreatitis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Hypoglycaemia (broad)
Write-up: p/vax pt pt exp joint pain, stress, fatigue (chronic), forgetfulness & nausea;physical therapy 4/99;got worse w/2nd, third & fourth shot;

VAERS ID:127435 (history)  Vaccinated:1999-08-10
Age:34.0  Onset:1999-08-10, Days after vaccination: 0
Gender:Female  Submitted:1999-08-13, Days after onset: 3
Location:California  Entered:1999-08-23, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: pending allergy appt at medical center
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0410SCLA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Dizziness, Injection site hypersensitivity, Injection site pain, Malaise, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt devel chills x20 min; had dizziness; malaise; felt feverish; devel vomiting & loose BM x1 w/local soreness; erythema/tenderness at inj site;

VAERS ID:127444 (history)  Vaccinated:1999-07-22
Age:34.2  Onset:1999-07-22, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Wisconsin  Entered:1999-08-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: paxil 40mg a day
Current Illness: depression
Preexisting Conditions:
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0411SCLA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Dizziness, Headache
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: p/vax pt felt dizzy; has chronic fatigue; & frequent h/a; seen own MD, no tests done; told to not take 3rd shot;

VAERS ID:127474 (history)  Vaccinated:1999-07-07
Age:34.0  Onset:1999-07-07, Days after vaccination: 0
Gender:Female  Submitted:1999-08-09, Days after onset: 33
Location:Pennsylvania  Entered:1999-08-23, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: allergies; sulfa drugs; wilson dz; hpothroidism
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM123B90IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Amnesia, Arthralgia, Headache, Hyperhidrosis, Influenza, Paraesthesia, Pyrexia, Visual disturbance
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: p/vax pt devel low grade fever; sweats; numbness in arms & legs; h/a; shadowing of vision; knee pain; memory loss; flu symptoms; congestion; tx w/NSAIDS; Follow up 02/07/05: The adverse event originally reported on 11/19/99m rec=iccyrred Hykty-Septermber 2004 with similar symptoms. The patient was diagnosed September 2004 with Fibromyalgia(coded only as 729.90m but much more complex an issue accounting for all the reported events). It is very likely the vaccine kicked off a fibromyalgia flare. She is hypersensitive and reactive to over 50 products, including sulfates which there is one listed in the components in the lymerix vaccine.

VAERS ID:127481 (history)  Vaccinated:1999-05-12
Age:34.8  Onset:1999-05-13, Days after vaccination: 1
Gender:Male  Submitted:1999-08-07, Days after onset: 86
Location:Michigan  Entered:1999-08-23, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: IPPD, conn, #250111
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.01215 IM 
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt devel hives; itching over arms; neck; tx z-pack; itching better; hives resolved spontaneously

VAERS ID:127539 (history)  Vaccinated:1999-08-11
Age:34.6  Onset:1999-08-13, Days after vaccination: 2
Gender:Male  Submitted:1999-08-20, Days after onset: 7
Location:North Carolina  Entered:1999-08-24, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: none
Current Illness: none
Preexisting Conditions: allergies: PCN and derivitives
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0374SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt noticed large, red, swollen area @ inj site; warm to the touch; lasting 6days

VAERS ID:127620 (history)  Vaccinated:0000-00-00
Age:34.0  Onset:1999-01-14
Gender:Female  Submitted:1999-08-19, Days after onset: 216
Location:Alabama  Entered:1999-08-25, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up:

VAERS ID:127624 (history)  Vaccinated:1999-08-12
Age:34.0  Onset:1999-08-12, Days after vaccination: 0
Gender:Male  Submitted:1999-08-16, Days after onset: 4
Location:Unknown  Entered:1999-08-26, 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: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0410 LA
Administered by: Military     Purchased by: Unknown
Symptoms: Chills, Diarrhoea, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)
Write-up: p/vax pt had myalgias, chills, nausea & watery diarrhea which lasted at least 72 hr;

VAERS ID:127632 (history)  Vaccinated:1999-03-12
Age:34.1  Onset:1999-03-12, Days after vaccination: 0
Gender:Unknown  Submitted:1999-08-20, Days after onset: 160
Location:North Carolina  Entered:1999-08-26, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recv hep b, tetanus, oral polio 1/25/99 & hep b #22 3/1/99;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: evoked potential test, blood test;
CDC Split Type:
Vaccination
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Lot
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Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER    
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Neuralgia, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: neuromuscular sx tingling, abn sensations, burning along nerves, joint pain;

VAERS ID:127641 (history)  Vaccinated:1999-08-10
Age:34.2  Onset:1999-08-10, Days after vaccination: 0
Gender:Male  Submitted:1999-08-13, Days after onset: 3
Location:New Jersey  Entered:1999-08-26, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: tender abrasion dorsal lateral lt elbow
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESV0003BA  RA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Injection site mass, Injection site pain, Myalgia, Neck pain, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: p/vax pt c/o pain & aching in jaws, ankles & back of neck;also c/o deep muscle pain;pain inc when extends & rotates arm;large tender, swelling @ the inj site rt shoulder;

VAERS ID:127711 (history)  Vaccinated:1999-08-09
Age:34.3  Onset:1999-08-24, Days after vaccination: 15
Gender:Female  Submitted:1999-08-24, Days after onset: 0
Location:Texas  Entered:1999-08-27, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: urine preg test positive 8/24/99;
CDC Split Type:
Vaccination
Manufacturer
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IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.N014621SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1751H1SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09447801IMLA
Administered by: Public     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: pt given vax 8/9/99;positive preg test 8/24/99-gestation approx 6wk;

VAERS ID:127716 (history)  Vaccinated:1999-08-17
Age:34.4  Onset:1999-08-17, Days after vaccination: 0
Gender:Female  Submitted:1999-08-19, Days after onset: 2
Location:Texas  Entered:1999-08-27, 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: PPD by Parkdale lot# 00159P given 8/17/99;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09394401 LA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dizziness, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: arm sore during day-not @ noc;fever & chills-noc of vax & next day until 5PM 8/18/99;nausea & dizziness next day until Friday 8/20/99;fatigue from noc of vax until 8/19/99;

VAERS ID:127731 (history)  Vaccinated:1999-08-28
Age:34.6  Onset:1999-08-29, Days after vaccination: 1
Gender:Female  Submitted:1999-08-29, Days after onset: 0
Location:New Jersey  Entered:1999-08-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0412 LA
Administered by: Military     Purchased by: Unknown
Symptoms: Chills, Diarrhoea, Dizziness, Dyspnoea, Injection site hypersensitivity, Injection site oedema, Injection site pain, Pruritus, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt exp swelling, itching, pain @ site & around inj site; shortness of breath; light headedness; nausea; vomiting; diarrhea; & chills;

VAERS ID:127903 (history)  Vaccinated:1999-08-21
Age:34.0  Onset:1999-08-21, Days after vaccination: 0
Gender:Male  Submitted:1999-08-22, Days after onset: 1
Location:Delaware  Entered:1999-09-03, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1982H0SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Syncope, Vasodilatation, Visual field defect
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: tunnel vision, perfusion, near syncope, flushing of the skin;

VAERS ID:128094 (history)  Vaccinated:1999-04-27
Age:34.8  Onset:1999-04-27, Days after vaccination: 0
Gender:Male  Submitted:1999-06-16, Days after onset: 50
Location:Kansas  Entered:1999-09-07, Days after submission: 83
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: ukn
Diagnostic Lab Data: none
CDC Split Type: KS99016
Vaccination
Manufacturer
Lot
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7F91700  LA
Administered by: Public     Purchased by: Public
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)
Write-up: p/vax pt had a metallic taste in mouth; goes away p/a few days; returned a wk later for a few days; this continues off & on since this week has it again

VAERS ID:128126 (history)  Vaccinated:1999-07-14
Age:34.5  Onset:1999-07-21, Days after vaccination: 7
Gender:Female  Submitted:1999-09-01, Days after onset: 42
Location:Virginia  Entered:1999-09-08, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: PPD by Connaught lot# 250211 given 7/14/99;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: VA99040
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3080B60IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Hypersensitivity
SMQs:, Angioedema (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax pt c/o pain in all joints which started about 1wk p/vax;pt states pain is most noticeable in knees & elbows but moves around & is ongoing;postponed vax until saw MD;MD felt had an allergy to vax;

VAERS ID:128153 (history)  Vaccinated:1999-05-20
Age:34.9  Onset:1999-07-01, Days after vaccination: 42
Gender:Female  Submitted:1999-09-07, Days after onset: 68
Location:Rhode Island  Entered:1999-09-09, 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: not specified
Current Illness:
Preexisting Conditions: NKA; not specified
Diagnostic Lab Data: home preg test: p/ 5/20/99=pos
CDC Split Type: 1999013447
Vaccination
Manufacturer
Lot
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Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120G91  
Administered by: Other     Purchased by: Other
Symptoms: Abortion
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: p/vax pt found to be preg via home preg test; last menstrual period 4/16/99;estimated delivery date was1/25/00; during 1st wk july/99 approx 6wks p/recv 2nd dose vax pt had miscarriage; MD visit required;

VAERS ID:128156 (history)  Vaccinated:1999-08-21
Age:34.0  Onset:1999-08-22, Days after vaccination: 1
Gender:Female  Submitted:1999-09-01, Days after onset: 10
Location:Delaware  Entered:1999-09-09, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: kidney stone
Diagnostic Lab Data: CBC; ANA; LFS; SED RATE; CK
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0413 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Amnesia, Asthenia, Insomnia, Paraesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (narrow)
Write-up: p/vax ringing in both ears inc; continue currently; from elbows to tips of fingers numbing & cold feeling; insomnia episode; no sleep;occasional short term memory loss; occasional extreme fatigue;

VAERS ID:128259 (history)  Vaccinated:1999-08-27
Age:34.6  Onset:1999-08-27, Days after vaccination: 0
Gender:Female  Submitted:1999-08-31, Days after onset: 4
Location:Illinois  Entered:1999-09-14, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DNA; PPD, conn, #251111
Current Illness: DNA
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7360BA  LA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: p/vax pt presented w/difficulty breathing & lightheadedness; paramedic called; epinephrine given;pt taken to hosp for further management

VAERS ID:128424 (history)  Vaccinated:1999-08-23
Age:34.5  Onset:1999-08-24, Days after vaccination: 1
Gender:Male  Submitted:1999-08-26, Days after onset: 2
Location:Kansas  Entered:1999-09-21, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: TB skin test by Parke Davis lot# 03608P given 8/23/99;
Current Illness: denied
Preexisting Conditions: year ago approx severe diarrhea w/dehydration
Diagnostic Lab Data: NA
CDC Split Type: KS99022
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0989580  LA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Headache, Hyperhidrosis, Pyrexia, Thirst
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: past 2 nights, temp elevation, fever breaks in AM w/diaphoresis;dizzy w/h/a & diarrhea x 36hr;inc fluid intake, especially H2), Ibuprofen for fever;

VAERS ID:129288 (history)  Vaccinated:1999-10-02
Age:34.8  Onset:1999-10-02, Days after vaccination: 0
Gender:Male  Submitted:1999-10-03, Days after onset: 1
Location:Michigan  Entered:1999-10-13, 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: possible viral URI (prior to vaccine)
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0384  
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Malaise, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: 1-3hr p/vax lightheaded, chest tightness, SOB ( no stridor or resp distress);amb to ER w/ IV-Lactated Ringers, unk pain med 20 hr p/gen malaise, aches/pains;rx ibuprofen PRN; .

VAERS ID:129576 (history)  Vaccinated:1999-10-05
Age:34.0  Onset:1999-10-07, Days after vaccination: 2
Gender:Male  Submitted:1999-10-15, Days after onset: 8
Location:New Jersey  Entered:1999-10-20, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: pt recv IPPD 10/5/99;
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONe
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV044 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: p/vax s/p immun pt devel rash on lt arm deltoid;

VAERS ID:129711 (history)  Vaccinated:1999-10-12
Age:34.6  Onset:1999-10-13, Days after vaccination: 1
Gender:Female  Submitted:1999-10-15, Days after onset: 2
Location:Alaska  Entered:1999-10-22, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982092IMLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7301BA1IMLA
Administered by: Private     Purchased by: Other
Symptoms: Abdominal pain, Influenza, Injection site hypersensitivity, Injection site pain, Nausea, Pyrexia, Vasodilatation
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 24hr p/vax pt devel soreness & pain lateral & inferior to inj sites & flu like sx w/nausea & stomach pain;inc redness & hot, red area (not directly) @ inj site;seen by MD;T99.2;rx w/rocephin;cellulitis;

VAERS ID:129771 (history)  Vaccinated:1999-10-14
Age:34.8  Onset:1999-10-14, Days after vaccination: 0
Gender:Female  Submitted:1999-10-21, Days after onset: 7
Location:Illinois  Entered:1999-10-25, 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: NONE
Current Illness: NONE
Preexisting Conditions: allergic to PCn & codeine
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982790IMLA
Administered by: Military     Purchased by: Unknown
Symptoms: Dyspnoea, Face oedema, Hypertension, Rash maculo-papular
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: devel red blotchy rash & lip swelling, heavy breathing;inc BP;had EKG done;02 sat & put on pred x 5 days & DPH;

VAERS ID:129802 (history)  Vaccinated:1999-10-18
Age:34.2  Onset:1999-10-18, Days after vaccination: 0
Gender:Female  Submitted:1999-10-19, Days after onset: 1
Location:New York  Entered:1999-10-25, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: phobic to certain events;
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0106EA  LA
Administered by: Public     Purchased by: Unknown
Symptoms: Agitation, Stupor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: pt fainted became unresponsive for approx 1min then became conscious started coughing-911 called;

VAERS ID:130032 (history)  Vaccinated:1999-10-03
Age:34.5  Onset:1999-10-06, Days after vaccination: 3
Gender:Female  Submitted:1999-10-08, Days after onset: 2
Location:California  Entered:1999-10-29, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETHE24249GA IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: c/o pain & redness & swelling on rt upper arm w/size of 15cm x 2mm;

VAERS ID:130090 (history)  Vaccinated:1999-08-27
Age:34.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Washington  Entered:1999-11-01
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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TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)PFIZER/WYETH49880176IMLA
Administered by: Military     Purchased by: Military
Symptoms: Hypersensitivity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: urticarial, anaphyl shock delayed hypersensitivity;pred, atarax, zyrtec;

VAERS ID:130188 (history)  Vaccinated:1999-10-19
Age:34.8  Onset:1999-10-19, Days after vaccination: 0
Gender:Male  Submitted:1999-10-30, Days after onset: 11
Location:Pennsylvania  Entered:1999-11-02, 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: low dose ASA dialy & propecia
Current Illness: NONE
Preexisting Conditions: childhood PCN allergy
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Chest pain, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: severe diff breathing, constriction of chest;lasted approx 24hr & sx decreased when antihistamine was taken;

VAERS ID:130200 (history)  Vaccinated:1999-10-20
Age:34.3  Onset:1999-10-20, Days after vaccination: 0
Gender:Female  Submitted:1999-10-26, Days after onset: 6
Location:Oregon  Entered:1999-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp nausea & arm pain w/flu vax;
Other Medications: vit
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0096EA  LA
Administered by: Private     Purchased by: Private
Symptoms: Oedema peripheral, Pain, Somnolence
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)
Write-up: arm was sore & swollen;became very sleepy & sx lasted 36hr;

VAERS ID:130207 (history)  Vaccinated:1999-10-12
Age:34.9  Onset:1999-10-12, Days after vaccination: 0
Gender:Female  Submitted:1999-10-27, Days after onset: 15
Location:Nebraska  Entered:1999-11-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergies;
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES60118AA8 A
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: shot swelled like big mosquito bite arm sore, swelled & feverish 3-4 days;

VAERS ID:130283 (history)  Vaccinated:1999-10-14
Age:34.9  Onset:1999-10-15, Days after vaccination: 1
Gender:Male  Submitted:1999-10-20, Days after onset: 5
Location:Virginia  Entered:1999-11-04, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: pt states was feeling like having cold
Preexisting Conditions: allergic to chicken embryos (as a child)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0374SC 
HEPA: HEP A (VAQTA)MERCK & CO. INC.0569H0IM 
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Diarrhoea, Dizziness, Headache, Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Laryngospasm, Paraesthesia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: p/vax pt c/o vomiting, diarrhea, h/a & abd cramping;also having sl tightness in throat;dizzy spells x 1wk;+lump, swelling, redness on inj area;lump larger than quarter;tender by touch;general tricep area, numbness, tingling on hands;

VAERS ID:130663 (history)  Vaccinated:1999-10-06
Age:34.0  Onset:1999-10-06, Days after vaccination: 0
Gender:Female  Submitted:1999-10-06, Days after onset: 0
Location:Pennsylvania  Entered:1999-11-10, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0127AA0 LA
Administered by: Other     Purchased by: Private
Symptoms: Laryngospasm, Salivary hypersecretion
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: increased phlegm in throat-felt like lump back of throat lasted several hours-onset 2hr p/vax; all sx resolved 10/7/99;

VAERS ID:130722 (history)  Vaccinated:0000-00-00
Age:34.0  Onset:0000-00-00
Gender:Female  Submitted:1999-11-08
Location:Texas  Entered:1999-11-12, 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: sinusitis
Preexisting Conditions: allergies-GERD-h/a;
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER4099G0107IMRA
Administered by: Private     Purchased by: Private
Symptoms: Oedema, Pain, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: burning, tender, red, swelling;

VAERS ID:130949 (history)  Vaccinated:1999-09-13
Age:34.9  Onset:1999-09-18, Days after vaccination: 5
Gender:Female  Submitted:1999-11-08, Days after onset: 51
Location:Arizona  Entered:1999-11-19, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: AZ9926
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3001A40 LA
Administered by: Other     Purchased by: Other
Symptoms: Facial palsy, Hyperaesthesia, Hypotonia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: numbing of lt side of face drooping lt lip, lt eye not blinking & sensitive to hearing;dx by MD w/bells palsy;

VAERS ID:131585 (history)  Vaccinated:1999-11-08
Age:34.2  Onset:1999-11-08, Days after vaccination: 0
Gender:Male  Submitted:1999-11-22, Days after onset: 14
Location:New York  Entered:1999-11-30, 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: PPD by Parkedale lot# 00159P given 11/8/99;
Current Illness: NONE
Preexisting Conditions: declines
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4988110 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: T103 10hr p/vax;c/o malaise;

VAERS ID:131674 (history)  Vaccinated:1999-10-16
Age:34.0  Onset:1999-10-18, Days after vaccination: 2
Gender:Male  Submitted:1999-10-31, Days after onset: 13
Location:Tennessee  Entered:1999-12-02, Days after submission: 32
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EKG=sinux b/adj,53;CXR,WNL;
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0432SCRA
Administered by: Military     Purchased by: Military
Symptoms: Anaphylactoid reaction, Asthenia, Asthma, Chest X-ray, Dyspnoea, Electrocardiogram, Influenza
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: persistant SOB & wheezing w/exertion & 2 rest since (2nd) anthrax vax;started w/flu like sx & fatigue immed p/vax. FU from physician indicates pt should not take this vaccine because of his anaphylactic type reaction. Follow up: Occassional shortness of breath and feeling of n ot being able to get enough oxygen. Wheezing, cough every morning, loss of concentration/memory

VAERS ID:131701 (history)  Vaccinated:1999-11-20
Age:34.0  Onset:1999-11-20, Days after vaccination: 0
Gender:Male  Submitted:1999-11-21, Days after onset: 1
Location:California  Entered:1999-12-02, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0242 LA
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: fever

VAERS ID:131702 (history)  Vaccinated:1999-11-08
Age:34.0  Onset:1999-11-09, Days after vaccination: 1
Gender:Male  Submitted:1999-11-09, Days after onset: 0
Location:North Dakota  Entered:1999-12-02, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: h/o undifferential spondyloarthropathy 7/96;seronegative arthritis 2/96;
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0312SCLA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0169AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Ecchymosis, Injection site hypersensitivity, Injection site mass, Malaise, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: p/vax pt woke w/chills (bad);took APAP which helped but presented to clinic c/o myalgia, malaise & feeling chills were returning;local induration rt deltoid;ecchymosis w/induration lt deltoid;tx APAP PRN;recovered;

VAERS ID:131707 (history)  Vaccinated:1999-11-21
Age:34.2  Onset:1999-11-22, Days after vaccination: 1
Gender:Male  Submitted:1999-11-23, Days after onset: 1
Location:California  Entered:1999-12-02, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0242 LA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0135AA  RA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Malaise, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: p/vax pt devel run dow, overly tired, general achiness;11/23 woke up to pain @ area of anthrax inj w/redness, firmness & swelling & cont general feeling poorly;

VAERS ID:131710 (history)  Vaccinated:1999-08-12
Age:34.1  Onset:1999-08-22, Days after vaccination: 10
Gender:Male  Submitted:1999-11-23, Days after onset: 93
Location:South Carolina  Entered:1999-12-02, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to PCN
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0240  
Administered by: Military     Purchased by: Unknown
Symptoms: Chills, Dizziness, Nausea, Pain, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)
Write-up: localized soreness of arm for 2 days p/vax;a return of soreness in same spot in arm 8 days later followed by nausea, chills, dizziness/vertigo which laste 2 days then subsided;

VAERS ID:132041 (history)  Vaccinated:1999-12-01
Age:34.6  Onset:1999-12-01, Days after vaccination: 0
Gender:Female  Submitted:1999-12-02, Days after onset: 1
Location:Washington  Entered:1999-12-03, Days after submission: 1
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zanax;Vitamins;endurol;Propanenol;
Current Illness: NONE
Preexisting Conditions: heart condition, chronic insomnia;wolf parkenson synd;sz disorder, panic attacks;
Diagnostic Lab Data: EKG;bloodwork;oxygen;resp-low;
CDC Split Type:
Vaccination
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HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1 LA
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER   RA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dizziness, Dyspnoea, Hypoventilation, Hypoxia, Laryngospasm, Pallor, Tachycardia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Respiratory failure (narrow)
Write-up: 5hr post vax throat closed & swelled, dizzy, pale, weak, rapid heart beat, trouble breathing;given other drugs that caused more rxn;

VAERS ID:132540 (history)  Vaccinated:1997-03-31
Age:34.9  Onset:0000-00-00
Gender:Female  Submitted:1999-12-09
Location:Massachusetts  Entered:1999-12-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness:
Preexisting Conditions: CODEINE SENSITIVITY (SEE IMAGE)
Diagnostic Lab Data: CBC, ESR, ANA, C3, C4, Farr, anticardiopin antibodies, etc. (see image)
CDC Split Type: WAES99060160
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.614519/1618D0  
Administered by: Other     Purchased by: Other
Symptoms: Amnesia, Asthenia, Injection site hypersensitivity, Injection site pain, Malaise, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: 3.31.97 & 5.2.97 rec''vd 1st & 2nd hep b vac recomb in L & R deltoid respectively. After 2nd, pt developed severe arm pain inject site. 3rd on 10.6.97 in L deltoid -- severe & shoulder pain, gen. malaise, memory loss, chronic fatigue symps.

VAERS ID:132556 (history)  Vaccinated:1999-10-27
Age:34.8  Onset:1999-10-28, Days after vaccination: 1
Gender:Male  Submitted:1999-11-01, Days after onset: 4
Location:Alaska  Entered:1999-12-15, Days after submission: 44
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: seizure disorder on persistent meds for, no previous heart problems
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0371 RA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: 10/28/99 burning,swelling from should to elbow,pain of rt arm. Chest pains on 10/29/99, increased w/activity and coughing. Pt still has golfball size swelling to back of arm,tender to touch and still has mild ongoing chest pain.

VAERS ID:132566 (history)  Vaccinated:1999-12-07
Age:34.0  Onset:1999-12-09, Days after vaccination: 2
Gender:Female  Submitted:1999-12-09, Days after onset: 0
Location:California  Entered:1999-12-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0311SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Vasodilatation
SMQs:, Hypersensitivity (narrow)
Write-up: 3 inch diameter redness around right arm sc area.

VAERS ID:132685 (history)  Vaccinated:1999-11-07
Age:34.0  Onset:1999-11-08, Days after vaccination: 1
Gender:Female  Submitted:1999-11-09, Days after onset: 1
Location:California  Entered:1999-12-21, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxin Cytomel
Current Illness: NONE
Preexisting Conditions: Allergic to PCN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49984220IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Hyperhidrosis, Injection site hypersensitivity, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Red area left deltoid, site of injection, 3"x1.5". Complaining of total body aches, chills, sweats, starting 8 hours after injection.

VAERS ID:132692 (history)  Vaccinated:1999-12-01
Age:34.0  Onset:1999-12-02, Days after vaccination: 1
Gender:Female  Submitted:1999-12-07, Days after onset: 5
Location:Unknown  Entered:1999-12-21, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0241SCLA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0268AA0SCLA
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESEJN169A1SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site reaction
SMQs:
Write-up: Large local reaction 20x20cm on left tricep.

VAERS ID:132157 (history)  Vaccinated:1999-10-28
Age:34.5  Onset:1999-10-28, Days after vaccination: 0
Gender:Male  Submitted:1999-11-09, Days after onset: 12
Location:Pennsylvania  Entered:1999-12-28, Days after submission: 49
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tetracycline
Current Illness: Rosacea
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PA9982
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982790IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Oedema peripheral, Pain, Paraesthesia
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt. reported tingling in hand, lasting 2-3 days. Then he noted painful swelling in index & middle finger on 11/1 that persists.

VAERS ID:131900 (history)  Vaccinated:1999-10-26
Age:34.7  Onset:1999-10-26, Days after vaccination: 0
Gender:Female  Submitted:1999-10-28, Days after onset: 2
Location:Missouri  Entered:1999-12-29, Days after submission: 62
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: celexa, premarin, thyroid
Current Illness: NONE
Preexisting Conditions: Allergy to anesthesia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0158AA IMA
Administered by: Other     Purchased by: Other
Symptoms: Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 10/28/99 - phone call to pt for follow up. Approximately 4 hours post vax, pt began feeling "achy and running a low temp. Family physician authorized ibuprofen.

VAERS ID:131979 (history)  Vaccinated:1999-10-20
Age:34.9  Onset:1999-10-21, Days after vaccination: 1
Gender:Female  Submitted:1999-10-29, Days after onset: 8
Location:California  Entered:1999-12-29, Days after submission: 61
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0109BA IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt. was red, sore & warm at injection site. Area approx. 3 x 2 in diameter. Sore for 3 days.

VAERS ID:132011 (history)  Vaccinated:1999-11-04
Age:34.7  Onset:1999-11-04, Days after vaccination: 0
Gender:Female  Submitted:1999-11-15, Days after onset: 11
Location:Minnesota  Entered:1999-12-29, Days after submission: 44
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: MN99022
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS01989P0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Dizziness, Myalgia, Nausea, Neck pain, Oedema peripheral, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt. had dizziness, nausea & faint, right away. On 11/8/99, she called to say, she is still having sx''s of dizziness, nausea, maybe a temp. & chills, muscular pain in shoulders & neck; arm hurting & hand slightly swollen; cold sx''s; by 11/12

VAERS ID:132898 (history)  Vaccinated:1999-11-17
Age:34.4  Onset:1999-11-17, Days after vaccination: 0
Gender:Female  Submitted:1999-12-17, Days after onset: 30
Location:North Carolina  Entered:1999-12-29, 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: PPD
Current Illness: NONE
Preexisting Conditions: Arthritis lower back, feet arms and hands
Diagnostic Lab Data: PPD
CDC Split Type: NC99104
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3082A40IMLA
Administered by: Public     Purchased by: Other
Symptoms: Hypertonia, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 15 min after injections, pt could feel pain in arm from medicine. Arm became stiff 4 hours post injection. Pt fell 3 years ago and muscles in L/arm (same muscles) have deteriorated from fall. Same day, nausea off and on for 2 days.

VAERS ID:132937 (history)  Vaccinated:1999-07-12
Age:34.8  Onset:1999-07-12, Days after vaccination: 0
Gender:Female  Submitted:1999-12-13, Days after onset: 154
Location:Oregon  Entered:1999-12-29, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: multi-vitamin, Micronor
Current Illness: NONE
Preexisting Conditions: Borderline hypertension
Diagnostic Lab Data: Lyme Disease test
CDC Split Type: OR9945
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0997390 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Hypoaesthesia, Myasthenic syndrome, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Sensation across mouth. 7/16 chest pain, numbness-arms, feet, tingling in feet. ER-dxed w/ heart attack. Continued numbness in arms & legs, shooting pain in both, left shoulder. Cramping in L arm & hand, difficulty writing, gives out.

VAERS ID:132984 (history)  Vaccinated:1999-11-30
Age:34.0  Onset:1999-11-30, Days after vaccination: 0
Gender:Female  Submitted:1999-12-01, Days after onset: 1
Location:Michigan  Entered:2000-01-03, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: MI99140
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS00199P0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: 11/30/99 Pt recv vax around 1 pm. Found unable to move finger on L hand same day. L hand feels numb. Had Drs visit and Dr was noncommittal relating symptoms to vax. Numbness had decreased markedly since 11/30/99.

VAERS ID:132415 (history)  Vaccinated:1999-11-10
Age:34.3  Onset:1999-11-10, Days after vaccination: 0
Gender:Male  Submitted:1999-11-29, Days after onset: 19
Location:Kentucky  Entered:2000-01-06, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: PCN, Bee stings
Diagnostic Lab Data:
CDC Split Type: KY990059
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P1IMA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Headache, Hypersensitivity, Hypertension, Myasthenic syndrome, Pallor, Rash, Tremor, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Approx 5-10 mins after vaccine, pt c/o of weakness, lightheaded, pounding headache, color pale, hands trembling, BP 128/80, 134/94, 160//80. Benadryl given, 911 called. Developed rash and hives at hospital, tx for allergic react to vax.

VAERS ID:132482 (history)  Vaccinated:1999-10-19
Age:34.7  Onset:1999-10-19, Days after vaccination: 0
Gender:Male  Submitted:1999-11-22, Days after onset: 34
Location:Ohio  Entered:2000-01-06, Days after submission: 45
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
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS4099G0101IMRA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Chills, diarrhea.

VAERS ID:133328 (history)  Vaccinated:1998-09-23
Age:34.0  Onset:1998-09-23, Days after vaccination: 0
Gender:Male  Submitted:2000-01-10, Days after onset: 474
Location:Delaware  Entered:2000-01-18, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: LDH, CK, ANA, C-reacti, CBC, RF/RA
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0300SCRA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Headache, Myalgia, Nervousness, Shock
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Dating back about 1 year ago; patient states to have the following symptoms - loss of circulation in the right arm, body aches all over, nervousness, fatigue and headaches. Patient states that he can''t point out a date from onset of symptons. He also states that these symptons can''t be pin pointed to one vaccine. This has occured over a period of time. This document was based on a series of vaccines starting with the first Anthrax vaccine.

VAERS ID:133454 (history)  Vaccinated:2000-01-10
Age:34.0  Onset:2000-01-10, Days after vaccination: 0
Gender:Male  Submitted:2000-01-13, Days after onset: 3
Location:New Hampshire  Entered:2000-02-01, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1267J0SCLA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4653280IMRA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Rash
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3 days post vacc, pt cam in and presents a large elevated rash of about 3" in diameter on back. 1" diameter rash center of back. Pt stated it started hours later than shots and also pain under ribs. Pain now in ribs.

VAERS ID:133493 (history)  Vaccinated:2000-01-08
Age:34.0  Onset:2000-01-09, Days after vaccination: 1
Gender:Male  Submitted:2000-01-10, Days after onset: 1
Location:Michigan  Entered:2000-02-01, 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:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0310SCRA
Administered by: Military     Purchased by: Military
Symptoms: Oedema, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Redness & swelling. Redness was 5 cm across. Swelling was slight more like a knot under the skin; started the morning after the shot & continued to grow.

VAERS ID:133680 (history)  Vaccinated:1999-11-05
Age:34.0  Onset:1999-11-05, Days after vaccination: 0
Gender:Female  Submitted:1999-11-08, Days after onset: 3
Location:Washington  Entered:2000-02-03, Days after submission: 87
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: Insulin dependent diabetic
Diagnostic Lab Data:
CDC Split Type: WA991612
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P16IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Severe redness and swelling at site of injection. Tx - Augmentin

VAERS ID:134032 (history)  Vaccinated:2000-01-08
Age:34.0  Onset:2000-01-09, Days after vaccination: 1
Gender:Male  Submitted:2000-01-16, Days after onset: 7
Location:Michigan  Entered:2000-02-15, Days after submission: 30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0310SC 
Administered by: Other     Purchased by: Other
Symptoms: Somnolence, Thinking abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)
Write-up: Lethargic, unable to concentrate, memory ok. Lasted approv 48 hrs then everything ok.

VAERS ID:134177 (history)  Vaccinated:2000-01-22
Age:34.0  Onset:2000-01-23, Days after vaccination: 1
Gender:Male  Submitted:2000-02-05, Days after onset: 13
Location:Michigan  Entered:2000-02-18, 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: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0311SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Large red swelling at site of inject - $g than 5 cm. Sm amt of pain when touched. Redness lasted for two weeks.

VAERS ID:134178 (history)  Vaccinated:2000-02-05
Age:34.0  Onset:0000-00-00
Gender:Male  Submitted:2000-02-07
Location:Michigan  Entered:2000-02-18, 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: NA
Current Illness: Getting over cold.
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0312SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Redness and swelling at inject site. approx 4 cm in diameter.

VAERS ID:134193 (history)  Vaccinated:2000-01-28
Age:34.0  Onset:2000-01-30, Days after vaccination: 2
Gender:Male  Submitted:2000-02-03, Days after onset: 4
Location:South Carolina  Entered:2000-02-18, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Depakote, Zestril, Tenornun, Procardia
Current Illness: NONE
Preexisting Conditions: hypertension
Diagnostic Lab Data:
CDC Split Type: SC00007
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0205AA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Oedema, Pain, Skin nodule, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: 2 days post vacc pt upper inside l/arm became red, swollen, warm to touch, tender to touch and developed a knot, measureing 2 1/2" x 2". Went to ER for evaluation. The MD''s diagnosis is cellulitis possibly due to Flu shot.

VAERS ID:134322 (history)  Vaccinated:2000-01-11
Age:34.0  Onset:2000-01-11, Days after vaccination: 0
Gender:Female  Submitted:2000-01-14, Days after onset: 3
Location:California  Entered:2000-02-29, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: PPD, Parkdale, 00769P, ID, 1st dose.
Diagnostic Lab Data: BP 80/60.
CDC Split Type: CA000015
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMENG3082A40IMLA
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Dizziness, Hyperhidrosis, Myalgia, Nausea, Stupor, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Dizzy, clammy. No dyspnea. Ringing in ears, abdominal pain, nausea. No skin erruptions. Not responding appropriately to commands. Next day pt was achy and had abdominal pain.

VAERS ID:134352 (history)  Vaccinated:2000-02-15
Age:34.0  Onset:0000-00-00
Gender:Male  Submitted:2000-02-22
Location:Alaska  Entered:2000-02-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pt has had 4 previous anthrax vaxs with similar sxs & each time, rxn gets worse.
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Breathing test and EKG
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 4  
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Injection site hypersensitivity, Injection site oedema, Injection site pain, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: 1 hr post/vax, I had tightness in my chest & difficulty breathing, dizziness & a local rxn of swelling & redness. I was Rx''d w/Bendaryl & to see an Allergist. On all 5 injections I have had, I had stinging sensation & rxns are getting worse

VAERS ID:132975 (history)  Vaccinated:1999-12-08
Age:34.0  Onset:1999-12-09, Days after vaccination: 1
Gender:Male  Submitted:1999-12-15, Days after onset: 6
Location:Unknown  Entered:2000-03-02, Days after submission: 78
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: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0243SC 
Administered by: Military     Purchased by: Military
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Papular erythema.

VAERS ID:134506 (history)  Vaccinated:1999-09-29
Age:34.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2000-03-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0412UNUN
Administered by: Military     Purchased by: Unknown
Symptoms: Arrhythmia, Dyspnoea, Granuloma, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)
Write-up: 3mm nodular granuloma on right upper lung - trouble breathing - rapid and irregular heartrate.

VAERS ID:134634 (history)  Vaccinated:0000-00-00
Age:34.0  Onset:2000-02-15
Gender:Male  Submitted:2000-02-27, Days after onset: 12
Location:Wisconsin  Entered:2000-03-08, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0311SCRA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Coordination abnormal, Injury, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad)
Write-up: Severe swelling on right arm, equilibrium problems (fell down stairs at work) and tired feeling in arm (still Persisting).

VAERS ID:134691 (history)  Vaccinated:1999-08-31
Age:34.0  Onset:1999-08-31, Days after vaccination: 0
Gender:Male  Submitted:2000-03-01, Days after onset: 183
Location:Hawaii  Entered:2000-03-10, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Hay fever
Diagnostic Lab Data: NONE
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0411SCRA
Administered by: Other     Purchased by: Other
Symptoms: Chest pain, Hypokinesia, Injection site pain, Myasthenic syndrome
SMQs:, Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Local soreness at R/shoulder that became decreased in strength to R/arm over period of 1 week, then had decreased fine motor skills/dexterity/writing to R/hand. Had chest pain in first 24 hrs. to R/chest.

VAERS ID:150046 (history)  Vaccinated:1999-12-07
Age:34.0  Onset:1999-12-18, Days after vaccination: 11
Gender:Male  Submitted:1999-12-20, Days after onset: 2
Location:Georgia  Entered:2000-03-14, Days after submission: 85
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: GA00005
Vaccination
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1970H0SCLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES90011AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Lymphadenopathy, Pharyngolaryngeal pain
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 12/18/1999 Woke up and noticed a swollen gland behind one ear, by afternoon the other side was also swollen. No fever, today the glands are still swollen. No fever. Today the glands are still swollen and now his throat is getting sore. The glands are a little larger than a pea.

VAERS ID:150150 (history)  Vaccinated:1999-02-01
Age:34.0  Onset:1999-02-28, Days after vaccination: 27
Gender:Male  Submitted:2000-03-01, Days after onset: 367
Location:Unknown  Entered:2000-03-16, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mysoline
Current Illness:
Preexisting Conditions: Cerebral palsy, mental retardation, seizures.
Diagnostic Lab Data: EEG - abn due to mild to moderate diffuse disturbance of brain activity.
CDC Split Type:
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HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: 0     Purchased by: 0
Symptoms: Convulsion, Electroencephalogram abnormal, Hallucination, auditory, Influenza, Mental impairment, Paranoia, Speech disorder
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: This pt experienced his first seizure (after a 17 year seizure-free period) following administration of vax. A flu-like syndrome appeared after the seizure episode. He has not regained his previous level of functioning, with paranoid ideation response to internally generated stimuli, disorganized speech, which has continued although abated with anti-psychotic treatment. No previous history of hallucinations or paranoid thinking. Follow up received 06/05/00, indicates that the pt is still suffering from auditory hallucinations and cognitive disorganization.

VAERS ID:150151 (history)  Vaccinated:1999-06-21
Age:34.0  Onset:0000-00-00
Gender:Male  Submitted:2000-03-02
Location:Maryland  Entered:2000-03-16, 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: NONE
Preexisting Conditions: Trees, grass, pollen allergies.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0434SC 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIES0150901B0PO 
Administered by: Military     Purchased by: Military
Symptoms: Oedema, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt had series in 10/98 and last series in 6/99. After receiving last vaccine scheduled, extreme skin swelling and rash.

VAERS ID:150162 (history)  Vaccinated:1999-11-16
Age:34.0  Onset:1999-12-15, Days after vaccination: 29
Gender:Male  Submitted:2000-02-23, Days after onset: 70
Location:Unknown  Entered:2000-03-17, Days after submission: 23
Life Threatening? No
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: NONE
Diagnostic Lab Data: EEG-generalized cortical seizures.
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0242SC 
Administered by: Military     Purchased by: Military
Symptoms: Agitation, Confusional state, Convulsion, Depersonalisation, Electroencephalogram abnormal, Encephalitis, Hypoxia, Neurological symptom, Pyrexia
SMQs:, Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt received Anthrax 3 on 11/16/99 with no significant local or systemic symptoms. 11/29 pt received influenza without reaction and was in good health until 12/15/99 when pt developed fever of 103.7. Pt progressed to altered mental status with agitation and confusion. Admitted to emergency room on 12/20/99. During hospital stay, developed seizures needing phenobarbitol. Pt was intubated and given anesthetic for several days. Dx with encephalitis of unknown etiology. Has permanent neurological deficits. Stable but not fully recovered.

VAERS ID:150181 (history)  Vaccinated:2000-02-28
Age:34.0  Onset:2000-03-10, Days after vaccination: 11
Gender:Male  Submitted:2000-03-13, Days after onset: 3
Location:Delaware  Entered:2000-03-17, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: high blood pressure
Diagnostic Lab Data:
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0310SCRA
Administered by: Military     Purchased by: Military
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patient states post vax on 3/10/00 he started experiencing general aches and sore muscles all over.

VAERS ID:150288 (history)  Vaccinated:2000-03-07
Age:34.0  Onset:2000-03-08, Days after vaccination: 1
Gender:Male  Submitted:2000-03-13, Days after onset: 5
Location:Texas  Entered:2000-03-22, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0474SCLA
Administered by: Military     Purchased by: Military
Symptoms: Hypersensitivity, Pruritus, Rash, Similar reaction on previous exposure to drug
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Symptoms are generalized itching that didn''t require medication. Large local 14cm X 7cm area on left upper arm. Injection site still itches.

VAERS ID:150290 (history)  Vaccinated:2000-03-11
Age:34.0  Onset:2000-03-12, Days after vaccination: 1
Gender:Male  Submitted:2000-03-14, Days after onset: 2
Location:Oklahoma  Entered:2000-03-22, Days after submission: 8
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:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0431SCRA
Administered by: Military     Purchased by: Military
Symptoms: Feeling hot, Hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (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: Right arm swollen, red, hot to touch and itches. Treated with cephalexin, prednisone and elevate to shoulder level and ice packs.

VAERS ID:150291 (history)  Vaccinated:0000-00-00
Age:34.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Utah  Entered:2000-03-22
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:
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Joint stiffness
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Rt elbow joint stiffness and pain. I have had 4 shots.

VAERS ID:150584 (history)  Vaccinated:1999-11-02
Age:34.0  Onset:0000-00-00
Gender:Female  Submitted:2000-01-19
Location:Wisconsin  Entered:2000-03-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergy to Compazine and sulfa
Diagnostic Lab Data:
CDC Split Type: 19990305971
Vaccination
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM  IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Headache, Injection site pain, Injection site urticaria, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On an unspecified date the pt received her first dose of Lymerix. The next day she was very sore at the injection site. This event resolved. On 11/2/99 the pt received her second dose of Lymerix. Several days after receiving dose 2 of Lymerix she experienced hives, itching at the injection site, joint pain, (could not bend her knee) and headaches. No treatment was given. The joint pain is ongoing. The headaches and hives have resolved. The most recent information received on 11/18/199 reports the condition of the pt as ongoing.

VAERS ID:150753 (history)  Vaccinated:2000-01-10
Age:34.0  Onset:2000-01-10, Days after vaccination: 0
Gender:Female  Submitted:2000-03-22, Days after onset: 72
Location:Massachusetts  Entered:2000-04-04, 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: Allergic to dairy products
Diagnostic Lab Data:
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0244SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site mass, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Lump in right arm 2 months after receiving vax #5. Tingling in right thumb, and in right toe.

VAERS ID:150773 (history)  Vaccinated:2000-03-01
Age:34.0  Onset:2000-03-06, Days after vaccination: 5
Gender:Male  Submitted:2000-03-31, Days after onset: 25
Location:New Jersey  Entered:2000-04-05, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0313SC 
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Legs and arms itch as well as small red bumps, small red bumps covered facial rash. 4-5 days post vax, last 2 weeks.

VAERS ID:150917 (history)  Vaccinated:2000-02-28
Age:34.0  Onset:2000-02-29, Days after vaccination: 1
Gender:Male  Submitted:2000-03-29, Days after onset: 29
Location:Unknown  Entered:2000-04-12, 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:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0474SC 
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Oedema peripheral, Skin nodule
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (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: Swelling/erythema and induration of arm 2nd day post vax - from mid tricep to mid forearm.

VAERS ID:150968 (history)  Vaccinated:1999-08-03
Age:34.0  Onset:1999-08-08, Days after vaccination: 5
Gender:Male  Submitted:2000-04-04, Days after onset: 240
Location:Unknown  Entered:2000-04-14, 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:
Current Illness: NONE
Preexisting Conditions: depression, allergy to pollen, mold, dust, bananas, kiwi, and sulfa
Diagnostic Lab Data: ANA-neg, RF-neg, CBC-wnl, ESR-1
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 0SC 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIES    
Administered by: Military     Purchased by: Military
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Hand swelling episodes began within 2 weeks of 1st Anthrax shot. The swelling lasted from days to weeks. No worsening of symptoms with 2nd or 3rd shots, although episodes continue.

VAERS ID:151034 (history)  Vaccinated:1999-09-21
Age:34.0  Onset:2000-01-07, Days after vaccination: 108
Gender:Male  Submitted:2002-01-24, Days after onset: 748
Location:Pennsylvania  Entered:2000-04-21, Days after submission: 643
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Loloft, Trazodone, Lorazepam, Dugpar, Alprazolax, Allergy, Prozac, Paxil, buspirone, Claritin D
Current Illness: UNK
Preexisting Conditions: Medical history included "life-long" depression, anxiety, unspecified speech impediment for which he received speech therapy, allergies to pollen and mold, allergic rhinitis, rustachian tube dysfunction, chronic serous otitis media, low blood pressure, prostatitis, fatigue, and chronic bilateral knee pain, chronic sinusitis, lebyrinthitis, Lyme disease, sinus bradycardia, premature
Diagnostic Lab Data: MRI-nml; LP-nml; protein profile-consistent with multiple sclerosis. 01/26/2000 MRI brain (with and without contrast): "IMPRESSON: 1. Findings compatible with left optic neuritis. 2. A single focus of deep white matter disease in the left
CDC Split Type: 2000004258
Vaccination
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM123B91IMLA
Administered by: Other     Purchased by: Other
Symptoms: Laboratory test abnormal, Multiple sclerosis, Optic neuritis
SMQs:, Optic nerve disorders (narrow), Demyelination (narrow), Ocular infections (broad)
Write-up: This is a spontaneous report from an infectious disease physician. On an unspecified date, the vaccinee received the second dose of Lymerix. The vaccinee subsequently, experienced optic neuritis. Physician stated that at this time is was not clear whether the pt developed multiple sclerosis or if this could be adverse effect of the vaccine. This case is considered to be medically serious. The most recent information, received on 4/19/2000, reports the condition of the pt is unknown. Request for additional information has been forwarded to the primary care physician. Follow-up states that this report describes multiple sclerosis in a 33 male who received Lyme disease vaccine recombinant. Additional info was received via the litigation process. Medical history included "life-long" depression, anxiety, unspecified speech impediment for which he received speech therapy, allergies to pollen and mold, allergic rhinitis, rustachian tube dysfunction, chronic serous otitis media, low blood pressure, prostatitis, fatigue, and chronic bilateral knee pain. Following the reported onset of the multiple sclerosis, the vaccinee experienced bursitis of the right heel, tendonits/bursitis of the right shoulder after a fall from ten foot, acute pharyngitis/bronchitis, otitis media and externa sinusitis, urinary tranct infection caused by escherichia coli, chest pain, and cholelithiasis. These were not reported as adverse events due to vaccine administration, but were found during the course of review of the vaccinee''s medical records. Therefore, they are not listed as adverse events. He reports bilateral knee pain, left being worse. He''s had his parin for two years; however, he feels it became worse a month after he received his second LYMErix. The vaccinee returned to the physician''s office on 11/24/1999 with chief complaints of "possible sinus infection, cough." The vaccinee also wanted the physician "to recheck his knee. He''s continuing to have locking and extreme stiffness when he gets down to do any filing. he''s unable to strai

VAERS ID:151073 (history)  Vaccinated:2000-03-09
Age:34.0  Onset:2000-03-23, Days after vaccination: 14
Gender:Male  Submitted:2000-03-25, Days after onset: 2
Location:Texas  Entered:2000-04-24, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC: 4.9 WBC, 4.69 RBC, 13.8 HGB, 40.6 HCT, 86.6 MCV, 50 46 seg slightly microcytic, 23 L/M (manual), MONO: 28 (manual), ESR: 19, LFT-nml.
CDC Split Type:
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MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA184AB0SCRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR0320 IMLA
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Lymphadenopathy, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Left axillary node swelling/tenderness. Fever(subjective), chills, achy, left sided abdominal pain. No nausea, vomiting, or diarrhea. Norma appetite.

VAERS ID:151131 (history)  Vaccinated:2000-04-15
Age:34.0  Onset:2000-04-16, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Missouri  Entered:2000-04-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV048B0SC 
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Sore, red spot 1.5" to 2" across upper arm, lasted 3 days and soreness lasted 6 days.

VAERS ID:151200 (history)  Vaccinated:2000-04-10
Age:34.0  Onset:2000-04-10, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Delaware  Entered:2000-05-03
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 (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0310SCRA
Administered by: Military     Purchased by: Military
Symptoms: Headache
SMQs:
Write-up: Pt experienced a headache, ranging from a dull ache to extreme pain since 2 1/2 hours after immunization. Persisted since 4/10/00.

VAERS ID:151804 (history)  Vaccinated:2000-04-24
Age:34.0  Onset:2000-04-28, Days after vaccination: 4
Gender:Male  Submitted:2000-05-02, Days after onset: 4
Location:Alaska  Entered:2000-05-10, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: mildly elevated liver function
Diagnostic Lab Data:
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0473SC 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR02341IM 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt developed an onset of joint pain right 1st MTP (metatarsal phalangeal), left heel and both elbows 4 days post vax.

VAERS ID:151864 (history)  Vaccinated:1999-08-11
Age:34.0  Onset:1999-08-13, Days after vaccination: 2
Gender:Male  Submitted:2000-04-06, Days after onset: 237
Location:Delaware  Entered:2000-05-12, Days after submission: 36
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:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0413SCLA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Haemorrhoids, Influenza like illness, Injection site mass, Insomnia
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Pt states after 4th Anthrax shot he started having severe flu-like symptoms, hemorrhoids, symptoms intensive, insomnia, knee joints ache and knots or lumps in the upper left arm where shots were administered. Pt states that also these symptoms continued up to or through the 5th vaccine. Pt states that after the 5th shot, the flu-like symptoms were so severe that he actually thought he had the flu. The pt states also to currently be taking medication for insomnia.

VAERS ID:151905 (history)  Vaccinated:1999-06-08
Age:34.0  Onset:1999-06-08, Days after vaccination: 0
Gender:Female  Submitted:2003-02-14, Days after onset: 1347
Location:New Jersey  Entered:2000-05-12, Days after submission: 1008
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Augmentin, Amoxicillin Trihydrate/C
Current Illness:
Preexisting Conditions: Allergic to morphine, alopecia areata, left ear pain, nasal congestion, pharyngitis, sinus pressure, bull''s eye skin lesion, obestiy, ulcerative colitis
Diagnostic Lab Data: Aldolase 4.9U/L 4/6/00; chemistry normal 4/6/00; erythrocyte sedimentation rate 5mm/hr; granulocyte count 3600/cu mm; platelet count 357000/cu mm. Complement CH50, 4/6/00: 148 CAE. HLA phenotyping, 8/24/00: HLA-DR antigens present:DR1, DR52
CDC Split Type: 2000007075
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120D90IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Fatigue, Headache, Joint swelling, Pain
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: On 6/8/99, the pt received her first dose of Lymerix. Almost immediately post - vax, she experienced "achy" muscle pain in both thighs. Arthalgia, can''t stand for very long, pain. Can''t walk for very long, pain. Fatigue, hair loss, headaches, joint stiffness, joint swelling, muscle pain, pain in feet, pain in hands and pain in lower back. In November, 1999, the pt had surgery for twisted fallopian tube (left ovary). This event was not related to Lymerix per consumer. She was negative for endometriosis. Now she is having pain in hands, lower back and feet. In addition to headaches and fatigue. She cannot stand or walk for very long. She was treated with anti-inflammatory medication, which did not help. A neurologist was consulted. A recent Lyme test was neg. The most recent information received on 3/10/00 reports the condition of the pt is ongoing. The following info was obtained from medical records. From 5/18/00 to at least 3/21/02, the subject was under the care of an "emerging disease specialist." The subject reported that she experienced, beginning in June 1999, "from waist down musle and joint pain particularly upper legs and pelvic area. Feet, hands, shoulders, arms, lower back-aches, spasms, pain. Fatigue and feeling drained." On a questionnaire, the vaccinee indicated that she experienced the following additional symptoms beginning in June 1999: irregular heartbeat; joint pain involving the wrist, hips, knees, ankles and elbows; swelling of the ankle joints; back pain "below the waist"; sciatica; "radiating nerve root pain" of the shoulder; unexplained weight gain; increased Lyme symptoms during menstrual periods; headache; "weakness/paralysis legs severe"; "tingling, numbness hands feet"; and "depression/behavioral change." She indicated that all of these symptoms were on-going. She also indicated that she experienced incrreased menstrual bleeding from July 1999 until November 1999. While under the care of this specialist, the vaccinee also reported irritability, short-term memory loss, shar

VAERS ID:151940 (history)  Vaccinated:1999-05-09
Age:34.0  Onset:1999-05-12, Days after vaccination: 3
Gender:Male  Submitted:2000-05-04, Days after onset: 358
Location:California  Entered:2000-05-15, 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:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0413SC 
Administered by: Military     Purchased by: Military
Symptoms: Eczema, Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Pt experienced a rash at site of injection, subsequent eczema on hands and upper body.

VAERS ID:151977 (history)  Vaccinated:1998-12-11
Age:34.0  Onset:1998-12-11, Days after vaccination: 0
Gender:Female  Submitted:2000-03-07, Days after onset: 452
Location:Kentucky  Entered:2000-05-16, Days after submission: 69
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99010802
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received regarding a pt who, several hours post vax, experienced a rash and itching. The pt sought unspecified medical attention and took diphenhydramine hcl (Benadryl) to ease the itching. No further information is available.

VAERS ID:152024 (history)  Vaccinated:2000-05-05
Age:34.0  Onset:2000-05-07, Days after vaccination: 2
Gender:Male  Submitted:2000-05-08, Days after onset: 1
Location:Unknown  Entered:2000-05-17, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0471SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt experienced erythematous area 9.5 x 16.5 cm ovoid patch.

VAERS ID:152138 (history)  Vaccinated:1999-05-17
Age:34.0  Onset:1999-05-20, Days after vaccination: 3
Gender:Female  Submitted:2000-03-07, Days after onset: 292
Location:Illinois  Entered:2000-05-19, Days after submission: 72
Life Threatening? No
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:
Preexisting Conditions: Hypothyroidism
Diagnostic Lab Data:
CDC Split Type: WAES99051368
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  IM 
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Hypersensitivity, Vertigo
SMQs:, Angioedema (broad), Anticholinergic syndrome (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from an RN concerning a 34 year old female who on 5/17/99 was vaccinated with Hep-B vaccine recombinant. Concomitant therapy included Measles virus vaccine (MSD). On 5/20/99, the pt experienced dizziness and vertigo and was takne to the ER. She was dx''d with an allergic reaction and was hospitalized. Additional information has been requested. No further information is available.

VAERS ID:152141 (history)  Vaccinated:1998-10-02
Age:34.0  Onset:1998-10-02, Days after vaccination: 0
Gender:Female  Submitted:2000-03-07, Days after onset: 522
Location:Wyoming  Entered:2000-05-19, Days after submission: 72
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: Hypothyroidism
Diagnostic Lab Data:
CDC Split Type: WAES99051481
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Asthenia, Dizziness, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: Information has been received from an RN concerning a 34 year old white female pt who was vaccinated with a 1st and 2nd dose of Hep-B vaccine recombinant on 8/12/98 and 10/2/98, respectively and an hour, post vax, on 10/2/98, the pt experienced increased heart rate, weakness, dizziness and joint pain. It was reported that these symptoms lasted for 1.5 days. Consequently, on 10/3/98, the pt recovered. On 7/12/99, the pt was vaccinated with a 3rd dose of Hep-B vaccine recombinant. There were no adverse experiences reported with the 3rd dose.

VAERS ID:152187 (history)  Vaccinated:0000-00-00
Age:34.0  Onset:0000-00-00
Gender:Male  Submitted:2000-03-07
Location:Illinois  Entered:2000-05-19, Days after submission: 72
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES99061095
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.626301/026531IM 
Administered by: Public     Purchased by: Other
Symptoms: Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Headache, Fever, Myalgia, Nausea Information has been received from a registered nurse concerning a 34 year old black male who on 6-Aug-1999 was vaccinated IM via left deltoid with second dose of hepatitis b vaccine recombinant. On 6-Aug-1999 following vaccination the patient experienced headache with nausea, muscle aches and low-grade fever. Subsequently, the patient recovered from the episodes. It was indicated that the patient did not develop any adverse event following vaccination with the first dose of the vaccine. Two additional patients were reported with similar symptoms following vaccination with second dose of hepatitis b vaccine recombinant (WAES #99080961 and 99081095).

VAERS ID:152297 (history)  Vaccinated:1999-09-20
Age:34.0  Onset:1999-09-27, Days after vaccination: 7
Gender:Female  Submitted:2000-03-07, Days after onset: 162
Location:Nebraska  Entered:2000-05-23, Days after submission: 76
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99102113
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0904J0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a health care professional concerning a 34 year old female who on 9/20/99 was vaccinated IM in the left deltoid with the first dose of Hep B vaccine. Subsequently, the pt experienced a rash in the elbow vicinity of the injection arm. The rash began approximately 7 days post vax. The pt sought unspecified medical treatment. On an unspecified date the pt recovered. No additional information is available.

VAERS ID:152386 (history)  Vaccinated:2000-03-29
Age:34.0  Onset:2000-04-04, Days after vaccination: 6
Gender:Female  Submitted:2000-04-04, Days after onset: 0
Location:Oklahoma  Entered:2000-05-25, Days after submission: 51
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl
Current Illness: NONE
Preexisting Conditions: hayfever
Diagnostic Lab Data: NONE
CDC Split Type: OK0012
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER09155 SC 
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURERUOO10AA SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site haemorrhage, Injection site mass, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Pt complained of pain in arm the day of vaccination. Pt also complained of swollen arm. The swelling ceased and the arm quit hurting. On 3/31/00, the arm became swollen again and started hurting with touch. Pt experienced induration, bruising and redness.

VAERS ID:152528 (history)  Vaccinated:1998-09-22
Age:34.0  Onset:1998-10-01, Days after vaccination: 9
Gender:Male  Submitted:2000-04-06, Days after onset: 553
Location:Delaware  Entered:2000-05-30, Days after submission: 54
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 (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0302SCRA
Administered by: Military     Purchased by: Military
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Numbness, tingling in right hand constant, intermittent hand.

VAERS ID:152536 (history)  Vaccinated:2000-04-05
Age:34.0  Onset:2000-04-05, Days after vaccination: 0
Gender:Female  Submitted:2000-04-07, Days after onset: 2
Location:Unknown  Entered:2000-05-30, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0476 RA
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETHU03410243 LA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)PFIZER/WYETHU03430231  
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Headache, Injection site hypersensitivity, Injection site oedema, Muscle spasms, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (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: The pt received three different vaccines on the same day. Six hours post vax, the pt developed pruritic erythematous swelling of a 20 x 20 mm diameter painful area at injection site. Pt also complained of fatigue, fever, muscle cramps and headache. Treatment was cold compresses, Benadryl, Prednisone.

VAERS ID:152777 (history)  Vaccinated:1998-10-09
Age:34.0  Onset:0000-00-00
Gender:Unknown  Submitted:1998-11-03
Location:South Carolina  Entered:2000-06-07, Days after submission: 581
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U1998006290
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0980580   
Administered by: Other     Purchased by: Other
Symptoms: Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: It was reported that a 34 year old female received Fluzone 98-99 sometime between 10/9/98 to 10/12/98. Reportedly sometime after the vax, the pt experienced systemic reactions of headache and nausea. From additional information received November 2, 1998 it was reported that the pt''s symptoms lasted 48 hours. Reportedly the pt recovered from this experience.

VAERS ID:153095 (history)  Vaccinated:2000-03-31
Age:34.0  Onset:2000-04-01, Days after vaccination: 1
Gender:Female  Submitted:2000-04-05, Days after onset: 3
Location:California  Entered:2000-06-08, Days after submission: 64
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TB skin test
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU007AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Complaining of fever, left arm hurts for 2 days with increased redness and soreness at site; 2cm diameter, erythema with mild induration.

VAERS ID:153232 (history)  Vaccinated:2000-04-12
Age:34.0  Onset:2000-05-04, Days after vaccination: 22
Gender:Male  Submitted:2000-05-10, Days after onset: 6
Location:Massachusetts  Entered:2000-06-08, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1858H0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Infection
SMQs:
Write-up: Severe varicella eruption total body, approximately 3 weeks, post vax. Afebrile. Treated with Zovirax, etc.

VAERS ID:153401 (history)  Vaccinated:2000-04-13
Age:34.0  Onset:2000-04-20, Days after vaccination: 7
Gender:Male  Submitted:2000-04-25, Days after onset: 5
Location:Minnesota  Entered:2000-06-09, Days after submission: 45
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergy to amoxicillin
Diagnostic Lab Data: NONE
CDC Split Type: MN00002
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM651860IMLA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESVA155AA0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Rash morbilliform, Upper respiratory tract infection
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt experienced a generalize measle type rash and URI symptoms.

VAERS ID:153713 (history)  Vaccinated:2000-05-08
Age:34.0  Onset:2000-05-09, Days after vaccination: 1
Gender:Female  Submitted:2000-05-18, Days after onset: 9
Location:Florida  Entered:2000-06-09, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES462360 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chest pain, Injection site oedema, Injection site pain, Neck pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad)
Write-up: 5/9/2000 complained of swelling and pain at left deltoid injection site radiating to neck and chest. Evaluation occupational results negative. Naprosyn prescribed.

VAERS ID:153748 (history)  Vaccinated:2000-05-04
Age:34.0  Onset:2000-05-09, Days after vaccination: 5
Gender:Female  Submitted:2000-05-10, Days after onset: 1
Location:Missouri  Entered:2000-06-09, Days after submission: 30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: phentermin, Triphamid
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MO2000036
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM654A41IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Neck pain, Pain
SMQs:, Arthritis (broad)
Write-up: 5/9/2000 Soreness in left deltoid area with movement. Increased soreness in neck and shoulder blade area. 5/10/00 less soreness in arm. Denies activities that would be cause for soreness. Denies any swelling or redness visible.

VAERS ID:153915 (history)  Vaccinated:1999-10-01
Age:34.0  Onset:1999-10-02, Days after vaccination: 1
Gender:Male  Submitted:2000-06-10, Days after onset: 252
Location:Texas  Entered:2000-06-12, Days after submission: 2
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
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0372SCLA
Administered by: Military     Purchased by: Military
Symptoms: Nausea, Pharyngolaryngeal pain, Pyrexia, Sinusitis
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: 1 day post vax, the pt experienced fever, nausea, sore throat was dx 1 week post vax with sinus infection.

VAERS ID:153945 (history)  Vaccinated:2000-05-12
Age:34.0  Onset:2000-05-13, Days after vaccination: 1
Gender:Male  Submitted:2000-06-01, Days after onset: 19
Location:Illinois  Entered:2000-06-13, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0583J0IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR023420IMRA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUA212AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Reported fever $g 103 F 24 hours post vax, continued with low grade fevers, fatigue and achiness $g week symptomatic treatment (Tylenol) per pt. Declined medical F/U

VAERS ID:153957 (history)  Vaccinated:2000-05-30
Age:34.0  Onset:2000-06-05, Days after vaccination: 6
Gender:Female  Submitted:2000-06-05, Days after onset: 0
Location:Montana  Entered:2000-06-13, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1735J1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Subcutaneous nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Pt called to say that she had hip pain and lumps on her left calf. Seen by MD on 6/5/00 and he indicated that it could have been a reaction to vax. Medrol iniated.

VAERS ID:154015 (history)  Vaccinated:1999-11-15
Age:34.0  Onset:1999-11-15, Days after vaccination: 0
Gender:Female  Submitted:1999-11-23, Days after onset: 8
Location:Delaware  Entered:2000-06-13, Days after submission: 202
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: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ6134219NOV1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH 0IM 
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Chills, Fatigue, Headache
SMQs:, Arthritis (broad)
Write-up: The evening post vax, the pt developed a headache, fatigue, chills, and arthralgia.

VAERS ID:154424 (history)  Vaccinated:0000-00-00
Age:34.0  Onset:0000-00-00
Gender:Female  Submitted:1999-08-19
Location:New Jersey  Entered:2000-06-15, Days after submission: 301
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: calcium, vitamin (nos), flax seed oil
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: 19990207131
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Joint stiffness, Malaise, 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: This is a spontaneous report from a physician and a 34 year old female who received 1st dose of Lymerix in April, 1999, and 2nd dose in May, 1999, respectively. One day after 1st dose, the pt experienced a fever (102) which resolved. One week after receiving 2nd dose, the pt experienced joint and muscular pain, malaise and stiffness in hands, knees and feet. The pt stated that when the 2nd dose was given, the nurse hit a nerve and she had instant pins and needles to her hands. No treatment was given. The fever resolved. All other adverse events are ongoing. The most recent information, received on 8/18/99, reports that the condition of the pt is ongoing.

VAERS ID:154532 (history)  Vaccinated:2000-06-08
Age:34.0  Onset:2000-06-08, Days after vaccination: 0
Gender:Female  Submitted:2000-06-08, Days after onset: 0
Location:Florida  Entered:2000-06-19, 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: PPD (received 5/30)
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1285J0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Dysphonia, Pruritus
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt received MMR at 7:45 AM. By 8:20 when pt presented to the ER, she complained of severe itching and hoarseness.

VAERS ID:154671 (history)  Vaccinated:1999-10-30
Age:34.0  Onset:1999-11-01, Days after vaccination: 2
Gender:Female  Submitted:2000-05-24, Days after onset: 204
Location:Connecticut  Entered:2000-06-19, Days after submission: 26
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: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99110275
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  IM 
HEPA: HEP A (VAQTA)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Two days, post vax, the pt experienced hives. Medical attention was sought. No further information is available.

VAERS ID:154725 (history)  Vaccinated:1999-03-22
Age:34.0  Onset:1999-04-06, Days after vaccination: 15
Gender:Male  Submitted:2000-05-24, Days after onset: 414
Location:New York  Entered:2000-06-19, Days after submission: 26
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: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99040585
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1281H0IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0816H SC 
Administered by: Other     Purchased by: Other
Symptoms: Malaise, Pharyngolaryngeal pain, Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approximately 2 weeks post vas pt developed a maculopapular erythematous rash on his face, chest, neck and back, as well as a sore throat and general malaise. Pt was afebrile and was treated with Benadryl.

VAERS ID:154863 (history)  Vaccinated:1998-10-09
Age:34.0  Onset:0000-00-00
Gender:Female  Submitted:1999-02-24
Location:South Carolina  Entered:2000-06-21, Days after submission: 482
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: Amoxicillin, Septra, PCN
Diagnostic Lab Data: NONE
CDC Split Type: U1998-006370
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0960580 IM 
Administered by: Public     Purchased by: Public
Symptoms: Headache, Malaise, Myalgia, 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 experienced systemic reactions of headache, general malaise, fever, nausea, vomiting and myalgia. Follow-up information received on 2/23/98, reported that the headaches, nausea and upset stomach lasted about 48 hours and the pt recovered from this experience.

VAERS ID:154903 (history)  Vaccinated:1998-09-29
Age:34.0  Onset:1998-09-29, Days after vaccination: 0
Gender:Female  Submitted:1998-12-22, Days after onset: 84
Location:Missouri  Entered:2000-06-21, Days after submission: 546
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: U199800721
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR0981790   
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injection site erythema, Injection site oedema, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (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 (broad)
Write-up: It was reported that a 34 year old female received Fluzone SV 98-99 USP on 09/29/1998. Reportedly sometime after the vaccination the pt experienced a fever of 100-101F and a swollen, red arm. From additional information received on 11/16/1998 it was reported that the pt recovered from this experience.

VAERS ID:154984 (history)  Vaccinated:1999-11-30
Age:34.0  Onset:1999-12-01, Days after vaccination: 1
Gender:Female  Submitted:2000-03-23, Days after onset: 113
Location:Pennsylvania  Entered:2000-06-21, Days after submission: 89
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: UNK
Diagnostic Lab Data: UNK
CDC Split Type: HQ7562406DEC1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)PFIZER/WYETH  IMRA
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Injection site hypersensitivity, Injection site mass, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: One day post vax, pt developed an injection site reaction characterized by redness, swelling, warmth and induration.

VAERS ID:155005 (history)  Vaccinated:0000-00-00
Age:34.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Virginia  Entered:2000-06-21
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: UNK
Diagnostic Lab Data: UNK
CDC Split Type: 899125118A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (ACETONE INACTIVATED DRIED)PFIZER/WYETH  IM 
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Pyrexia, Skin disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A 34 year old male reported that he received a booster dose of Typhoid Vaccine, USP, Acetone Inactivated, Dried in 1996 and subsequently developed fever and weakness. He was seen in the ER, but was not treated. He also developed a skin disorder characterized by thinning, cracked and bleeding skin of the axilla and genital areas. A dermatologist prescribed a "steroid and moisturizing cream which has helped". However, the skin disorder returns whenever he stops using the creams.

VAERS ID:155229 (history)  Vaccinated:1999-07-30
Age:34.0  Onset:1999-08-06, Days after vaccination: 7
Gender:Male  Submitted:2000-05-24, Days after onset: 292
Location:Florida  Entered:2000-06-22, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99080911
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This pt received MMR and one week post vax, experienced lymphadenopathy of the neck, submandibular and suboccipital regions. Additional information has been requested.

VAERS ID:155426 (history)  Vaccinated:2000-06-12
Age:34.0  Onset:2000-06-13, Days after vaccination: 1
Gender:Male  Submitted:2000-06-16, Days after onset: 3
Location:Oklahoma  Entered:2000-06-27, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0435SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site mass, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Developed nausea and induration and pain at injection site.

VAERS ID:155427 (history)  Vaccinated:2000-05-23
Age:34.0  Onset:2000-05-23, Days after vaccination: 0
Gender:Male  Submitted:2000-06-12, Days after onset: 20
Location:Alaska  Entered:2000-06-27, Days after submission: 15
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: CBC-wnl, LP, ANA pending
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0081SC 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Back pain, Hypoaesthesia, Neck pain, Pain
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: 1st IZ, transient, unilateral upper arm numbness, pain and tenderness in shoulder to finger distribution. 2nd IZ; milder transient, unilateral arm pain, numbness, tenderness followed by over a week of back and neck pain and stiffness.

VAERS ID:155779 (history)  Vaccinated:2000-06-02
Age:34.0  Onset:2000-06-03, Days after vaccination: 1
Gender:Male  Submitted:2000-06-14, Days after onset: 11
Location:California  Entered:2000-06-29, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0083SCRA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Diarrhoea, Influenza like illness, Malaise, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Complaining of flu-like symptoms, nausea, vomiting, diarrhea, chills and malaise for 1 day, post vax.

VAERS ID:155896 (history)  Vaccinated:2000-06-21
Age:34.0  Onset:2000-06-22, Days after vaccination: 1
Gender:Male  Submitted:2000-06-23, Days after onset: 1
Location:Unknown  Entered:2000-07-03, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0474SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt''s arm swollen to 6cm X 6cm, with redness and tenderness.

VAERS ID:156049 (history)  Vaccinated:2000-05-02
Age:34.0  Onset:2000-05-04, Days after vaccination: 2
Gender:Female  Submitted:2000-06-28, Days after onset: 55
Location:California  Entered:2000-07-05, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
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TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4988148 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Two days post vax pt experienced redness and tenderness at injection site. ER physician diagnosed reaction to DT booster. Pt was treated with Vicodan and Keflex.

VAERS ID:156058 (history)  Vaccinated:2000-06-22
Age:34.0  Onset:2000-06-23, Days after vaccination: 1
Gender:Male  Submitted:2000-06-26, Days after onset: 3
Location:Colorado  Entered:2000-07-05, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: hypertension
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUA225AB0  
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR02340SCRA
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt developed a fever, chills one day post vax with watery diarrhea 2 days post vax. Seen by MD on 7/26/00, treated with Imodium AD.

VAERS ID:156067 (history)  Vaccinated:1999-07-12
Age:34.0  Onset:1999-12-10, Days after vaccination: 151
Gender:Female  Submitted:2000-06-30, Days after onset: 202
Location:New York  Entered:2000-07-06, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: progesterone
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Amniocentesis-nml, dx labs-varicella antibodies-neg, ultrasound on 9/24/99-pregnancy dating 6.6 weeks IVF, ultrasound-hydrocephalus
CDC Split Type: WAES99091660
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Private     Purchased by: Other
Symptoms: Abortion, Hydrocephalus
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: Six weeks post vax, the pt became pregnant. Follow-up information from a physician indicated that on approximately 12/11/99 the pt electively terminated her pregnancy. FU info states pre and post diagnosis was hydrocephalus by sonogram. Post mortem exam could not confirm the diagnosis of hydrocephalus.

VAERS ID:156293 (history)  Vaccinated:0000-00-00
Age:34.0  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:Unknown  Entered:2000-07-11
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: asthma and hayfever
Diagnostic Lab Data: serum sickness
CDC Split Type:
Vaccination
Manufacturer
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Dose
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Site
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR023420IMLA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Erythema, Injection site oedema, Injection site pain, Joint swelling, Pyrexia, Serum sickness
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 (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt developed an injection site reaction on left arm characterized by swelling and tenderness, and low grade fever that resolved in two days. Pt then developed migrating arthralgia - joint pain and swelling or redness.

VAERS ID:156576 (history)  Vaccinated:1999-11-22
Age:34.0  Onset:1999-11-24, Days after vaccination: 2
Gender:Female  Submitted:2000-05-16, Days after onset: 173
Location:Nebraska  Entered:2000-07-13, Days after submission: 58
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: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99111794
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1346J SC 
Administered by: Private     Purchased by: Private
Symptoms: 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: On 11/24/99, 2 days post vax, the pt presented to the clinic with a red, hot, swollen reaction at the injection site. The area was described as a 3 X 2 inch patch on her arm that appeared to have a white ring around it. The pt was treated with Diprolene cream twice daily. On 11/27/99, the pt recovered.

VAERS ID:156628 (history)  Vaccinated:0000-00-00
Age:34.0  Onset:2000-03-01
Gender:Female  Submitted:2000-05-16, Days after onset: 75
Location:California  Entered:2000-07-14, Days after submission: 59
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES00031659
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Headache, Infection, Pyrexia, Rash, Rash maculo-papular, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Subsequent to receiving two doses of varicella virus vaccine live, the pt developed atypical chickenpox with fever, headache and a rash consisting of flat red splotches and a few vesicles.

VAERS ID:156640 (history)  Vaccinated:1997-12-16
Age:34.0  Onset:1998-11-19, Days after vaccination: 338
Gender:Female  Submitted:2004-05-14, Days after onset: 2002
Location:Iowa  Entered:2000-07-14, Days after submission: 1400
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:12/3/1997); meperidine allergy
Diagnostic Lab Data: serum alpha-fetoprotein normal levels; chlamydia and gonorrhea cultures negative; ultrasound within normal limits; diagnostic laboratory, 10/21/1998, results discussed in narrative diagnostic pathological,10/15/98, placenta normal ultras
CDC Split Type: WAES98020512
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.6240610808E1SC 
Administered by: Other     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: Subsequent to receiving the first and second dosed of varicella virus vaccine live the pt became pregnant. The pt delivered an normal baby girl. This is in follow up to report(s) previously submitted on 05/16/2000. Information has been received through the Varivax pregancy registry from a RN concerning a 34 year old Native American female pt with an allergy to meperidine (Demerol) who on 12Nov97 and 16Dec97 was vaccinated with the first and second doses, respectively, of varicella virus vaccine live SC. Concomitant medication on 12Nov97 included multivitamins. Subsequently, the pt became pregnant (LMP:20Dec97, EDD:07Oct98). A cervical culture collected on 16Apr98 was negative for chlamydia and gonorrhea and a maternal serum alpha fetoprotein was within normal limits. An ultrasound performed on 14May98 was also within normal limits. At 11:03 hours on 15Oct98 the pt gave birth via spontaneous vaginal delivery to a normal Caucasian female baby (8lbs 0 oz) at 41 weeks gestation, with spontaneous respiration and no birth trauma reported. A pathological examination following delivery revealed a normal placenta. The pt experienced a slight fever of 99.6 degrees F and slight urinary discomfort post delivery. On 21Oct98, laboratory tests were performed for primary hypothyroidism, galactosemia, phenylketonuria, hemoglobin disorders, and congenital adrenal hyperplasia. All results were within normal limits. It was reported that on 16Oct98 the infant received one dose of hepatitis b vaccine IM in the left thigh. On 19Nov98 the child presented with drainage from the unbilicus with no signs of nitrate. On 10Dec98 the child presented with a lump on the outside corner of her left eye and the upper lid consistent with a small dermoid and no other signs of abnormality. Her growth and development were noted to be satisfactory. At this time the child was vaccinated with one dose each of poliovirus vaccine, hepatitis b vaccine, and haemophilus b conjugate vaccine. On 08Jan99 the child experienced congestion and a cough. No further in

VAERS ID:156774 (history)  Vaccinated:1999-03-17
Age:34.0  Onset:1999-03-31, Days after vaccination: 14
Gender:Male  Submitted:2000-05-16, Days after onset: 411
Location:Minnesota  Entered:2000-07-14, Days after submission: 59
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES99040294
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1050H0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous, Pharyngitis, Rhinitis
SMQs:, Severe cutaneous adverse reactions (narrow), Agranulocytosis (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fourteen days post one dose of varicella virus vaccine live the pt developed a rash that started with 3 small bumps and was believed to be a spider bite. The rash progressed to his legs, stomach, arms and face with under 20 mild, blister-type lesions that crusted. He also experienced cold symptoms.

VAERS ID:156789 (history)  Vaccinated:1999-01-18
Age:34.0  Onset:0000-00-00
Gender:Female  Submitted:2000-05-16
Location:New York  Entered:2000-07-14, Days after submission: 59
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 varicella zoster negative varicella titers
CDC Split Type: WAES99040538
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Subsequent to receiving first and second doses of varicella virus vaccine live a serum varicella zoster virus antibody test revealed a lack of seroconversion. The pt sought unspecified medical attention.

VAERS ID:156912 (history)  Vaccinated:1999-03-11
Age:34.0  Onset:1999-04-29, Days after vaccination: 49
Gender:Female  Submitted:2000-05-16, Days after onset: 383</